Analysis of cholesterol-recognition motifs of the plasma membrane Ca2+-ATPase.

The plasma membrane Ca2+-ATPase (PMCA) is crucial for the fine tuning of intracellular calcium levels in eukaryotic cells. In this study, we show the presence of CARC sequences in all human and rat PMCA isoforms and we performed further analysis by molecular dynamics simulations. This analysis focuses on PMCA1, containing three CARC motifs, and PMCA4, with four CARC domains. In PMCA1, two CARC motifs reside within transmembrane domains, while the third is situated at the intracellular interface. The simulations depict more stable RMSD values and lower RMSF fluctuations in the presence of cholesterol, emphasizing its potential stabilizing effect. In PMCA4, a distinct dynamic was found. Notably, the total energy differences between simulations with cholesterol and phospholipids are pronounced in PMCA4 compared to PMCA1. RMSD values for PMCA4 indicate a more energetically favorable conformation in the presence of cholesterol, suggesting a robust interaction between CARCs and this lipid in the membranes. Furthermore, RMSF analysis for CARCs in both PMCA isoforms exhibit lower values in the presence of cholesterol compared to POPC alone. The analysis of H-bond occupancy and total energy values strongly suggests the potential interaction of CARCs with cholesterol. Given the crucial role of PMCAs in physiological calcium regulation and their involvement in diverse pathological processes, this study underscores the significance of CARC motifs and their interaction with cholesterol in elucidating PMCA function. These insights into the energetic preferences associated with CARC-cholesterol interactions offer valuable implications for understanding PMCA function in maintaining calcium homeostasis and addressing potential associated pathologies.

CETP-derived Peptide Seq-1, the Key Component of HB-ATV-8 Vaccine Prevents Stress Responses, and Promotes Downregulation of Pro-Fibrotic Genes in Hepatocytes and Stellate Cells.

BACKGROUND: The nasal vaccine HB-ATV-8 has emerged as a promising approach for NAFLD (non-alcoholic fatty liver disease) and atherosclerosis prevention. HB-ATV-8 contains peptide seq-1 derived from the carboxy-end of the Cholesteryl Ester Transfer Protein (CETP), shown to reduce liver fibrosis, inflammation, and atherosclerotic plaque formation in animal models. Beyond the fact that this vaccine induces B-cell lymphocytes to code for antibodies against the seq-1 sequence, inhibiting CETP's cholesterol transfer activity, we have hypothesized that beyond the modulation of CETP activity carried out by neutralizing antibodies, the observed molecular effects may also correspond to the direct action of peptide seq-1 on diverse cellular systems and molecular features involved in the development of liver fibrosis. METHODS: The HepG2 hepatoma-derived cell line was employed to establish an in vitro steatosis model. To obtain a conditioned cell medium to be used with hepatic stellate cell (HSC) cultures, HepG2 cells were exposed to fatty acids or fatty acids plus peptide seq-1, and the culture medium was collected. Gene regulation of COL1A1, ACTA2, TGF-ß, and the expression of proteins COL1A1, MMP-2, and TIMP-2 were studied. AIM: To establish an in vitro steatosis model employing HepG2 cells that mimics molecular processes observed in vivo during the onset of liver fibrosis. To evaluate the effect of peptide Seq-1 on lipid accumulation and pro-fibrotic responses. To study the effect of Seq-1-treated steatotic HepG2 cell supernatants on lipid accumulation, oxidative stress, and pro-fibrotic responses in HSC. RESULTS AND CONCLUSION: Peptide seq-1-treated HepG2 cells show a downregulation of COLIA1, ACTA2, and TGF-ß genes, and a decreased expression of proteins such as COL1A1, MMP-2, and TIMP-2, associated with the remodeling of extracellular matrix components. The same results are observed when HSCs are incubated with peptide Seq-1-treated steatotic HepG2 cell supernatants. The present study consolidates the nasal vaccine HB-ATV-8 as a new prospect in the treatment of NASH directly associated with the development of cardiovascular disease.

Underlying and proximate drivers of biodiversity changes in Mesoamerican biosphere reserves.

