Concurrent uper limb and hip fracture in the elderly: experience at our centre. / Fracturas concomitantes de miembro superior y cadera en pacientes mayores de 65 años: experiencia en nuestro centro.

INTRODUCTION: The incidence of hip fracture in the elderly is on the rise, occasionally accompanied by concurrent upper limb fractures. Our investigation aims to determine whether these patients experience poorer functional outcomes, prolonged hospitalization, or higher mortality rates when compared to those with isolated hip fracture. MATERIAL AND METHODS: We retrospectively reviewed 1,088 elderly patients admitted to our centre with hip fracture between January 2017 and March 2020. We recorded the presence of concomitant fractures and their treatment. We analyzed the duration of hospital stay, in-hospital mortality and function. RESULTS: We identified 63 patients with concomitant upper limb fracture (5.6%). Among them, 93.7% were women, and the average age was 86.4 years. 80.9% of the upper limb fractures were distal radius or proximal humerus. Patients with concomitant fracture had increased length of stay (mean, 19.6 vs, 12.8, p=0.002), decreased proportion of patients returning to their own home at discharge (23.6% vs, 26.3%, p=0.042) and increased in-hospital mortality rate (9.5% vs, 5.9%, p=0.003). CONCLUSIONS: Patients with concomitant upper limb fracture require a longer length of stay and exhibit an elevated in-hospital mortality rate. Furthermore, this condition is associated with a reduced short-term functional recovery, thereby decreasing the chances of the patient returning home upon hospital discharge.

Intubación orotraqueal a través de mascarilla laríngea Ambu(R) Auragain(TM) en paciente pediátrico con lipomatosis infiltrante congénita / Endotracheal intubation through laryngeal Ambu(R) Auragain(TM) mask airway mask in paediatric patients affected by congenital infiltrating lipomatosis

Las malformaciones congénitas que afectan a la vía aérea pueden generar problemas para realizar una ventilación efectiva, intubación o incluso ambas, con el consiguiente aumento del riesgo de hipoxemia. Es esencial para el anestesiólogo pediátrico el conocimiento exacto de la anatomía de la vía aérea del paciente, así como una planificación preoperatoria cuidadosa. Cada vez son más los dispositivos diseñados para el control de la vía aérea en el paciente pediátrico. Este caso clínico describe el uso de la mascarilla laríngea de tercera generación (Ambu(R) Auragain(TM)) para la intubación orotraqueal de un paciente pediátrico con vía aérea difícil prevista secundaria a lipomatosis infiltrante congénita en la región facial

Congenital defects that affect paediatric airway could lead to several difficulties for effective ventilation, intubation, or even both, increasing the risk of hypoxaemia. It is essential for the paediatric anaesthesiologist to have accurate knowledge of the anatomy of patient́s airway, as well as judicious preoperative planning. Increasingly, more devices have been designed for the control of difficult airway in the paediatric patient. This case report describes the application of a third-generation laryngeal mask (- Ambu(R) Auragain (TM)) for endotracheal intubation of a child with anticipated difficult airway, secondary to congenital diffuse infiltrating facial lipomatosis

Endotracheal intubation through laryngeal Ambu® Auragain™ mask airway mask in paediatric patients affected by congenital infiltrating lipomatosis. / Intubación orotraqueal a través de mascarilla laríngea Ambu® Auragain™ en paciente pediátrico con lipomatosis infiltrante congénita.

Congenital defects that affect paediatric airway could lead to several difficulties for effective ventilation, intubation, or even both, increasing the risk of hypoxaemia. It is essential for the paediatric anaesthesiologist to have accurate knowledge of the anatomy of patient́s airway, as well as judicious preoperative planning. Increasingly, more devices have been designed for the control of difficult airway in the paediatric patient. This case report describes the application of a third-generation laryngeal mask (- Ambu® Auragain ™) for endotracheal intubation of a child with anticipated difficult airway, secondary to congenital diffuse infiltrating facial lipomatosis.

Beetle (Ulomoides dermestoides) fat improves diabetes: effect on liver and pancreatic architecture and on PPARγ expression.

