Enhancing the nutritional and bioactive benefits of faba bean flour by combining preprocessing and thermoplastic extrusion: A comprehensive study on digestion-resistant peptides.

This research assessed how three preprocessing techniques [soaking (S), soaking and reconstitution (SR), and soaking and dehulling (SD)] impact the protein digestibility and bioactivity of faba bean flours when combined with thermoplastic extrusion. Samples were compared against a control (C) of extruded faba bean flour without preprocessing. Applying preprocessing techniques followed by extrusion diminished antinutrient levels while enhancing protein hydrolysis and in vitro bioactivity in higher extent compared to C. Specifically, SD combined with extrusion was the most effective, achieving an 80% rate of protein hydrolysis and uniquely promoting the release of gastric digestion-resistant proteins (50-70 kDa). It also resulted in the highest release of small peptides (<3kDa, 22.51%) and free amino acids (15.50%) during intestinal digestion. Moreover, while all preprocessing techniques increased antioxidant (ABTS radical-scavenging), antidiabetic, and anti-hypertensive activities, SD extruded flour displayed the highest levels of dipeptidyl peptidase inhibition (DPP-IVi, IC50=13.20 µg/mL), pancreatic α-amylase inhibition (IC50=8.59 mg/mL), and angiotensin I-converting enzyme inhibition (ACEi, IC50=1.71 mg protein/mL). As a result, it was selected for further peptide and in silico bioactive analysis. A total of 24 bioactive peptides were identified in intestinal digests from SD extruded flour, all with potential DPP-IVi and ACEi activities, and six were also predicted as antioxidant peptides. VIPAGYPVAIK and GLTETWNPNHPEL were highlighted as resistant bioactive peptides with the highest antidiabetic and antioxidant potential. Our findings demonstrated that combining preprocessing (particularly SD) and thermoplastic extrusion enhances protein digestibility in faba beans and promotes the release of beneficial bioactive peptides in the intestine.

Interpreter usage and associations with latent tuberculosis infection treatment acceptance and completion in the USA among non-U.S.-born persons, 2012-2017.

BACKGROUND: Latent tuberculosis infection (LTBI) screening and treatment interventions that are tailored to optimize acceptance among the non-U.S.-born population are essential for U.S. tuberculosis elimination. We investigated the impact of medical interpreter use on LTBI treatment acceptance and completion among non-U.S.-born persons in a multisite study. METHODS: The Tuberculosis Epidemiologic Studies Consortium was a prospective cohort study that enrolled participants at high risk for LTBI at ten U.S. sites with 18 affiliated clinics from 2012 to 2017. Non-U.S.-born participants with at least one positive tuberculosis infection test result were included in analyses. Characteristics associated with LTBI treatment offer, acceptance, and completion were evaluated using multivariable logistic regression with random intercepts to account for clustering by enrollment site. Our primary outcomes were whether use of an interpreter was associated with LTBI treatment acceptance and completion. We also evaluated whether interpreter usage was associated treatment offer and whether interpreter type was associated with treatment offer, acceptance, or completion. RESULTS: Among 8,761 non-U.S.-born participants, those who used an interpreter during the initial interview had a significantly greater odds of accepting LTBI treatment than those who did not use an interpreter. There was no association between use of an interpreter and a clinician's decision to offer treatment or treatment completion once accepted. Characteristics associated with lower odds of treatment being offered included experiencing homelessness and identifying as Pacific Islander persons. Lower treatment acceptance was observed in Black and Latino persons and lower treatment completion by participants experiencing homelessness. Successful treatment completion was associated with use of shorter rifamycin-based regimens. Interpreter type was not associated with LTBI treatment offer, acceptance, or completion. CONCLUSIONS: We found greater LTBI treatment acceptance was associated with interpreter use among non-U.S.-born individuals.

Multiparity favors same-sex partner preference in male rats.

Same-sex partner preference is present in many mammals, including rodents. Several possible causal factors have been proposed for the establishment of this preference. The Fraternal Birth Order effect refers to the observation that older brothers increase the probability of homosexuality in men, but no experiment has analyzed this possibility. In this study, partner preference (tested in a three compartments box) and female and male sexual behavior (studied in a cylindrical arena) were evaluated in young male rats (3 months) born to multiparous mothers that had 4-6 previous gestations and around 12 months of age. Control groups were young male rats born to primiparous young (4 months) or aged (12 months) mothers. In the partner preference test, the males born to multiparous dams spent less time interacting with the receptive female and more time interacting with the sexually active male, and a 39% exhibited same-sex partner preference. This high percentage seems related to multiparity of their mothers and not to maternal age, because the males born to primiparous aged females (12 months) showed a similar low proportion of same-sex partner preference than the males born to young (4 months) primiparous females (4%). In the sexual behavior tests, no male born of a multiparous dam and with same-sex preference ejaculated and 54% displayed proceptivity and lordosis. Present results suggest that the fraternal birth order effect may occur also in rats.

