Hipertensión arterial y diabetes gestacional en pacientes obesas y con sobrepeso, Centro de Salud Alonso Suazo, Tegucigalpa / Blood hypertension and gestational diabetes in obese patients and overweight,Health Center Alonso Suazo, Tegucigalpa

Antecedentes: El impacto de la obesidad e incremento excesivo de peso en embarazo y efectos en recién nacidos (peso elevado, prematuridad etc) está claramente documentado, así como resultados perinatales adversos. Objetivo: determinar frecuencia de hipertensión y diabetes gestacional en mujeres embarazadas obesas y con sobrepeso sometidas a dieta y ejercicio en centro de salud Alonso Suazo de Tegucigalpa.- Métodos: Estudio descriptivo realizado en el centro de Salud Alonso Suazo, septiembre 2016 a mayo 2017; muestreo por conveniencia captando todas las mujeres embarazadas con obesidad; se les dio seguimiento para evaluación y manejo del sobrepeso en las citas de control prenatal. Los datos recolectados se ingresaron en paquete estadístico IBM SPSS statistics 21. Resultados: participaron 68 pacientes embarazadas IMC mayor de 25, edad promedio 31 años (DE 4), Se indicó dieta y ejercicio al 100% de las pacientes y restricción de pastillas prenatales al 50%, se obtuvo un control de peso satisfactorio en 50% de las pacientes; 50% no logro un control satisfactorio de peso, 7.4% de pacientes presentaron complicaciones correspondientes al grupo que no tuvieron control satisfactorio de peso en el embarazo OR=1.172 (IC95%=1.020-1.348, p=0.020). Conclusión: El control satisfactorio del peso en las mujeres obesas y con sobrepeso con dieta adecuada y ejercicio contribuye a disminuir complicaciones relacionadas a la obesidad y el embarazo tales como diabetes gestacional e hipertensión arterial.

Variante de Dandy Walker: reporte de un caso / Dandy-Walker variant: Case report

Introducción: La variante de Dandy Walker se define como una hipoplasia variable del vermis cerebeloso, con o sin aumento de la fosa posterior y sin elevación del tentorio. Objetivo: Describir el caso de una enfermedad poco frecuente y hacer énfasis en la necesidad de precisar la etiología de malformaciones prenatales en niños que son clasificados erróneamente como parálisis cerebral secundaria a asfixia, así como su manejo multidisciplinario. Caso clínico: Paciente varón, de 8 años de edad, con antecedentes de parálisis cerebral infantil, epilepsia y retraso del desarrollo, que fue ingresado por historia de convulsiones tónico-clónicas. Durante su hospitalización presentó múltiples episodios convulsivos, controlados con anticonvulsivantes. Se realizó tomografía computarizada, observándose comunicación entre la cisterna magna y el cuarto ventrículo; este último aumentado de tamaño. Además, el vermis del cerebelo presentaba hipoplasia parcial, siendo estos hallazgos compatibles con una variante del síndrome Dandy Walker. Conclusión: La variante de Dandy Walker puede ser sintomática o asintomática, y las imágenes encontradas no necesariamente se relacionan con las alteraciones del desarrollo, debido a los múltiples síndromes y alteraciones cromosómicas vinculadas a este cuadro. La presentación clínica y el pronóstico dependen de las alteraciones presentes. Por ello, es importante un manejo multidisciplinario considerando que el tratamiento depende de los síntomas presentados.

Introduction: Dandy Walker variant is defined by a variable hypoplasia of the cerebellar vermix with or without posterior fossa increase and without tentorium elevation. Objective: describe the case of a rare disease and emphasise the need to clarify the aetiology of prenatal malformations, as well as its multidisciplinary management. Case report: A male patient, 8 years of age, with a history of Infantile Cerebral Palsy and epilepsy, who was admitted with a history of tonic-clonic seizures. He was admitted due to psycho-motor developmental delay. During his hospitalisation, he had multiple seizure episodes, controlled with anticonvulsants. A computerized tomography was performed, in which communication was observed between the cisterna magna and fourth ventricle (the latter increased in size). In addition, the cerebellar vermix showed a partial hypoplasia. All these findings were compatible with a variant of the Dandy Walker syndrome. Conclusion: Dandy Walker variant may be asymptomatic and the images found may not indicate them as the cause of developmental disorders, due to its association with multiple syndromes and chromosomal abnormalities. Clinical presentation and prognosis depends on the related disorders, and a multidisciplinary approach is important, because the treatment depends on the symptoms presented.

