Mediterranean-style diet reduces metabolic syndrome components in obese children and adolescents with obesity.

BACKGROUND: The beneficial effects of the Mediterranean diet have been amply proven in adults with cardiovascular risk factors. The effects of this diet have not been extensively assessed in pediatric populations with obesity, insulin resistance (IR) and metabolic syndrome (MetS). The aim of this study was to assess the efficacy of the Mediterranean style diet (MSD) to decrease cardiovascular risk factors in children and adolescents with obesity. METHODS: Participants were randomly assigned to a MSD rich in polyunsaturated fatty acids, fiber, flavonoids and antioxidants (60% of energy from carbohydrate, 25% from fat, and 15% from protein, (n = 24); or a standard diet (55% of carbohydrate, 30% from fat and 15% from protein, (n = 25), the caloric ingest was individualized. At baseline and 16-week of intervention, the glucose, triglycerides (TG), total cholesterol (TC), HDL-C, LDL-C were measured as well as the body composition and anthropometric data. The diet compliance was determined by the 24-hour recalls.Paired Student's t and Macnemar's test were used to compare effects in biochemical, body composition, anthropometric, and dietary variables. RESULTS: The MSD group had a significantly decrease in BMI, lean mass, fat mass, glucose, TC, TG, HDL-C and LDL-C. (p < 0.05); the diet compliance increased consumption of omega 9 fatty acids, zinc, vitamin E, selenium, and decreased consumption of saturated fatty acids (p < 0.05). The standard diet group decrease in glucose levels and frequency of glucose >100 mg/dL (p < 0.05). CONCLUSION: The MSD improves the BMI, glucose and lipid profile in children and adolescents with obesity and any MetS component.

Meiotic pairing of B chromosomes, multiple sexual system, and Robertsonian fusion in the red brocket deer Mazama americana (Mammalia, Cervidae).

Deer species of the genus Mazama show significant inter- and intraspecific chromosomal variation due to the occurrence of rearrangements and B chromosomes. Given that carriers of aneuploidies and structural rearrangements often show anomalous chromosome pairings, we here performed a synaptonemal complex analysis to study chromosome pairing behavior in a red brocket deer (Mazama americana) individual that is heterozygous for a Robertsonian translocation, is a B chromosome carrier, and has a multiple sex chromosome system (XY1Y2). The synaptonemal complex in spermatocytes showed normal chromosome pairings for all chromosomes, including the autosomal and sex trivalents. The electromicrographs showed homology among B chromosomes since they formed bivalents, but they also appeared as univalents, indicating their anomalous behavior and non-Mendelian segregation. Thus, synaptonemal complex analysis is a useful tool to evaluate the role of B chromosomes and rearrangements during meiosis on the intraspecific chromosomal variation that is observed in the majority of Mazama species.

Elucidating the evolution of the red brocket deer Mazama americana complex (Artiodactyla; Cervidae).

The red brocket deer Mazama americana is a neotropical species that exhibits extensive karyotype variation under an unvarying morphotype. In order to deduce red brocket deer genetic units for conservation, gene flow between populations, and genetic variation, we initiated a cytogenetic and molecular genetic study based on representative samples from throughout their Brazilian geographic range. These data represent the first cytotaxonomical and molecular systematics, and although sample sizes are limited, our results clearly suggest that red brocket deer populations are significantly differentiated with respect to karyotypes and the mitochondrial sequences analyzed. We clearly recognized 2 independent species, and we will be focusing further research in analyzing the meiotic dynamic to determine the existence of other evolutionarily significant units under the red brocket complex.

Dynamic evaluation of neutrophil-to-lymphocyte ratio as prognostic factor in stage III non-small cell lung cancer treated with chemoradiotherapy.

PURPOSE: Locally advanced non-small cell lung cancer (LA-NSCLC) is frequently treated with chemoradiotherapy (CRT). Despite the efforts, long-term outcomes are poor, and novel therapies have been introduced to improve results. Biomarkers are needed to detect early treatment failure and plan future follow-up and therapies. Our aim is to evaluate the role of dynamics of neutrophil-to-lymphocyte ratio (NLR) in patients with locally advanced NSCLC treated with CRT. METHODS: We retrospectively reviewed patients diagnosed with LA-NSCLC receiving definitive CRT at our center from 2010 to 2015. Baseline and post-treatment NLR were collected from our center database. NLR was dichotomized (threshold = 4) and patients were divided into two groups based on the variation from baseline to post-treatment NLR. The prognostic role and association with response were examined with logistic regression and multivariate Cox regression model, respectively. RESULTS: Ninety-two patients were included. Our analysis shows that NLR after treatment is associated with response to treatment [OR in the multivariate analysis 4.94 (1.01-24.48); p value = 0.048]. Furthermore, NLR and ECOG are independent prognostic factors for progression-free survival (PFS) and overall survival (OS). Specifically, PFS was 25.79 months for the good prognosis group and 12.09 for the poor prognosis group [HR 2.98 (CI 95% = 1.74-5.10), p < 0.001]; and OS was 42.94 months and 18.86 months, respectively [HR 2.81 (CI 95% = 1.62-4.90), p < 0.001]. CONCLUSION: Dynamics of NLR have a prognostic value in stage III NSCLC treated with definitive CRT. Pre- and post-CRT NLR should be evaluated in prospective clinical trials involving consolidation treatment with immunotherapy.

