Prevalencia de malnutrición y factores asociados en adultos mayores del cantón Gualaceo, Ecuador / Prevalence of malnutrition and associated factors among the elderly of Gualaceo, Ecuador

RESUMEN La malnutrición y los factores que la determinan preocupan a nivel mundial; pues muchos de ellos podrían modificarse e impactar en favor de un envejecimiento saludable. El objetivo fue determinar la prevalencia de malnutrición y factores asociados en adultos mayores del cantón Gualaceo, Ecuador, mediante un estudio transversal en 250 adultos mayores, con muestreo probabilístico, estratificado y aleatorizado. Se evaluó el estado nutricional con Mini Nutritional Assessment y factores asociados como: depresión con la Escala abreviada de Depresión Geriátrica de Yesavage, actividad física con el Cuestionario Internacional de Actividad Física, el nivel socioeconómico con la Encuesta de Estratificación del Nivel Socioeconómico del Instituto Nacional de Estadísticas y Censos, y parámetros de laboratorio. Se realizó estadística descriptiva y la asociación con razón de prevalencia y su intervalo de confianza al 95% y análisis multivariado. La prevalencia de malnutrición fue 20.4 %, el riesgo de malnutrición 47.2% y estado nutricional satisfactorio de 32.4%. La media de edad fue 76,3 (±8.2) años. Se evidenció que la quinta parte de la muestra tomada de adultos mayores del cantón Gualaceo tenía malnutrición y se asoció con: depresión, sedentarismo, bajo nivel socioeconómico y anemia, ratificando a la malnutrición como un problema de salud pública.

ABSTRACT Malnutrition and its underlying factors are a worldwide concern; as many of them can be modified, which in turn would positively impact healthy aging. The objective of this study was to determine the prevalence of malnutrition and associated factors among the elderly of Gualaceo, Ecuador, using a cross-sectional design with 250 elderly participants. Sampling was probabilistic, stratified and randomized in Gualaceo, Ecuador. Nutritional status was assessed using the Mini Nutritional Assessment; depression with the Yesavage Geriatric Depression Scale; physical activity with the International Physical Activity Questionnaire, socioeconomic level with the Survey Of Stratification of the Socioeconomic Level of the National Institute of Statistics and Censuses, and laboratory parameters. Descriptive statistics, prevalence ratios with 95% confidence intervals were calculated and multivariate analysis was conducted. The prevalence of malnutrition was 20.4%, the risk of malnutrition 47.2%, and 32.4% had a satisfactory nutritional status. The mean age was 76.3 (±8.2) years. One fifth of the sample of elderly residents of the Gualaceo town had malnutrition and is associated with depression, sedentary lifestyle, low socioeconomic status and anemia, ratifying malnutrition as a public health problem.

Efecto de la ingesta aguda de vanillina sobre la resistencia insulínica en humanos / Effect of a single oral dose of vanillin on insulin resistance in humans

Background: NADPH oxidase is a source of reactive oxygen species that may contribute to insulin resistance (IR). Aim: To assess the effect of a single oral dose of vanillin (a putative inhibitor of the enzyme) on IR in humans. Material and Methods: Using a crossover, random, double-blind design, eight lean and 10 obese males ingested 600 mg of vanillin or placebo followed by the ingestion of 75g of glucose. Serum/plasma glucose, free-fatty acids, insulin, glutathione, C reactive protein concentrations and red blood cell glutathione concentration were determined. Insulin resistance was estimated by the Matsuda index. Results: Under fasting conditions, obese individuals had higher glucose and insulin and lower red blood cell glutathione levels than their lean counterparts (p < 0.01). Serum free-fatty acids, total and oxidized plasma glutathione concentrations were similar in both groups. After glucose ingestion, obese individuals had a lower red blood cell total glutathione concentration and increased plasma oxidized glutathione concentration than their lean counterparts (p < 0.05). In addition, obese participants had a higher level of IR (p < 0.001) and impaired serum free-fatty acid suppression (p < 0.001) than their lean counterparts. Ingestion of vanillin did not modify any of these variables when compared with placebo in obese individuals. In lean volunteers a reduction in Matsuda index was detected when vanillin was administered, compared to placebo (4.3 +/- 0.6 and 3.6 +/- 0.6 respectively; p < 0.05). Conclusions: IR was ameliorated after vanillin ingestion among lean but not obese participants.