Protected areas are of paramount relevance to conserving wildlife and ecosystem contributions to people. Yet, their conservation success is increasingly threatened by human activities including habitat loss, climate change, pollution, and species overexploitation. Thus, understanding the underlying and proximate drivers of anthropogenic threats is urgently needed to improve protected areas' effectiveness, especially in the biodiversity-rich tropics. We addressed this issue by analyzing expert-provided data on long-term biodiversity change (last three decades) over 14 biosphere reserves from the Mesoamerican Biodiversity Hotspot. Using multivariate analyses and structural equation modeling, we tested the influence of major socioeconomic drivers (demographic, economic, and political factors), spatial indicators of human activities (agriculture expansion and road extension), and forest landscape modifications (forest loss and isolation) as drivers of biodiversity change. We uncovered a significant proliferation of disturbance-tolerant guilds and the loss or decline of disturbance-sensitive guilds within reserves causing a "winner and loser" species replacement over time. Guild change was directly related to forest spatial changes promoted by the expansion of agriculture and roads within reserves. High human population density and low nonfarming occupation were identified as the main underlying drivers of biodiversity change. Our findings suggest that to mitigate anthropogenic threats to biodiversity within biosphere reserves, fostering human population well-being via sustainable, nonfarming livelihood opportunities around reserves is imperative.

Bridging the gap: A new species of arboreal Abronia (Squamata: Anguidae) from the Northern Highlands of Chiapas, Mexico.

The mountain forests of Middle America are renowned for their endemic biodiversity, and arboreal alligator lizards (genus Abronia) are high-profile vertebrates endemic to this region. In this work, we describe a new species of arboreal Abronia that is known only from the type locality in the Northern Highlands of Chiapas, Mexico. The new species is diagnosed from all other members of the genus Abronia by the following combination of characters: lack of protuberant or spine-like supra-auricular scales, lack of protuberant or casque-like posterolateral head scales, dorsum of head pale yellow with distinct dark markings, 35-39 transverse dorsal scale rows, lateralmost row of ventral scales enlarged relative to adjacent medial row, and dorsum brown with darker crossbands that are sometimes reduced to rows of spots. We provisionally include the new species in the subgenus Lissabronia based on genomic and morphological evidence, but our results also suggest a close relationship to the subgenus Abaculabronia. The new species is geographically separated from the nearest Lissabronia and Abaculabronia species by the lowland Central Depression of Chiapas. Ongoing habitat loss and other factors imperil the new species, leading us to propose its listing under multiple threatened species frameworks. Because the Northern Highlands have poor coverage of protected areas, we briefly comment on the potential of this new species for stimulating conservation in the region.

The cholesteryl-ester transfer protein isoform (CETPI) and derived peptides: new targets in the study of Gram-negative sepsis.

BACKGROUND: Sepsis is a syndrome where the dysregulated host response to infection threatens the life of the patient. The isoform of the cholesteryl-ester transfer protein (CETPI) is synthesized in the small intestine, and it is present in human plasma. CETPI and peptides derived from its C-terminal sequence present the ability to bind and deactivate bacterial lipopolysaccharides (LPS). The present study establishes the relationship between the plasma levels of CETPI and disease severity of sepsis due to Gram-negative bacteria. METHODS: Plasma samples from healthy subjects and patients with positive blood culture for Gram-negative bacteria were collected at the Intensive Care Unit (ICU) of INCMNSZ (Mexico City). 47 healthy subjects, 50 patients with infection, and 55 patients with sepsis and septic shock, were enrolled in this study. CETPI plasma levels were measured by an enzyme-linked immunosorbent assay and its expression confirmed by Western Blot analysis. Plasma cytokines (IL-1ß, TNFα, IL-6, IL-8, IL-12p70, IFNγ, and IL-10) were measured in both, healthy subjects, and patients, and directly correlated with their CETPI plasma levels and severity of clinical parameters. Sequential Organ Failure Assessment (SOFA) scores were evaluated at ICU admission and within 24 h of admission. Plasma LPS and CETPI levels were also measured and studied in patients  with liver dysfunction. RESULTS: The level of CETPI in plasma was found to be higher in patients with positive blood culture for Gram-negative bacteria that in control subjects, showing a direct correlation with their SOFA values. Accordingly, septic shock patients showing a high CETPI plasma concentration, presented a negative correlation with cytokines IL-8, IL-1ß, and IL-10. Also, in patients  with liver dysfunction, since higher CETPI levels correlated with a high plasma LPS concentration, LPS neutralization carried out by CETPI might be considered a physiological response that will have to be studied in detail. CONCLUSIONS: Elevated levels of plasma CETPI were associated with disease severity and organ failure in patients  with Gram-negative bacteraemia, defining CETPI as a protein implicated in the systemic response to LPS.