[Dandy-Walker variant: Case report]. / Variante de Dandy Walker: reporte de un caso.

INTRODUCTION: Dandy Walker variant is defined by a variable hypoplasia of the cerebellar vermix with or without posterior fossa increase and without tentorium elevation. OBJECTIVE: describe the case of a rare disease and emphasise the need to clarify the aetiology of prenatal malformations, as well as its multidisciplinary management. CASE REPORT: A male patient, 8 years of age, with a history of Infantile Cerebral Palsy and epilepsy, who was admitted with a history of tonic-clonic seizures. He was admitted due to psycho-motor developmental delay. During his hospitalisation, he had multiple seizure episodes, controlled with anticonvulsants. A computerized tomography was performed, in which communication was observed between the cisterna magna and fourth ventricle (the latter increased in size). In addition, the cerebellar vermix showed a partial hypoplasia. All these findings were compatible with a variant of the Dandy Walker syndrome. CONCLUSION: Dandy Walker variant may be asymptomatic and the images found may not indicate them as the cause of developmental disorders, due to its association with multiple syndromes and chromosomal abnormalities. Clinical presentation and prognosis depends on the related disorders, and a multidisciplinary approach is important, because the treatment depends on the symptoms presented.

Geometric influence on intramolecular photoinduced electron transfer in platinum(II) acetylide-linked donor-acceptor assemblies.

A new donor-acceptor system, in which the electron donor triphenylamine (TPA) and the electron acceptor C60 are bridged through a cis- or trans-platinum(II) acetylide spacer have been prepared. Ground-state studies were conducted using electrochemistry and UV/Vis spectroscopy. Fluorescence studies suggested that charge transfer is the deactivation mechanism for the singlet excited state, and this was verified by transient absorption spectroscopy. Selective photoexcitation of 1 and 2 at 387 nm leads to a fast charge transfer between the TPA and C60, which gives rise to a radical ion-pair state (TPA(·+)-Pt-C60(·-)). Our results suggest that charge transfer is favored for the cis configuration while the presence of the trans configuration in the Pt(II) diacetylide results in a longer-lived charge separated states.

Synthesis and characterization of electron donor-acceptor platinum(II) complexes composed of N,N-diphenylpyridineamine and triphenylamine ligands.

The synthesis and electronic properties of a series of platinum(II) complexes composed of electron-donor and electron-acceptor components as potential photovoltaic materials is reported. The complexes are composed of triphenylamines (TPA) and pyridine-derivatized TPAs as the electron-donating components, and alkynyl derivatives of 2,1,3-benzothiadiazole and cyclopentadithiophenone as the electron acceptors. The complexes containing the pyridine-derivatized ligands were prepared to examine the effect that direct coordination of a heteroatom-modified TPA may have on the electronic properties of donor-acceptor (D-A) complexes. Four complexes composed of meta- and para- pyridine-derivatized TPAs were prepared, and their electronic properties were compared with three structurally similar complexes composed of TPA, as well as with purely organic D-A compounds. Data collected from UV-vis and cyclic voltammetry show minor differences on the properties of the complexes containing the pyridine-derivatized ligands when compared to the TPA analogs, exhibiting similar highest occupied molecular orbital-lowest unoccupied molecular orbital bandgaps ranging from 2.156 to 2.705 eV for the pyridine-derivatized complexes (6a,b and 7a,b), 2.038-2.320 eV for the TPA complexes (8a,b and 9a), 2.301 eV for organic molecule 10a, and 1.997 eV for 10b. All compounds are stable, exhibiting no decomposition in the solid indefinitely, and only minor decomposition in solution. All compounds were characterized by (1)H and (13)C nuclear magnetic resonance, infrared spectroscopy, and electrospray mass spectrometry. All complexes were also characterized by (31)P nuclear magnetic resonance and elemental analysis of CHN; determination of Ag content for 6a,b and 7a,b (carried through the synthetic steps) was determined by inductively coupled plasma optical emission spectrometry. The para-pyridine-derivatized complex of 2,1,3-benzothiadiazole (6a) was further characterized by X-ray crystallography as a AgNO3 clathrate. X-ray quality crystals were grown from a solution of hexanes/CH2Cl2 and from diffusion of hexanes into a CH2Cl2 solution of the complex, providing a solvent-free crystal and a solvate of CH2Cl2, respectively.