Ulomoides dermestoides is a beetle traditionally consumed to treat diabetes. In this study, we performed a composition analysis of U. dermestoides to obtain the principal fractions, which were used to assess the effect on glycemia, liver and pancreatic architecture, and PPARγ and GLUT4 expression. Normal mice and alloxan-induced diabetic mice were administered fractions of chitin, protein or fat, and the acute hypoglycemic effect was evaluated. A subacute study involving daily administration of these fractions to diabetic mice was also performed over 30 days, after which the liver and pancreas were processed by conventional histological techniques and stained with hematoxylin and eosin to evaluate morphological changes. The most active fraction, the fat fraction, was analyzed by gas chromatography-mass spectrometry (GC-MS), and PPARγ and GLUT4 mRNA expressions were determined in 3T3-L1 adipocytes. The protein and fat fractions exhibited hypoglycemic effects in the acute as well as in the 30-day study. Only the fat fraction led to elevated insulin levels and reduced glycemia, as well as lower intake of water and food. In the liver, we observed recovery of close hepatic cords in the central lobule vein following treatment with the fat fraction, while in the pancreas there was an increased density and percentage of islets and number of cells per islet, suggesting cellular regeneration. The GC-MS analysis of fat revealed three fatty acids as the major components. Finally, increased expression of PPARγ and GLUT4 was observed in 3T3-L1 adipocytes, indicating an antidiabetic effect.

Effect of ultrasound pre-treatment on the physicochemical composition of Agave durangensis leaves and potential enzyme production.

Approximately 1 million tons of agave plants are processed annually by the Mexican tequila and mezcal industry, generating vast amounts of agroindustrial solid waste. This type of lignocellulosic biomass is considered to be agroindustrial residue, which can be used to produce enzymes, giving it added value. However, the structure of lignocellulosic biomass makes it highly recalcitrant, and results in relatively low yield when used in its native form. The aim of this study was to investigate an effective pre-treatment method for the production of commercially important hydrolytic enzymes. In this work, the physical and chemical modification of Agave durangensis leaves was analysed using ultrasound and high temperature as pre-treatments, and production of enzymes was evaluated. The pre-treatments resulted in modification of the lignocellulosic structure and composition; the ultrasound pre-treatment improved the production of inulinase by 4 U/mg and cellulase by 0.297 U/mg, and thermal pre-treatment improved ß-fructofuranosidase by 30 U/mg.

Economic burden of primary compared with recurrent Clostridium difficile infection in hospitalized patients: a prospective cohort study.

BACKGROUND: Few studies have investigated the additional healthcare costs of recurrent C. difficile infection (CDI). AIM: To quantify inpatient treatment costs for CDI and length of stay among hospitalized patients with primary CDI only, compared with CDI patients who experienced recurrent CDI. METHODS: This was a prospective, observational cohort study of hospitalized adult patients with primary CDI followed for three months to assess for recurrent CDI episodes. Total and CDI-attributable hospital length of stay (LOS) and hospitalization costs were compared among patients who did or did not experience at least one recurrent CDI episode. FINDINGS: In all, 540 hospitalized patients aged 62±17 years (42% males) with primary CDI were enrolled, of whom 95 patients (18%) experienced 101 recurrent CDI episodes. CDI-attributable median (interquartile range) LOS and costs (in US$) increased from 7 (4-13) days and $13,168 (7,525-24,456) for patients with primary CDI only versus 15 (8-25) days and $28,218 (15,050-47,030) for patients with recurrent CDI (P<0.0001, each). Total hospital median LOS and costs increased from 11 (6-22) days and $20,693 (11,287-41,386) for patients with primary CDI only versus 24 (11-48) days and $45,148 (20,693-82,772) for patients with recurrent CDI (P<0.0001, each). The median cost of pharmacological treatment while hospitalized was $60 (23-200) for patients with primary CDI only (N=445) and $140 (30-260) for patients with recurrent CDI (P=0.0013). CONCLUSION: This study demonstrated that patients with CDI experience a significant healthcare economic burden attributed to CDI. Economic costs and healthcare burden increased significantly for patients with recurrent CDI.