A redescription of the poorly known Central American toad Inciliustacanensis (Anura, Bufonidae), with a summary of its biology and conservation status.

Based on examination of most of the existing museum specimens of the rare bufonid frog Inciliustacanensis, we present a redescription and new diagnosis for this species. The species is limited to small region of the Pacific chain of volcanoes in southeastern Chiapas, Mexico, and adjacent areas of Guatemala. The species has not been observed in the wild since 1984 and may have been reduced or eliminated by regional epidemics of chytridiomycosis.

ResumenBasándonos en la revisión de la mayoría de los especímenes de museo existentes del raro sapo bufónido Inciliustacanensis, presentamos una redescripción y una nueva diagnosis para esta especie. La especie se limita a una pequeña región de la cadena de volcanes del Pacífico en el sureste de Chiapas, México, y áreas adyacentes de Guatemala. La especie no se ha observado en la naturaleza desde 1984 y puede haber sido reducida o eliminada por epidemias regionales de quitridiomicosis.

Peptides as Therapeutic Molecules to Neutralize Gram-negative Bacterial Lipopolysaccharides in Sepsis and Septic Shock.

During the last years, infections have become a global health emergency, where the appearance of bacteria highly resistant to traditional antibiotics have set off an alarm worldwide. Moreover, the increased incidence and mortality resulting from its aggravated states, sepsis, and septic shock, have been observed with growing concern. In this context, knowing the need for a new concept for treatment, peptides such as antimicrobial peptides (AMP) and host defense peptides (HDP), have started to show interesting properties in the development of new antimicrobial agents and host response modulatory therapies. Nevertheless, since it is a well-known fact that a peptide-based drug development is a long process that consumes a significant number of resources, recent approaches that tend to mitigate these obstacles, have included the implementation of novel in silico strategies for the optimization of naturally occurring AMP and HDP. In this review, we analyze these strategies that seek to improve not only peptide design, but also production, by including the incorporation of computational biology techniques such as molecular dynamics.

Peptide VSAK maintains tissue glucose uptake and attenuates pro-inflammatory responses caused by LPS in an experimental model of the systemic inflammatory response syndrome: a PET study.

The present investigation using Positron Emission Tomography shows how peptide VSAK can reduce the detrimental effects produced by lipopolysaccharides in Dutch dwarf rabbits, used to develop the Systemic Inflammatory Response Syndrome (SIRS). Animals concomitantly treated with lipopolysaccharides (LPS) and peptide VSAK show important protection in the loss of radiolabeled-glucose uptake observed in diverse organs when animals are exclusively treated with LPS. Treatment with peptide VSAK prevented the onset of changes in serum levels of glucose and insulin associated with the establishment of SIRS and the insulin resistance-like syndrome. Treatment with peptide VSAK also allowed an important attenuation in the circulating levels of pro-inflammatory molecules in LPS-treated animals. As a whole, our data suggest that peptide VSAK might be considered as a candidate in the development of new therapeutic possibilities focused on mitigating the harmful effects produced by lipopolysaccharides during the course of SIRS.

New insights into lipopolysaccharide inactivation mechanisms in sepsis.