Synthesis, characterization, and evaluation of cis-diphenyl pyridineamine platinum(II) complexes as potential anti-breast cancer agents.

Although cisplatin is considered as an effective anti-cancer agent, it has shown limitations and may produce toxicity in patients. Therefore, we synthesized two cis-dichlorideplatinum(II) compounds (13 and 14) composed of meta- and para-N,N-diphenyl pyridineamine ligands through a reaction of the amine precursors and PtCl2 with respective yields of 16 and 47 %. We hypothesized that compounds 13 and 14, with lipophilic ligands, should transport efficiently in cancer cells and demonstrate more effectiveness than cisplatin. When tested for biological activity, compounds 13 and 14 were found to inhibit the growth of MCF 7 and MDA-MB-231 cells (IC50s 1 ± 0.4 µM and 1 ± 0.2 µM for 13 and 14, respectively, and IC50 7.5 ± 1.3 µM for compound 13 and 1 ± 0.3 µM for compound 14). Incidentally, these doses were found to be lower than cisplatin doses (IC50 5 ± 0.7 µM for MCF 7 and 10 ± 1.1 µM for MDA-MB-231). Similar to cisplatin, 13 and 14 interacted with DNA and induced apoptosis. However, unlike cisplatin, they blocked the migration of MDA-MB-231 cells suggesting that in addition to apoptotic and DNA-binding capabilities, these compounds are useful in blocking the metastatic migration of breast cancer cells. To delineate the mechanism of action, computer-aided analyses (DFT calculations) were conducted for compound 13. Results indicate that in vivo, the pyridineamine ligands are likely to dissociate from the complex, forming a platinum DNA adduct with anti-proliferative activity. These results suggest that complexes 13 and 14 hold promise as potential anti-cancer agents.

CeO2 and ZnO nanoparticles change the nutritional qualities of cucumber (Cucumis sativus).

There is lack of information about the effects of nanoparticles (NPs) on cucumber fruit quality. This study aimed to determine possible impacts on carbohydrates, proteins, mineral nutrients, and antioxidants in the fruit of cucumber plants grown in soil treated with CeO2 and ZnO NPs at 400 and 800 mg/kg. Fourier transform infrared spectroscopy (FTIR) was used to detect changes in functional groups, while ICP-OES and µ-XRF were used to quantify and map the distribution of nutrient elements, respectively. Results showed that none of the ZnO NP concentrations affected sugars; however at 400 mg/kg, CeO2 and ZnO NPs increased starch content. Conversely, CeO2 NPs did not affect starch content but impacted nonreducing sugar content (sucrose). FTIR data showed changes in the fingerprint regions of 1106, 1083, 1153, and 1181, indicating that both NPs altered the carbohydrate pattern. ZnO NPs did not impact protein fractionation; however, CeO2 NPs at 400 mg/kg increased globulin and decreased glutelin. Both CeO2 and ZnO NPs had no impact on flavonoid content, although CeO2 NPs at 800 mg/kg significantly reduced phenolic content. ICP-OES results showed that none of the treatments reduced macronutrients in fruit. In case of micronutrients, all treatments reduced Mo concentration, and at 400 mg/kg, ZnO NPs reduced Cu accumulation. µ-XRF revealed that Cu, Mn, and Zn were mainly accumulated in cucumber seeds. To the best of the authors' knowledge this is the first report on the nutritional quality of cucumber fruit attributed to the impact of CeO2 and ZnO NPs.

