The impact of parenting practices and family economy on psychological wellbeing and learning patterns in higher education students

Abstract Background There is a large literature on the significant impact of rearing factors in the psychological development of different child's learning patterns and wellbeing in elementary and secondary schools, but there is a scarcity of studies on to what extent those influences remain stable up to higher education. Objective In this study, parenting practices and family status were analyzed as predictors of the different learning styles, psychological difficulties, mental health factors, and academic performance, comprising the psychosocial diversity in learning (DinL) at the university classroom. Methods Using a cross-sectional design, a questionnaire was administered to a sample of 2522 students at the Complutense University of Madrid (Spain). It included a DinL scale measuring five psychological learning dimensions (coping with difficulties, effort, autonomy, Social/Physical Context, and understanding/career interest), plus several items on retrospective parenting practices, family, and sociodemographic variables. Multiple regressions and analyses of variance were conducted with the family factors as independent variables and the learning factors as dependent variables. Results Results showed parenting variables, parents' education, and family economy as having a significant impact on psychological learning dimensions, academic performance, and especially on the students' wellbeing and mental health status, being an important contributors to explain the DinL in the university classroom. Conclusion The results bring interesting conclusions for developmental and health psychologists when working with parents aimed at fostering wellbeing and learning strategies related to academic inclusion and achievement.

Isquemia aguda por trombosis aórtica en COVID-19: A propósito de un caso

Objetivo: Presentar un caso de isquemia aguda por trombosis aórtica en paciente con infección por COVID-19 y exponer la importancia del diagnóstico y manejo oportuno. Introducción: El coronavirus (COVID-19) afecta principalmente al tracto respiratorio, pero presenta predisposición a fenómenos trombóticos y sus complicaciones, siendo una de las más graves la isquemia aguda por trombosis aórtica. Caso clínico: Paciente masculino de 68 años, que cursa con cuadro clínico de neumonía grave por COVID-19, presenta de forma concomitante episodio de trombosis aórtica aguda, resultando con isquemia aguda de extremidades inferiores. Se realizó trombectomía, post procedimiento y asociado a reperfusión, presentó paro cardiorrespiratorio con asistolia sostenida, falleciendo pese a maniobras de reanimación. Conclusión: Pese a las medidas de profilaxis con heparina de bajo peso molecular (HBPM), se deben sospechar y buscar las complicaciones tromboembólicas en pacientes que cursan con esta infección para dar un manejo oportuno y vigilar las complicaciones post quirúrgicas que pueden ser mortales.

Aim: To present a case of acute ischemia due to aortic thrombosis in a patient with COVID-19 infection and explain the importance of diagnosis and timely management. Introduction: The coronavirus (COVID-19) mainly affects the respiratory tract, but it has a predisposition to thrombotic phenomena and its complications, one of the most serious being acute ischemia due to aortic thrombosis. Clinical case: 68-year-old man, coronary heart disease with severe pneumonia due to COVID-19, presents aortic thrombosis, resulting in acute lower extremity ischemia. Thrombectomy was performed, post procedure and associated with reperfusion, presented cardiorespiratory arrest with sustained asystole, died despite resuscitation maneuvers. Conclusion: Despite prophylaxis measures with low molecular-weight heparins (LMWH), thromboembolic complications should be sought in patients with this infection to provide timely management and monitor post-surgical complications that can be fatal.

Effects of sympathectomy on myocardium remodeling and function

OBJECTIVES: To evaluate the effects of sympathectomy on the myocardium in an experimental model. METHODS: The study evaluated three groups of male Wistar rats: control (CT; n=15), left unilateral sympathectomy (UNI; n=15), and bilateral sympathectomy (BIL; n=31). Sympathectomy was performed by injection of absolute alcohol into the space of the spinous process of the C7 vertebra. After 6 weeks, we assessed the chronotropic properties at rest and stress, cardiovascular autonomic modulation, myocardial and peripheral catecholamines, and beta-adrenergic receptors in the myocardium. The treadmill test consisted of an escalated protocol with a velocity increment until the maximal velocity tolerated by the animal was reached. RESULTS: The bilateral group had higher levels of peripheral catecholamines, and consequently, a higher heart rate (HR) and blood pressure levels. This suggests that the activation of a compensatory pathway in this group may have deleterious effects. The BIL group had basal tachycardia immediately before the exercise test and increased tachycardia at peak exercise (p<0.01); the blood pressure had the same pattern (p=0.0365). The variables related to autonomic modulation were not significantly different between groups, with the exception of the high frequency (HF) variable, which showed significant differences in CT vs UNI. There was no significant difference in beta receptor expression between groups. There was a higher concentration of peripheral norepinephrine in the BIL group (p=0.0001), and no significant difference in myocardial norepinephrine (p=0.09). CONCLUSION: These findings suggest that an extra cardiac compensatory pathway increases the sympathetic tonus and maintains a higher HR and higher levels of peripheral catecholamines in the procedure groups. The increase in HF activity can be interpreted as an attempt to increase the parasympathetic tonus to balance the greater sympathetic activity.

Agua corporal total y composición corporal: efecto del ejercicio de 30 minutos y rehidratación con agua en adultos residentes permanentes de gran altitud, La Paz Bolivia / Total body water and body composition: effect of the 30 minute exercise and water rehydration in high altitude permanent resident adults, La Paz-Bolivia