The complex pathophysiology of sepsis makes it a syndrome with limited therapeutic options and a high mortality rate. Gram-negative bacteria containing lipopolysaccharides (LPS) in their outer membrane correspond to the most common cause of sepsis. Since the gut is considered an important source of LPS, intestinal damage has been considered a cause and a consequence of sepsis. Although important in the maintenance of the intestinal epithelial cell homeostasis, the microbiota has been considered a source of LPS. Recent studies have started to shed light on how sepsis is triggered by dysbiosis, and an increased inflammatory state of the intestinal epithelial cells, expanding the understanding of the gut-liver axis in sepsis. Here, we review the gut-liver interaction in Gram-negative sepsis, exploring the mechanisms of LPS inactivation, including the recently described contribution of an isoform of the cholesteryl-ester transfer protein (CETPI). Although several key questions remain to be answered when the pathophysiology of sepsis is reviewed, new contributions coming to light exploring the way LPS might be inactivated in vivo, suggest that new applications might soon reach the clinical setting.

Lipid Modulation in the Formation of ß-Sheet Structures. Implications for De Novo Design of Human Islet Amyloid Polypeptide and the Impact on ß-Cell Homeostasis.

Human islet amyloid polypeptide (hIAPP) corresponds to a 37-residue hormone present in insulin granules that maintains a high propensity to form ß-sheet structures during co-secretion with insulin. Previously, employing a biomimetic approach, we proposed a panel of optimized IAPP sequences with only one residue substitution that shows the capability to reduce amyloidogenesis. Taking into account that specific membrane lipids have been considered as a key factor in the induction of cytotoxicity, in this study, following the same design strategy, we characterize the effect of a series of lipids upon several polypeptide domains that show the highest aggregation propensity. The characterization of the C-native segment of hIAPP (residues F23-Y37), together with novel variants F23R and I26A allowed us to demonstrate an effect upon the formation of ß-sheet structures. Our results suggest that zwitterionic phospholipids promote adsorption of the C-native segments at the lipid-interface and ß-sheet formation with the exception of the F23R variant. Moreover, the presence of cholesterol did not modify this behavior, and the ß-sheet structural transitions were not registered when the N-terminal domain of hIAPP (K1-S20) was characterized. Considering that insulin granules are enriched in phosphatidylserine (PS), the property of lipid vesicles containing negatively charged lipids was also evaluated. We found that these types of lipids promote ß-sheet conformational transitions in both the C-native segment and the new variants. Furthermore, these PS/peptides arrangements are internalized in Langerhans islet ß-cells, localized in the endoplasmic reticulum, and trigger critical pathways such as unfolded protein response (UPR), affecting insulin secretion. Since this phenomenon was associated with the presence of cytotoxicity on Langerhans islet ß-cells, it can be concluded that the anionic lipid environment and degree of solvation are critical conditions for the stability of segments with the propensity to form ß-sheet structures, a situation that will eventually affect the structural characteristics and stability of IAPP within insulin granules, thus modifying the insulin secretion.

Geographical distribution of Lasaia Bates, 1868 (Lepidoptera: Riodinidae) across the biogeographical provinces of Mexico.

Riodinidae are one of the most diverse families of Lepidoptera, mainly in the Neotropical region; however, their biology, ethology, taxonomy, systematics, and biogeography are poorly known. In Mexico, the regional and local distributions of the family are still incomplete. We review the distributional data of the genus Lasaia Bates (Lepidoptera: Riodinidae), based on records from four national and seven international collections. We record five species and seven subspecies in Mexico, with 2722 records, distributed in 314 localities of 24 states. The states with higher species richness are Chiapas, Oaxaca, and Veracruz; also, the genus was recorded in 11 of the 14 biogeographical provinces of Mexico. The tropical semi-deciduous and deciduous forests, below of 1000 m a.s.l., contain most of the diversity of Lasaia. Historical data are crucial for the study of local and regional diversity and ecological patterns at large temporal scales. Data presented here show the morphological and ecological variation of Lasaia over the last 80 years, mostly from the XX century when anthropogenic disturbances were intensified. This kind of studies is the first step in recording the historical distribution of these taxa, which will lead to more complex analyses on distribution range shifts, their causes and consequences.

Comparison of ocular vestibular myogenic response by acoustic stimulation at 500 and 1000 Hz in healthy subjects.

