Is Dietary Nonadherence Unique to Obesity and Weight Loss? Results From a Randomized Clinical Trial.

OBJECTIVE: Weight stigma is associated with poor dietary adherence, yet adherence is essential for weight loss and maintenance. This study aimed to determine differences in dietary adherence and perceived hunger between lean individuals and two groups of individuals with obesity. METHODS: In a 6-week outpatient dietary intervention (23 males; aged 48 [SD 14] years), lean participants (n = 23; BMI 23 [SD 2] kg/m2 ) received a weight-maintaining energy needs (WMEN) diet, and participants with obesity (BMI 36 [SD 7]) were randomized to either WMEN (n = 18) or a 35% calorie-reduced (CR) diet (n = 19). All food was provided, and multiple adherence and hunger ratings were assessed daily and weekly on an outpatient basis and in person at twice-weekly visits (e.g., 24-hour recall, diaries). RESULTS: Weight decreased more in the group of CR individuals with obesity (ß = -0.301 kg/wk, P = 0.02) compared with the group of lean individuals and the group of WMEN individuals with obesity. However, total percent adherence did not differ between groups (P = 0.60), and hunger scores did not change across groups over time (P = 0.08). CONCLUSIONS: Results indicate that there are no differences in dietary adherence between lean individuals and individuals with obesity and adherence is not associated with adiposity or hunger. Thus, the belief that nonadherence (e.g., lack of willpower) is unique to obesity is untrue and may perpetuate weight bias and stigma.

Clonal distribution of Streptococcus suis isolated from diseased pigs in the central region of Chile.

The characteristics of 29 Chilean field strains of Streptococcus suis recovered between 2007 and 2011 from pigs with clinical signs at different farms were studied. Serotyping with use of the coagglutination test revealed that all but 1 strain belonged to serotype 6; the remaining strain was serotype 22. All the serotype-6 strains were suilysin (hemolysin)-negative; in addition, they were found to be genotypically homogeneous by enterobacterial repetitive intergenic consensus sequence-based polymerase chain reaction (ERIC-PCR) and sensitive to ampicillin, ceftiofur, penicillin, and trimethoprim/sulfamethoxazole. The results indicate that, in contrast to what is generally observed in other countries, a single clone of S. suis was isolated from diseased pigs in the central region of Chile.

Les caractéristiques de 29 souches de Streptococcus suis d'origine chilienne provenant de porcs malades, dont la plupart d'entre elles n'ont aucun lien épidémiologique, ont été étudiées. Toutes les souches ont montré appartenir au sérotype 6 sauf 1, qui a été caractérisée comme étant un sérotype 22. De plus, toutes les souches du sérotype 6 se sont révélées négatives pour la production de suilysine (hémolysine). Avec l'utilisation d'un test PCR ciblant des séquences consensus intergéniques répétées d'entérobactéries (ERIC-PCR), toutes les souches de sérotype 6 testées se sont avérées être génétiquement homogènes. Finalement, ces souches se sont montrées sensibles à l'ampicilline, au ceftiofur, à la pénicilline ainsi qu'à l'association triméthoprime-sulfaméthoxazole. Les résultats indiquent que, contrairement à ce qui a déjà été observé dans d'autres pays, un seul clone de S. suis est majoritairement isolé chez des porcs malades dans la région centrale du Chili.(Traduit par les auteurs).

Clinical management of patients with hip and knee osteoarthritis: patient satisfaction with treatment switch.

Hip and knee osteoarthritis (OA) is a common cause of disability, with great quality of life and economic impact, hence the need for effective treatment. Patient satisfaction with treatment is a measure of therapeutic effectiveness and may be used to assess treatment switch in OA patients. A 3-month multicenter, prospective, epidemiologic, non-interventional study was conducted in patients with hip and/or knee OA to assess therapeutic efficacy in patients requiring treatment switch due to lack of effectiveness and/or tolerability in primary care settings. Therapeutic effectiveness was assessed by patient satisfaction using the osteoARthritis Treatment Satisfaction (ARTS) scale. The 3-month disease change [by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a pain visual analog scale (VAS)] and its correlation with treatment satisfaction were also assessed, as well as patient gastrointestinal (GI) and cardiovascular (CV) profiles. 5,976 patients were analyzed (mean age 68.8 years, 65.1 % female). 67 and 61.8 % showed high GI and CV risk, respectively. The proportion of patients on acetaminophen treatment during the study decreased from 74.8 % at baseline to 23.9 %, while the proportion on non-steroidal anti-inflammatory drugs (NSAIDs) increased from 59.8 to 85.8 %. At 3 months, the standardized (0-100) overall ARTS score increased from 57.7 to 71.6 (p < 0.0001), while disease severity decreased. There was a significant (p < 0.0001) negative association between the ARTS, and the WOMAC and VAS scores. Treatment switching from acetaminophen to NSAIDs as a consequence of poor effectiveness and/or tolerability resulted in increased patient satisfaction with treatment and lower OA severity.