PREGUNTA DE INVESTIGACIÓN: ¿Cuál será la composición corporal, el agua corporal total, y el agua extra e intracelular relacionados a los cambios después del ejercicio submáximo de 30 minutos y post rehidratación con agua pura en adultos residentes permanentes de gran altitud, La Paz, Bolivia, gestión 2019? OBJETIVO: Determinar la composición corporal, el agua corporal total, y el agua extra e intracelular relacionados a los cambios después del ejercicio submáximo de 30 minutos y post rehidratación con agua pura en adultos residentes permanentes de gran altitud, La Paz, Bolivia, gestión 2019. MATERIAL Y MÉTODOS: el trabajo de investigación fue tipo experimental, antes y después, sobre Fisiología de Altitud, en 29 jóvenes residentes de gran altitud (3600 m.s.n.m.). Se evaluó variables antes y después de realizar una prueba de ejercicio submáxima, de 30 minutos, y la rehidratación post ejercicio, tras el consumo de agua pura. Variables dependientes fueron: 1. Composición corporal, medida a través del análisis de impedancia bioeléctrica (AIB), 2. Volumen de agua corporal total, determinado por AIB. 3. Agua extra e intracelular evaluada por AIB y 4. Estado de rehidratación, evaluado por el cambio de peso post ejercicio, y mediante el AIB. Las variables independientes fueron el ejercicio a través de la prueba submáxima de 30 minutos y la rehidratación con agua pura. RESULTADOS: en jóvenes residentes de gran altitud, se estima que el porcentaje de agua corporal total en las mujeres está disminuida en relación a la referencia de poblaciones del nivel del mar. La masa grasa corporal está muy incrementada en las mujeres. La diferencia de agua basal versus el agua post ejercicio entre varones y mujeres no es significativa. La diferencia de agua del líquido extra e intracelular basal versus el agua post ejercicio entre varones y mujeres no es significativa. La diferencia en la distancia recorrida en 30 minutos de ejercicio de trote submáximo es estadísticamente significativa a favor de los varones (4424 vs. 3619 metros). La correlación del IMC y el porcentaje de masa grasa es muy baja (r=0.109). El IMC entre varones y mujeres no presenta diferencia estadísticamente significativa (26±3 vs 24±3 respectivamente). La frecuencia de exceso de grasa corporal evaluada por AIB, es del 55% en las mujeres y de 0% en varones. La presión arterial sistémica en varones (PS: 107±6 y PD:73± 4mmHg) y en mujeres (PS:104±8 y PD:70± 7mmHg), está disminuida en relación a referencia del nivel del mar. La frecuencia respiratoria esta incrementada tanto en varones (21±2) y mujeres (23±3). CONCLUSIONES: el método de AIB permite evaluar la composición corporal y el agua corporal total y por tanto la masa grasa, mismo que fue validado en altitud por el método estándar de referencia de dilución isotópica en estudios previos en altitud. El ejercicio de trote submáximo ejecutado, ha exigido más a los universitarios estudiados. Se verifica que en el mismo tiempo los varones han recorrido una mayor distancia que las mujeres. Se estima que en mujeres la masa grasa corporal (MGC) esta incrementada y que el exceso de grasa (obesidad) es del 55%. La diferencia del agua al momento basal y post ejercicio y el LEC y LIC entre varones y mujeres no es significativa. El IMC subestima en este grupo la frecuencia de obesidad, principalmente en mujeres. El uso de técnicas nucleares, ha permitido a través del análisis del deuterio estudiar el agua, la composición corporal, y se asocia fuertemente con determinaciones similares mediante el uso de la bioimpedancia eléctrica.

RESEARCH QUESTION: what will be the body composition, the total body water, and the extra and intracellular water related to the changes after submaximal exercise of 30 minutes and post rehydration with pure water in permanent resident adults of high altitude, La Paz, Bolivia, management 2019? OBJECTIVE: to determine the body composition, the total body water, and the extra and intracellular water related to the changes after submaximal exercise of 30 minutes and post rehydration with pure water in permanent residents of high altitude adults, La Paz, Bolivia, management 2019. MATERIAL AND METHODS: the research work was experimental, before and after, on Altitude Physiology, in 29 young residents of high altitude (3600 m.a.s.l.). Variables were evaluated before and after performing a 30-minute submaximal exercise test and post-exercise rehydration after consuming pure water. Dependent variables were: 1. Body composition, measured through bioelectrical impedance analysis (AIB), 2. Total body water volume, determined by AIB. 3. Extra and intracellular water evaluated by AIB and 4. Rehydration status, evaluated by post-exercise weight change, and by AIB. The independent variables were exercise through the 30-minute submaximal test and rehydration with pure water. RESULTS: in young residents of high altitude, it is estimated that the percentage of total body water in women is decreased in relation to the reference of sea level populations. Body fat mass is greatly increased in women. The difference in basal water versus post-exercise water between men and women is not significant. The difference in water from basal extra and intracellular fluid versus post-exercise water between men and women is not significant. The difference in distance covered in 30 minutes of submaximal jogging exercise is statistically significant in favor of men (4424 vs. 3619 meters). The correlation of BMI and the percentage of fat mass is very low (r = 0.109). The BMI between men and women did not present a statistically significant difference (26 ± 3 vs 24 ± 3 respectively). The frequency of excess body fat evaluated by AIB is 55% in women and 0% in men. The systemic blood pressure in men (PS: 107 ± 6 and PD: 73 ± 4mmHg) and in women (PS: 104 ± 8 and PD: 70 ± 7mmHg), is decreased in relation to the sea level reference. Respiratory rate is increased in both men (21 ± 2) and women (23 ± 3). CONCLUSIONS: the AIB method allows evaluating body composition and total body water and therefore fat mass, which was validated at altitude by the isotopic dilution reference standard method in previous studies at altitude. The submaximal trot exercise performed has demanded more from the university students studied. It is verified that in the same time the men have traveled a greater distance than the women. It is estimated that in women the body fat mass (FGM) is increased and that the excess fat (obesity) is 55%. The difference in water at baseline and post-exercise and the LEC and LIC between men and women is not significant. The BMI underestimates the frequency of obesity in this group, mainly in women. The use of nuclear techniques has allowed the analysis of deuterium to study water, body composition, and is strongly associated with similar determinations through the use of electrical bioimpedance.

Gasometría arterial en residentes a gran altura, El Alto ­ Bolivia 2020 / Arterial blood gas analysis in residents at high altitude, El Alto, Bolivia 2020

INTRODUCCIÓN: la presión barométrica determina la presión parcial de los gases tanto en el medio ambiente como a nivel alveolar pulmonar, por lo que, para una determinada presión barométrica, la presión de oxígeno y dióxido de carbono es distinta. OBJETIVO: el objetivo del presente estudio es caracterizar los valores de gasometría arterial en residentes adultos sanos a muy alta altitud en la ciudad de El Alto. METODOLOGÍA: Estudio serie de casos, realizado durante la gestión 2019 en 22 (73%) mujeres y 8 varones (27%), con una media de edad de 36.07 años. El estudio contó con la aprobación del Comité de Ética Hospitalario. RESULTADOS: a 4150 metros sobre el nivel del mar, el pH tiende hacia la alcalosis (7.43) así como la PaO2 es menor (58.69mmHg), el valor de PaCO2 (26.14mmHg) es menor correspondiente a una ciudad con mayor altitud, el valor de bicarbonato sérico (20.14mmol/L) se encuentra disminuido en compensación a la disminución de la PaCO2 y el valor de la SatO2% (91.7%) es menor al reportado a nivel del mar. Hay que destacar que el índice PaO2/FiO2 no concuerda con el cálculo realizado según la fórmula propuesta dentro de la definición de los Criterios de Berlín. Se evidencia también que, en la muestra, si bien la correlación entre la PaO2 y la SatO2% resulta como alta, no resulta perfectamente lineal. CONCLUSIÓN: resulta imperativo precisar las características propias a la fisiología correspondientes a cada altitud, buscando aplicar parámetros propios como los de la gasometría arterial para el tratamiento de las enfermedades prevalentes en cada región, así como desarrollar investigaciones específicas a gran altura, ensayar posibilidades y documentarlas.