OBJECTIVE: To compare the amplitude of potentials by acoustic stimulation at 500 Hz versus 1000 Hz in healthy subjects. METHODS: 25 subjects; potentials were performed with acoustic stimuli burst-type at 500 and 1000 Hz with a stimulation rate of 5.1 at 100 dB in both ears. Descriptive statistics tests were performed, confidence intervals were calculated for the mean with 95% reliability, standard error graphs and t-test for related samples. RESULTS: The values obtained in amplitude when performing an acoustic stimulus at 1000 Hz show a faster response compared to that obtained in the frequency of 500 Hz. The t-test showed a significant difference in the amplitude in the 1000 Hz frequency between ears with a significance value of p < 0.025. CONCLUSIONS: It is strengthened the hypothesis that in the amplitude of potentials by aerial acoustic stimulation in the frequency of 1000 Hz a greater amplitude is generated in relation to the one generated in the frequency of 500 Hz.

OBJETIVO: Comparar la amplitud de los potenciales miogénicos vestibulooculares por estimulación acústica a 500 y 1000 Hz en sujetos sanos. MÉTODO: Se estudiaron 25 sujetos y se realizaron potenciales con estímulos acústicos tipo burst a 500 y 1000 Hz con una tasa de estimulación de 5.1 a 100 dB en ambos oídos. Se realizaron pruebas de estadística descriptiva y se calcularon los intervalos de confianza para la media con un 95% de confiabilidad, las gráficas de error estándar y la prueba t para muestras relacionadas. RESULTADOS: Los valores obtenidos en amplitud al realizar estímulo acústico a 1000 Hz muestran una respuesta más rápida en comparación con la obtenida en la frecuencia de 500 Hz. La prueba t mostró una diferencia significativa en la amplitud en la frecuencia 1000 Hz entre oídos, con un valor de significancia p < 0.025. CONCLUSIONES: Se fortalece la hipótesis de que en los potenciales por estimulación acústica aérea en la frecuencia de 1000 Hz se genera una mayor amplitud en relación con la generada en la frecuencia de 500 Hz.

Family involvement in eating disorder treatment among Latinas.

Latinos are less likely to seek health care for eating disorders and more likely to drop out of treatment than members of other ethnic groups, highlighting existing challenges to engagement in traditional mental health care. This study explored the role of family in the treatment of adult Latinas with eating disorders through content analysis of family sessions adjunctive to cognitive behavioral therapy. This study yielded insight into the experiences of 10 Latinas with eating disorders (M age = 39.90 years) and 10 relatives (M age = 39.50) from the Promoviendo una Alimentación Saludable trial who were randomly selected to receive six family enhancement sessions. Data from 53 sessions were analyzed using a qualitative content analysis approach. Family intervention might serve as a valuable adjunct to conventional treatment by positively influencing social, family, and emotional support for Latinas with eating disorders.

Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience.

BACKGROUND: Non-Hodgkin lymphoma (NHL) is the most common cancer in people with HIV. Although 95% of HIV patients are in developing countries like Peru, the majority of these studies have been conducted in developed countries. In this study we aim to evaluate prognostic factors associated with outcomes in HIV positive patients undergoing systemic therapy for treatment of NHL. METHODS: This retrospective study includes patients with NHL seen in the Instituto Nacional de Enfermedades Neoplasicas (INEN) between 2004 to 2014. Patients were divided into two groups: antiretroviral therapy (ART) -naïve (n = 34) and those previously treated, ART-exposed (n = 13), at the time of diagnosis. All patients received chemotherapy and ART. The medical records were reviewed. Data were analyzed using t-test and chi-square test. Survival curves were estimated by the Kaplan-Meier method and comparison was done by log-rank test. Multivariate analysis for overall survival (OS) was performed with the Cox proportional hazard regression model. RESULTS: All ART-exposed patients were from the capital city (p = 0.039); they had significantly lower hemoglobin levels compared to ART-naïve patients (p = 0.026). The median OS was 47.7 months with a 5-yr OS of 36.1%. The median OS for ART naïve patients was significantly higher than that for ART-exposed patients (57.05 and 21.09 months, respectively; p = 0.018). Advanced stage and low serum albumin were associated with lower OS in both groups. Age > 60 was associated with worse outcomes in the ART-naïve cohort. CONCLUSIONS: Advanced stage, low serum albumin and previous ART treatment were the primary prognostic factors associated with poorer outcomes in patients with NHL and HIV infection. In ART-naïve patients, age > 60 was associated with worse outcomes but in this cohort, older patients still had better overall outcomes than ART-exposed patients.

