Evaluación del perfil cardiometabólico en profesionales de salud de Latinoamérica / Evaluation of cardiometabolic profile in Health Professionals of Latin America

Objetivo: Evaluar la presencia de factores de riesgo para enfermedades cardiovasculares (ECV) y diabetes mellitus tipo 2 (DM2) en un grupo de trabajadores de la salud. Métodos: Durante el X Congreso Latinoamericano de Medicina Interna realizado en agosto del 2017, en Cartagena, Colombia, se invitó a los asistentes a participar del estudio que incluyó encuesta sobre antecedentes médicos, farmacológicos, familiares, hábitos de vida, medición de presión arterial, antropometría, fuerza muscular y laboratorios. Se utilizaron las escalas INTERHEART y FINDRISC para calcular el riesgo de ECV y diabetes. Resultados: En 186 participantes con edad promedio de 37,9 años, 94% médicos (52,7% especialistas) la prevalencia de hipertensión fue 20,4%, sobrepeso 40,3%, obesidad 19,9% y dislipidemia 67,3%. El 20,9% eran fumadores actuales o habían fumado y 60,8% eran sedentarios. Los hipertensos tuvieron mayor edad, índice de masa corporal (IMC), circunferencia de cintura, relación cintura/cadera, porcentaje de grasa corporal, grasa visceral, fueron más fumadores y tuvieron menor fuerza muscular (salto alto: 0,38 vs. 0,42̊cm; p̊=̊0,01). El 44,3% presentaron riesgo cardiovascular alto. La prevalencia de diabetes fue 6,59% y 27,7% estaban en riesgo. Conclusión: La prevalencia de factores de riesgo para ECV entre los médicos Latinoamericanos estudiados fue similar a la reportada en la población general. La prevalencia de puntuación de alto riesgo para ECV y DM2 fue alta y los hábitos de vida saludables fueron bajos. Es necesario mejorar la adherencia a estilos de vida saludable entre estos médicos encargados del control de esos factores en la población general.(AU)

Objective: To evaluate presence of risk factors for cardiovascular diseases (CVD) and type 2 diabetes mellitus (DM2) in a group of health care workers. Methods: During the X Latin American Congress of Internal Medicine held in August 2017, in Cartagena, Colombia, attendees were invited to participate in the study that included a survey on medical, pharmacological and family history, lifestyle habits, blood pressure measurement, anthropometry, muscle strength and laboratory studies. The INTERHEART and FINDRISC scales were used to calculate the risk of CVD and diabetes, respectively. Results: Among 186 participants with an average age of 37.9 years, 94% physicians (52.7% specialists), the prevalence of hypertension was 20.4%, overweight 40.3%, obesity 19.9%, and dyslipidemia 67.3%. 20.9% were current smokers or had smoked, and 60.8% were sedentary. Hypertensive patients were found to be older, had higher Body Mass Index (BMI), higher waist circumference, higher waist-to-hip ratio, higher of body fat and visceral fat, smoked more and had lower muscle strength (high jump: 0.38 vs. 0.42̊cm; p̊=̊0.01). In 44.3% of participants was observed a high-risk score for CVD. The prevalence of diabetes was 6.59% and 27.7% were at risk. Conclusion: The prevalence of risk factors for CVD among the Latin American physicians studied was similar to that reported in the general population. The prevalence of high-risk scores for CVD and DM2 was high and healthy lifestyle habits were low. It is necessary to improve adherence to healthy lifestyles among these physicians in charge of controlling these factors in the general population.(AU)

Evaluation of cardiometabolic profile in Health Professionals of Latin America. / Evaluación del perfil cardiometabólico en profesionales de salud de Latinoamérica.