CDC6 expression is regulated by lineage-specific transcription factor GATA1.

GATA1 is a hematopoietic transcription factor essential for expression of most genes encoding erythro-megakaryocytic proteins, i.e., globins and platelet glycoproteins. A role for GATA1 as a cell proliferation regulator has been proposed, as some of its bona fide targets comprise global regulators, such as c-KIT or c-MYC, or cell cycle factors, i.e., CYCLIN D or p21CIP1. In this study, we describe that GATA1 directly regulates the expression of replication licensing factor CDC6. Using reporter transactivation, electrophoretic mobility shift and chromatin immunoprecipitation assays, we show that GATA1 stimulates CDC6 transcription by binding to a canonical binding site located within a 166bp enhancer region upstream CDC6 promoter. This evolutionary conserved GATA binding site conforms to recently described chromatin occupancy rules, i.e., preferred bases within core WGATAR (TGATAA), 5' and 3' flanking bases (GGTGATAAGG) and distance to the transcription initiation site. We also found adjacent conserved binding sites for ubiquitously expressed transcription factor CP2, needed for GATA activity on CDC6 enhancer. Our results add to the growing evidence for GATA1 acting as a direct transcriptional regulator of the cell cycle machinery, thus linking cell proliferation control and specific gene expression programs during lineage differentiation.

Differential expression of potassium channels in placentas from normal and pathological pregnancies: targeting of the K(ir) 2.1 channel to lipid rafts.

Potassium channels play important physiological roles in human syncytiotrophoblasts (hSTBs) from placenta, an epithelium responsible for maternal-fetal exchange. Basal and apical plasma membranes differ in their lipid and protein composition, and the latter contains cholesterol-enriched microdomains. In placental tissue, the specific localization of potassium channels is unknown. Previously, we described two isolated subdomains from the apical membrane (MVM and LMVM) and their respective microdomains (lipid rafts). Here, we report on the distribution of K(ir)2.1, K(v)2.1, TASK-1, and TREK-1 in hSTB membranes and the lipid rafts that segregate them. Immunoblotting experiments showed that these channels are present mainly in the apical membrane from healthy hSTBs. Apical expression versus basal membrane was 84 and 16% for K(ir)2.1 and K(v)2.1, 60 and 30% for TREK-1, and 74 and 26% for TASK-1. Interestingly, K(v)2.1 showed differences between apical membrane subdomains: 26 ± 8% was located in the LMVM and 59 ± 9% in MVM. In pathological placentas, the expression distribution changed in the basal membrane: preeclampsia shifted to 50% and intrauterine growth restriction to 42% for TASK-1 and both pathologies increased to 25% for K(ir)2.1 and K(v)2.1, K(ir)2.1 appeared to be associated with rafts that were sensitive to cholesterol depletion in healthy, but not in pathological, placentas. K(v)2.1 and TREK-1 emerged in the nonraft fractions. The precise membrane localization of ion channels in hSTB membranes is necessary to understand the physiological events.

Lipid rafts and cytoskeletal proteins in placental microvilli membranes from preeclamptic and IUGR pregnancies.

Intrauterine growth restriction (IUGR) and preeclampsia (PE) are leading causes of perinatal and maternal morbidity and mortality. Previously we reported the expression of lipid rafts in classical microvillous membrane (MVM) and light microvillous membrane (LMVM), two subdomains in apical membrane from the human placental syncytiotrophoblast (hSTB), which constitute the epithelium responsible for maternal-fetal transport. Here the aim was to study the raft and cytoskeletal proteins from PE and IUGR. Microdomains from MVM and LMVM were tested with raft markers (placental alkaline phosphatase, lipid ganglioside, and annexin 2) and a nonraft marker (hTf-R). No changes were detected with those markers in whole purified apical membranes in normal, PE, and IUGR pregnancies; however, their patterns of distribution in lipid rafts were different in PE and IUGR. Cholesterol depletion modified their segregation, confirming their presence in lipid rafts, although unlike normal placenta, in these pathologies there is only one type of microdomain. Additionally, the cytoskeleton proteins actin, ezrin, and cytokeratin-7 showed clear differences between normal and pathological membranes. Cytokeratin-7 expression decreased to 50% in PE, and the distribution between LMVM and MVM (~43 and 57%, respectively) changed in both PE and IUGR, in contrast with the asymmetrical enrichment obtained in normal LMVM (~62%). In conclusion, lipid rafts from IUGR and PE have different features compared to rafts from normal placentae, and this is associated with alterations in the expression and distribution of cytoskeletal proteins.