INTRODUCTION: barometric pressure determines the partial pressure of gases both in the environment and at the pulmonary alveolar level, so for a given barometric pressure, the pressure of oxygen and carbon dioxide is different. The objective of this paper is to characterize arterial blood gas values in healthy adult residents at very high altitude in the city of El Alto. METHODOLOGY: case series study, carried out during 2019; 22 volunteers (73%) women and 8 men (27%), mean age 36.07 years are included. The study was approved by the Hospital Bioethics Committee. RESULTS: at 4150 meter above sea level, pH tends towards alkalosis (7.43) as well as PaO2 is lower (58.69mmHg), the value of PaCO2 (26.14mmHg) is lower corresponding to a city with higher altitude, the value of serum bicarbonate (20.14mmol/L) is lower in compensation at the decrease in PaCO2 and the value of SatO2% (91.7%) is lower than that reported at sea level. The PaO2/FiO2 index does not match the calculation made according to the proposed formula within the definition of the Berlin Criteria. It is also evident that, although the correlation between PaO2 and SatO2% is high, it is not perfectly linear. CONCLUSION: it is imperative to precise the characteristics corresponding to the physiology corresponding to each altitude, looking forward to apply these parameters, such as those of arterial blood gas, in the treatment of prevalent diseases for each region, and so as develop specific studies at high altitude, also testing and reporting them.

Dietary addition of curcumin favors weight gain and has antioxidant, anti-inflammatory and anticoccidial action in dairy calves / La adición de curcumina en la dieta de los terneros lecheros favorece el aumento de peso y tiene acción antioxidante, antiinflamatoria y anticoccidial / A adição de curcumina na dieta dos bezerros leiteiros favorece o aumento de peso e tem ação antioxidante, anti-inflamatória e anticoccidiostática

Abstract Background: Curcumin has been used as an additive in the diet of animals in recent years due to the potent medicinal properties of this molecule. Objective: To evaluate whether the addition of curcumin to the diet of calves at different phases (pre- and post-weaning) has a positive effect on metabolic profile, performance, and anti-coccidian action. Methods: Thirty-three Holstein calves were selected at various phases of development: Experiment 1 (E1: n=10) 18±7 (pre-weaning), Experiment 2 (E2: n=11) 64±4 (pre-weaning) and Experiment 3 (E3: n=12) 95±8 (post-weaning) days of life. The calves were separated in three groups according to their phase of development. In each experiment, animals were divided into two sub-groups: control and curcumin. The curcumin groups received 200 mg of additive per animal/day either in milk (pre-weaning) or concentrate (post-weaning). Fecal collections were performed on days 0, 10 and 15 of the experiment to count Eimeria oocysts per gram of feces and to perform fecal score analysis. Complete blood counts, oxidant and antioxidant profiles, protein metabolism markers, lipid levels, glucose levels, and animal weights were measured. Analyses of digestibility and composition of the diet used in Experiment 3 (post-weaning) were also performed. Results: Independent of phase, animals that received curcumin had greater weight gain on days 0 to 15 (E1, E2 and E3 p=0.04, 0.001 and 0.001, respectively), probably due to the increased digestibility of hay and concentrate at 72h (p=0.03 and 0.02, respectively). The supplemented calves had lower level of oxidants (thiobarbituric acid reactive substances -TBARS- and reactive oxygen species -ROS-), indicating that free radical levels in serum and lipid peroxidation were lower. This was probably due to increased enzymatic antioxidants gluthatione S-transferase (E1, E2 and E3 p=0.001, 0.001 and 0.02, respectively), catalase (E1 p=0.001) and superoxide dismutase (E3 p=0.001) in treated animals at day 15. Furthermore, calves receiving curcumin had lower numeric number of Eimeria infection during the experimental period, and the difference was significant in day 15 (E1 and E2 p=0.02, and 0.001, respectively). Conclusion: Curcumin supplementation to dairy calves has coccidiostatic potential, favoring weight gain.

Resumen Antecedentes: Curcumina ha sido utilizada como aditivo en la dieta de animales en los últimos años, debido a las potentes propiedades medicinales de esa molécula. Objetivo: Evaluar si la adición de curcumina en la alimentación de terneras en diferentes fases (pre y post-destete) presenta efecto positivo sobre el perfil metabólico, desempeño de los animales, y acción anti-coccidial. Métodos: Se seleccionaron 33 terneros Holstein en varias etapas de desarrollo: Experimento 1 (E1: n=10) 18±7 (pre-destete), Experimento 2 (E2: n=11) 64±4 (pre-destete) y Experimento 3 (E3: n=12) 95±8 (post-destete) días de vida. Para todos los experimentos, el período experimental fue de 15 días. Los animales se dividieron en dos grupos: control y tratados con curcumina. Los grupos con curcumina recibieron una dosis de 200 mg del aditivo por animal/día en la leche (pre-destete) o en el concentrado (post-destete). Las colectas de heces y sangre fueron realizadas en los días 0, 10 y 15 para conteo de ooquistes de Eimeria por gramo de heces y análisis de puntaje fecal. Se realizó hemograma, perfil oxidante y antioxidante, metabolismo proteico, lipídico, glucosa sanguínea y pesaje de los animales. También se realizó análisis de digestibilidad de la dieta total para los animales del Experimento 3 (post-destete). Resultados: Encontramos que, independientemente de la fase, los animales que recibieron curcumina tuvieron una mayor ganancia de peso en los días 0 a 15 (E1, E2 y E3, p=0,04, 0,001 y 0,001, respectivamente), probablemente debido al aumento de la digestibilidad del heno y concentrado a las 72 h (p=0,03 y 0,02, respectivamente). En los terneros suplementados observamos un nivel más bajo de oxidantes (oxidantes (sustancias reactivas al ácido tiobarbitúrico y especies reactivas de oxígeno); es decir, los niveles séricos de radicales libres y la peroxidación lipídica fueron más bajos. Esto se debió, probablemente, a los antioxidantes enzimáticos glutatión S-transferasa (E1, E2 y E3 p=0,001, 0,001 y 0,02 respectivamente), catalasa (E1, p=0,001) y superóxido dismutasa (E3, p=0,001) que aumentaron en los animales tratados al día 15. Además, los terneros que recibieron curcumina tuvieron niveles más bajos de infección por Eimeria durante el período experimental y fueron significativos en el día 15 (E1 y E2, p=0,02 y 0,001, respectivamente). Conclusión: La suplementación con curcumina tiene potencial coccidiostático y favorece la ganancia de peso en terneros Holstein.

