Sex-specific effects of neonatal oral sucrose treatment on growth and liver choline and glucocorticoid metabolism in adulthood.

Hospitalized preterm infants experience painful medical procedures. Oral sucrose is the nonpharmacological standard of care for minor procedural pain relief. Infants are treated with numerous doses of sucrose, raising concerns about potential long-term effects. The objective of this study was to determine the long-term effects of neonatal oral sucrose treatment on growth and liver metabolism in a mouse model. Neonatal female and male mice were randomly assigned to one of two oral treatments (n = 7-10 mice/group/sex): sterile water or sucrose. Pups were treated 10 times/day for the first 6 days of life with 0.2 mg/g body wt of respective treatments (24% solution; 1-4 µL/dose) to mimic what is given to preterm infants. Mice were weaned at age 3 wk onto a control diet and fed until age 16 wk. Sucrose-treated female and male mice gained less weight during the treatment period and were smaller at weaning than water-treated mice (P ≤ 0.05); no effect of sucrose treatment on body weight was observed at adulthood. However, adult sucrose-treated female mice had smaller tibias and lower serum insulin-like growth factor-1 than adult water-treated female mice (P ≤ 0.05); these effects were not observed in males. Lower liver S-adenosylmethionine, phosphocholine, and glycerophosphocholine were observed in adult sucrose-treated compared with water-treated female and male mice (P ≤ 0.05). Sucrose-treated female, but not male, mice had lower liver free choline and higher liver betaine compared with water-treated female mice (P < 0.01). Our findings suggest that repeated neonatal sucrose treatment has long-term sex-specific effects on growth and liver methionine and choline metabolism.

Binge drinking at time of bariatric surgery is associated with liver disease, suicides, and increases long-term mortality.

BACKGROUND AND AIMS: Alcohol use disorder has been reported in patients undergoing bariatric procedures, but the pattern of alcohol consumption has not been evaluated. We investigated the prevalence, risk factors, and impact of binge drinking (BD) at the time of surgery and during follow-up. METHODS: A prospective, longitudinal study of subjects undergoing bariatric surgery was included in the LABS-2 registry between 2006 and 2009. Participants with AUDIT questionnaire at the time of surgery and a minimum of 12 months follow-up were included. BD was defined as consuming ≥5 drinks on at least 1 occasion in the previous month. Liver biopsies were obtained during bariatric procedures in not all cases. Survival analysis was performed with the adjusted Cox regression model and competing risk. RESULTS: A total of 2257 subjects were included, with a median follow-up of 79 months. The prevalence of BD at time of surgery was 12%, and it raised up to 23% during follow-up. Patients with BD predominantly had a binge eating disorder (OR=1.35 [95% CI: 1.04-1.76]), regularly consumed fast food [OR=1.4 (95% CI: 1.07-1.85)] and used other drugs (OR=2.65 [95% CI: 1.74-4.04]). Within liver biopsies evaluation, BD showed higher hepatic iron deposits (OR=3.00 [95% CI: 1.25-7.21]). BD at the time of surgery was associated with a higher risk of BD during follow-up (OR=10.49 [95% CI: 7.86-14.00]) and long-term mortality (HR: 3.21 [95% CI: 1.67-6.18]). Specific causes of death in these patients with BD were liver disease (p=0.020), suicide (p=0.015), neoplasms (p=0.034), and respiratory (p=0.025). CONCLUSIONS: The prevalence of BD in patients undergoing bariatric surgery is high and increases the risk of postoperative liver disease, suicides, and long-term mortality.

Post-COVID-19 Syndrome: Audiometric Findings in Patients with Audiological Symptoms.