OBJECTIVE: To evaluate presence of risk factors for cardiovascular diseases (CVD) and type 2 diabetes mellitus (DM2) in a group of health care workers. METHODS: During the X Latin American Congress of Internal Medicine held in August 2017, in Cartagena, Colombia, attendees were invited to participate in the study that included a survey on medical, pharmacological and family history, lifestyle habits, blood pressure measurement, anthropometry, muscle strength and laboratory studies. The INTERHEART and FINDRISC scales were used to calculate the risk of CVD and diabetes, respectively. RESULTS: Among 186 participants with an average age of 37.9 years, 94% physicians (52.7% specialists), the prevalence of hypertension was 20.4%, overweight 40.3%, obesity 19.9%, and dyslipidemia 67.3%. 20.9% were current smokers or had smoked, and 60.8% were sedentary. Hypertensive patients were found to be older, had higher Body Mass Index (BMI), higher waist circumference, higher waist-to-hip ratio, higher of body fat and visceral fat, smoked more and had lower muscle strength (high jump: 0.38 vs. 0.42̊cm; p̊=̊0.01). In 44.3% of participants was observed a high-risk score for CVD. The prevalence of diabetes was 6.59% and 27.7% were at risk. CONCLUSION: The prevalence of risk factors for CVD among the Latin American physicians studied was similar to that reported in the general population. The prevalence of high-risk scores for CVD and DM2 was high and healthy lifestyle habits were low. It is necessary to improve adherence to healthy lifestyles among these physicians in charge of controlling these factors in the general population.

Survey of knowledge for diagnosing and managing prediabetes in Latin-America: cross-sectional study.

BACKGROUND: Prediabetes has been proposed as a risk factor for the development of type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD). Despite the clinical importance of prediabetes, little is known about the level of knowledge, beliefs and barriers to screening and treating prediabetes amongst care health providers in Latin America. The aim of the present survey was to evaluate the knowledge and beliefs about prediabetes amongst in Latin American health care providers. METHODOLOGY: In a cross-sectional study, we adapted the written survey designed by the Johns Hopkins University group, and applied it to health care providers across Latin America during three meetings, in 2017, and with physicians from primary care centers in Bucaramanga, Colombia convened in 2017. The survey consisted of questions under four headings, diabetes screening, management of prediabetes, pharmacological treatment-metformin use, and demographic information. We perform a descriptive analysis to determine the differences in responses between different medical specialties. RESULTS: The majority of the care providers that answered the survey were Colombian physicians, 54.5% of respondents had 10 years or more since completing their training and more women responded. Only 9.5% identified the 12 prediabetes risk factors described in the literature. The most common risk factor identified was a family history of diabetes, followed by overweight, a sedentary lifestyle and dyslipidemia, while ethnicity was the risk factor least commonly. 47.1% answered that laboratory tests to detect prediabetes are fasting glucose and HbA1C, 82.5% correctly identified fasting plasma glucose as the best test, 35.9% correctly responded that to the recommended weight loss goal is 5 to 7% and 49.1% that 150 min is considered the minimum level of physical activity per week. 78% agreed that the identification and treatment of prediabetes is important. 56% believed that patients with prediabetes progress more rapidly to diabetes and 40.6% considered that metformin could reduce the risk of diabetes in patients already diagnosed with prediabetes. CONCLUSION: These results demonstrate that there are important gaps in the knowledge of the diagnosis, clinical implications and management of prediabetes amongst Latin America health providers.

The simultaneous assessment of glycosylated hemoglobin, fasting plasma glucose and oral glucose tolerance test does not improve the detection of type 2 diabetes mellitus in Colombian adults.

