Chronic hemodialysis patients: A comparison of clinical, laboratory and nutritional parameters among elderly and non-elderly patients

ABSTRACT Aim: To compare nutritional, clinical and laboratory parameters data among elderly and non-elderly patients on hemodialysis. Methods: It is a cross-sectional study, with a sample of 34 patients (17 non-elderly participants between 18 to 59 years of age, and 17 elderly participants aged 60 years or older), from the Nephrology Unit, Hospital Santa Casa de Misericórdia, Pelotas/RS/BR. Demographic, socioeconomic, clinical, laboratory, anthropometric data and information on food consumption were collected. Results: Most elderly and non-elderly patients had low income and education. Among elderly participants, weight values, pre and post-dialysis, interdialytic weight gain, median diastolic blood pressure pre and post-dialysis and urea, were higher than among the non-elderly. About 65% of the non-elderly and 70.6% of the elderly subjects had inadequate caloric intake. The same occurred with protein intake, for which 58.8% of the non-elderly and 82.3% of the elderly patients presented inadequate protein intake. Conclusion: There was a tendency of weight gain in the elderly, which may increase the risks of treatment. Evidence indicates an association between the intake of energy and protein in the diet of patients on hemodialysis, requiring an adequate diet and dialysis, in order to avoid complications related to kidney disease.

RESUMEN Objetivos: Comparar parámetros nutricionales, clínicos y de laboratorio de pacientes ancianos y no ancianos sometidos a hemodiálisis. Métodos: Estudio transversal, realizado con una muestra de 34 pacientes, de los cuales 17 eran no ancianos de 18 años y más y menos de 60 años y 17 ancianos de 60 años y más, de la Unidad de Nefrología del Hospital Santa Casa. de Misericórdia de Pelotas / RS / BR. Se recopilaron datos demográficos, socioeconómicos, clínicos, de laboratorio, antropométricos y de consumo de alimentos. Resultados: La mayoría de los pacientes ancianos y no ancianos eran de bajos ingresos y educación. En los ancianos, se encontraron valores de peso, pre y posdiálisis, aumento de peso interdialítico, mediana de la presión arterial diastólica pre y posdiálisis y urea más alta en comparación con los no ancianos. Aproximadamente el 65% de las personas no ancianas y el 70,6% de las personas mayores presentaban una ingesta calórica inadecuada, lo mismo ocurrió con la ingesta proteica, donde el 58,8% de las personas no ancianas y el 82,3% de las personas mayores presentaban una ingesta proteica inadecuada. Conclusión: Hubo una tendencia al aumento de peso en los ancianos, lo que puede traer riesgos al tratamiento. La evidencia indica una asociación entre la ingesta energética y proteica en la dieta de pacientes en hemodiálisis, requiriendo adaptación de la dieta y diálisis para evitar complicaciones relacionadas con la enfermedad renal.

The effect of paraoxonase 1 (PON1) gene polymorphisms T(-107)C and L55M and diet composition on serum PON1 activity in women

ABSTRACT Objective: The aim of this study was to evaluate the serum activity of PON1 in women according to SNPs L55M and T-107C and diet composition. Materials and methods: Blood and serum samples from 26 women were used. DNA extraction, PCR and digestion with restriction enzymes of the PCR fragment were performed for genotyping the PON1 SNPs T-107C and L55M. Serum PON1 activity was measured in a single time point. Patients completed the semi-quantitative food frequency questionnaire and diet composition was estimated. Results: Genotypic distribution for L55M SNP was 56% for the LL genotype, 32% for LM and 12% for MM; for the PON1 C(-107)T SNP it was 28% for the TT genotype, 41% for CT and 31% for CC. Individuals with C and L alleles had higher serum PON1 activity. Combining the two SNPs, we observed that individuals carrying the LL and CC genotypes had twice the activity of carriers of the TT and MM genotypes. Considering food intake, no significant difference was observed between genotypes and intake levels. Conclusion: PON1 T(-107)C and L55M SNPs exert a strong effect on serum PON1 activity in an additive manner and are more important than diet to predict serum PON1 activity.