Tratamiento de tumores neuroendocrinos (TNE) con péptidos análogos de la somatostatina marcados con radionucleidos / Treatment of neuroendocrine tumors (NET) with radiolabelled somatostatin analogues

Propósito. Los TNE avanzados tienen escasa respuesta a radioterapia o quimioterapia, el tratamiento sistémico con análogos de la SST radiactivos es una herramienta promisoria en su tratamiento. Presentamos nuestra experiencia, pionera en Latinoamérica, utilizando análogos de SST marcados con 90Y ó 177Lu. Material. Evaluamos 40 pacientes (50.3 años, rango 12-74) con TNE confirmados histológicamente y sobre-expresión de receptores de SST demostrada mediante imágenes. SPECT (111In-DOTATOC) ó PET/CT (68Ga-DOTATATE). Se evaluó respuesta clínica, laboratorio, imágenes con 111In-DOTATATE, post-terapia con 90Y ó 177Lu, 68Ga-DOTATATE PET/CT o TAC. Resultados. Observamos progresión de enfermedad en 10 (25.0 por ciento), remisión parcial en 25 (62.5 por ciento), enfermedad estable en 3 (7.5 por ciento) y remisión completa en 2 (5.0 por ciento). Hubo escasa toxicidad sin deterioro renal significativo. Observamos reducción tumoral y mejoría de calidad de vida en la mayoría de los pacientes. Conclusión. La terapia con radiopéptidos es un procedimento seguro y efectivo en el tratamiento de TNE avanzados.

Purpose. Advanced NETs have little response to radiotherapy or chemotherapy, systemic treatment with radioactive SST analogous is a promissory tool in its treatment. We present our pioneering experience in Latin America using analogous of SST labeled either with 90Y or 177Lu. Materials. We evaluated 40 patients (50.3 years, range 12-74) with histological proved NET and SST receptors over-expression demonstrated by SPECT or PET/CT images with 111In-DOTATOC or 68Ga-DOTATATE. We evaluated clinical response, laboratory test, images with 111In-DOTATATE, 90Y, 177Lu, and 68Ga-DOTATATE PET/CT or CT. Results. We observed progression of disease in 10 (7,5 percent), partial remission in 25 (62,5 percent), stable disease in 3 (7,5 percent) and complete remission in 2 (5,0 percent). There was little toxicity without significant renal deterioration. We observed tumor mass reduction and improvement of quality of life in most of the patients. Conclusion. The therapy with radiopeptides is a safe and effective procedure in the treatment of advanced NET.

The "bat sign" of pectoral rhabdomyolysis.

A 22-year-old man with foot pain was referred for evaluation of sesamoiditis. A Tc-99m methylene-diphosphonate bone scan was performed which revealed increased radiopharmaceutical uptake in the big toes, but also showed curious abnormal thoracic activity. Normal activity at sternoclavicular joints and sternum mimics ears, head and body of a bat, and the pectorals mimic the wings. The patient mentioned that he had started lifting weights a few days earlier. Clinical and echographic evaluations were diagnostic of pectoral inflammation suggesting rhabdomyolysis.

Repercusión de la terapia floral en el tratamiento del desequilibrio emocional relacionado con la violencia intrafamiliar / Effect of flower therapy in the treatment of family violence-related emotional unbalance