Resumo Antecedentes: Curcumina tem sido usado como aditivo na dieta de animais nos últimos anos, devido as propriedades medicinais potente dessa molécula. Objetivo: Avaliar se a adição de curcumina na alimentação de bezerras em diferentes fases (pré e pós-desmame) apresenta efeito positivo sobre perfil metabólico, desempenho e ação anti-coccidéo. Métodos: Para isso, 33 bezerros holandeses foram selecionados em vários estágios de desenvolvimento: Experimento 1 (E1: n=10) 18±7 (pré-desmame), Experimento 2 (E2: n=11) 64±4 (pré-desmame) e Experimento 3 (E3: n=12) 95±8 (pós-desmame) dias de vida. Para todos os experimentos o período experimental foi de 15 dias, assim como foram delineados com dois grupos: controle e tratados com curcumina. Os grupos de curcumina receberam 200 mg do aditivo por animal/dia no leite (pré-desmame) ou em concentrado (pós-desmame). Coletas de fezes e sangue foram realizadas nos dias 0, 10 e 15 de experimento para contagem de oocistos de Eimeria por grama de fezes e análise de escore fecal. Do sangue colhido foram realizados: hemograma, perfil oxidante e antioxidante, metabolismo proteico, lipídico, glicose, além da pesagem dos animais. Também foi realizado análise de digestibilidade da dieta total ofertada aos animais do Experimento 3 (pós-desmame). Resultados: Independentemente da fase, os animais que receberam curcumina tiveram maior ganho de peso do dia 0 a 15 (E1, E2 e E3, p=0,04, 0,001 e 0,001, respectivamente), provavelmente devido ao aumento da digestibilidade ao feno e concentrado após 72 h (p=0,03 e 0,02, respectivamente). Nos bezerros suplementados, observou-se menor nível de oxidantes (substâncias reativas ao ácido tiobarbitúrico e espécies reativas de oxigênio), ou seja, os níveis séricos de radicais livres e a peroxidação lipídica foram menores. Isto foi provavelmente devido a antioxidantes enzimáticos glutationa S-transferase (E1, E2 e E3, p=0,001, 0,001 e 0,02, respectivamente), catalase (E1, p=0,001) e superóxido dismutase (E3, p=0,001) aumentando nestes animais tratados no dia 15. Além disso, bezerros recebendo curcumina tiveram menores níveis de infecção por Eimeria durante o período experimental e significativos no dia 15 (E1 e E2, p=0,02 e 0,001, respectivamente). Conclusão: A suplementação de curcumina aumenta o potencial coccidiostático e favorece o ganho de peso.

Valores típicos de dosis para tomografía computada de cerebro en pacientes adultos / Typical dose values for brain computed tomography in adult patients

Resumen: Debido al aumento en el uso de la Tomografía Computada (TC), y en consecuencia, la probabilidad de generar un incremento progresivo de la dosis recibida por los paciente y su relación en el potencial riesgo de los efectos de las radiaciones ionizantes, es importante implementar el uso de niveles de referencia diagnóstico (DRLs) en TC, como herramienta fundamental dentro de un programa de control de calidad que permita la evaluación y optimización de las dosis entregadas a los pacientes según la tarea clínica deseada. Con el objetivo de establecer valores típicos de dosis en TC de cerebro en Clínica Bupa Reñaca, se estudió una muestra de 73 informes dosimétricos generados en un equipo TC Toshiba Aquilion 64, en términos de indicadores de dosis para TC: Índice de dosis en TC por volumen (CTDIvol) y Producto dosis longitud (DLP). Con los datos obtenidos, se estimó el valor del percentil 50 (p50) para cada indicador de dosis, y se determinaron los valores típicos de dosis en cada grupo estudiado según sexo, edad e indicación clínica. Se logró definir y establecer una metodología que permitió la obtención de los valores típicos de dosis para TC de cerebro, optimizando las dosis sin producir una disminución en la calidad de la imagen necesaria para nuestro propósito clínico.

Abstract: Due to the increase in the use of Computed Tomography (CT), and consequently, the probability of generating a progressive increase in the dose received by the patient and its relationship in the potential risk of the effects of ionizing radiation, it is important to implement the use of diagnostic reference levels (DRLs) in CT, as a fundamental tool within a quality control program that allows the evaluation and optimization of the doses delivered to patients according to the desired clinical task. In order to establish typical dose values in brain CT at Bupa Reñaca Clinic, a sample of 73 dosimetric reports generated on a Toshiba Aquilion 64 CT unit was studied, in terms of dose indicators for CT: Dose rate on CT by volume (CTDIvol) and Dose Length Product (DLP). With the data obtained, the value of the 50th percentile (p50) for each dose indicator was estimated, and typical dose values were determined in each group studied according to sex, age and clinical indication. It was possible to define and establish a methodology that allowed obtaining typical dose values for brain CT, optimizing the doses without producing a decrease in the image quality necessary for our clinical purpose.

Prospective cohort analyzing risk factors for chronic kidney disease progression in children / Coorte prospectiva que analisa os fatores de risco para progressão de doença renal crônica (DRC) em crianças

Abstract Objective: To identify risk factors for chronic kidney disease progression in Brazilian children and to evaluate the interactions between factors. Methods: This was a multicenter prospective cohort in São Paulo, involving 209 children with CKD stages 3-4. The study outcome included: (a) death, (b) start of kidney replacement therapy, (c) eGFR decrease >50% during the followup. Thirteen risk factors were tested using univariate regression models, followed by multivariable Cox regression models. The terms of interaction between the variables showing significant association with the outcome were then introduced to the model. Results: After a median follow-up of 2.5 years (IQR = 1.4-3.0), the outcome occurred in 44 cases (21%): 22 started dialysis, 12 had >50% eGFR decrease, seven underwent transplantation, and three died. Advanced CKD stage at onset (HR = 2.16, CI = 1.14-4.09), nephrotic proteinuria (HR = 2.89, CI = 1.49-5.62), age (HR = 1.10, CI = 1.01-1.17), systolic blood pressure Z score (HR = 1.36, CI = 1.08-1.70), and anemia (HR = 2.60, CI = 1.41-4.77) were associated with the outcome. An interaction between anemia and nephrotic proteinuria at V1 (HR = 0.25, CI = 0.06-1.00) was detected. Conclusions: As the first CKD cohort in the southern hemisphere, this study supports the main factors reported in developed countries with regards to CKD progression, affirming the potential role of treatments to slow CKD evolution. The detected interaction suggests that anemia may be more deleterious for CKD progression in patients without proteinuria and should be further studied.