Gestational monitoring in buffalo females: detection of Neospora caninum by PCR.

This study establishes the serological frequency against Neospora caninum on day zero and the presence of N. caninum DNA surveyed throughout the gestation of Bubalus bubalis females in a bovine buffalo system in the central zone of the state of Veracruz, Mexico. Blood samples were taken from 11 females in 6 different sampling periods and analyzed for N. caninum antibodies detection on day zero. DNA detection by PCR was performed on all sampling periods. The gestation months of the females were recorded for five trimesters by ultrasonography, as well as births and pregnancy losses. Recorded seropositivity and positivity for agent DNA were 90.9% (95% CI 58.7-9.7) and 36.3% (95% CI 10.9-69.2), respectively, on day zero. N. caninum DNA was detected between 18.1% (95% CI 2.3-51.7) and 45.4% (95% CI 16.7-76.6) over the five trimesters of observation, with three births and three abortions recorded. The studied water buffalo population had a high presence of N. caninum antibodies; however, the detection of N. caninum DNA remained below 47% in the females. The association was only observed in the detection of DNA with pregnant females (P 0.007). Our results support the hypothesis of the resistance of water buffaloes to infection and the onset of clinical signs against infection by N. caninum even upon a high possibility of infection and reinfection described in this production system in Mexico.

From ancient crop to modern superfood: Exploring the history, diversity, characteristics, technological applications, and culinary uses of Peruvian fava beans.

The search for plant-based superfoods has shown that many regional populations already have these foods in their diet, with significant potential for production and marketing. This critical review intends to show the history, diversity, characteristics, and uses, emphasizing their significance in traditional diets and potential in the food industry of Peruvian fava beans. As a valuable plant-based protein source, fava beans offer essential micronutrients and have diverse culinary applications. Innovative food industry applications include plant-based meat alternatives, fortified gluten-free products, and a natural color, protein, and fiber source in extruded foods. Key studies have highlighted the successful incorporation of fava beans into various food products, improving their nutritional properties, though some studies also point to limitations in their sensory acceptance. Further research is needed to understand the bioactive components, health effects, and techno-functional characteristics of beans. Challenges facing cultivating and consuming fava beans in Peru include adapting to climate change, enhancing productivity and quality, and promoting consumption and added value. Addressing these challenges involves developing climate-resilient varieties, optimizing agricultural practices, and providing access to resources and financing. In conclusion, this review highlights the promising prospects of Peruvian fava beans as a sustainable, nutritionally rich, and versatile ingredient in the food industry. By harnessing their potential and overcoming challenges, Peruvian fava beans can transition from an ancient crop to a modern superfood, inspiring a global shift towards sustainable and nutritionally balanced diets, aiding the fight against malnutrition, and enriching culinary traditions worldwide.

Plasma Fatty Acid Biomarkers of Dairy Consumption Are Associated with Sex-Dependent Effects on Metabolic Syndrome Components in Mexican Adolescents.

INTRODUCTION: During adolescence, dairy product intake has shown conflicting associations with metabolic syndrome (MetS) components, which are risk factors for cardiovascular disease (CVD). This study aims to investigate the association between plasma fatty acids (FAs) C15:0, C17:0, and t-C16:1n-7, as biomarkers of dairy intake, with MetS and its components in Mexican adolescents. METHODS: A sample of 311 participants from the Early Life Exposure in Mexico City to Environmental Toxicants (ELEMENT) cohort was included in this cross-sectional analysis. FA concentrations were measured in plasma as a percentage of total FA. We used quantile regression models stratified by sex to evaluate the association between FA quantiles and MetS components, adjusting for age, socioeconomic status (SES), sedentary behavior, BMI z-score, pubertal status, and energy intake. RESULTS: We found significant associations between dairy biomarkers and the median of MetS variables. In females, t-C16:1n-7 was associated with a decrease of 2.97 cm in WC (Q4 vs. Q1; 95% CI: -5.79, -0.16). In males, C15:0 was associated with an increase of 5.84 mm/Hg in SBP (Q4 vs. Q1; CI: 1.82, 9.85). For HDL-C, we observed opposite associations by sex. C15:0 in males was associated with decreased HDL-C (Q3 vs. Q1: ß = -4.23; 95% CI: -7.98, -0.48), while in females, C15:0 and t-C16:1n-7 were associated with increased HDL-C (Q3 vs. Q1: ß = 4.75; 95% CI: 0.68, 8.82 and Q4 vs. Q1: ß = 6.54; 95% CI: 2.01, 11.07), respectively. Additionally, in both sexes, different levels of C15:0, C17:0, and t-C16:1n-7 were associated with increased triglycerides (TG). CONCLUSION: Our results suggest that adolescent dairy intake may be associated in different directions with MetS components and that associations are sex-dependent.