Aislamiento de Escherichia coli productor de toxina Shiga durante un brote de gastroenteritis en un Jardín Maternal de la Ciudad de Mar del Plata / Isolation of Shiga toxin-producing Escherichia coli strains during a gastrointestinal outbreak at a day care center in Mar del Plata City

Entre el 15 de octubre y el 8 de noviembre de 2003 ocurrió un brote de gastroenteritis en un Jardín Maternal de un Hospital de la ciudad de Mar del Plata. Catorce de un total de 80 niños (17,5%), edad promedio 23,6 ± 13,9 meses, presentaron diarrea, y un caso evolucionó a síndrome urémico hemolítico. La madre de uno de los afectados presentó diarrea simultáneamente. No se pudo establecer el origen del brote, pero probablemente la transmisión haya sido fundamentalmente persona a persona. Las prácticas habituales en el lactario del jardín maternal, y las condiciones inadecuadas de infraestructura y hábitos de higiene de la cocina del Hospital fueron señalados como factores de riesgo. En un caso se detectó Escherichia coli productor de toxina Shiga (STEC) O103:H2, y STEC O26:H11 en otro. En el niño infectado por STEC O26:H11, la excreción se extendió por un período de 37 días. La no detección de STEC en aquellos casos en los cuales el intervalo entre el inicio de los síntomas y la toma de muestra fue mayor a 6 días, enfatiza la necesidad de la recolección temprana de especímenes. Las principales conclusiones de este estudio fueron la necesidad de establecer normas óptimas de higiene, informar rápidamente la ocurrencia de casos de gastroenteritis y confirmar la negativización de la excreción del patógeno.

From October 15 to November 8, 2003, a gastrointestinal outbreak occurred at a day care center in a Hospital in Mar del Plata City. Fourteen out of 80 (17.5%) children, mean age 23.6 ± 13.9 months, and the mother of one of them had diarrhea. One case developed hemolytic uremic syndrome. No conclusive evidence of the origin of the outbreak was found, but the epidemic curve suggested person-to-person spread. The usual practices at the place where infant milk formula was prepared at the day care center, together with the inadequate infrastructure conditions and hygiene practices at the kitchen of the hospital, were considered risk factors. One case had Shiga toxin-producing Escherichia coli (STEC) O103:H2 infection and other STEC O26:H11.The duration of shedding for the child with O26:H11 infection was 37 days. In the other symptomatic children, the pathogen was not recovered from fecal samples collected 6 or more days after the onset of the illness. This emphasizes that the collection of early samples is necessary to recover STEC strains. In order to prevent and control enteric diseases in day care facilities the following measures are necessary: optimal hygiene standards, early case reporting, and exclusion of those who remain culture-positive.

Effects of 2-methoxy 6-Chloro-9-Acridine in lepromatous leprosy

From this study, the effects of the three combinations: namely 2-methoxy-6-chloro-9-acridine alone and 2-methoxy-6-choloro-9-acridine and DDS and DDS alone on the advanced cases of lepromatous type of leprosy confined at the Central Luzon Sanitarium- have been carefully evaluated. Our results have shown that 2-methoxy-6-choloro-9-acridine is more effective and very promising in the treatment of leprosy when given parenterally than by mouth. The explanation is that the parenteral 2-mthoxy-6-chloro-9-acridine can act as one molecule in the inhibition of the utilization of glycerol by the Mycobacterium leprae in contrast to the enteral 2-methoxy-6-chloro-9-acridine, which splits into the alkylamino radical and the acridine nucleus. On the other hand, this anti-metabolic action of 2-methoxy-6-chloro-9-acridine potentiated that of DDS when both are administered simultaneously. This is shown in the rapid regression of clinical signs and symptoms associated with the nagative bacteriological findings up to the time of this writing. Also, the lepra reactions have been controlled by prolonged treatment with parenteral 2-methoxy-6-chloro-9-acridineHowever, it is the strong opinion and recommendation of the researchers that though this is a controlled experiment, further study should be done for at most a period of five years in the different leper colony in the world. (Summary)

Insulin receptor has tyrosine kinase activity toward Shc in rat liver

Insulin induces tyrosine phosphorylation of Shc in cell cultures and in insulin-sensitive tissues of the intact rat. However, the ability of insulin receptor (IR) tyrosine kinase to phosphorylate Shc has not been previously demonstrated. In the present study, we investigated insulin-induced IR tyrosine kinase activity towards Shc. Insulin receptor was immunoprecipitated from liver extracts, before and after a very low dose of insulin into the portal vein, and incubated with immunopurified Shc from liver of untreated rats. The kinase assay was performed in vitro in the presence of exogenous ATP and the phosphorylation level was quantified by immunoblotting with antiphosphotyrosine antibody. The results demonstrate that Shc interacted with insulin receptor after infusion of insulin, and, more important, there was insulin receptor kinase activity towards immunopurified Shc. The description of this pathway in animal tissue may have an important role in insulin receptor tyrosine kinase activity toward mitogenic transduction pathways.