Resumo Objetivo: Identificar os fatores de risco para progressão da DRC em crianças do Brasil e avaliar as interações entre os fatores. Métodos: Coorte prospectiva multicêntrica em São Paulo, envolvendo 209 crianças com DRC em estágios 3-4. O desfecho do estudo incluiu: a) óbito, b) início da terapia de substituição renal, c) redução de > 50% na taxa estimada de filtração glomerular (eGFR) durante o acompanhamento. Foram testados 13 fatores de risco com o modelo de regressão univariada seguido do modelo de regressão multivariado de Cox. Os termos de interação entre as variáveis mostraram associação significativa e foram introduzidos ao modelo. Resultados: Após média de acompanhamento de 2,5 anos (IIQ = 1,4 a 3,0), 44 casos (21%) apresentaram desfecho: 22 iniciaram diálise, 12 apresentaram redução de > 50% na eGFR, sete foram submetidos a transplante e três morreram. Estágio avançado de DRC no acometimento (RR = 2,16, IC = 1,14-4,09), proteinúria nefrótica (RR = 2,89, IC = 1,49-5,62), idade (RR - 1,10, IC = 1,01-1,17), escore Z da pressão arterial sistólica (RR = 1,36, IC = 1,08-1,70) e anemia (RR = 2,60, IC - 1,41-4,77) foram associados ao resultado. Foi detectada interação entre anemia e proteinúria nefrótica na primeira visita (V1) (RR = 0,25, IC = 0,06-1,00). Conclusões: Como a primeira coorte de DRC no hemisfério sul, este estudo é concordante com os principais fatores relatados em países desenvolvidos com relação à progressão da DRC, afirmando o possível papel dos tratamentos para mostrar a evolução da DRC. A interação detectada sugere que a anemia pode ser mais nociva na progressão da DRC em pacientes sem proteinúria e deve ser ainda mais estudada.

Characterization of Cardiopulmonary Exercise Testing Variables in Patients with Endomyocardial Fibrosis after Endocardial Resection / Caracterização das Variáveis do Teste de Esforço Cardiopulmonar em Pacientes com Endomiocardiofibrose após Cirurgia de Ressecção Endocárdica

Abstract Background: Endomyocardial fibrosis (EMF) is a rare disease, characterized by diastolic dysfunction which leads to reduced peak oxygen consumption (VO2). Cardiopulmonary exercise testing (CPET) has been proved to be a fundamental tool to identify central and peripheral alterations. However, most studies prioritize peak VO2 as the main variable, leaving aside other important CPET variables that can specify the severity of the disease and guide the clinical treatment. Objective: The aim of this study was to evaluate central and peripheral limitations in symptomatic patients with EMF by different CPET variables. Methods: Twenty-six EMF patients (functional class III, NYHA) were compared with 15 healthy subjects (HS). Functional capacity was evaluated using CPET and diastolic and systolic functions were evaluated by echocardiography. Results: Age and gender were similar between EMF patients and HS. Left ventricular ejection fraction was normal in EMF patients, but decreased compared to HS. Peak heart rate, peak workload, peak VO2, peak oxygen (O2) pulse and peak pulmonary ventilation (VE) were decreased in EMF compared to HS. Also, EMF patients showed increased Δ heart rate /Δ oxygen uptake and Δ oxygen uptake /Δ work rate compared to HS. Conclusion: Determination of the aerobic capacity by noninvasive respiratory gas exchange during incremental exercise provides additional information about the exercise tolerance in patients with EMF. The analysis of different CPET variables is necessary to help us understand more about the central and peripheral alterations cause by both diastolic dysfunction and restrictive pattern.

Resumo Fundamento: A endomiocardiofibrose (EMF) é uma doença rara, caracterizada por disfunção diastólica que leva à redução consumo de oxigênio (VO2) pico. O teste de esforço cardiopulmonar (TECP) tem se mostrado uma ferramenta fundamental na identificação de alterações centrais e periféricas. No entanto, a maioria dos estudos prioriza o VO2 pico como a variável principal, em detrimento de outras importantes variáveis do TECP que poderiam identificar a gravidade da doença e direcionar o tratamento clínico. Objetivo: O objetivo deste estudo foi avaliar limitações centrais e periféricas em pacientes com EMF sintomáticos por meio de variáveis do TECP. Métodos: Vinte e seis pacientes com EMF (classe funcional III, NYHA) foram comparados com 15 indivíduos controle saudáveis (CS). A capacidade funcional foi avaliada por TECP e funções sistólicas e diastólicas por ecocardiografia. Resultados: A idade e o gênero foram similares entre pacientes com EMF e CS. A fração de ejeção do ventrículo esquerdo foi normal em pacientes com EMF, porém diminuída em comparação aos CS. Os picos de frequência cardíaca, carga de trabalho, VO2, pulso de oxigênio (O2) e da ventilação pulmonar (VE) estavam diminuídos em pacientes com EMF em comparação aos CS. Ainda, os pacientes com EMF apresentaram Δ frequência cardíaca /Δ consumo de oxigênio e Δ consumo de oxigênio /Δ taxa de trabalho aumentados em comparação aos CS. Conclusão: A determinação da capacidade aeróbica por troca respiratória não invasiva durante exercício progressivo fornece informações sobre a tolerância ao exercício em pacientes com EMF. É necessária uma análise das diferentes variáveis do TECP para nos ajudar a compreender mais acerca das alterações centrais e periféricas causadas tanto pela disfunção diastólica como pelo padrão restritivo.

Rats treated with Hypericum perforatum during pregnancy generate offspring with behavioral changes in adulthood

Abstract Drugs used in the treatment of depression can cross the placenta giving rise to questions regarding the effects these drugs exert on the fetus. Hypericum perforatum L., Hypericaceae, is a natural product used to treat depression. However, information about its toxicity and the occurrence of alterations in the central nervous system development of the offspring is scarce. This work assessed the behavior of adult male rats born from mothers treated with Hypericum extract during gestation and analyzed the fluorescence of the extract in different organs of mothers and fetuses. Male pups were divided into three treated groups, corresponding to the administration of the Hypericum extract to mothers at the dose levels of 36 mg/kg, 72 mg/kg and 144 mg/kg, and one control group in which the mothers received distilled water. At 90 days of age, the offspring underwent the following tests: rotarod, pentobarbital-induced sleep time, elevated plus maze, hole-board and forced swimming test. The observed fluorescence indicated the presence of the extract in all tissues analyzed. The obtained results suggest lasting changes in the performances displayed in the CNS, depression and anxiety tests, indicating that the use of Hypericum during gestation could interfere with the behavioral development of the offspring reducing anxiety and depression when they become adults. We suggest that these alterations are associated with the reprogramming of the brain regions related to changes in emotional reactivity.