Estudio multicéntrico argentino sobre la utilidad del panel BCID2 del Sistema FilmArrayTM en la detección de bacteriemias / Argentine multicenter study on the usefulness of the BCID2 panel of the FilmArray™ System in the detection of bacteremia

Resumen El panel BCID2 de BioFire® (BioFire, Salt Lake City, EE.UU.) utiliza un análisis de PCR múltiple a partir de hemocultivos positivos con resultados en una hora. El objetivo de este estudio fue determinar el desempeño del método a partir de hemocultivos positivos de pacientes sépticos en 5 hospitales de la Argentina. Se incluyeron 121 pacientes y 124 episodios. Con respecto a la identificación microbiana, la sensibilidad global y la correspondiente a los microorganismos incluidos en la base de datos fue del 94% y 97% respectivamente. La sensibilidad del BCID2 para detectar CTX-M, KPC, NDM, VIM, IMP, mecA/C, vanA/B fue del 100% y la especificidad fue del 99% para NDM y VIM y del 100% para el resto. Esto llevó a cambios en el tratamiento antimicrobiano en 57/98 episodios (58%). El panel BCID2 es una herramienta importante para la adecuación del tratamiento antimicrobiano de pacientes con sepsis.

Abstract The BioFire® BCID2 panel (BioFire, Salt Lake City, UT) uses multiplex PCR analysis from positive blood cultures with results within one hour. The objective of this study was to determine the performance of the method from positive blood cultures of septic patients in 5 hospitals in Argentina. A total of 121 patients and 124 episodes were included. With regard to microbial identification, the global sensitivity and that corresponding to the microorganisms included in the database was 94% and 97%, respectively. The sensitivity of BCID2 to detect CTX-M, KPC, NDM, VIM, IMP, mecA/C, vanA/B was 100% and the specificity was 99% for NDM and VIM and 100% for the rest. This led to changes in antimicrobial treatment in 57/98 episodes (58%). The BCID2 panel is an important tool for the adequacy of antimicrobial treatment of patients with sepsis.

Resumo Estudo multicêntrico argentino sobre a utilidade do painel BCID2 do Sistema FilmArray™ na detecção de bacteremia O painel BCID2 de BioFire® B (BioFire, Salt Lake City, EUA) utiliza uma análise de PCR múltipla de hemoculturas positivas com resultados em uma hora. O objetivo deste estudo foi determinar o desempenho do método a partir de hemoculturas positivas de pacientes sépticos em 5 hospitais da Argentina. Cento e vinte e um pacientes e 124 episódios foram incluídos. No que se refere à identificação microbiana, a sensibilidade global e correspondente aos microrganismos incluídos na base de dados foi de 94% e 97%, respectivamente. A sensibilidade do BCID2 para detectar CTX-M, KPC, NDM, VIM, IMP, mecA/C, vanA/B foi de 100% e a especificidade foi de 99% para NDM e VIM e 100% para o resto. Isso levou a mudanças no tratamento antimicrobiano em 57/98 episódios (58%). O painel BCID2 é uma ferramenta importante para a adequação do tratamento antimicrobiano de pacientes com sepse.

Evolución clínica de pacientes internados con cáncer e infección por COVID-19 / Clinical outcomes in cancer patients hospitalized with COVID-19

Resumen Los pacientes con cáncer y COVID-19 tienen más complicaciones que la población general. Comunicamos una cohorte de 74 pacientes con cáncer y COVID-19 internados en una institución on cológica. El 87.8% tenía diagnóstico de tumores sólidos y 12.2% oncohematológicos. Entre los tumores sólidos, el 61.5% presentó enfermedad metastásica. El 78.3% (N = 58) tenía infiltrados pulmonares al diagnóstico de COVID-19. La infección fue intrahospitalaria en 20 pacientes. Habían recibido tratamiento antineoplásico den tro de los 30 días anteriores al diagnóstico 39 pacientes (52.7%); uno se encontraba recibiendo radioterapia. Veinticuatro pacientes (32.4%) se derivaron a terapia intensiva (UTI) y 18 (75%) de ellos requirieron asistencia respiratoria mecánica (ARM). La mortalidad general durante la internación fue 32.4% (N = 24). La mortalidad en UTI fue 62.5% (N = 15). La mortalidad en ARM fue 72.2% (N = 13). La edad, recuento de neutrófilos, índice neutrófilo/linfocito, dímero D, ferritina, tabaquismo y haber adquirido la infección durante la internación resultaron estadísticamente significativos en el análisis univariado para mortalidad. No hallamos diferencias en mortalidad por estadio de enfermedad, en los pacientes con tumores sólidos, ni por haber recibido tratamiento antineoplá sico dentro de los 30 días del diagnóstico de COVID-19. En el análisis multivariado con el modelo de regresión logística, solo la edad y el tabaquismo fueron predictores de mortalidad. Los odds ratios (IC 95) ajustados para la edad ≥65 años y el tabaquismo fueron 8.87 (1.35-58.02) y 8.64 (1.32-56.64), respectivamente. Este trabajo puede resultar de utilidad para instituciones polivalentes que asistan pacientes oncológicos durante la pandemia.