Synchrotron verification of TiO2 accumulation in cucumber fruit: a possible pathway of TiO2 nanoparticle transfer from soil into the food chain.

The transfer of nanoparticles (NPs) into the food chain through edible plants is of great concern. Cucumis sativus L. is a freshly consumed garden vegetable that could be in contact with NPs through biosolids and direct agrichemical application. In this research, cucumber plants were cultivated for 150 days in sandy loam soil treated with 0 to 750 mg TiO2 NPs kg(-1). Fruits were analyzed using synchrotron µ-XRF and µ-XANES, ICP-OES, and biochemical assays. Results showed that catalase in leaves increased (U mg(-1) protein) from 58.8 in control to 78.8 in 750 mg kg(-1) treatment; while ascorbate peroxidase decreased from 21.9 to 14.1 in 500 mg kg(-1) treatment. Moreover, total chlorophyll content in leaves increased in the 750 mg kg(-1) treatment. Compared to control, FTIR spectra of fruit from TiO2 NP treated plants showed significant differences (p ≤ 0.05) in band areas of amide, lignin, and carbohydrates, suggesting macromolecule modification of cucumber fruit. In addition, compared with control, plants treated with 500 mg kg(-1) had 35% more potassium and 34% more phosphorus. For the first time, µ-XRF and µ-XANES showed root-to-fruit translocation of TiO2 in cucumber without biotransformation. This suggests TiO2 could be introduced into the food chain with unknown consequences.

Toxicity assessment of cerium oxide nanoparticles in cilantro (Coriandrum sativum L.) plants grown in organic soil.

Studies have shown that CeO2 nanoparticles (NPs) can be accumulated in plants without modification, which could pose a threat for human health. In this research, cilantro (Coriandrum sativum L.) plants were germinated and grown for 30 days in soil amended with 0 to 500 mg kg⁻¹ CeO2 NPs and analyzed by spectroscopic techniques and biochemical assays. At 125 mg kg⁻¹, plants produced longer roots (p ≤ 0.05), and at 500 mg kg⁻¹, there was higher Ce accumulation in tissues (p ≤ 0.05). At 125 mg, catalase activity significantly increased in shoots and ascorbate peroxidase in roots (p ≤ 0.05). The FTIR analyses revealed that at 125 mg kg⁻¹ the CeO2 NPs changed the chemical environment of carbohydrates in cilantro shoots, for which changes in the area of the stretching frequencies were observed. This suggests that the CeO2 NPs could change the nutritional properties of cilantro.

The use of ultrasound elastography in the assessment of malignancy risk in thyroid nodules and multinodular goitres.

OBJECTIVE: The objective of our work is to use a surgical series to analyse the validity of elastography in evaluating the malignancy of thyroid nodules and multinodular goitres. PATIENTS AND METHODS: The study examined 156 patients, 134 women (85·9%) and 22 men (14·1%), who underwent surgery for nodular thyroid disease between October 2008, and November 2010. The average age of the patients was 52 years (±14·42). Thirty-six patients (23·1%) presented with a single nodule, and 120 (76·9%) exhibited multinodular goitres. Prior to surgical intervention, all patients underwent colour eco-elastography using a qualitative five-point ordinal scale for nodule classifications. Test results were analysed using a receiver operating characteristic (ROC) curve, and an anatomical pathologic examination of surgical specimens was used as a gold standard diagnostic tool for comparison. RESULTS: Of the 192 nodules analysed, 28 (14·6%) were malignant. Using elastography data, an ROC curve was obtained with an area under the curve of 0·662 (±0·060) and a 95% confidence interval (CI 95%) between 0·545 and 0·779 (P = 0·006). By establishing a cut-off point that classified thyroid nodules with an elastographic value greater than or equal to 3 as malignant, we achieved a sensitivity of 75%, specificity of 45·73%, positive predictive value of 19·1% and negative predictive value of 91%. The positive and negative likelihood ratios were 1·38 and 0·55, respectively. CONCLUSIONS: Ultrasound elastography can provide information regarding malignancy risk in thyroid nodules and multinodular goitres. However, the sensitivity and specificity values obtained in our study are below those reported by other groups, a finding that calls into question the current clinical utility of ultrasound elastography.

