Características clínicas y sociodemográficas de pacientes con diabetes tipo 1 en un Hospital Universitario de Colombia / Clinical and sociodemographic characteristics of patients with diabetes mellitus type 1 in a University Hospital of Colombia

Resumen ANTECEDENTES: La diabetes mellitus tipo 1 es una enfermedad autoinmunitaria causada por la interacción de múltiples factores ambientales y genéticos que conducen a la destrucción autoinmunitaria de células B pancreáticas productoras de insulina. La incidencia y prevalencia de la diabetes mellitus tipo 1 varían considerablemente en todo el mundo. OBJETIVO: Establecer las características clínicas y sociodemográficas de los pacientes con diabetes mellitus tipo 1. MATERIAL Y MÉTODO: Estudio descriptivo de corte transversal y retrospectivo en el que se incluyeron pacientes con diabetes tipo 1 que ingresaron a un hospital universitario de Colombia en el periodo comprendido entre 2012 y 2016. Posteriormente se realizó análisis estadístico según las variables. RESULTADOS: La prevalencia intrahospitalaria de la diabetes mellitus tipo 1 fue de 19 casos por cada 100,000 pacientes mayores de 13 años. Fue más frecuente en mujeres con 61.3%, la edad promedio al diagnóstico fue de 14.89 años. El diagnóstico se estableció de forma clínica sin estudios de autoinmunidad, se trataba de pacientes con enfermedad no controlada con HbA1c promedio de 11.5%, las complicaciones más frecuentes fueron la cetoacidosis diabética con 46.6%, al igual que la hipoglucemia. La insulina más frecuentemente prescrita en este grupo de pacientes fue glargina, glulisina y e insulina regular. CONCLUSIÓN: Los hallazgos sugieren que algunas características de la diabetes mellitus tipo 1 podrían ser similares y algunas diferentes a lo reportado en otros estudios; sin embargo, pueden plantearse algunas posibles investigaciones tomando estos resultados como base.

Abstract BACKGROUND: Diabetes mellitus type 1 is an autoimmune disease caused by the interaction of multiple environmental and genetic factors leading to the autoimmune destruction of pancreatic B cells producers of insulin. The incidence and prevalence of diabetes mellitus type 1 vary considerably all around the world. OBJECTIVE: To establish the clinical and socio-demographic characteristics of diabetes mellitus type 1. MATERIAL AND METHOD: A descriptive, cross-sectional and retrospective study that included patients with diabetes type 1 who entered to a university hospital of Colombia from 2012 to 2016. Then, a statistical analysis was done according to variables. RESULTS: Intrahospitalary prevalence of diabetes mellitus type 1 was of 19 cases for each 100,000 patients older tan 13 years. It was more frequent in women with 61.3%; the mean age at diagnosis was of 14.89 years. Diagnosis was established in a clinical manner without autoimmunity studies, they were patients with not-controlled disease with a mean HbA1c of 11.5%; the frequent complications were: diabetic cetoacidosis with 46.6%, as well as hypoglycemia. The most frequently prescribed insulin in these patients was glargine, glulisine and regular insulin. CONCLUSIONS: The findings suggest that some characteristics of diabetes mellitus 1 could be similar and some different to that reported in other studies; however, some possible investigations may be considered taking these results as basement.

Alteraciones tiroideas: ¿Predictores de mortalidad en Cuidados Intensivos? / Thyroid disorders: Predictors of mortality in Intensive Care?