INTRODUCTION: Guidelines recommend early detection of type 2 diabetes mellitus (DM2). The objective of the present study was to evaluate the capacity to identify DM2 in subjects that were screened for DM2 simultaneously with all three of the tests recommended-fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c) and a 2-hour post 75-g oral glucose tolerance test (OGTT). METHODS AND RESULTS: The present analysis of an anonymous database of 1113 adults from a reference clinical laboratory in Bucaramanga, Colombia, was an observational, descriptive, cross-sectional secondary source study. 259 individuals met at least one of the criteria for DM2: FPG ≥ 126mg/dL (7.0mmol/L), HbA1c ≥ 6.5% (48mmol/mol) and OGTT ≥ 200mg/dL (11.1mmol/L). 30 subjects (2.7%) were diabetic according to FPG, 56 subjects (5.0%) by HbA1c and 250 subjects (22.5%) by OGTT. In total 259 subjects (23.3% [IC 95%: 20.7%- 25.8%] were diabetic either by FPG, OGTT or HbA1c. DISCUSSION: The largest number of patients were identified as diabetic with the OGTT. The combination of two or three tests did not increase the detection of new cases of DM2. Our findings suggest that routinely requesting FPG, OGTT and HbA1c at the same time may be inappropriate in at risk individuals, as this approach does not significantly improve the diagnostic capacity compared to using FPG+OGTT and substantially increases the financial burden on the health system, insurers or individual.

Caracterización histológica e inmunocitoquímica de la grasa infrapatelar de Hoffa / Histological and immunohistochemical characterization of infrapatellar Hoffa's fat

El presente estudio tuvo como objetivo la caracterización histológica e inmunocitoquímica de la grasa infrapatelar de Hoffa (GIH) en 12 pacientes intervenidos por artroscopia, meningoplastia o remplazo de rodilla. Las fibras elásticas estuvieron presentes en la grasa infrapatelar con distribución unidireccional fascicular, se plantea una relación funcional en la biomecánicas del movimiento articular de la rodilla. Por otra parte las pruebas de inmunocitoquimica arrojaron marcaje positivo para vimentina, marcador de células del tejido conectivo; células mesenquimales y negativo para el resto de los anticuerpos estudiados.

Aislamiento e identificación de células madre adultas a partir de la grasa infrapatelar de Hoffa / Isolation and identification of stem cells derived of infrapatelar fat pad

Introducción: La grasa infrapatelar de Hoffa es una inclusión infraarticular presente en la rodilla y existen evidencias que células multipotentes están presentes en tejido adiposo del humano adulto. Objetivo: El propósito de este trabajo es aislar e identificar células mesenquimales a partir de muestras de la grasa de Hoffa tomadas de pacientes a los que se les practicó cirugía de rodilla que expongan este tejido. Metodología: Una vez obtenido el consentimiento informado de un total de 12 pacientes, se obtuvo la muestra de tejido graso. La grasa fue disgregada incubándola en colagenasa en PBS a 37ºC y con agitación, luego se inactivó con suero fetal bovino, se separaron mediante centrifugación los adipocitos maduros de las células multipotentes y se obtuvieron las muestras para sembrar en medio Mesencult. Una porción de muestra fue utilizada para identificación mediante citometría de flujo y otra parte para ser coloreada con azul de metileno. Resultados y Discusión: Tanto en las tinciones con azul de metileno como en los cultivos celulares se han apreciado células con la morfología propia de una célula mesenquimal en forma de estrella y que fueron corroborados mediante citometría de flujo para los marcadores CD13, CD29, CD59 y CD105; igualmente hemos podido observar la efectividad del tratamiento enzimático. Conclusiones: En la actualidad nos encontramos consolidando los cultivos primarios para posteriormente diferenciarlos en líneas celulares específicas que puedan ser utilizadas en estudios de patologías, tales como obesidad, diabetes y trastornos articulares...