Synthesis of bridged molecular gyroscopes with closed topologies: triple one-pot macrocyclization.

We describe the synthesis and characterization of six bridged molecular gyroscopes with m-alkoxy-substituted trityl stators and dialkynylphenylene rotators. All of the bridged molecular gyroscopes were synthesized convergently to form the phenolic stator-rotator framework, while the alkyl and benzophenone bridges were installed in one step by relatively efficient one-pot reactions to form macrocyclic diether or diester linkages. The isolated yield per bond-forming reaction varied from ca. 42% to 80%, with one exception where macrocyclization failed to produce the desired product. The molecular structure and crystal packing of each of the bridged molecular gyroscopes were determined via single crystal X-ray diffraction. Like most molecular gyroscopes with open topologies previously studied, the singly bridged structures pack by interdigitating one trityl stator in one molecule next to the rotator of an adjacent molecule in the lattice. In contrast, the triply bridged molecular gyroscopes were found to pack in lamellar sheets that prevent the rotator-stator interdigitation of adjacent molecules. However, solvent molecules and conformationally flexible bridges tend to fill in the packing volume by collapsing next to the rotator or by extending one of their bridges into the cavity of a neighboring molecule.

Synthesis of a triply-bridged molecular gyroscope by a directed meridional cyclization strategy.

A crystalline triply bridged molecular gyroscope has been prepared and analyzed by single-crystal X-ray diffraction. A convergent synthetic strategy was developed to control the direction of the three bridges, from the preferred two zonal and one meridional arrangement of a one-step cylclization process to the directed three meridional bridges achieved by a north-south desymmetrization.

Crystalline molecular machines: a quest toward solid-state dynamics and function.

Complex molecular machinery may be envisioned as densely packed, multicomponent, self-assembling systems built with high structural precision to control the dynamics of one or more internal degrees of freedom. With molecular gyroscopes as a test, we describe a general strategy to design crystals capable of supporting structurally programmed molecular motions, a practical approach to their synthesis, convenient strategies to characterize their solid-state dynamics, and potential applications based on polar structures responding collectively to external fields.

Hinged molecular capsules: synthesis and conformational control via temperature, pH, or solvent composition.

Three new covalently linked molecular capsules were synthesized from their resorcinarene cavitand precursors in good yields. The capsules undergo reversible conformational switching between the closed "vase" form and the open "kite" form upon temperature or pH variation. The kite conformation obtained via either method in CDCl(3) switches to vase conformation upon addition of polar solvents such as acetone-d(6) or THF-d(8).

Molecular compasses and gyroscopes with polar rotors: synthesis and characterization of crystalline forms.

We report the highly convergent synthesis and solid-state characterization of six crystalline "molecular compasses" consisting of a central phenylene rotor with polar substituents, or compass needle, and two trityl groups axially connected by acetylene linkages to the 1,4-positions. Compounds with fluoro-, cyano-, nitro-, amino-, diamino-, and nitroamino substituents are expected to emulate the parent compound which was shown to form crystals where the central phenylene can rotate about its 1,4-axis with rate constants in the 10(3) -10(6) s(-)(1) dynamic ranges near ambient temperature, depending on crystal morphology. With data from single-crystal X-ray diffraction analysis, solid-state CPMAS (13)C NMR, differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA), it is shown that a relatively small structural perturbation by a single polar group (F, CN, NO(2), NH(2)) results in isomorphous structures with analogous properties. In analogy to the parent compound, crystals grown from benzene formed clathrate structures in the space group Ponemacr; with one molecular compass and two benzene molecules per unit cell. Solvent-free crystals with the same space group obtained by a first-order phase transition between 60 and 130 degrees C were shown to be spectroscopically identical to those obtained by slow solvent evaporation from a mixture of CH(2)Cl(2) and hexanes. A qualitative analysis of the positionally disordered phenylene groups in terms of the expected solid-state rotational dynamics suggests a nonsymmetric, 2-fold rotational potential, or a process involving full 360 degrees turns.