Introducción: El objetivo del estudio es describir y analizar la función tiroidea en el paciente crítico. Describir si algún patrón se asocia a una mayor tasa de mortalidad. Métodos: Se analizó a todos los pacientes ingresados en nuestra Unidad de Cuidados Intensivos, entre enero de 2015 y agosto de 2016, y que permanecieron allí, al menos, siete días. Resultados: Se incluyeron 242 pacientes. Se hallaron diferencias significativas en los valores medios de los índices de gravedad entre los no supervivientes y los supervivientes: SOFA (10,45 vs. 7,9); APACHE II (24,42 vs. 20,71); SAPS II (63,14 vs. 50,69). Se encontraron diferencias estadísticamente significativas en los valores medios de T3 en el grupo de supervivientes y no supervivientes: 1,5 pg/ml vs. 1,15 pg/ml (p <0,001; IC95% 0,224 ± 0,487). No hubo diferencias estadísticamente significativas en los valores medios de T4 y TSH. Al realizar el subanálisis según grupo de ingreso, no se hallaron diferencias estadísticamente significativas entre las cifras de TSH, T3 o T4. Sí hubo diferencias significativas en los valores medios de T3 en la mayor parte de los subgrupos. Conclusiones: Se hallaron diferencias estadísticamente significativas entre los valores medios de T3 en el grupo de supervivientes y no supervivientes. Los valores de T3 parecen asociarse a la mortalidad. Su descenso no parece asociarse a la enfermedad subyacente, sino a su gravedad.(AU)

Introduction: The aim of this study is to describe and analyse the thyroid function in the critically ill patient, and to describe if any pattern is associated with a higher mortality rate. Methods: Patients admitted to the Intensive Care Unit, between January 2015 and August 2016, with a stay of seven days or more, were enrolled. Results: Two hundred and forty-two patients were included. Significant differences were observed in the severity scores related to mortality during their stay in the Intensive Care Unit (no survivors vs. survivors): SOFA (10.45 vs. 7.9); APACHE II (24.42 vs. 20.71); SAPS II (63.14 vs. 50.69). Statistically significant differences were observed in the mean values of T3 between survivors and non-survivors: 1.5 pg/ml vs. 1.15 pg/ml (p <0.001; CI95% 0.224 ± 0.487). There were no statistically significant differences in the mean values of T4 and TSH. After subgroup analysis according to the admission group, no significant differences among the TSH, T3 and T4 values were detected. However a statistically difference in T3 average value was found in most subgroups. Conclusions: A statistically significant difference was found in mean T3 values in survivors and non-survivors. T3 concentration appears to be associated with mortality. Decrease of this thyroid hormone does not seem to associate with the underlying disease, but with its severity.(AU)

Edematogenic and myotoxic activities of the Duvernoy's gland secretion of Philodryas olfersii from the north-east region of Argentina

Philodryas olfersii is found in South America, from Amazonas to Patagonia. It is important to characterize the venom of P. olfersii, who inhabits the North-East region of Argentina, since snake venoms are known to exhibit considerable variability in composition and biological activities. In this work, mice weighing 18-20 g (n = 4 for each experimental group) were used. For the edematogenic activity mice were injected s.c. in the right foot pad with 50 microl of solutions containing different amounts of venom, whereas the left foot pad was injected with 50 microl of PBS. Two hours after injection mice were killed by cervical dislocation and both feet were cut off and weighed individually. For the myotoxic activity mice were injected i.m. with 100 microl of solutions containing 40 microg of venom. Blood samples were extracted after 1, 3, 6, 8, 10, 12, 14, 16 and 24 h of venom injection to determinate serum CPK activity and mice were sacrificed at the same time intervals to obtain the inoculated gastrocnemius muscle. They were fixed with Bouin solution and stained with Hematoxylin-Eosin. Results showed that P. olfersii venom exhibits a high edematogenic activity (MED = 0.31 microg) and a moderate myotoxic activity. Myonecrosis reached its highest level after 12 h of venom injection as shown by plasmatic CPK levels (5,401 +/- 330 IU/l) and microscopic assay. It demonstrates the potential toxicity of the venom of P. olfersii, who inhabits the North-East region of Argentina. It also reinforces the original warning concerning the potential danger of bites by colubrids.

Um século de experiência no controle da ancilostomíase / One century of experience with the control of ancylostomiasis

In the beginning of the XX century, ancylostomiasis was considered a serious public health problem and governments started the first systematic planning for the control of an endemic disease, in large scale. Thereafter, ancylostomiasis was considered a less important subject, because efficient anti-helminthic drugs were introduced, this in combination with the economic development in rich countries, reduced undernourishment and improved housing and sanitary conditions. Consequently, the residual cases of the infection became in general asymptomatic. However, in the third world the problem is still present, and must be considered with realism and managed accordingly. Various suggestions for controling the disease are presented in this paper.