"Las penas con pan duelen menos": The role of food and culture in Latinas with disordered eating behaviors.

This study elucidated the experiences of eighteen Latina adults (mean age = 38.5 years) from "Promoviendo una Alimentación Saludable" Project who received nutritional intervention as part of the clinical trial. Half of the participants were first generation immigrants from Mexico (50%), followed by U.S. born with 16.7%. Remaining nationalities represented were Bolivia, Colombia, Guatemala, Honduras, Peru, and Venezuela with 33.3% combined. The average duration of living in the U.S. was 11.1 years. The mean body mass index (BMI) at baseline was 36.59 kg/m(2) (SD = 7.72). Based on the DSM-IV, 28% (n = 5) participants were diagnosed with binge-eating disorder, 33% (n = 6) with bulimia nervosa purging type and 39% (n = 7) with eating disorder not otherwise specified. Participants received up to three nutritional sessions; a bilingual dietitian conducted 97.8% of sessions in Spanish. In total, fifty nutritional sessions were included in the qualitative analysis. A three step qualitative analysis was conducted. First, a bilingual research team documented each topic discussed by patients and all interventions conducted by the dietitian. Second, all topics were classified into specific categories and the frequency was documented. Third, a consensus with the dietitian was performed to validate the categories identified by the research team. Six categories (describing eating patterns, emotional distress, Latino culture values, family conflicts associated with disturbed eating behaviors, lack of knowledge of healthy eating, and treatment progress) emerged from patients across all nutritional sessions. Considering the background of immigration and trauma (60%, n = 15) in this sample; the appropriate steps of nutritional intervention appear to be: 1) elucidating the connection between food and emotional distress, 2) providing psychoeducation of healthy eating patterns using the plate method, and 3) developing a meal plan.

[Analysis of the joint and a posteriori probability between primary empty sella, its comorbidities and audiovestibular pathology]. / Análisis de la probabilidad conjunta y a posteriori entre aracnoidocele selar primario, sus comorbilidades y enfermedad audiovestibular.

BACKGROUND: Primary empty sella is a herniation of the sellar diaphragm into the pituitary space. It is an incidental finding and patients may manifest neurological, ophthalmological and/or endocrine disorders. Episodes of vertigo, dizziness, and hearing loss, have been reported. OBJECTIVE: To determine the conditional probability, as well as the statistical dependency, through the Bayesian analysis in patients with primary empty sella and audiovestibular disorders. PATIENTS: Individuals who attended the National Rehabilitation Institute from January 2010 to December 2011, diagnosed with primary empty sella and audiovestibular disorders. MATERIAL AND METHODS: An analysis was performed on a sample of 18 patients with a diagnosis of primary empty sella confirmed with magnetic resonance studies and who had signs of vertigo, hearing loss and dizziness. RESULTS: Of the 18 patients studied, 3 (16.66%) had primary empty sella as the only clinical evidence. In 9 patients (50%) empty sella was associated with vertigo, and 16 patients (88.88%) were diagnosed with hearing loss, with sensorineural hearing loss being the most frequent (77.77%). The intersection between the proportions of primary empty sella with the presence and type of hearing loss was calculated. Thus for sensorineural hearing loss, the calculated ratio was P(AB)=0.6912, and for conductive and mixed hearing loss the value of P(AB)=0.0493 in both cases. CONCLUSIONS: Bayesian analysis and conditional probability enables the dependence between two or more variables to be calculated. In this study both mathematical models were used to analyse comorbidities and audiovestibular disorders in patients diagnosed with primary empty sella.

[Hearing gain with binaural-bimodal adaptation in patients with a cochlear implants].

