Factores de estrés y su asociación con los biomarcadores del síndrome metabólico

Introducción: el síndrome metabólico es considerado como un conjunto de factores de riesgo para desarrollar enfermedades cardiovasculares y diabéticas, en adición a esto, los biomarcadores determinan un diagnóstico del síndrome metabólico. Existen diversos factores que pueden causar el síndrome metabólico, uno de ellos, el estrés, que se concibe como la reacción de un individuo ante eventos o situaciones que exceden los mecanismos de adaptación. Objetivos: explorar la literatura científica existente para identificar y sintetizar los diferentes factores de estrés fisiológico que se han investigado en relación con el síndrome metabólico, y evaluar críticamente la evidencia disponible sobre la asociación entre los factores de estrés identificados y los biomarcadores específicos del síndrome metabólico. Además, realizar un análisis de la calidad metodológica de los estudios incluidos en la revisión para evaluar la validez y la fiabilidad de los resultados obtenidos. Materiales y Métodos: se realizó una revisión sistemática usando bases de datos como PubMed, Redalyc, SciELO y Google Scholar, en donde se incluyeron investigaciones que busquen establecer una relación entre el estrés y los biomarcadores del síndrome metabólico en publicaciones desde enero del 2017 a noviembre del 2022. Se tomaron en cuenta criterios de la Declaración PRISMA. Resultados: se incluyeron un total de 32 artículos, en donde se pudo observar que los biomarcadores del estrés oxidativo que influyen en el padecimiento del síndrome metabólico son diversos y pueden afectar de múltiples formas al ser humano, generando enfermedades como la diabetes, enfermedades cardiovasculares, pulmonares y hasta neuropsicológicas. Conclusiones: los biomarcadores del estrés oxidativo influyen de manera directa en el padecimiento de síndrome metabólico y son identificados como un factor determinante para diagnosticar enfermedades desencadenantes de este síndrome.

Introduction: Metabolic syndrome is considered as a set of risks factors for developing cardiovascular and diabetic diseases. Additionally, biomarkers determine a diagnosis of metabolic syndrome. Several of them can cause metabolic syndrome, and one of them, stress, is conceived as an individual's reaction to events or situations that exceed adaptation mechanisms. Materials and methods: A systematic review was carried out using database such as PubMed, Redalyc, Scielo and Google Scholar, which included research that relates oxidative stress to biomarkers of metabolic syndrome in publications from January 2017 to November 2022. The criteria considered were those of the PRISMA Declaration. Results: A total of 32 articles were included, and it was possible to observe that the biomarkers of oxidative stress that influence the condition of metabolic syndrome are diverse and can affect humans in multiple ways, generating diseases such as diabetes, cardiovascular, pulmonary, and even neuropsychological. Conclusions: Oxidative stress biomarkers have a direct influence on suffering from metabolic syndrome and are identified as a determining factor in diagnosing diseases that trigger this syndrome.

Anatomical positions of the inferior dental canal and its relationship with impacted lower third molars in 18-to 29-year-old Ecuadorians

The third molars are the dental organs with the most variations in terms of their formation and time of eruption, which can cause several pathologies. The incidence of third molar impaction varies between 20% and 30%, with predominance in females. Through the inferior dental canal, goes the inferior dental nerve to innervate the molars and lower premolars. Recent studies on variations in the position of the lower dental canal have shown a low incidence of variations. Objective: To determine the prevalence of anatomical variations of the inferior dental canal in relation to impacted lower third molars, by means of digital image analysis in patients who attended the X-Ray Imaging Center in Azogues in 2016. Materials and Methods: A cross-sectional study was conducted on patients who attended the center X-Ray Imaging Center in Azogues in 2016. The following variables were analyzed: sex, age, variation of the position of the inferior dental canal in relation to the third impacted molar, the radiographic details according to the Monaco classification, and tooth position according to the Winter classification. In total, 64 radiographs were analyzed. Results: It was found that 5% of participants showed no relation of the inferior dental canal with the lower third molar, 72% had a relation of the dental canal with the third molar, and 23% presented with absence of the third molar. According to the Winter classification, the prevalence was 53% mesioangular, 18% horizontal, 19% vertical, 6% vestibuloversion, and 4% inverted. Conclusion: The third molars present high indexes of relation with the inferior dental canal in 18- to 29-year-old Ecuadorians

Fenilcetonuria de diagnóstico tardío y mutaciones asociadas en una familia ecuatoriana / Phenylketonuria of late diagnosis and associated mutations in an Ecuadorian family

La fenilcetonuria es un error innato del metabolismo, producido por mutaciones en el gen de la fenilalanina hidroxilasa. Se describe el caso de un adolescente de 15 años con diagnóstico tardío de fenilcetonuria, quien presenta retardo mental severo, convulsiones e hipopigmentación. En este estudio se realizó el diagnóstico molecular de fenilcetonuria y se detectó la mutación p.R252W en homocigosis en el gen que codifica para la fenilalanina hidroxilasa. La presencia de esta variante nos permitió inferir la falta de respuesta a la terapia con sapropterina, medicamento que actúa como cofactor de la enzima, por la ausencia de actividad enzimática residual reportada para esta variante. Debido al retraso psicomotor del paciente, se decidió aplicar terapia lúdica y fortalecimiento muscular a través de la intervención fisioterapéutica; sin embargo, no se observó una mejoría permanente al aplicar este tratamiento, motivado por la falta de continuidad.

Phenylketonuria is an inborn error of metabolism due to mutations on the phenylalanine hydroxylase gene. We described the case of a 15 years old-adolescent with late diagnosis of phenylketonuria, who presents severe mental retardation, convulsions and hypopigmentation. In this study, the molecular diagnosis of phenylketonuria was performed, detecting p.R252W mutation in homozygous state on the phenylalanine hydroxylase gene. The presence of this variant allowed us to infer the lack of response to drug therapy with sapropterina which works as an enzyme cofactor, due to the absence of residual enzymatic activity reported for the p.R252W variant. Physical therapy was applied through playful therapy and muscular strengthening, because of the psychomotor retardation present in the patient. The failing in continuing with the physical therapy program stopped the patient´s improvement.