Perfil de las funciones ejecutivas de niños con TDAH en comparación con población general / Profile of executive functions of children with ADHD compared to general population

INTRODUCCIÓN: Las alteraciones en las funciones ejecutivas se han relacionado con diversos cuadros psicopatológicos y de manera especial con la sintomatología nuclear del trastorno por déficit de atención con hiperactividad. OBJETIVOS: Analizar las diferencias en el perfil de las funciones ejecutivas en niños con trastorno por déficit de atención con hiperactividad y niños con neurodesarrollo típico y de manera secundaria en aquellos niños de ambos grupos que muestren un funcionamiento académico deficiente. Material y metodología. Estudio prospectivo en niños de 6-14 años con trastorno por déficit de atención con hiperactividad procedentes de dos centros de salud mental infanto-juvenil y niños control de un servicio de pediatría habiendo descartado psicopatología a través del Cuestionario de Capacidades y Dificultades (SDQ). El perfil de las funciones ejecutivas se registró a través del Cuestionario BRIEF para padres. RESULTADOS: Se reclutaron 94 sujetos, 25 niños en el grupo con trastorno por déficit de atención con hiperactividad (72% hombres) y 69 en el grupo control (51% hombres). Todas las puntuaciones registradas en el cuestionario respecto a las funciones ejecutivas mostraron diferencias significativas entre ambos grupos (p = 0,001). Niños con deficiente funcionamiento académico, en el grupo trastorno por déficit de atención con hiperactividad un 72%, y grupo control 7,25% (p = 0,001). AAquí hubo diferencias significativas en todas las funciones ejecutivas a excepción de la de Control emocional, iniciativa, orden y supervisión. CONCLUSIÓN: Los niños con trastorno por déficit de atención con hiperactividad muestran una evidente disfunción en las funciones ejecutivas en comparación con población de niños con neurodesarrollo típico, independientemente de si tienen un deficiente funcionamiento académico o no

INTRODUCTION: Impairment of executive functions has been associated with different psychopathological disorders, especially with Attention Deficit Hyperactivity Disorder. OBJECTIVES: Principal: to analyze the differences in the profile of executive functions in children with Attention Deficit Hyperactivity Disorder and children with typical neurodevelopment, and secondarily those children in both groups showing poor academic performance. Material and methodology. Prospective study of children aged 6-14 years with Attention Deficit Hyperactivity Disorder attended in two clinics of child and adolescent mental health, and healthy children of same ages attended in a pediatric office, out-ruling psychiatric pathology with Capabilities and Difficulties Questionnaire SDQ. Primary endpoint: executive functions evaluated by questionnaire BRIEF for parents. RESULTS: 94 subjects were recruited, 25 children in Attention Deficit Hyperactivity Disorder group (72% men), and 69 in control group (51% men). All executive functions showed significant differences between both groups (p = 0.001). Children with poor academic performance, in Attention Deficit Hyperactivity Disorder group 72%, and controls 7.28% (p = 0.001). In this case, all executive functions showed significant differences except Emotional Control, initiate, organization of materials and monitor. CONCLUSION: Children with Attention Deficit Hyperactivity Disorder have obvious dysfunction in executive functions compared to typically developing children, regardless if they had poor academic performance or not. Children without Attention Deficit Hyperactivity Disorder but with poor academic performance have similar difficulties in controlling their emotions as a child with Attention Deficit Hyperactivity Disorder

Postnatal neurogenesis in the cow pineal gland: an immunohistochemical study.

In the pineal gland of cows and rats structures designated rosettes have been described both during embryonic development and in adult animals. In order to investigate the possible nature of the cells comprising such structures, in the present work we studied the pineal glands from 10 cows of one- or four-years-old using conventional immunocytochemical and confocal microscopy techniques. As markers of glial cells, we used anti-vimentin (Vim) and glial fibrillary acidic protein (GFAP) and anti-S-100 sera, and the pinealocytes were labelled with ß-III tubulin. As a marker of stem cells, we used an antinestin serum, while an anti-PCNA serum was employed to label proliferating cells. To explore the neuronal nature of some cells of the rosettes, we used an anti-SRIF serum. The rosettes were seen to be present throughout the glandular parenchyma and displayed a central cavity surrounded by cells, most of which expressed all or just some of the above glial labels and nestin, although there were also some rosettes with cells that expressed ß-III tubulin and other cells that expressed SRIF. Likewise, in the cells of the rosettes the cell nucleus showed strong expression of PCNA. Confocal microscopy revealed that the walls of the rosettes contained cells that coexpressed Vim/S-100, Vim/GFAP and Vim/nestin. The number of rosettes was significantly greater in the animals of one year of age with respect to the four-year-old cows. The present findings allow us to suggest that rosettes are evolving structures and that most of the cells present in their walls should be considered stem cells, and hence responsible for the postnatal neurogenesis occurring in the pineal gland of cows.

Optimization of tannase production by Aspergillus niger in solid-state packed-bed bioreactor.