Since the SARS-CoV-19 pandemic, the possibility of audiological involvement by this virus has been speculated without being able to generate a true cause-effect relationship. The objective of this observational, descriptive cross-sectional study is to describe the audiometric findings of post-COVID-19 patients with audiological symptoms. A sample of 47 patients with a diagnosis of COVID-19 infection was included: The age range was between 18 and 50 years old, the mean age was 37.0 years with a standard deviation of ±8.3 years, and 32 patients (68.1%) were female and 15 male patients (31.9%). Patients were recruited by the Otolaryngology service at Civil Fray Antonio Mayor Hospital from September 2020 to December 2022. Tonal audiometry was performed in a window of no more than 3 months from the onset of symptoms. The Chi-square test was used and odds ratios (OR) were established to associate the variables of post-COVID-19 audiological symptoms and the prevalence of hearing loss. A 95% confidence interval (CI) and statistical significance were considered of p ≤ 0.05. The audiological symptoms presented a prevalence of 74.4% for a sensation of ear fullness, 59.6% for tinnitus, and 51.1% for a sensation of hearing loss.

Multiple micronutrient deficiencies alter energy metabolism in host and gut microbiome in an early-life murine model.

Introduction: Micronutrients perform a wide range of physiological functions essential for growth and development. However, most people still need to meet the estimated average requirement worldwide. Globally, 2 billion people suffer from micronutrient deficiency, most of which are co-occurring deficiencies in children under age five. Despite decades of research, animal models studying multiple micronutrient deficiencies within the early-life period are lacking, which hinders our complete understanding of the long-term health implications and may contribute to the inefficacy of some nutritional interventions. Evidence supporting the Developmental Origins of Health and Disease (DOHaD) theory demonstrates that early-life nutritional deficiencies carry life-long consequences mediated through various mechanisms such as abnormal metabolic programming, stunting, altered body composition, and the gut microbiome. However, this is largely unexplored in the multiple micronutrient deficient host. Methods: we developed a preclinical model to examine undernutrition's metabolic and functional impact on the host and gut microbiome early in life. Three-week-old weanling C57BL/6N male mice were fed a low-micronutrient diet deficient in zinc, folate, iron, vitamin A, and vitamin B12 or a control diet for 4-weeks. Results: Our results showed that early-life multiple micronutrient deficiencies induced stunting, altered body composition, impaired glucose and insulin tolerance, and altered the levels of other micronutrients not depleted in the diet within the host. In addition, functional metagenomics profiling and a carbohydrate fermentation assay showed an increased microbial preference for simple sugars rather than complex ones, suggestive of a less developed microbiome in the low-micronutrient-fed mice. Moreover, we found that a zinc-only deficient diet was not sufficient to induce these phenotypes, further supporting the importance of studying co-occurring deficiencies. Discussion: Together, these findings highlight a previously unappreciated role of early-life multiple micronutrient deficiencies in shaping the metabolic phenome of the host and gut microbiome through altered glucose energy metabolism, which may have implications for metabolic disease later in life in micronutrient-deficient survivors.

Cutaneous cryptococcal infection: Initial manifestation of acquired T-cell immunodeficiency due to malignant thymoma.

Background and Purpose: Cryptococcosis is a known opportunistic infection. Thymomas are known to cause immune dysregulation. We describe an atypical case of cutaneous cryptococcosis in a patient with acquired T cell immunodeficiency that has been found to be secondary to a type B3 thymoma with progression to carcinoma. Case report: A 63-year-old male presented with a chronic skin lesion confirmed as Cryptococcus neoformans on biopsy and an incidental mediastinal mass found during infectious work-up for the notable cluster of differentiation 4 (CD4)+ lymphopenia. This led to the diagnosis of a type B3 thymoma requiring resection. The cryptococcal lesion was treated successfully with azole therapy. Conclusion: C. neoformans is an opportunistic infection rarely associated with isolated T cell immunodeficiency due to thymomas. A multidisciplinary approach and understanding of the pathogenicity of cryptococcus and the immunological effect of thymic dysfunction are paramount to diagnosis and treatment.

Controlled release of glibenclamide from monolithic silica subdermal implants produced by the sol-gel process and its use for hyperglycaemia treatment in a murine model.

