Decreased muscle strength is associated with proinflammatory cytokines but not testosterone levels in men with diabetes

The aim of this study was to compare muscle strength in male subjects with type 2 diabetes mellitus (DM2) with and without low plasma testosterone levels and assess the relationship between muscle strength, testosterone levels, and proinflammatory cytokines. Males (75) aged between 18 and 65 years were divided into 3 groups: control group that did not have diabetes and had a normal testosterone plasma level (>250 ng/dL), DnormalTT group that had DM2 with normal testosterone levels, and the DlowTT group that had DM2 and low plasma testosterone levels (<250 ng/dL). The age (means±SD) of the groups was 48.4±10, 52.6±7, and 54.6±7 years, respectively. Isokinetic concentric and isometric torque of knee flexors and extensors were analyzed by an isokinetic dynamometer. Plasma testosterone and proinflammatory cytokine levels were determined by chemiluminescence and ELISA, respectively. Glycemic control was analyzed by glycated hemoglobin (HbA1C). In general, concentric and isometric torques were lower and tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β plasma levels were higher in the groups with diabetes than in controls. There was no correlation between testosterone level and knee torques or proinflammatory cytokines. Concentric and isometric knee flexion and extension torque were negatively correlated with TNF-α, IL-6, and HbA1C. IL-6 and TNF-α were positively correlated with HbA1C. The results of this study demonstrated that muscle strength was not associated with testosterone levels in men with DM2. Low muscle strength was associated with inflammatory markers and poor glycemic control.

Recorrência da infecçäo por H pylori em portadores de úlcera péptica submetidos à erradicaçäo da bactéria / Recurrence of H pilori infection in patients peptic ulcer disease submited to eradication treatment

A maioria dos autores executa controle de erradicaçäo após um mês do término do tratamento, todavia, avolumam relatos de taxas crescentes de recorrência da infecçäo pelo Hp na mewdida em que aumenta o período de avaliaçäo pós-tratamento. Foi avaliada a evoluçäo quanto à infecçäo pelo Hp em adultos portadores de úlcera peptica (UP) que presentaram pesquisa negativa após 3 meses do trataemtno de erradicaçäo. O diagnóstico de UP baseou-se na endoscopia digestiva alta e histologia, no caso de lesäo gástrica. A pesquisa do Hp foi realizada em duas biópsias endoscópicas de antro gástrico, através do teste da urease ou da análise histológica. No periódo de março/93 a setembro/97, 57 dos 92 pacientes que receberam integralmente o tratamento de erradicaçäo retornaram para controle após 3 meses do término do tratamento, sendo que 21 permaneceram infectados pelo Hp. Os 36 pacientes Hp negativo foram avaliados trimestralmente durante 15 meses, para determinaçäo de infecçäo pelo Hp. Dos 36 pacientes avaliados, 11 mantiveram-se Hp negativo, 11 sofreram positivaçäo e 14 pacientes näo completaram o acompanhamento. O indice de recorrência da infecçäo aos 6, 9, 12 e 15 meses do término do tratamento foi de 3,3 por cento, 4,5 por cento, 15,8 por cento e 50 por cento respectivamente. A baixa taxa de erradicaçäo provavalmente implicou a elevada recorrência, sendo imperativo que os tratamentos em nosso meio atinjam melhores níveis de eficácia