Tannin acyl hydrolase, also known as tannase, is an enzyme with important applications in the food, feed, pharmaceutical, and chemical industries. However, despite a growing interest in the catalytic properties of tannase, its practical use is very limited owing to high production costs. Several studies have already demonstrated the advantages of solid-state fermentation (SSF) for the production of fungal tannase, yet the optimal conditions for enzyme production strongly depend on the microbial strain utilized. Therefore, the aim of this study was to improve the tannase production by a locally isolated A. niger strain in an SSF system. The SSF was carried out in packed-bed bioreactors using polyurethane foam as an inert support impregnated with defined culture media. The process parameters influencing the enzyme production were identified using a Plackett­Burman design, where the substrate concentration, initial pH, and incubation temperature were determined as the most significant. These parameters were then further optimized using a Box-Behnken design. The maximum tannase production was obtained with a high tannic acid concentration (50 g/l), relatively low incubation temperature (30°C), and unique low initial pH (4.0). The statistical strategy aided in increasing the enzyme activity nearly 1.97-fold, from 4,030 to 7,955 U/l. Consequently, these findings can lead to the development of a fermentation system that is able to produce large amounts of tannase in economical, compact, and scalable reactors.

Optimization of nisin production by Lactococcus lactis UQ2 using supplemented whey as alternative culture medium.

Lactococcus lactis UQ2 is a nisin A-producing native strain. In the present study, the production of nisin by L. lactis UQ2 in a bioreactor using supplemented sweet whey (SW) was optimized by a statistical design of experiments and response surface methodology (RSM). In a 1st approach, a fractional factorial design (FFD) of the order 2(5-1) with 3 central points was used. The effect on nisin production of air flow, SW, soybean peptone (SP), MgSO(4)/MnSO(4) mixture, and Tween 80 was evaluated. From FFD, the most significant factors affecting nisin production were SP (P = 0.011), and SW (P = 0.037). To find optimum conditions, a central composite design (CCD) with 2 central points was used. Three factors were considered, SW (7 to 10 g/L), SP (7 to10 g/L), and small amounts of added nisin as self-inducer (NI 34.4 to 74.4 IU/L). Nisin production was expressed as international units (IU). From RSM, an optimum nisin activity of 180 IU/mL was predicted at 74.4 IU/L NI, 13.8 g/L SP, and 14.9 or 5.11 g/L SW, while confirmatory experiments showed a maximum activity of 178 +/- 5.2 IU/mL, verifying the validity of the model. The 2nd-order model showed a coefficient of determination (R(2)) of 0.828. Optimized conditions were used for constant pH fermentations, where a maximum activity of 575 +/- 17 IU/mL was achieved at pH 6.5 after 12 h. The adsorption-desorption technique was used to partially purify nisin, followed by drying. The resulting powder showed an activity of 102150 IU/g. Practical Application: Nisin production was optimized using supplemented whey as alternative culture medium, using a native L. lactis UQ2 strain. Soybean peptone, SW, and subinhibitory amounts of nisin were successfully employed to optimize nisin production by L. lactis UQ2. Dried semipurified nisin showed an activity of 102150 IU/g.

Pineal gliosis and gland ageing. The possible role of the glia in the transfer of melatonin from pinealocytes to the blood and cerebrospinal fluid

Using immunohistochemical approaches appliedto 6 ìm-thick sections from the pineal glands ofcows with ages between 1 and 7 years, we studiedthe expression of GFAP, vimentin and S-100and of â-tubulin. The latter compound appearedin both pinealocytes and in some nerve fibres. Inboth younger and older cows, vimentin wasexpressed in the somata of cells localised inperipheral zones of the glands and in fibres witha bead-like aspect that coursed deep into the centresof the glands, as well as in pericapillary cells,apparently in the endothelia of vessels and, likeGFAP and S-100, in a thick network of prolongationslocated between the basal side of theepithelial cells of the pineal recess and pinealocytes,sometimes reaching the ependymal lumen.The network of glial prolongations formed aspace with a reticulated aspect interposedbetween the pinealocytes and the ependymalepithelium. The thickness of this network wasespecially striking in the older cows. The expressionof GFAP and S-100 was also observed in thesomata and the cytoplasmic prolongations of cellsdistributed throughout the gland that surroundedthe pinealocytes. In cows with ages of 4 and 7years the pineal gland showed a pronounceddegree of gliosis that isolated the pinealocytesfrom one another and from the vascular bed.Additionally, all three glial markers wereexpressed in cells whose somata and cytoplasmicprolongations configured spaces with a trabecularaspect, very poor in connective tissue, whichcoursed throughout the glands to reach the reticulatedspace, in especially thin neighbouringzones of the epithelium of the pineal recess. Theresults suggest a decisive role of the pineal glia ingland ageing, in the secretion of melatonin, andin the configuration of the vascular and ependymalpathways that the hormone must follow frompinealocytes to its target organs (AU)

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[Perioperative care in subthalamic stimulation surgery]. / Cuidados perioperatorios en la cirugía de estimulación subtalámica.