Abstract Cancer patients are exposed to more complications from COVID-19 than non-cancer patients. We report a cohort of 74 cancer patients (87.8% with solid neoplasia and 12.2% with hematological diseases) with COVID-19 infection admitted to a tertiary medical cancer center in Argentina. Pulmonary infiltrates were diagnosed at admission in 78.3% (N = 58) of the cases. COVID-19 infection was hospital-acquired in 20 (27.0%) patients. Thirty-nine patients (52.7%) received anticancer therapy within the 30 days prior to COVID-19 diagnosis; one was on radiation therapy. Twenty-four (32.4%) patients were admitted in the intensive care unit (ICU) and 18 (75.0%) required mechanical ventilation. All cause in-hospital mortality was 32.4% (N = 24) and ICU mortality was 62.5% (N = 15). Mortality under me chanical ventilation was 72.2% (N = 13). In the univariate analysis age, neutrophil count, neutrophil/lymphocyte index, D-dimer, ferritin, smoking, and nosocomial acquired infection were associated with in-hospital mortality. There were no statistically significant differences in mortality related to disease stage for solid tumors, neither cancer treatment within 30 days of COVID-19 diagnosis. Age and smoking were associated with mortality in the multivariate analysis. The adjusted odds ratios (95 CI) for age ≥ 65 years and smoking were 8.87 (1.35-58.02) and 8.64 (1.32 - 56.64), respectively. Our experience can be useful for other institutions that assist cancer patients during the pandemic.

Interest in food and triglyceride concentrations in children and adolescents with autistic spectrum disorder

Abstract Objective: To investigate eating behavior and serum concentration of triglycerides in children and adolescents with autistic spectrum disorder. Methods: Cross-sectional study conducted in the neurodevelopment nucleus, from October 2018 to April 2019 in a neurodevelopment center in the city of Pelotas/RS. Blood samples were collected, and serum was essayed for triglycerides by colorimetric enzymatic reaction. The Children's Eating Behavior Questionnaire was applied to the parents. The comparison between two or three categories of variables was performed with nonparametric tests. Linear regression was used to access the association between the log triglyceride serum concentration and the score above or below the median score of the food response and emotional overeating subscales. Results: Sixty patients were evaluated. The average age was 8.6 ± 3.2 years and most were white (75 %), male (80 %), and overweight (66%). Half of the sample had elevated triglycerides. Triglyceride concentrations were higher among overweight children and adolescents with higher median scores on the "food response" and "emotional overeating" subscales. In the adjusted analysis, the association between triglycerides and higher scores on subscales reflecting interest in food remained significant. Conclusion: Children and adolescents with autistic spectrum disorder present high triglyceride concentrations associated with a greater interest in food. Knowledge of this eating behavior may provide more effective nutritional intervention in this population.

