Prematurity and congenital malformations differ according to the type of pregestational diabetes.

BACKGROUND: Diabetes mellitus (DM) is the most common metabolic disorder in pregnancy. Women with Type 2 DM seems to have no better perinatal outcomes than those with Type 1 DM. METHODS: Single-center prospective cohort observational study. Pregnant women with diabetes (141 with Type 1 DM and 124 with Type 2 DM) that were followed in the university hospital between 2009 and 2021 were included in this study. Clinical data and obstetric and perinatal outcomes were collected. RESULTS: As expected, women with Type 1 DM were younger and had a longer duration of diabetes than women with Type 2 DM. Obesity and chronic hypertension were higher in the group of women with Type 2 DM and their value of HbA1c in the second and third trimesters were lower than in Type 1 DM. No differences in prematurity were found, but more extreme prematurity was observed in Type 2 DM, as well as a higher rate of congenital malformations. The frequency of hypoglycemia and the weight of the newborn was higher in Type 1 DM. The maternal independent factors related to the weight of the newborn were: the glycemic control at the third trimester, the weight gain during pregnancy, and pregestational BMI. CONCLUSIONS: Newborns born to mothers with Type 1 DM were larger and had a higher frequency of hypoglycemia, while congenital malformations and precocious preterm was more associated to Type 2 DM. Metabolic control, weight gain and pregestational weight were important determinants of both obstetric and neonatal complications.

Development of a full-thickness acellular dermal graft from human skin: Case report of first patient rotator cuff patch augmentation repair.

The processing and initial testing of a new human tissue preparation is described. Full-thickness Acellular Dermal Matrix (ftADM) is the extracellular matrix (ECM) obtained by decellularization of full-thickness human skin from cadaveric donors. The safety, stability and usability of the graft are discussed with respect to the results of the residual cellular content, maintenance of ECM components, and biomechanical properties. Quantitative and qualitative analysis of the ECM demonstrated the absence of cell debris, while the native structure of human dermis was maintained. Biomechanical testing showed stiffness values comparable to other commercial products used for tendon reinforcement, suggesting that our ftADM could be successfully used not only in soft tissue regeneration surgeries, but also in tendon reinforcement. First case of ftADM in rotator cuff augmentation is described. Technical management of the patch during surgery and clinical outcomes are discussed.

Acute pancreatitis promotes the generation of two different exosome populations.

Exosomes are small extracellular vesicles that act as intercellular messengers. Previous studies revealed that, during acute pancreatitis, circulating exosomes could reach the alveolar compartment and activate macrophages. However, proteomic analysis suggested that the most likely origin of these exosomes could be the liver instead of the pancreas. The present study aimed to characterize the exosomes released by pancreas to pancreatitis-associated ascitic fluid (PAAF) as well as those circulating in plasma in an experimental model of taurocholate-induced acute pancreatitis in rats. We provide evidence that during acute pancreatitis two different populations of exosomes are generated with relevant differences in cell distribution, protein and microRNA content as well as different implications in their physiological effects. During pancreatitis plasma exosomes, but not PAAF exosomes, are enriched in the inflammatory miR-155 and show low levels of miR-21 and miR-122. Mass spectrometry-based proteomic analysis showed that PAAF exosomes contains 10-30 fold higher loading of histones and ribosomal proteins compared to plasma exosomes. Finally, plasma exosomes have higher pro-inflammatory activity on macrophages than PAAF exosomes. These results confirm the generation of two different populations of exosomes during acute pancreatitis. Deep understanding of their specific functions will be necessary to use them as therapeutic targets at different stages of the disease.

El suicidio de indígenas desde la determinación social en salud / Indigenous suicide based on social health determinations / O suicídio dos indígenas a partir da determinação social em saúde

Resumen El suicidio es causa frecuente de muerte en el mundo, su expresión en los pueblos indígenas es un problema de salud pública dadas las tasas de suicidio más altas en ellos que en población general afectando preferentemente a hombres jóvenes, de bajo nivel socioeconómicos, desempleados, y consumidores de sustancias. Dada la magnitud del problema y el impacto sobre pueblos originarios incluso en peligro de extinción, se buscó ampliar las comprensiones sobre el tema, posibilitando plantear investigaciones e intervenciones apropiadas que ayuden en la solución. Objetivo: Analizar el suicidio consumado por población indígena, desde la determinación social de la salud. Metodología: Se realizó un estado del arte sobre suicidio en pueblos indígenas, período 1993 - 2013; 57 artículos fueron seleccionados por su calidad y pertinencia, y analizados a la luz de la determinación social en salud. Resultados: Se delinearon las matrices de procesos críticos que describen procesos protectores y destructivos alrededor del suicidio en pueblos indígenas. Conclusión: El enfoque empleado permitió identificar condiciones estructurales de violencia que impactan el bienestar de los indígenas y son partícipes principales en el fenómeno del suicidio consumado en estos pueblos.

Abstract Introduction: Suicide is a common cause of death in the world. Its expression in indigenous populations is a public health problem due to the fact that suicide rates are higher among them than in the general population, preferably affecting low income, unemployed young men who are involved in substance abuse. The magnitude of the problem and its impact on the original populations, even in danger of extinction, allowed the study to expand its comprehension regarding the subject matter, and propose research studies and suitable interventions that can lead to possible solutions. Objective: Annalise completed suicide in indigenous populations based on a social health determination. Methodology: The study conducted a review of the state-of-the-art regarding suicide in indigenous populations from 1993 to 2013; 57 articles were selected because of their quality and pertinence, and they were analyzed in the light of social health determinations. Results: Critical process matrixes where outlined which describe protective destructive processes surrounding suicide in indigenous populations. Conclusion: The approach used in this study allowed the identification of structural conditions of violence that affect indigenous people's well-being, who are the main participators in completed suicide in these populations.

Resumo Introdução: O suicídio é uma causa frequente de morte no mundo, sua expressão nos povos indígenas é um problema de saúde pública, porque as taxas de suicídio são mais altas neles do que na população em geral, afetando principalmente os homens jovens de baixo nível. Socioeconômicos, desempregados e utentes de substâncias. A magnitude do problema e o impacto sobre os povos nativos, incluindo aqueles em perigo de extinção, nos permitiu ampliar nossa compreensão sobre o assunto e propor pesquisas e intervenções apropriadas para orientar possíveis soluções. Objetivo: Analisar o suicídio consumado pela população indígena, a partir da determinação social da saúde. Metodologia: Uma revisão do estado da arte sobre o suicídio em povos indígenas foi realizada entre 1993 e 2013; 57 artigos foram selecionados por sua qualidade e relevância, e analisados à luz da determinação social em saúde. Resultados: Matrizes de processos críticos que descrevem processos protetores e destrutivos em torno do suicídio em povos indígenas foram delineados. Conclusão: O enfoque empregado permitiu identificar condições estruturais de violência que impactam o bem-estar dos indígenas, partícipes principais no fenómeno do suicídio consumado nestes povos.