Evaluación in vitro de la actividad antimicrobiana de un gel para manos con nanomoléculas de cobre / In vitro evaluation of the antimicrobial activity of a hand gel with copper nanomolecules

Introducción: en los últimos años el uso del cobre se ha propuesto como una alternativa para la disminución de IAAS. Objetivos: evaluar la actividad antimicrobiana in vitro de un gel para manos, con nanomoléculas de cobre en cepas de: Candida albicans, C. parapsilosis, Staphylococcus aureus, Enteroccus faecalis, Escherichia coli y Pseudomona aeruginosa. Materiales y Método: estudio experimental in vitro. Se sembraron cepas de referencia (ATCC) en medios de cultivos y se colocaron cuatro discos de gasas estériles con gel de cobre, clorhexidina, alcohol gel y de agua destilada. Se midieron los halos a las 24, 48 hs y 7 días. Se utilizó la prueba de Anova y test HSD Tukey para análisis estadístico. Resultados: para C. albicans y C. parapsilosis el gel de cobre presentó un halo de inhibición a las 24, 48 hs y 7 días, siendo mayor al de clorhexidina (p< 0,001) en el caso de la C. albicans. Para S. aureus, E. coli y P. aeruginosa presentó un halo menor (p< 0,001) que el de clorhexidina a las 24 hs, sin embargo, no hubo inhibición a las 48 hs ni a los 7 días. En E. faecalis no hubo halo de inhibición a ningún tiempo. Conclusiones: el gel de cobre presentó actividad in vitro tanto para C. albicans como para C. parapsilosis, hasta los 7 días. Presentó actividad sobre S. aureus, E. coli y P. aeruginosa hasta las 24 hs. No presentó actividad antimicrobiana sobre E. faecalis.

Introduction: in the last few years the use of copper has been proposed as an alternative for reducing HAIs. Objective: to assess in vitro antimicrobial activity of a gel with copper nanomolecules on strains of Candida albicans , C. parapsilosis, Staphylococcus aureus, Enteroccus faecalis , Escherichia coli and Pseudomona aeruginosa. Materials and Methods: in vitro experimental study. Reference strains (ATCC) were seeded in growth medium and then four disks of sterile gauze impregnated with gel copper, chlorhexidine, gel alcohol and distilled water were placed in the culture. Halos were measured at 24, 48 hours and 7 days. Anova test and Tukey HSD test were used to statistical analysis. Results: for C. albicans and C. parapsilosis copper gel provided an inhibition at 24, 48 hours and 7 days, being higher than chlorhexidine (p <0.001) in the case of C. albicans. For S. aureus, E. coli and P. aeruginosa copper gel showed a lower halo (p <0.001) than chlorhexidine at 16 and 24 hours, however there was no inhibition at 48 hrs or 7 days. In E. faecalis no inhibition halo was found at any time. Conclusions: the copper gel showed in vitro activity for C. albicans and C. parapsilosis up to 7 days. Presented activity on S. aureus, E. coli and P. aeruginosa up to 24 hrs. It did not show antimicrobial activity against E. faecalis.

Traqueostoma persistente: cierre con colgajo invertido. reporte de tres casos clínicos y revisión de la literatura / Persistent tracheostoma: closure with inverted flap. report of three cases and literature review

El traqueostoma persistente es la complicación tardía más frecuente asociada al uso de traqueostomía. Se reportan tres casos de pacientes que se les realizó un cierre exitoso del traqueostoma persistente mediante técnica de cierre primario por planos con colgajo invertido. Las ventajas del método utilizado son que representa una alternativa simple, susceptible de realizar con anestesia local y de manera ambulatoria, con excelentes resultados estéticos, mejorando significativamente la calidad de vida de estos pacientes.

Persistent tracheostoma is the most common late complication associated with the use of tracheostomy. We report three cases in which patients underwent a successful closure of persistent tracheostoma using primary closure in layers with inverted flap technique. The advantages of this method are that it represents a simple alternative and is able to be performed under local anesthesia on an outpatient basis, with excellent aesthetic results, significantly improving the quality of life of these patients.

Biochemical detection of E-ADA on Neospora caninum tachyzoites and the effects of a specific enzymatic inhibitor / Detección bioquímica de E-ADA en taquizoitos de Neospora caninum y los efectos de un inhibidor enzimático específico

Objective. This study aimed to investigate the presence and activity of the ecto adenosine deaminase (E-ADA) enzyme in tachyzoites of Neospora caninum (Nc-1 strain), as well as to assess the activity of a well-known E-ADA inhibitor, the deoxycoformycin. Materials and methods. The parasites were grown in cell culture, being subsequently separated in a pellet of tachyzoites, on which the E-ADA activity was tested using the concentrations 0 (control), 0.2, 0.4 and 0.8 mg mL-1. Results. The E-ADA showed high activity, progressively increasing its activity according to the enhancement of the protein concentration. The test was carried out with different concentrations of deoxycoformycin, showing that it was able to inhibit the E-ADA present on the free form of the parasite. Conclusions. Based on these results we conclude that the E-ADA is present on tachyzoites of N. caninum, and deoxycoformycin is able to inhibit this enzyme. In this sense, knowing the negative impact of N. caninum on reproductive issue in cattle (mainly abortion), might it is an alternative in order to deal with this parasitic infection.

Objetivo. Este estudio tuvo como objetivo investigar la presencia y la actividad de la adenosina deaminasa (E-ADA) en taquizoitos de Neospora caninum (Nc-1 cepa), así como ensayar un conocido inhibidor de estas enzimas. Material y métodos. Los parásitos se multiplicaron en cultivo celular y posteriormente fueron separados en un sedimento de taquizoitos. La actividad de E-ADA fue probada en el parásito, usando concentraciones de 0 (control), 0.2, 0.4 y 0.8 mg mL-1. Resultados. El E-ADA tenía una alta actividad aumentó progresivamente de acuerdo con la concentración de proteínas. La prueba se llevó a cabo con diferentes concentraciones del inhibidor E-ADA (desoxicoformicina) y fue capaz de inhibir la presente E-ADA en el parásito. Conclusiones. Por la observación de los resultados se concluye que la enzima E-ADA está presente en taquizoítos de N. caninum, y desoxicoformicina es capaz de inhibir la acción de la enzima. En este sentido, conocer el impacto negativo del parásito en los problemas productivos y reproductivos en el ganado (principalmente abortos), estos resultados pueden ser una alternativa para evitar esta enfermedad parasitaria.