Influence of nutritional factors and the PON1 C(-107)T polymorphism on paraoxonase-1 activity in childhood / Influência de fatores nutricionais e do polimorfismo PON1 C(-107)T sobre a atividade da Paraoxonase 1 na infância

Abstract Objective: The cardioprotective enzyme paraoxonase-1 (PON1) suffers an important influence from genetic polymorphisms and nutritional factors. The aim of this study was to investigate the influence of diet, nutritional status, and the C(-107)T polymorphism on PON1 arylesterase activity in children. Methods: This was a cross-sectional study with 97 children, aged between 5 and 8 years, of both genders, from a pediatric outpatient clinic in southern Brazil. A sociodemographic, behavioral, and food consumption questionnaire was applied, and anthropometric measurements and laboratory blood samples were taken. PON1 arylesterase activity was measured by phenol extinction (U/mL), and DNA extraction and analysis of the PON1 C(-107)T polymorphism were performed. The Hardy-Weinberg equilibrium was tested with the chi-squared test and linear regression was used to estimate PON1 activity according to four adjustment models, with an acceptable error of 5%. Results: In the sample, the male gender accounted for 50.5%, 39.2% were 6 years of age, 54.5% had normal weight, and 51.5% had PON1 activity below the median (90.0, 15-30 U/mL). Genotype frequency was 54.6% (53/97), 31.0% (30/97), and 14.4% (14/97), respectively, for CT, CC, and TT, consistent with the Hardy-Weinberg equilibrium (p = 0.22). In the regression analysis, the model that included sociodemographic variables as well as frequency of consumption of fruits, vegetables, legumes, dairy products, and beans estimated a variability of 14.8% in PON1 activity combined with the PON1 C(-107)T polymorphism. Conclusions: During childhood, a good-quality diet with greater inclusion of healthy foods was important to predict the activity of the cardioprotective enzyme PON1 combined with the C(-107)T polymorphism of the PON1 gene.

Resumo Objetivo: A enzima cardioprotetora Paraoxonase 1 (PON1) sofre importante influência de polimorfismos genéticos e fatores nutricionais. O objetivo deste estudo foi investigar a influência da alimentação, do estado nutricional e do polimorfismo C(-107)T sobre a atividade arilesterase da PON1 em crianças. Métodos: Estudo transversal com 97 crianças entre 5 e 8 anos, de ambos os sexos, de um ambulatório de pediatria no sul do Brasil. Realizou-se questionário sociodemográfico, de comportamento e de consumo alimentar, medidas antropométricas e coleta de sangue em laboratório. A atividade arilesterase da PON1 foi mensurada pela extinção de fenol (U/mL), realizada extração do DNA e análise do polimorfismo PON1 C(-107)T. O equilíbrio de Hardy-Weinberg foi testado com qui-quadrado e usada regressão linear para estimar a atividade da PON1 segundo quatro modelos de ajuste, erro aceitável de 5%. Resultados: Na amostra o sexo masculino representou 50,5%, 39,2% tinham 6 anos, 54,5% eram eutróficos e 51,5% tinha atividade da PON1 inferior à mediana (90,0;15-30 U/ml). A frequência dos genótipos foi 54,6% (53/97), 31,0% (30/97) e 14,4% (14/97), respectivamente, para CT, CC e TT, estiveram em equilíbrio de Hardy-Weinberg (p = 0,22). Na análise de regressão o modelo que incluiu variáveis sociodemográficas, de frequência do consumo de frutas, verduras, legumes, laticínios e feijões estimou uma variabilidade de 14,8% na atividade da PON1 combinada ao polimorfismo PON1 C(-107)T. Conclusões: Na infância uma alimentação de boa qualidade, com maior participação de alimentos saudáveis foi importante para predizer a atividade da enzima cardioprotetora PON1 combinada ao polimorfismo C(-107)T do gene da PON1.

Influência da vitamina C na lipoperoxidação hepática e muscular de camundongos C57BL/6 submetidos à dieta de cafeteria / Influence of vitamin C on hepatic and muscular lipoperoxidation of C57BL / 6 mice conducted on the cafeteria diet