[Kaposi's sarcoma of the bile ducts with cutaneous involvement in a patient with AIDS]. / Sarcoma de Kaposi de la vía biliar sin afectación cutánea en paciente con SIDA.

A 30 year-old man with acquired immunodeficiency syndrome was admitted because of abdominal pain, jaundice and fever. A severe pancreatitis without gallstones was detected. Later, dilation of biliary tract and clinical worsening appeared. Cholangiography revealed sclerosing cholangitis and papillary stenosis. Kaposi's sarcoma of the gallbladder invading the biliary tract was found. Only two reports of Kaposi's sarcoma of the biliary tract without cutaneous lesions have been published in a living patient. Pancreatitis has not been previously described as a clinical presentation of this malignancy.

Non-Hodgkin's lymphoma of the head and neck in association with HIV infection.

People infected with HIV have a greater risk of developing malignancies. The most frequent one is the Kaposi's sarcoma (KS). The second is the Non-Hodgkin's lymphoma (NHL). We report six cases of NHL in association with HIV infection (NHL-HIV) of the head and neck. Three of them had extranodal location (2 oral lymphomas and one case affecting the maxillary sinus). The other 3 cases were located in the cervical nodes. The oral malignancies were treated with radiotherapy (RT). Chemotherapy was applied to the other 4. Only one of our patients has survived more than two years. In one case the NHL was the first manifestation of the infection with HIV. Diagnosis of extranodal NHL requires search for AIDS.

[Tuberculous chronic otitis media. A clinical case]. / Otitis media crónica tuberculosa. Un caso clínico.

Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and mastoid. Patients typically have chronic tympanic membrane perforation and ear discharge associated with progressive, profound hearing loss, and resistance to antibiotic treatment. Diagnosis is often delayed by a low clinical suspicion, thus leading to complications such as irreversible hearing loss and facial nerve paralysis. Histological examination of a biopsy specimen reveals tuberculous changes. The disease is treated with antituberculosis agents.

Leishmaniasis as an opportunistic infection in HIV-infected patients: determinants of relapse and mortality in a collaborative study of 228 episodes in a Mediterreanean region.

The clinical presentation of visceral leishmaniasis shares similarities with other geographically specific infectious diseases associated with AIDS in terms of relapsing course and atypical presentation. However, visceral leishmaniasis has not, until now, been included in the AIDS case definition. The aim of this study was to describe the clinical features and determinants for relapse and case-fatality of visceral leishmaniasis in HIV-infected patients from a Spanish Mediterranean area. A chart review was conducted in 16 hospitals in the autonomous communities of Valencia and Murcia (Spain). From 1988 to 2001, a total of 228 episodes of visceral leishmaniasis were diagnosed in 155 HIV-infected patients by the detection of amastigotes in bone marrow aspirates or in other tissue samples. Most patients had advanced HIV disease, with a median CD4(+) lymphocyte cell count of 55 cells x 10(9) l, and 56% of them had a previous AIDS-indicator disease. The median duration of follow-up was 8.4 months. HIV-infected patients with visceral leishmaniasis presented with fever (76%), hepatomegaly (77%), splenomegaly (78%), and varying degrees of cytopenias. Leishmania was detected in atypical sites in 22 (14%) patients. A total of 37 (24%) patients had a relapse of visceral leishmaniasis. Female gender was a risk factor for relapse, whereas administration of secondary prophylaxis for visceral leishmaniasis and a completed therapy for visceral leishmaniasis were protective factors against relapse. A total of 86 (54%) patients died. Independent determinants for survival were CD4(+) lymphocyte cell count, completed therapy for leishmania, and secondary prophylaxis for visceral leishmaniasis. The findings show that, in HIV-infected patients, visceral leishmaniasis occurs in late stages of HIV disease and often has a relapsing course. Secondary prophylaxis reduces the risk of relapse. Visceral leishmaniasis in the HIV-infected population should be included in the CDC clinical category C for the definition of AIDS in the same way that other geographically specific opportunistic infections are included.

Otitis media crónica tuberculosa. Un caso clínico / Tuberculous chronic otitis media. A clinical case

La tuberculosis de oído medio es una causa rara de infección supurativa de oído medio y mastoides. Los pacientes, típicamente, tienen una perforación timpánica crónica, supuración ótica asociada a una progresiva hipoacusia con resistencia a los tratamientos antibióticos. Hay frecuentemente un considerable retraso en el diagnóstico porque el grado de sospecha es bajo, con el resultado frecuente de complicaciones como hipoacusia y parálisis facial. Examen histológico de pieza de biopsia revela cambios tuberculosos. Tratamiento con agentes antituberculosos (AU)

Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and mastoid. Patients typically have chronic tympanic membrane perforation and ear discharge associated with progressive, profound hearing loss, and resistance to antibiotic treatment. Diagnosis is often delayed by a low clinical suspicion, thus leading to complications such as irreversible hearing loss and facial nerve paralysis. Histological examination of a biopsy specimen reveals tuberculous changes. The disease is treated with antituberculosis agents (AU)