INTRODUCTION: Bilateral stimulation of the subthalamic nucleus (STN) seems to be one of the most effective treatments for advanced forms of Parkinson's disease. Success of the postoperative clinical outcome depends on the quality of the inclusion of patients and the optimal targeting and stimulation of the cerebral nucleus.

CASE REPORT: We describe the case of a 68 years old male with intracerebral hemorrhage, cognitive deterioration and generalized convulsions in the early postoperative period of a bilateral deep brain stimulation (DBS) of STN. CONCLUSIONS: Although this kind of surgery is included in the concept of "minimal invasive" surgery, there are risks and side effects, some of them very serious, as in the case report we present. Perioperative management is complex because of the nature of the surgery and the type of patient, so that some of the aspects are still under debate for both the anesthesiologist and the rest of specialists involved.

Cuidados perioperatorios en la cirugía de estimulación subtalámica / Perioperative care in subthalamic stimulation surgery

Introducción. La estimulación subtalámica bilateral parece ser uno de los tratamientos más eficaces en los casos de enfermedad de Parkinson avanzada. El éxito de la evolución clínica postoperatoria depende de la selección de los pacientes y de que todo el proceso de localización y estimulación de los núcleos cerebrales se lleve a cabo de la forma más precisa posible. Caso clínico. Presentamos el caso de un paciente de 68 años que sufre una hemorragia cerebral con deterioro cognitivo y convulsiones generalizadas en el postoperatorio inmediato de una cirugía de estimulación cerebral profunda bilateral del núcleo subtalámico. Conclusiones. A pesar de que este tipo de cirugía se incluye dentro de lo que se conoce como «minimamente invasiva », existen riesgos y complicaciones, algunas de ellas graves, como en el caso clínico que presentamos. El abordaje perioperatorio es complejo por la naturaleza de la intervención y por el tipo del paciente de que se trata, de tal forma que existen todavía algunos puntos en debate tanto para el anestesiólogo como para el resto de especialistas implicados

Introduction. Bilateral stimulation of the subthalamic nucleus (STN) seems to be one of the most effective treatments for advanced forms of Parkinson's disease. Success of the postoperative clinical outcome depends on the quality of the inclusion of patients and the optimal targeting and stimulation of the cerebral nucleus. Case report. We describe the case of a 68 years old male with intracerebral hemorrhage, cognitive deterioration and generalized convulsions in the early postoperative period of a bilateral deep brain stimulation (DBS) of STN. Conclusions. Although this kind of surgery is included in the concept of «minimal invasive» surgery, there are risks and side effects, some of them very serious, as in the case report we present. Perioperative management is complex because of the nature of the surgery and the type of patient, so that some of the aspects are still under debate for both the anesthesiologist and the rest of specialists involved

Bougie-guided insertion of the ProSeal laryngeal mask airway has higher first attempt success rate than the digital technique in children.

BACKGROUND: We tested the hypothesis that bougie-guided insertion of the ProSeal laryngeal mask airway (ProSeal LMA) has higher success rate than the digital technique in children. METHODS: One hundred and twenty children (ASA I-II, aged 1-16 yr) were randomly allocated for ProSeal LMA insertion using the digital or bougie-guided technique. The digital technique was performed according to the manufacturer's instructions. The bougie-guided technique involved priming the drain tube with a bougie, placing the bougie in the oesophagus under direct vision and railroading the ProSeal LMA into position. Unblinded data were collected about ease of insertion (number of attempts and time taken to provide an effective airway), efficacy of seal, ease of gastric tube placement, haemodynamic responses and blood staining. Blinded data were collected about postoperative airway morbidity. RESULTS: The first attempt success rate was higher for the bougie-guided technique (59/60 vs 52/60, P=0.015), but effective airway time was longer (37 vs 32 s, P<0.001). There were no differences in efficacy of seal, ease of gastric tube placement, haemodynamic responses, blood staining or postoperative airway morbidity. CONCLUSION: We conclude that bougie-guided insertion of the ProSeal LMA has a higher first attempt success rate than the digital technique in children.