Analisar o efeito do tratamento com vitamina C sobre a lipoperoxidação hepática e muscular, assim como sobre parâmetros bioquímicos de camundongos C57BL/6 submetidos à dieta de cafeteria durante nove semanas. Dezessete camundongos da linhagem C57BL/6, com dois meses de idade foram alocados em três grupos: 1) Controle, 2) Cafeteria e 3) Cafeteria + Vitamina C. O ensaio biológico foi conduzido por nove semanas, os animais foram mantidos em jejum de doze horas, e depois de sacrificados, o sangue e os tecidos foram coletados para dosagens bioquímicas. A partir de amostras de fígado e músculo sóleo, foram quantificados os teores de espécies reativas ao ácido tiobarbitúrico (TBARS) e de lipídeos totais. Os fígados dos camundongos alimentados com dieta de cafeteria tratados ou não com vitamina C apresentaram maiores teores de TBARS comparados aos controles (p<0,05). Já o teor de TBARS muscular foi maior nos camundongos do grupo Cafeteria + Vitamina C comparado àquele encontrado para os animais Cafeteria e Controle (p<0,05). As concentrações de colesterol hepático e muscular foram mais elevadas no grupo Cafeteria + Vitamina C comparadas às dos grupos Controle e Cafeteria (p<0,05). O tratamento com vitamina C aumentou a lipoperoxidação muscular, mas não influenciou esse parâmetro no fígado de camundongos C57BL/6 alimentados com dieta de cafeteria. Além disso, a vitamina C elevou a concentração de colesterol nos tecidos hepático e muscular, mas não alterou a glicemia e os lipídeos séricos dos animais após nove semanas de tratamento.(AU)

To analyze the effect of vitamin C treatment on hepatic and muscular lipoperoxidation, as well as on biochemical parameters of C57BL / 6 mice submitted to the cafeteria diet for nine weeks. Seventeen mice of the C57BL / 6 lineage, two months old, were allocated to three groups: 1) Control, 2) Cafeteria and 3) Cafeteria + Vitamin C. The biological assay was conducted for nine weeks, the animals were kept in fasting for 12 hours and after being sacrificed, blood and tissues were collected for biochemical dosages. From the samples of liver and muscle, the contents of thiobarbituric acid reactive species (TBARS) and total lipids were quantified. The livers of mice fed with a diet of coffee or not treated with vitamin C showed higher levels of TBARS compared to controls (p <0.05). The muscle TBARS content was higher in the mice of the Cafeteria + Vitamin C group compared to that found for the Cafeteria and Control animals (p <0.05). The concentrations of hepatic and muscular cholesterol were higher in the Cafeteria + Vitamin C group compared to the Control and Cafeteria groups (p <0.05). Treatment with vitamin C increased muscle lipoperoxidation, but did not influence this parameter in the liver of C57BL 6 mice fed with cafeteria diet. In addition, vitamin C increased cholesterol concentration in liver and muscle tissues, but did not change serum glycemia and serum lipids after nine weeks of treatment.(AU)

Paraoxonase 1 serum activity in women: the effects of menopause, the C(-107)T polymorphism and food intake

ABSTRACT Objective The aims of this study were to investigate changes in serum paraoxonase 1 (PON1) activity in women at the pre and postmenopausal stages and its association with the PON1 C(-107)T polymorphism and food intake profile. Subjects and methods A cross-sectional study with female patients aged between 35 and 59 years old was conducted. Women were divided into two groups: premenopausal (n = 40) and postmenopausal (n = 36). Women enrolled in the study had serum PON1, total cholesterol, HDL, LDL, glucose and HbA1c, as well as the BMI measured. Additionally, women were genotyped for the PON1 T(-107)C polymorphism and the food intake profile was obtained through interview. Results Glucose (p = 0.03), HbA1c (p = 0.002) and total cholesterol (p = 0.002)concentrations were higher in post than premenopausal women, however PON1 activity was not different (p > 0.05). Carriers of the C allele had higher PON1 activity (CC: 88.9 ± 6.5 U/mL and CT: 79.9 ± 4.7 U/mL) than women of the TT genotype (66.6 ± 5.9 U/mL) (p < 0.05). However, the model predicting PON1 activity was slightly better when genotype, total fat and cholesterol content in the diet were all included. Conclusion In sum, we observed that the PON1 C(-107)T genotype was the major regulator of PON1 activity, and menopause had no effect on PON1 activity. The lipid and glycemic profile were altered in postmenopausal women.