Distribution of estrogen receptors alpha and beta in the brain of male rats with same-sex preference.

Two distinct estrogen receptors (ERs) exist, ERα and ERß. Both receptors participate in sexual differentiation of the rat brain and likely participate in the regulation of adult sexual orientation (i.e. partner preference). This last idea was investigated herein by examining males treated with the aromatase inhibitor, letrozole, administered prenatally (0.56 µg/kg G10-22). This treatment usually provokes same-sex preference in 1-2 males per litter. Vehicle-treated males (with female preference) and females in spontaneous proestrus (with male preference) were included as controls. ERα and ERß expression was analyzed by immunohistochemistry in brain areas known to control masculine sexual behavior and partner preference, like the medial preoptic area (MPOA), bed nucleus of the stria terminalis (BNST), medial amygdala (MeA) and ventromedial hypothalamic nucleus (VMH), as well as other brain regions suspected to participate in these processes. In addition, serum levels of estradiol were determined in all male groups. Letrozole-treated male rats that preferred sexually experienced males (LPM) showed over-expressed ERα in the hippocampal cornu Ammonis (CA 1, 3, 4) and dentate gyrus. The LPM group showed up-regulated ERß expression in the CA2 and reticular thalamic nucleus. The levels of estradiol did not differ between the groups. Higher expression of ERs in these males was different than their expression in females, with male sex-preference. This suggests that males with same-sex preference showed a unique brain, this sui generis steroid receptor expression probably participates in the biological underpinnings of sexual preference.

Andean purple maize to produce extruded breakfast cereals: impact on techno-functional properties and sensory acceptance.

BACKGROUND: Andean purple maize (APM) is an ancient crop widely used as a natural coloring in traditional Peruvian cuisine. However, it has been little explored within the food industry. The present study assessed how APM impacts on techno-functional properties and sensory acceptance of breakfast cereals. Extruded samples formulated with 100, 75, 50, and 25% APM, and complemented with yellow corn grits (YCG), were analyzed for their techno-functional and sensory properties. RESULTS: Increases in bulk density, as well as reduction in the expantion and porosity were observated for extrudates containing ≥ 50% APM, accompanied by an increase in purple color intensity. Increase in milk absorption index, reduction in milk solubility index and decrease in cereal hardness with increase in APM were also observed. Despite this, APM extented the cereal bowl-life. High sensory scores of overall liking (6) and color (7) were obtained for extruded formulations containing ≥ 50% APM and low values for extrudates with 25% APM. Aroma, flavor, and texture scores did not present significant differences. CONCLUSION: APM is an ingredient with the potential to be used to produce breakfast cereals since it improves their techno-functional characteristics and sensory acceptance, at the same time, it leads to the production of healthy, nutritious, and sustainable food. © 2022 Society of Chemical Industry.

Androgen receptors immunoreactivity in the rat brain of males with same-sex preference.

Androgen receptors (AR) are crucial in the control of male sexual behavior and sex preference. AR are particularly concentrated in areas related with the neuroendocrine control of sex preference including the medial amygdala (MeA), the ventromedial nucleus of the hypothalamus (VMH), the bed nucleus of the stria terminalis (BNST), the medial preoptic area (MPOA), the nucleus accumbens (Acb), the suprachiasmatic (SCh) and supraoptic (SO) nuclei, but also seem to be important for the control of reproductive processes in the hippocampus (CA1-CA4 and dentate gyrus, DG). In the present study we analyzed the density of AR in these brain areas of adult male rats with sexual preference (established in a three-compartment box). Same-sex preference was produced in male rats by the prenatal administration of the aromatase inhibitor, letrozole (0.56 µg/kg/ml s.c. G10-22) that usually produces 1-2 animals per litter with same sex preference, while the others retain a female sex preference. We also included a group of proestrus females that had a clear preference for a sexually active male. AR were analyzed by immunocytochemistry using PG21 as primary antibody. We also measured total plasma testosterone concentrations by radioimmunoassay. In males with same sex preference there was a specific AR overexpression in CA3 and CA4 that suggests a feminized pattern because females in proestrus trend to show a higher density of AR in these hippocampal areas. Sex differences in AR density were found in the anterior cingulate cortex (ACg) and frontoparietal cortex (FrPa). Serum levels of testosterone did not differ between groups. Data are discussed based on the role of AR in the hippocampus.

Prevention of Cardiorenal Complications with Sodium-Glucose Cotransporter Type 2 Inhibitors: A Narrative Review.