The essential oil from Lippia alba induces biochemical stress in the silver catfish (Rhamdia quelen) after transportation

This study investigated the effects of the essential oil (EO) from Lippia alba on biochemical parameters related to oxidative stress in the brain and liver of silver catfish (Rhamdia quelen) after six hours of transport. Fish were transported in plastic bags and divided into three treatments groups: control, 30 µL L- 1 EO from L.alba and 40 µL L-1 EO from L.alba. Prior to transport, the fish were treated with the EO from L. alba (200 µL L -1 for three minutes), except for the control group. Fish transported in bags containing the EO did not have any alterations in acetylcholinesterase, ecto -nucleoside triphosphate diphosphohydrolase and 5'nucleotidase activity in the brain or superoxide dismutase activity in the liver. The hepatic catalase (CAT), glutathione-S-transferase (GST), glutathione peroxidase (GPx), nonprotein thiol and ascorbic acid levels were significantly lower compared to the control group. However, the hepatic thiobarbituric acid- reactive substances, protein oxidation levels and the lipid peroxidation/catalase+glutathione peroxidase (LPO/CAT+GPx) ratio were significantly higher in fish transported with both concentrations of the EO, indicating oxidative stress in the liver. In conclusion, considering the hepatic oxidative stress parameters analyzed in the present experiment, the transport of previously sedated silver catfish in water containing 30 or 40 µL L-1 of EO from L. alba is less effective than the use of lower concentrations.

Este estudo investigou os efeitos do óleo essencial (OE) de Lippia alba sobre parâmetros bioquímicos relacionados ao estresse oxidativo em cérebro e fígado de jundiá (Rhamdia quelen), após seis horas de transporte. Os peixes foram transportados em sacos plásticos e divididos em três tratamentos: controle, 30 µL L-1 e 40 µL L-1 de OE de L.alba. Antes do transporte, os peixes foram tratados com o OE de L. alba (200 µL L-1 por três minutos), exceto para o grupo controle. Os peixes transportados em sacos contendo o OE não tiveram alterações na atividade da acetilcolinesterase (AChE), ecto-nucleosídeo trifosfato difosfohidrolase (NTPDase) e 5'nucleotidase, em cérebro ou superóxido dismutase (SOD) no fígado. O tiol não proteico (NPSH), os níveis de ácido ascórbico, catalase (CAT), glutationa-S-transferase (GST) e glutationa-peroxidase (GPx) hepáticos, foram significativamente mais baixos em comparação com o grupo controle. No entanto, as substâncias reativas ao ácido tiobarbitúrico (TBARS), os níveis de oxidação proteica e a taxa de peroxidação lipídica/catalase+glutationa peroxidase (LPO/ CAT+GPx) foram significativamente maiores nos peixes transportados com ambas as concentrações de OE, indicando estresse oxidativo no fígado. Em conclusão, considerando os parâmetros de estresse oxidativo do fígado analisados no presente experimento, o transporte de jundiás previamente sedados em água contendo 30 ou 40 µL L-1 de OE de L.alba é menos efetivo que utilizando concentrações menores.

Alteraciones en mucosa bucal y percepción de salud oral en adultos mayores portadores de prótesis / Oral mucosal alterations and oral health perception in older adults bearing dental prostheses

Actualmente, los problemas asociados al progresivo envejecimiento de la población son objeto de mayor atención, debido al aumento de las personas mayores, especialmente en las sociedades industrializadas. En el corto y el mediano plazo, estaremos frente a una población importante de adultos mayores; así, se tendrá que asumir la atención de este grupo poblacional. Estas personas pueden haber perdido piezas dentarias y la instalación de un aparato protésico constituye una solución para rehabilitar la función del sistema estomatognático. La terapia prostodóntica debe conservar la salud de los tejidos bucales y disminuir la resorción ósea. El descubrimiento y la prevención de las lesiones significará prolongar la esperanza y la calidad de vida de las personas de la tercera edad. La forma en que las personas perciben su salud bucal está relacionada con el bienestar; una boca saludable contribuye a que se sienta bien y ayuda a su satisfacción. Por ello, la percepción de salud bucal puede ser considerada como un factor predictor de la calidad de vida y se asocia a una variedad de indicadores de salud general y conductas saludables. Existen estudios que informan sobre la asociación entre la autopercepción de la salud bucal global con la autopercepción específica de limitaciones funcionales bucales. Los instrumentos para evaluar la calidad de vida relacionada con la salud bucal, son sensibles para detectar la influencia de los tratamientos odontológicos en la percepción del paciente sobre su salud bucal, lo que podría ser útil para relacionar satisfacción y percepción del paciente en relación a su rehabilitación

Evaluation of postpartum behaviour in rats treated with Hypericum perforatum during gestation

Gestational depression is detrimental to the health of the mother and the offspring and contributes to the appearance of depressive and anxiety symptoms during the postnatal period. Traditional antidepressants have undesirable side effects when utilised during gestation, but Hypericum perforatum has been characterised as an efficient and safe antidepressant that prevents the recurrence of symptoms. This study verified the effects of Hypericum perforatum on the behaviour of Wistar rats that were treated during gestation and evaluated 10 and 60 days post-treatment. Pregnant Wistar rats were divided into four groups of ten animals each: one control group that received distilled water and three treatment groups that were treated orally with 36, 72 or 144 mg/kg Hypericum perforatum extract. At 10 and 60 days after parturition and post-treatment, the rats were submitted to the holeboard, the tail suspension, and the forced swim tests. The animals treated with 144 mg/kg Hypericum perforatum exhibited greater head-dipping activity in the hole-board test and reduced immobility in the tail suspension and forced swim tests, suggesting less anxiety and depression 10 and 60 days post-treatment.The results indicated that treating rats with Hypericum perforatum during the gestational period decreased depressive behaviour and anxiety 10 and 60 days post-treatment.