[Variability in the calculation of coronary risk in type-2 diabetes mellitus]. / Variabilidad en la estimación del riesgo coronario en la diabetes mellitus tipo 2.

OBJECTIVE: To determine the concordance and predictive capacity of various methods for calculating coronary risk in diabetic patients. DESIGN: Prospective study of cohorts, with a 10-year follow-up. SETTING: Urban health centre in a socially depressed area, with high prevalence of DM2. PARTICIPANTS: Population diagnosed with type-2 diabetes mellitus in 1991-93 (112 individuals, with an average age of 66.7+/-11.6 years, 59% of whom were male). MAIN MEASUREMENTS: At the moment of diagnosis, the parameters normally used to calculate coronary risk were determined. The tables of the Framingham scale '91 and '98, of the United Kingdom Prospective Study (UKPDS) (based on an exclusively diabetic population) and of the REgistre GIroni del COr (REGICOR-Girona Heart Register) (based on a Mediterranean population) were each used to calculate individually coronary risk at 10 years. The coronary events suffered in the 10 years following DM2 diagnosis were recorded. The Kappa indices for concordance of the tables and their predictive capacity were calculated. RESULTS: 18.2% of men and 15.2% of women suffered some coronary event. The coronary risk calculations were, for men and women, 30%-20% (Framingham '91), 36%-21% (Framingham '98), 38%-23% (UKPDS), and 15%-10% (REGICOR). CONCLUSIONS: The various methods for calculating coronary risk in diabetics suffer large variability. We should highlight their low diagnostic value in individual cases, with sensitivities of 25%-75% and low specificity (mainly in men) regarding real risk of coronary disease.

Variabilidad en la estimación del riesgo coronario en la diabetes mellitus tipo 2 / Variability in the calculation of the coronary risk of type-2 diabetes mellitus

Objetivo. Determinar la concordancia y capacidad predictiva de distintos métodos de cálculo de riesgo coronario en pacientes diabéticos. Diseño. Estudio de cohortes prospectivo con un seguimiento de 10 años. Emplazamiento. Centro de salud urbano de un área sociodeprimida con una elevada prevalencia de diabetes mellitus tipo 2 (DM2) . Participantes. Población diagnosticada de DM2 entre los años 1991 y 1993 (112 individuos; edad media, 66,7 ± 11,6 años; 59%, varones). Mediciones principales. En el momento del diagnóstico se determinan los parámetros de uso habitual para el cálculo del riesgo coronario. Se utilizan las tablas de Framingham 91 y 98, del United Kingdom Prospective Study (UKPDS) (basadas en la población exclusivamente diabética) y del REgistre GIroní del COR (REGICOR), (basadas en la población mediterránea) y se calcula individualmente el riesgo coronario en 10 años según cada una de ellas. Se registran los eventos coronarios aparecidos en los primeros 10 años tras el diagnóstico de DM2. Se calculan los índices kappa de concordancia entre ellas y su capacidad predictiva. Resultados. Un 18,2% de los varones y un 15,2% de las mujeres presentaron algún evento coronario. Las estimaciones de riesgo coronario fueron para varones-mujeres del 30-20% (Framingham’91), 36-21% (Framingham’98), 38-23% (UKPDS) y 15-10% (REGICOR). Conclusiones. Hay una gran variabilidad entre las distintas estimaciones de riesgo coronario en diabéticos. Cabe destacar el discreto valor diagnóstico individual de todas ellas, con sensibilidades del 25-75% y una baja especificidad (principalmente en varones) con respecto al riesgo real de coronariopatía