Glibenclamide is an anti-hyperglycaemic drug that is commonly used for the treatment of type 2 diabetes mellitus and has promising new medical indications. However, this drug is associated with high rates of serious hypoglycaemic episodes as a result of its pharmacological activity. Administering the drug through controlled release delivery systems could reduce the incidence of these episodes. In this study, glibenclamide silica monolithic xerogel implants for subdermal application (GMSIx) were developed using the sol-gel technique for matrix synthesis with TEOS with different drying conditions (environmental, 60, 90, and 120 °C, which were named as GMSIE, GMSI60, GMSI90, and GMSI120, respectively). The inclusion of the drug in monoliths was monitored by DSC, FTIR, and PXRD. The effect of drying conditions on the morphology, moisture content, hardness, dosage uniformity, surface characteristics, and drug release mechanism of glibenclamide from the matrices was systematically investigated. Oral Glucose Tolerance Tests were performed with mice to evaluate the efficacy of the GMSI in maintaining blood glucose levels. Glibenclamide was completely included in a non-crystalline solid form in the matrixes. The moisture content, hardness, dosage uniformity, and surface characteristics depend on the drying conditions. The monolithic matrices showed a mesoporous surface with high surface area, and a narrower pore size distribution occurred for GMSI60. GMSIE and GMSI60 showed non-Fickian anomalous Korsmeyer-Peppas glibenclamide release kinetics. GMSI90 and GMSI120 showed controlled release of the drug through dissolution. When GMSI60 was administered to mice, glucose blood levels were effectively maintained despite a high oral glucose load in the animals, showing a sustained effect of the drug released from this new sol-gel drug delivery system.

Sensorineural Hearing Impairment and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients Without Traditional Cardiovascular Risk Factors.

OBJECTIVES: This study aims to evaluate the association of hearing impairment with carotid intima-media thickness and subclinical atherosclerosis in rheumatoid arthritis (RA) patients. PATIENTS AND METHODS: A total of 41 RA patients (2 males, 39 females; mean age 46.5±10.2 years; range 20 to 63 years) with no known traditional cardiovascular risk factors were included. Routine clinical and laboratory assessments for RA patients were performed. Pure tone air (250-8000 Hz) and bone conduction (250-6000 Hz) thresholds were obtained, tympanograms and impedance audiometry were conducted. Sensorineural hearing impairment was defined if the average thresholds were ≥25 decibels. Carotid intima-media thickness was assessed and classified with a cut-off point of 0.6 mm. RESULTS: Thirteen patients (31.7%) had normal audition, while 28 (68.3%) had hearing impairment. Of these, 22 had bilateral sensorineural hearing impairment. Four patients had conductive hearing impairment (right in three patients and left in one patient). Patients with sensorineural hearing impairment had increased carotid intima-media thickness in the media segment of carotid common artery compared to patients with normal hearing (right ear p=0.007; left ear p=0.075). Thickening of the carotid intima-media thickness was associated with sensorineural hearing impairment in RA patients. CONCLUSION: Rheumatoid arthritis patients should be evaluated by carotid intima-media thickness as a possible contributing factor of hearing impairment in patients without cardiovascular risk factors.

Necesidades de auxiliares auditivos en escolares mexicanos / Hearing aids requirements in mexican children

Se efectuó un estudio transversal, descriptivo y observacional en una muestra de conveniencia, para la detección de defectos auditivos, en 2031 escolares de segundo año de primaria, en el área metropolitana del Distrito Federal y nueve Estados de la República Mexicana. Se encontró que la frecuencia global fue de 314 escolares con hipoacusia (15.46 por ciento). La hipoacusia superficial se encontró en 226 escolares (11.13 por ciento), la hipoacusia media en 64 infantes (3.15 por ciento), la hipoacusia severa en 20 sujetos (0.98 por ciento) y la hipoacusia profunda en 4 sujetos (0.20 por ciento). Si consideramos que solo los escolares con hipoacusia media y severa bilateral así como los de hipoacusia profunda unilateral son los que necesitan de amplificación, encontramos que los sujetos de la muestra que requirieron de la adaptación de un auxiliar auditivo, serian el 1.92 por ciento del total de los sujetos estudiados.