The hypertriglyceridemic waist phenotype in young adults from the Southern Region of Brazil / Cintura hipertrigliceridêmica em adultos jovens no Sul do Brasil / Cintura hipertrigliceridémica en adultos jóvenes en el sur de Brasil

The present study aimed to assess the prevalence of the hypertriglyceridemic waist phenotype and its associated factors among subjects that have been followed up from birth. In 1982, all maternity hospitals in the city of Pelotas, in the Southern Region of Brazil, were visited and all births were recorded. Babies whose parents lived in the urban area of Pelotas were subsequently followed up on several occasions. A 22 to 23-year follow-up of this birth cohort was carried out in 2004 and 2005. The presence of the hypertriglyceridemic waist phenotype was defined as waist circumference ≥ 90cm and triglyceride levels ≥ 177mg/dL for males, and waist circumference ≥ 85cm and triglyceride levels ≥ 133mg/dL for females. The prevalence of the hypertriglyceridemic waist phenotype was 5.9% and 4.5% among men and women, respectively. Among males, a sedentary lifestyle during leisure time, smoking and obesity were associated with the presence of the hypertriglyceridemic waist phenotype, whereas among females the condition was positively associated with skin color, family income, obesity and dietary fat intake.

O presente estudo teve como objetivo determinar a prevalência do fenótipo da cintura hipertrigliceridêmica e seus fatores associados entre indivíduos que foram seguidos desde o nascimento. Em 1982, as maternidades de Pelotas, sul do Brasil, foram visitadas e todos os nascimentos foram identificados. Em 2004-2005, buscou-se acompanhar toda a coorte. A presença de fenótipo da cintura hipertrigliceridêmica foi definida como circunferência da cintura ≥ 90cm e triglicerídeos ≥ 177mg/dL para o sexo masculino, e circunferência da cintura ≥ 85cm e triglicerídeos ≥ 133mg/dL para as mulheres. A prevalência de fenótipo da cintura hipertrigliceridêmica foi de 5,9% e 4,5% entre os homens e mulheres, respectivamente. Para os homens, o sedentarismo no lazer, tabagismo e obesidade estiveram associados com fenótipo da cintura hipertrigliceridêmica. Por outro lado, entre as mulheres, fenótipo da cintura hipertrigliceridêmica foi positivamente associado com a cor da pele, renda familiar, obesidade e consumo de gordura.

El presente estudio tuvo como objetivo determinar la prevalencia del fenotipo de la cintura hipertrigliceridémica y sus factores asociados entre individuos que fueron observados desde su nacimiento. En 1982, las maternidades de Pelotas, sur de Brasil, fueron visitadas y todos los nacimientos fueron identificados. En 2004-2005, se decidió realizar un seguimiento de toda la cohorte. La presencia del fenotipo de la cintura hipertrigliceridémica se definió como una circunferencia de la cintura ≥ 90cm y triglicéridos ≥ 177mg/dL para el sexo masculino y circunferencia de la cintura ≥ 85cm y triglicéridos ≥ 133mg/dL para las mujeres. La prevalencia del fenotipo de la cintura hipertrigliceridémica fue de un 5,9% y un 4,5% entre los hombres y mujeres, respectivamente. Para los hombres, el sedentarismo en el ocio, tabaquismo y obesidad estuvo asociado con el fenotipo de la cintura hipertrigliceridémica. Por otro lado, entre las mujeres, el fenotipo de la cintura hipertrigliceridémica fue positivamente asociado con el color de la piel, renta familiar, obesidad y consumo de grasa.

Resistencia a la insulina en niños y adolescentes con obesidad de Asunción, Paraguay / Insulin resistance in children and adolescents with obesity in Asuncion, Paraguay

Introducción: Existe un incremento marcado en la prevalencia de la obesidad y del síndrome metabólico, y con ellos, la resistencia a la insulina en niños y adolescentes. Objetivo: Determinar la presencia de resistencia a la insulina en un grupo de pacientes pediátricos con obesidad. Material y Método: Diseño prospectivo, observacional, descriptivo. Se incluyeron 41 pacientes de 6 a 16 años con diagnóstico de obesidad en quienes se determino insulina basal y glicemia tras 8 horas de ayuno. La resistencia a la insulina se definió mediante el índice HOMA (Homeostasis Model Assessment), utilizándose el punto de corte establecido por Keskin de 3,1. Los resultados fueron expresados en términos de media y desviación estándar. Resultados: Fueron evaluados 1215 pacientes, de los cuales el 13,2% (n=160) eran obesos. De ellos, fueron seleccionados al azar 41 pacientes, de los cuales el 51% (n=21) eran de sexo masculino, con una edad promedio de 9,6 años (±2,9). El 12% (n=5) de los pacientes presentó resistencia a la insulina, con una media de HOMA de 4,23 (±0,59). De ellos, el 60% (n=3) correspondió al sexo masculino. Conclusión: La presencia de resistencia a la insulina en el 12% de la población estudiada, a una edad temprana, constituye signo de alarma, y conlleva grave riesgo cardiovascular.

Introduction: There exists a marked increase in the prevalence of obesity and metabolic syndrome, and alongside them, insulin resistance in children and adolescents. Objective: To determine the presence of insulin resistance in a group of pediatric patients who suffer obesity. Materials and Methods: Prospective, observational, descriptive design. Forty one patients aged 6 to 16 with diagnosed obesity, whose basal insulin and glycaemia were determined following 8 hours of fasting. Insulin resistance was defined according to HOMA (Homeostasis Model Assessment), using the 3,1 cut-off point established by Keskin. Results were expressed in terms of mean and standard deviation. Results: 1215 patients were evaluated, of which 13,2% (n=160) were obese. 41 patients were randomly selected among them, of which 51% (n=21) were males, with an average age of 9,6 years (±2,9). 12% (n=5) of patients presented insulin resistance, with a HOMA mean of 4,23 (±0,59). Among those, 60% (n=3) corresponded to males. Conclusion: The presence of insulin resistance in 12% of the studied population, and at an early age, constitutes a sign of alarm and entails serious cardiovascular risk.

Hormonal Sensitivity of Adenylyl Cyclase in the Myocardium, Brain and Testes of 18-month-old Non-Diabetic and Diabetic Rats.

The alterations and abnormalities in hormone-sensitive adenylyl cyclase (AC) system occur at early stages of the type 2 diabetes mellitus (T2DM) and at later stages of the disease they are, according to our view, one of the factors causing T2DM complications. To study the changes in AC system likely to be involved in the development of these complications one needs a very long model of T2DM. Purpose: The aim of this work was the study of AC system in the myocardium, brain and testes of three-, eight- and 18-month-old male rats with experimental T2DM compared with control animals of the same age.