Objective. To determine the concordance and predictive capacity of various methods for calculating coronary risk in diabetic patients. Design. Prospective study of cohorts, with a 10-year follow-up. Setting. Urban health centre in a socially depressed area, with high prevalence of DM2. Participants. Population diagnosed with type- 2 diabetes mellitus in 1991-93 (112 individuals, with an average age of 66.7±11.6 years, 59% of whom were male). Main measurements. At the moment of diagnosis, the parameters normally used to calculate coronary risk were determined. The tables of the Framingham scale ‘91 and ‘98, of the United Kingdom Prospective Study (UKPDS) (based on an exclusively diabetic population) and of the REgistre GIroni del COr (REGICOR–Girona Heart Register) (based on a Mediterranean population) were each used to calculate individually coronary risk at 10 years. The coronary events suffered in the 10 years following DM2 diagnosis were recorded. The Kappa indices for concordance of the tables and their predictive capacity were calculated. Results. 18.2% of men and 15.2% of women suffered some coronary event. The coronary risk calculations were, for men and women, 30%-20% (Framingham ‘91), 36%-21% (Framingham ‘98), 38%-23% (UKPDS), and 15%-10% (REGICOR). Conclusions. The various methods for calculating coronary risk in diabetics suffer large variability.We should highlight their low diagnostic value in individual cases, with sensitivities of 25%-75% and low specificity (mainly in men) regarding real risk of coronary disease

Melatonin-like immunoreactivity in the pineal gland of the cow: an immunohistochemical study.

With a view to checking the presence of melatonin in the pineal gland of the cow, in the present work we used six adult animals, ranging in age from one to six years, which were sacrificed at dawn. Sections of 6 micro m thickness of Bouin-fixed and paraffin-embedded pineal glands were incubated in an anti-melatonin serum, which was provided by the Institute for Molecular and Cellular Recognition, Gunma University, Maebshi, Japan. After incubation and successive washings in PBS, some of the sections were treated with the avidin-biotin-peroxidase complex (ABC) technique using antisera from Sigma, and developed with the method of Graham and Karnovsky (which employs 3,3'-diaminobenzidine and H2O2 as developer). Other sections were incubated in a goat-anti-rabbit IgG (H+L) bound to fluorochrome Cy5 for immunofluorescence studies. An intense reaction for melatonin was observed in the cytoplasm but not in the nucleus of melatonin secreting pinealocytes located in peripheral and intermediate zones of the pineal gland. Immunoabsorption of the antimelatonin primary antibody with melatonin at a dilution of 10 mM per 0.1 ml of serum prevented the reaction, as happened when any of the antisera used in the procedure were used. Immunoabsorption of anti-melatonin serum with different amounts of bovine albumin (ranging between 1/5 to 1/50) failed to inhibit the immunoreactivity. When a bovine anti-albumin antibody was employed, working with the above methods, no immunoreaction was detected. Our data suggest that the pinealocytes of cows sacrificed at dawn contain immunoreactive melatonin.

[An epidemiological index to assess the nutritional status of children based in a polynomial model of values from Z punctuation for the age in Mexico]. / Indice epidemiológico de nutrición infantil basado en un modelo polinomial de los valores de puntuación Z del peso para la edad.

A nutritional status index was built by modeling the mathematical function of the mean Z scores of weight for age, from 60,079 children under five years of age, selected in a probabilistic fashion from the Mexican population. The most precise mathematical model was a fifth degree polynomial. The correlation coefficient was between .937

Indice epidemiológico de nutrición infantil basado en un modelo polinomial de los valores de puntuación Z del peso para la edad / An epidemiological index to assess the nutritional status of children under five years of age

Se propone un índice que modeliza la función matemática de los promedios de la puntuación Z del peso para la edad de 60,079 niños menores de 5 años de la República Mexicana obtenidos a partir de muestras probabilísticas. El modelo matemático de mayor precisión fue un polinomio de quinto grado. El coeficiente de correlación se ubicó en el intervalo 937

Cellular proliferation in the rat pineal gland during postnatal development.

To establish a possible correlation between the rate of cellular proliferation and already documented functional and morphological characteristics of the rat pineal gland during postnatal development, the bromodeoxyuridine labelling method was used to evaluate the fraction of cells at the S phase of the cell cycle in paraffin sections from 1-, 7-, 14- and 28-day-old rats. Numerical density, taken as an indirect measure of cell hypertrophy, was also evaluated. During the first week after birth the percentage of S phase-cells in the rat pineal gland sharply decreased from around 9% to 1.3%. A smaller but also significant decrease was found from the 7th to the 14th postnatal day where S phase cells were less than 0.5% of all pineal cells. A very low percentage was also seen in samples from 28-day-old rats. Numerical density, namely, the total number of cells per surface unit of pineal section, decreased from birth to the end of the first month. This decrease was also steeper from birth to the 7th postnatal day than at any other period of the study. These results support the idea that a strong expansion of the cellular population of the rat pineal gland precedes morphological and functional maturation and opens the way to further exploration of the relationship between functional and proliferative responses of the pineal gland.