Binaural hearing allows the optimal performance of the auditory system with a better perception of the sounds that make up language and better discrimination in noisy environments. The use of binaural-bimodal stimulation includes a combination of 2 different pacing modes: a cochlear implant in one ear , and acoustic stimulation through a conventional hearing aid in the other. The aim of this study is to determine the hearing gain in patients with cochlear implant alone and hearing aid. Twenty prelingually hearing impaired patients, 11 female and 9 male subjects were recruited with mean age at implantation and 3.91 ± 1.56 years and 6.07 ± 2.18 years at the time of audiological assessment at six months post-implantation. Implanted patients were assessed per month after the surgery for the first telemetry subsequently were reassessed every month to make changes to schedules stimulation map according to the auditory responses and progress shown in speech therapy. When calculating the mean and standard deviation of the auditory response in implanted subjects, you can appreciate that in the group of patients with cochlear implant plus hearing aid using the values obtained were lower at all frequencies, indicating a higher gain using auditory hearing aid over a cochlear implant, in comparison to patients who only used the cochlear implant. Comparing auditory responses in patients implanted with and without hearing aid, statistically significant differences were observed at all frequencies except at 2 kHz, showing that there is a better discrimination in noisy environments. The patients use more AA gain greater hearing gain compared with patients who only used the IC.

Audiometric evaluation short and medium term in cochlear implants.

OBJECTIVE: Our purpose is report the results of cochlear implant program in this Institute, since our first surgery from November 2007, until December 2012. MATERIAL AND METHODS: A cross-sectional study, observational, descriptive, analyzing the information about thresholds before and after implantation, using patients files (diagnosis, onset of hearing loss, brainstem auditory evoked potential (BAEP), computed tomography (CT), magnetic resonance imaging (MRI), implanted ear, brand and model of cochlear implants (CI) and audiometric studies before and after the CI. RESULTS: We report the evolution of 68 patients, age ranged 1 year 8 months to 39 years 3 months old. 94% patients (n = 64) had pre-lingual hearing loss being hereditary non-syndromic hearing loss the most common etiology (29.4%). 100% patients had auditory brainstem responses showing bilateral profound hearing loss, in the 77.9% type A tympanograms were obtained (Jerger's classification), and 100% had absence of stapedial reflexes and otoacoustic emissions with low reproducibility. CT reported as normal in 85.2% of patients, the findings: 5.8% had chronic mastoiditis changes, other findings reported in 1.4% of patients were: digastric right facial nerve, facial nerve canal dehiscence, enlarged vestibular aqueduct, occupation and poor pneumatization of mastoid air cells, lateral semicircular canals agenesis, incomplete partition of the cochlea with wide vestibular and vestibular aqueduct dilatation. Most frequent MR findings of skull with cerebellopontine angle approach were vascular loops of internal auditory canals unilaterally. In 10.2%, 55.8% of patients (n = 38) were implanted in the right ear, 56 (82.3%) with a CI from Advanced Bionics, HiRes 90K model, the remaining with Cochlear, Freedom and Nucleus 5 models. Developments in CI results by audiometric tests: prior to placement was 106.2 dB averages at frequencies assessed, one month later 62.4 dB, at 6 months 44 dB, and with satisfactory threshold 32.9 dB. 55.8% of patients (n = 38) with P + HiRes Fidelity 120 strategy, the remaining with Hires S + Fidelity 120, Hires S and ACE RE. DISCUSSION: Audiology service proposed to place the CI in the worst ear by threshold in audiometric tests, the otolaryngology service proposed the best ear from anatomical point view. Implanted in the INR more Advanced Bionics CI faq frequently due to the donation by the insurance for a new generation. Hearing thresholds using CI have improved since activation.

Influencia de la glucemia venosa en ayunas en el cálculo de la glucemia media estimada / Influence of venous blood glucose during fasting in the calculation of estimated average glucose