Frecuencia de defectos auditivos en 16 estados de México / Frecuency of hearing impairment in 16 states of Mexico

Objetivo: Determinar la frecuencia de los defectos auditivos en población abierta en 16 estados de la República Mexicana. Método: El diseño del estudio fue exploratorio, tipo encuesta de cohorte transversal y descriptivo, realizado de Enero de 1992 a Noviembre de 1996, en comunidades rurales de 16 estados de la República Mexicana. Los 7747 sujetos de estudiados pertenecen a una muestra de conveniencia, en individuos de ambos sexos. A cada sujeto de estudio se le realizó otoscopia, audiometría tonal e impedanciometría. Resultados: El 23.90 por ciento (1851) de individuos tuvo algún tipo de hipoacusia. El grado más frecuente fue la hipoacusia leve con un 11.20 por ciento, seguida de la hipoacusia profunda con un 4.82 por ciento, la menos frecuente fue la hipoacusia severa con un 2.00 por ciento. Conclusiones: Los defectos auditivos hallados, representan casi la cuarta parte de la población en estudio. La hipoacusia más frecuente fue la superficial que es la menos perceptible en la población que la presenta. Es recomendable la realización de estudios estadísticos representativos, para realizar una estimación del problema auditivo en nuestro país.

Morbilidad de los defectos auditivos en comunidades rurales de ocho estados de la República Mexicana / Morbidity of hearing impairment in rural communities of eight states of Mexico

Se efectuó in estudio transversal, descriptivo y observacional en muestreo de defectos auditivos en comunidades rurales de 8 Estados de la República Mexicana. Se encontró un incidencia global de 21.07 por ciento, con una alta incidencia de hipoacusias profundas (10.31 por ciento) y severas (6.39 por ciento). Se hizo en análisis de los defectos auditivos según la edad, el tipo de hipoacusia y la patología.

Adaptación y validación de la escala para evaluación de síntomas MSAS (Memorial Symptom Assessment Scale) e niños con cáncer de 2 a 20 años / Adaptation and validation of the scale for evaluation of symptoms MSAS (Memorial Symptom Assessment Scale) and children with cancer from 2 to 20 years

INTRODUCCIÓN En la atención de niños con cáncer es importante contar con herramientas que permitan medir síntomas. La validación de herramientas constituye una prioridad para avanzar el conocimiento en esta población de pacientes. La escala MSAS es una herramienta multidimensional que valora múltiples síntomas, ampliamente utilizada en la literatura y que ya cuenta con una traducción al español para Argentina. OBJETIVOS Contribuir al proceso de validación de tres versiones de la escala MSAS en español para la Argentina (MSAS 7 a 12 años, MSAS-adolescentes, y MSAS-padres). MÉTODOS Estudio de corte transversal de dos fases, con una fase de validación lingüística inicial y una segunda fase de evaluación de comprensibilidad, aceptabilidad y testeo de validez de construcción. Se recolectó una muestra de 90 díadas, pacientes de 2 a 20 años con diagnóstico de cáncer y sus cuidadores, a los que se les administró la escala MSAS. Además de la escala se utilizaron el PedsQL 4.0, una pregunta de bienestar general y un cuestionario de evaluación de comprensibilidad y aceptabilidad. RESULTADOS Se reclutaron un total de 91 díadas. 60 niños mayores a 7 años y 91 cuidadores. La mediana de edad de los niños fue de 9 años (RIC 5.7-14.6). El 91% de los niños mayores a 7 años y el 90% de los cuidadores pudieron auto-administrarse los cuestionarios. La mediana de síntomas fue de 2 (RIC 1-4) para niños, 9 (RIC 6-13) para adolescentes y 6 (RIC 3-12) para cuidadores. Respecto a la comprensibilidad más del 60% de los niños reportó que entendió las preguntas y a un 50% no le molestaría responder el cuestionario una vez por semana. DISCUSIÓN La utilización de la escala MSAS es factible y comprensible y bien aceptada por los participantes del estudio, especialmente en los cuidadores. Se requieren investigaciones ulteriores para entender el funcionamiento de esta escala en los niños con cáncer