Association between paraoxonase 1 (PON1) enzyme activity, PON1 C(−107)T polymorphism, nutritional status, and lipid profile in children

BACKGROUND: Paraoxonase 1 (PON1) is an enzyme that possesses anti-atherogenic and anti-inflammatory properties with serum levels determined by genetic and exogenous factors. Lower serum PON1 arylesterase activity is associated to metabolic alterations related to childhood overweight and onset and/or development of diabetes and CVD later in life. However, data on the relationship between genetic PON1 polymorphisms and nutritional status as well as lipid profile in children are limited. To investigate the distribution of the C(−107)T PON1 gene polymorphism and its relation with serum PON1 enzyme activity, nutritional status and lipid profile in children. METHODS: A cross-sectional study was performed including 73 children aged 5 to 7 years who attended public pediatric clinics. PON1 C(−107)T, arylesterase activity, body mass index for the age, and serum lipid profile were evaluated. RESULTS: PON1 activity was higher in overweight children compared to the normal weight ones (p= 0.02). The genotypic frequency did not differ between the two groups (p> 0.05). Carriers of CC genotype had higher enzyme activity than T allele carriers, and this difference was greater among normal weight children. HDL levels were higher among normal weight children carrying CC genotype, compared to those carrying the T allele (p< 0.01).CONCLUSION: The PON1 C(−107)T polymorphism is associated with higher serum enzyme activity in children, as observed previously in adults. In addition, this polymorphism also shows association to higher high density lipoprotein (HDL) levels and serum PON1 arylesterase activity in the normal weight children studied.

Age at onset of caloric restriction and its effects on the redox profile of the rat hippocampus

BACKGROUND: The benefits of caloric restriction (CR) on the protection against age-related neurodegenerative diseases have been the subject of several studies. However, the effects of CR on the central nervous system are still poorl y understood since most studies were carried out in mature animals. The present study aimed to investigate whether the age at onset of CR could differently affect the redox status of the rat hippocampus. METHODS: Thirty-two male Wistar rats at 35 days old (35d;n= 16) and 65 days old (65d;n= 16) were fed ad libitum or subjected to 30 % CR (n= 8 group/age) for 12 weeks. At the end of the experiment, the rats were euthanized, blood was collected, and the hippocampus was dissected for measuring the redox status. RESULTS: CR in 35d and 65d rats induced a 16 and 21% reduction in body weight gain, respectively, compared to controls (p< 0.05). Urea, total cholesterol, triacylglycerol, HDL cholesterol, and LDL cholesterol concentrations were lower in CR 35d rats than in 35d controls (p< 0.05). No differences were detected between the CR groups and controls in the object recognition test (p> 0.05) and in superoxide dismutase activity, nitric oxide content, and lipid peroxidation levels(p> 0.05). However, glutathione peroxidase activity was higher (p< 0.0001) in 65d rats compared to that in 35d rats, and GSH content was higher (p< 0.05) in CR-fed rats compared to that in controls at both ages. CONCLUSIONS: In conclusion, CR increased GSH content when started at both ages but did not affect the activity of antioxidant enzymes and the level of ROS in the hippocampus. In addition, CR did not induce any detrimental effects on memory and nutritional status when started in both 35d and 65d rats

Insulin binding characteristics in canine muscle tissue: effects of the estrous cycle phases / Características de ligação da insulina no tecido muscular canino: efeitos da fase do ciclo estral