A ancilostomíase despertou a atenção do mundo, no começo do século XX, como grave problema de saúde pública e deu origem aos primeiros planos sistemáticos de controle de uma endemia em larga escala. Passou depois a ser vista como questão de menor importância quando surgiram medicamentos anti-helmínticos eficazes e o desenvolvimento econômico dos países mais ricos reduziu neles a subnutrição, melhorando ao mesmo tempo as condições habitacionais e sanitárias que tornaram as infecções residuais clinicamente assintomáticas. O problema persiste; entretanto, no terceiro mundo que deve encará-lo com realismo e agir em conseqüência. Sugestões são feitas nesse sentido.

Fecundity of Biomphalaria straminea and B. glabrata in the laboratory: a twelve-month comparative study

In the present comparative study a Biomphalaria straminea sample from Picos (Piauí) showed expressive advantages related to fecundity over a B. glabrata sample from Belo Horizonte (Minas Gerais) such as: higher egg-mass production in 10 out of 12 months of study; higher egg production in all months of study; higher egg per egg-mass ratio in 11 out of 12 months of study; 66% of the egg-masses containing more than 20 eggs while in B. glabrata 70% of the egg-masses showed less than 20 eggs; three times less empty egg capsules than B. glabrata; attainning maximum fecundity in half the time required by B. glabrata. Mortality however was higher and sooner in B. straminea, suggesting higher semelparity in this species than in B. glabrata, a possibility that requires confirmation through long-term studies with other samples of both species. This first finding of a B. straminea sample more fecund than B. glabrata is discussed in relation to other data from the literature, and some recommendations are made on the quantification of fecundity of planorbid snails

Feeding behavior of different species of Chagas'disease vectors stimulated with blood sources at different temperatures

The feeding behavior of six triatomid species toward latex condoms filled with blood at 26 ñ 1 and 36 ñ 1 grade C was observed for 4 h. The speciesd studied were Triatoma infestans, Triatoma brasiliensis, Triatoma vitticeps, Triatoma pseudomaculata, Rhodnius prolixus and Panstrongylus megistrus, and 34 to 348 insects were studied in each group(average, 190). All the life stages of each species were used. Although most insects (80%, average for 6 species) preferred the warmer blood, 54% of the individuals of all species fed on blood kept at 26 greade C. For Triatoma pseudomaculata, a higher proportion of insects fed on blood at 26 grade C (2%) than on blood at 36 grade C (65%). These results suggest that bait containing insecticides which are effective through the digestive tract may be useful in the control of these vectors even at room temperature

Roedores silvestres como modelos experimentais da esquistossomose mansonica: Akodon arviculoides (Rodentia: Cricetidae) / Wild rodents as experimental models of schistosomiasis mansoni: Akodon arviculoides (Rodentia: Cricetidae)

A infeccao experimental do A. arviculoides atraves de diferentes vias de penetracao das cercarias de Schistosoma mansoni (transcutanea e subcutanea) foi estudada pela cinetica de eliminacao de ovos nas fezes, pela recuperacao dos vermes adultos (no sistema porta e nos vasos mesentericos) e pelo oograma quantitativo. Demonstrou-se que a infeccao do A. arviculoides assemelha-se a dos camundongos albinos que serviram de controle, quanto a eficacia das vias de penetracao, ao habitat dos vermes adultos e ao oograma. Esses resultados sugerem que se avaliem outros aspectos da relacao parasito-hospedeiro para que o A. arviculoides possa ser indicado como modelo experimental alternativo, nos estudos sobre a esquistossomose.

Inquerito-soro epidemiologico da malaria na regiao do Rio Limpopo; Mocambique

The authors present the results of a seroepid emiological survey of malaria in seven villages of the Limpopo river balley (Mozambique); in some of which the fight to the endemy has already started a few years ago. The methods used was that of immunofluorescence