Introduction: The infrapatellar fat pad (sometimes know Hoffa's pad) is a soft tissue that lies beneath the patella (kneecap) separating it from the femoral condyle. There is evidence suggesting the presence of stem cells on adipose tissue in the adult human. Objective: The purpose of this work is to isolate and identify grown stem cells from Hoffa's fat samples obtained from patients undergoing surgeries exposing this tissue. Materials and Methods: After obtaining informed consent, the biopsy of Hoff's fat pad was obtained. The samples were incubated with collagenase and PBS a 37ºC and agitated, then it was inactivated with fetal bovine serum and centrifuged, washed twice with PBS, the pellet was resuspended and one part was cultivated on Mesencult medium the other part was used for flow cytometry and stained with methylene blue for morphologic analysis. Also before and after the enzyme digestion, the samples were added to 10% formaldehyde to evaluate the collagenase treatment. Results and analysis: The results show the effectiveness of the enzymatic treatment, the architecture of the adipose tissue was lost. The star shape stem cells morphology was appreciated with methylene blue in the cultures, it was corroborated by flow cytometry with CD13, CD29, CD59 and CD 105 markers. Conclusions: Primary cultures are consolidating, the next aim will be to obtain differentiated specific cell types that can be use in the study of obesity, diabetes and articular illnesses...

Efecto lipolítico del Resveratrol en células 3T3-L1 / Lipolitic effect of Resveratrol in cells 3T3-L1

Introducción: La obesidad es uno de los mayores factores de riesgo para la resistencia a la insulina y la aparición de la diabetes tipo 2. Las proteínas Sirtruinas, entre ellas la Sirtruina 1 (Sirt 1), tiene la capacidad de inhibir la expresión de los genes controlados por el receptor nuclear PPARy promoviendo la movilización de los ácidos grasos desde el adipocito y evitando su almacenamiento. Objetivo: El propósito de este trabajo es evaluar la capacidad del Resveratrol como agente lipolítico en células adiposas diferenciadas. Materiales y métodos: La adipogénesis se realizó mediante la incubación preadipocitos de ratón de la línea celular 3T3.-L1 en presencia de un cóctel de diferenciación con Rosiglitazona, Isobutil Xantina y Dexametasona, y se llevaron a cabo observaciones cada dos días en el período comprendido entre los 0 y 10 días. Posteriormente, se aplicaron dosis de Rosiglitazona y Resveratrol y se realizaron nuevas observaciones hasta el día 6 para corroborar el efecto del Resveratrol. Resultados y discusión: Los resultados obtenidos nos permitieron observar el efecto lipolítico del Resveratrol sobre las células adiposas dado que la cantidad de triglicéridos dentro de las mismas fue menor con respecto a las células diferenciadas y que no fueron tratadas con éste. Esto puede ser causado por la capacidad del Resveratrol de estimular la actividad de la Sirt 1 que a su vez provoca la inhibición del PPARy. Conclusiones: Estos trabajos nos permitirán en el futuro desarrollar nuevas intervenciones en el tratamiento de la obesidad y sus complicaciones...

Introduction: The obesity it is one of the main risk factor for develop insulin resistance and type 2 diabetes, one component of calorie restriction in mammals it is given by Sirtuins proteins among them (SIRT 1), which have the capacity of inhibit the expression of the genes control by the nuclear receptor PPARy, promoting the mobilization of the fatty acids from the adipocyte and avoiding their storage. Objective: The purpose of this work is to evaluate the capacity of Resveratrol (flavonoid found in grape skin) as a lipolytic agent on adipose cells differentiated by Rosiglitazone. Materials and methods: Fibroblast preadipocyte adipogenesis was carried out using Rosiglitazona, incubating murine 3T3-L1 cells in the presence of a differentiation cocktail of Rosiglitazone, Isobutil Xantine and Dexametasone, monitoring between days 0 to 10 of differentiation every two days. Subsequently doses of Resveratrol and Rosiglitazone were added to each cells culture and followed up until day 6, to make sure the Resveratrol effect. The triglycerides quantification was performed qualitatively by red oil stain and quantitatively by isopropanol extraction and absorbance measurement at 510 nm.Results and analysis: The results allowed us to see the Resveratrol lipolytic effect on the adipocyte cells, because the amount of triglycerides was lower than the cultures differentiated by Rosiglitazone. This could be caused by the Resveratrol capacity of stimulate the SIRT 1 activity, which also inhibit PPARy. Conclusions: This kind of work will help in develop new interventions in the treatment of the obesity and complications...