Hormonal fluctuations during the different estrous cycle are a well-recognized cause of insulin resistance in bitches, and little is known about insulin receptor binding or post-binding defects associated with insulin resistance in dogs. To evaluate insulin binding characteristics in muscle tissue of bitches during the estrous cycle, 17 owned bitches were used in the study (six in anestrus, five in estrus, and six in diestrus). An intravenous glucose tolerance test (IVGTT) was performed in all patients by means of injection of 1mL/kg of a glucose 50% solution (500mg/kg), with blood sample collection for glucose determination at 0, 3, 5, 7, 15, 30, 45 and 60 minutes after glucose infusion. Muscle samples, taken after spaying surgery, were immediately frozen in liquid nitrogen and then stored at -80 ºC until the membranes were prepared by sequential centrifugation after being homogenized. For binding studies, membranes were incubated in the presence of 20,000cpm of human 125I-insulin and in increasing concentrations of unlabeled human regular insulin for cold saturation. The IVGTT showed no differences among bitches during the estrous cycle regarding baseline glycemia or glycemic response after glucose infusion. Two insulin binding sites - high-affinity and low-affinity ones - were detected by Scatchard analysis, and significant statistical differences were observed in the dissociation constant (Kd1) and maximum binding capacity (Bmax1) of the high-affinity binding sites. The Kd1 for the anestrus group (6.54±2.77nM/mg of protein) was smaller (P<0.001) than for the estrus (28.54±6.94nM/mg of protein) and diestrus (15.56±3.88nM/mg of protein) groups. Bmax1 in the estrus (0.83±0.42nM/mg of protein) and diestrus (1.24±0.24nM/mg of protein) groups were also higher (P<0.001) than the values observed in anestrus (0.35±0.06nM/mg of protein). These results indicate modulation of insulin binding characteristics during different phases of the estrous cycle in dogs, showing that muscle insulin binding affinity for its receptor is reduced during estrus and diestrus. However, this poor hormone-receptor affinity is compensated for by a greater total binding capacity, once there is no difference in patients' glycemic response after an intravenous glucose load.(AU)

As flutuações hormonais durante as diferentes fases do ciclo estral são uma causa importante de resistência insulínica em fêmeas caninas, e poucas informações são conhecidas sobre defeitos na ligação da insulina ao seu receptor, ou defeitos pós-receptor associados com resistência à insulina em cães. Para avaliar as características da ligação insulina-receptor no tecido muscular de cadelas durante o ciclo estral, dezessete pacientes foram utilizadas no estudo (seis em anestro, cinco em estro e seis em diestro). Um teste de tolerância à glicose intravenosa (IVGTT) foi realizado em todas as pacientes por meio da infusão de 1mL/kg de uma solução de glicose 50% (500mg/kg), com coletas de sangue para determinação de glicemia nos tempos 0, 3, 5, 7, 15, 30, 45 e 60 minutos da injeção de glicose. Amostras de tecido muscular foram coletadas durante ovariohisterectomia, imediatamente congeladas em nitrogênio líquido, e posteriormente armazenadas a -80°C até a preparação das membranas por meio de homogeneização e centrifugação sequencial. Para os experimentos de ligação hormônio-receptor, as membranas foram incubadas na presença de 20.000cpm de 125I-insulina humana, e concentrações crescentes de insulina regular humana não marcada para saturação fria. O IVGTT não mostrou diferenças entre as pacientes em diferentes fases do ciclo estral com relação a glicemia basal, ou na resposta glicêmica após infusão de glicose nos tempos estudados. Dois sítios de ligação da insulina, um de alta-afinidade, e outro de baixa afinidade, foram detectados pela análise de Scatchard, e diferenças significativas foram detectadas na constante de dissociação (Kd1) e capacidade de ligação máxima (Bmax1) dos sítios de ligação de alta-afinidade. O Kd1 para o grupo anestro (6,54±2,77nM/mg de proteína) foi menor (P<0,001) que os Kd1 dos grupos estro (28,54±6,94 nM/mg de proteína) e diestro (15,56±3,88nM/mg de proteína). Os Bmax1 dos grupos estro (0,83±0,42nM/mg de proteína) e diestro (1,24±0,24nM/mg de proteína) também foram maiores que os valores encontrados no grupo anestro (0,35±0,06nM/mg de proteína). Estes resultados demonstram uma modulação das características de ligação da insulina nas diferentes fases do ciclo estral em cães, evidenciando uma menor afinidade de ligação da insulina ao seu receptor no tecido muscular durante o estro e diestro. Contudo, esta menor afinidade de ligação hormônio-receptor é compensada por uma maior capacidade de ligação, o que fica também evidenciado pela ausência de diferenças na resposta glicêmica das pacientes após um desafio com glicose por via endovenosa.(AU)

Liquen plano siguiendo las líneas de Blaschko / Lichen planus following Blaschko`s lines

Se presenta el caso de una paciente de sexo femenino, de 49 años de edad, con una dermatosis de dos meses de evolución que sigue las líneas de Blaschko. Se realiza biopsia de piel con diagnóstico de liquen plano, presentando buena respuesta la tratamiento con corticoides tópicos.