La presente investigación se realizó con el objetivo de evaluar la repercusión de la terapia floral en el tratamiento del desequilibrio emocional relacionado con la violencia familiar, en una muestra de 95 pacientes de 30 familias, que acudieron a la consulta de Psicología, en el policlínico Chiqui Gómez Lubián en Santa Clara, en el período de desde mayo 2004 a enero 2005. Posterior al estudio psicológico se aplicó el sistema de E. Bach a los adolescentes con el objetivo de equilibrar las emociones negativas de aparición común encontradas en la muestra. Se combinaron estas esencias según el predominio de la sintomatología. En el caso de los adultos se aplicó la siguiente fórmula: Holly, Willow, Vine, Beech, Cherry Plum, Walnut con el fin de equilibrar las emociones negativas mas comunes en los agresores tales como celos, resentimiento, autoritarismo, intolerancia, descontrol emocional, conductas desadaptativas, agregando además la esencia tipológica. Se constató la presencia de en los agresores de: Agresividad, irritabilidad, autoritarismo, intolerancia, descontrol emocional, resentimientos y celos. En los agredidos: Miedos, ansiedad, depresión, inseguridad, baja autoestima, intolerancia y descontrol emocional. Se constató la disminución de la Violencia emocional y un mejoramiento de los estilos de comunicación, a partir de la terapéutica aplicada y quedó demostrado una alta efectividad en la terapia floral en el abordaje de los casos que sufren la violencia intrafamiliar y de aquellos que la ejercen(AU)

Linfocintigrafía en quilotórax: caso clínico / Lymphoscintigraphy in chylothorax: clinical case

Se presenta un caso de quilotórax de aparición espontánea en una niña de 13 años, sus manifestaciones clínicas, exámenes de laboratorio e imágenes que contribuyeron al diagnóstico, con énfasis en el uso de la linfocintigrafía que permitió detectar el sitio de la filtración de quilo hacia la cavidad pleural y que fue posteriormente confirmado y exitosamente reparado quirúrgicamente

Spect cerebral en jaqueca acompañada: presentación de 3 casos clínicos / Brain spect in migraine accompagnee: presentation of 3 clinical cases

Se presentan 3 casos clínicos de jaqueca acompañada, en quienes se pudo demostrar una reducción transitoria del flujo sanguíneo cerebral regional mediante un SPECT con 99mTc-HMPAO cerebral inyectado durante la fase aguda. En dos de ellos el SPECT de control de 24 horas demostró regresión de las alteraciones de perfusión

Osteoporose regional transitória idiopática (ORTI) do joelho / Idiopathic regional migratory osteoporosis of the knee

Os autores relatam um caso de osteoporose regional transitória idiopática do joelho esquerdo. Salientam o importante papel que tem a imagem no diagnóstico. Um homem de 44 anos apresenta acentuada dor e aumento de volume do joelho esquerdo; radiografia, TC, cintilografia e densitometria dessa articulaçao permitiram formular o diagnóstico. O tratamento com antiinflamatório nao esteróide (AINE) foi incapaz de controlar a dor, que desapareceu, entretanto, rapidamente, quando foi usada calcitonina. Dá-se importância em ter sempre presente esse diagnóstico para evitar procedimentos diagnósticos e/ou terapêuticos mais agressivos

Carcinoma in situ: nuevos aspectos (1985-1986) / Carcinoa in situ: new aspects (1985-1986)

Durante los años 1985-1986 se dignosticaron 100 casos de carcinoma in situ del cuello uterino en el Hospital Docente Maternoinfantil "10 de Octubre". En su diagnóstico se cumplieron todos los parámetros establecidos por el Programa Nacional de Cáncer Cervicouterino, citología confirmativa, colposcopia, biopsia por ponche o cono, con estudio anatomopatológico de la misma. Se estudiaron las diferentes etapas que son necesarias para llegar a un diagnóstico confirmativo, correlacionarlos y definir el tiempo necesario y mínimo en que se realiza este proceder diagnóstico con la mayor calidad; se valoran además las diferentes formas de tratamiento empleadas y se calcula la mayor brevedad de tiempo necesario para tratar a la paciente y reincorporarla a sus actividades sociales en el menor plazo posible

Carcinoma in situ: nuevos aspectos (1985-1986) / Carcinoma in situ: new aspects (1985-1986)

Durante los años 1985-1986 se dignosticaron 100 casos de carcinoma in situ del cuello uterino en el Hospital Docente Maternoinfantil "10 de Octubre". En su diagnóstico se cumplieron todos los parámetros establecidos por el Programa Nacional de Cáncer Cervicouterino, citología confirmativa, colposcopia, biopsia por ponche o cono, con estudio anatomopatológico de la misma. Se estudiaron las diferentes etapas que son necesarias para llegar a un diagnóstico confirmativo, correlacionarlos y definir el tiempo necesario y mínimo en que se realiza este proceder diagnóstico con la mayor calidad; se valoran además las diferentes formas de tratamiento empleadas y se calcula la mayor brevedad de tiempo necesario para tratar a la paciente y reincorporarla a sus actividades sociales en el menor plazo posible