INTRODUCCIÓN: La glucosa media estimada (eAG) es una aproximación en mg/dl de la concentración plasmática media de glucosa durante los 60-90 días previos. OBJETIVO: Conocer el papel de la glucemia venosa en ayunas y las glucemias posprandiales en el cálculo de eAG. MATERIAL Y MÉTODOS: Se incluyó a 413 pacientes con diabetes mellitus atendidos entre enero y julio de 2012, usando como criterios de exclusión las condiciones que pueden modificar los valores de A1c. Se recogieron las glucemias venosas en ayunas y A1c pertenecientes a una misma extracción. Se calculó el valor de eAG perteneciente a cada determinación de A1c, y la diferencia entre cada glucemia venosa y la eAG de 909 parejas de valores. RESULTADOS: Edad de 64 ± 13,5 años. El 53% eran varones, y en el 95% de los casos diabéticos tipo 2. La media de A1c en la muestra analizada fue de 8,1 ± 1,6%. El valor de eAG de este porcentaje es de 186 mg/dl. La glucemia venosa en ayunas fue de 172 ± 69 mg/dl. La diferencia entre la eAG y la media de las glucemias venosas en ayunas fue de 14 mg/dl, significativa con una p < 0,01. CONCLUSIÓN: La eAG es significativamente superior a la media de las glucemias en ayunas en los pacientes con diabetes. Podemos suponer que esta diferencia es consecuencia de la influencia de las glucemias posprandiales en el cálculo de eAG, y que la contribución de la glucemia en ayunas a dicho cálculo es aproximadamente del 92%, y la de la glucemia posprandial, del 8%

INTRODUCTION: The estimated average glucose (eAG) level is an approximate calculation in mg/dL of the plasma concentration of glucose over the previous 60-90 days. OBJECTIVE: To determine the role of venous blood glucose during fasting and post-prandial levels in the calculation of eAG. MATERIAL AND METHODS: We included 413 patients with diabetes mellitus that were being treated between January and July 2012. We considered any condition that could modify the values of A1c as exclusion criteria. We measured the fasting venous blood glucose levels and A1c in the same samples. We calculated the eAG level of each A1c measurement, and the difference between each venous blood glucose level and the eAG of 909 pairs of values. RESULTS: The mean age of the patients was 64 ± 13.5 years old. From our sample, 53% were male, and 95% of these cases were suffering from type 2 diabetes. The average A1c in the sample was 8.1% ± 1.6%. The eAG level for this percentage was 186 mg/dL. The fasting venous blood glucose was 172 ± 69 mg/dL. The difference between the eAG and the average of the fasting venous glucose levels was 14 mg/dL. This was found to be significant with P < 0.01. CONCLUSION: The eAG level is significantly higher than the mean of the levels in fasting in patients with diabetes. We can assume that this difference is due to the influence of the post-prandial glucose levels in the calculation of eAG; and that the contribution of fasting blood glucose to this calculation is approximately 92%, and that of post-prandial blood glucose only 8%

¿Es necesario suspender durante 4 semanas el tratamiento con tiroxina antes de la realización de un rastreo-ablación? / Should thyroxine treatment be discontinued for four weeks before I 131 thyroid ablation?

Introducción Es frecuente que la suspensión de aporte de tiroxina como preparación para un rastreo-ablación se prolongue durante 4 semanas, en las que es habitual la aparición de clínica de hipotiroidismo. Una alternativa útil en algunos casos es utilizar TSHhr, pero sus problemas de disponibilidad durante el año 2012 limitarán su uso. Pacientes y métodos Se realizó un análisis de la concentración de TSH y T4 libre en los días 7, 14, 21 y 28 desde el momento de la realización de una tiroidectomía total (12 pacientes) o desde la suspensión del tratamiento con tiroxina (20 pacientes). Se usó el test de Mann Wittney para analizar las comparaciones de variables cuantitativas y el Chi-cuadrado para las nominales. Resultados En el día 14, la concentración plasmática de TSH fue igual o superior a (..) (AU)

Background It is a usual practice to discontinue thyroxine treatment for four weeks before 131I ablation. Symptoms of hypothyroidism usually occur during this time. Use of rhTSH is a helpful alternative in some cases, but problems of availability of this agent during 2012 will limit its use. Patients and methods Plasma TSH and FT4 levels were measured on days 7, 14, 21, and 28 after total thyroidectomy (12 patients) or discontinuation of thyroxine treatment (20 patients). A Mann-Whitney U test was used to compare quantitative variables, and a Chi-square test was used for nominal variables. Results On day 14, TSH levels were (..) (AU)