Heart failure (HF) and chronic kidney disease (CKD) are the most frequent first cardiorenal conditions in patients with type 2 diabetes (T2D), which can be exacerbated by other comorbidities, such as hypertension, dyslipidemia, and obesity. To improve their clinical outcomes, patients with T2D need to achieve and maintain glycemic targets, as well as prevent cardiorenal disease onset and progression. Several clinical trials evaluating the sodium-glucose cotransporter type 2 inhibitors (SGLT2i) dapagliflozin, empagliflozin, canagliflozin, and ertugliflozin have shown consistent risk reduction in major adverse cardiovascular events and/or hospitalization for HF, together with lower risk of kidney disease progression. The benefits associated with SGLT2i in T2D are distinct from other antihyperglycemic drugs since they have been proposed to exert pleiotropic metabolic and direct effects on the kidney and the heart. In this review, we summarize and discuss the evidence regarding the mechanisms of action, the efficacy and safety profiles, and the clinical guidelines on the use of the therapeutic class of SGLT2i, highlighting their role in cardiorenal prevention beyond glycemic control.

Leptin Chronic Effect on Differentiation, Ion Currents and Protein Expression in N1E-115 Neuroblastoma Cells.

<b>Background and Objective:</b> Arcuate nucleus (ARC), a component of appetite-regulatory factors, contains populations of both orexigenic and anorexigenic neurons and one of the fundamental components of its system is leptin. Studies have evidenced the critical neurotrophic role in the development of ARC. To determine such effects on neuron development, N1E-115 neuroblastoma cells were used as an ARC model. <b>Materials and Methods:</b> N1E-115 neuroblastoma cells were treated with leptin [10 nM] for 24, 48 and 72 hrs. Dimethyl sulfoxide (DMSO) 1.5% was used as a known drug that promotes neurite expression. Cells percentage (%) that developed neurites was evaluated by bright field microscopy. Patch-clamp electrophysiology was used to analyze membrane ion currents, RT-PCR for quantifying changes in mRNA expression of anorexic peptides, proopiomelanocortin (POMC) and cocaine and amphetamine-related transcript (CART), in addition to principal Na_v, Ca_v ion channel subunits. <b>Results:</b> N1E-115 cells treated with leptin show neurite expression after 24 hrs of treatment, similar effects were obtained with DMSO. Leptin (time-dependent) increases the inward current in comparison with the control value at 72 hrs. Outward currents were not affected by leptin. Leptin and DMSO increased Na⁺ and Ca²⁺ current without changes in the kinetic properties. Lastly, leptin promotes an increase in mRNA level expression of transcripts to POMC, CART, Na_v1.2 and Ca_v1.3. <b>Conclusion:</b> Leptin chronic treatment promotes neurite expression, Up-regulation of Na⁺ and Ca²⁺ ion channels determining neuronal excitability, besides increasing the mRNA level expression of anorexic peptides POMC and CART in neuroblastoma N1E-115.

Kernel characterization and starch morphology in five varieties of Peruvian Andean maize.

Peruvian Andean maize (PAM) has been commonly used as an ingredient that confers color, flavor, and texture in culinary. Nevertheless, no studies are focusing on agro-industrial interest characteristics to develop new products. This study aimed to evaluate the physicochemical, nutritional, and technological characteristics of kernels and the starch granule morphology of the five main PAM varieties: Chullpi, Piscorunto, Giant Cuzco, Sacsa, and Purple. PAM's characterization was performed according to the official methods, and its morphology was observed by scanning electron microscopy (SEM). Physically, the varieties of larger kernels (Giant Cuzco and Sacsa) presented a higher 1000-kernel weight and a lower hectoliter weight than those of smaller size (Piscorunto, Purple, and Chullpi). Nutritionally, PAM had higher ether extract (5%) and ash (2%) contents than other pigmented maizes. Likewise, they presented more significant amounts of essential amino acids, as leucine (10 mg/g protein) and tryptophan (up to 2 mg/g protein); unsaturated fatty acids, oleic (30%) and linoleic (53%); and minerals, as magnesium (104 mg/100 g). SEM showed that endosperm structure and starch morphology vary according to maize types and their grain location. Starch granules of floury PAM varieties were small and polyhedral in the sub-aleurone endosperm, whereas those of the central area were bigger and spherical. In Chullpi, it was observed a portion of vitreous endosperm with a compact structure. The low protein content (8.3%) and the endosperm structure of floury varieties of PAM influenced their pasting properties. Their pasting temperature was <69 to 71 °C>, peak viscosity < 3200 to 4400 cP>, and seatback <1250 to 1706 cP>; therefore, they do not retrograde easily. The results suggest that PAM has characteristics that would help elaborate regional products with added value, such as soups, willows, beverages, and porridges.

Peruvian Andean maize: General characteristics, nutritional properties, bioactive compounds, and culinary uses.

Ancient grains are considered to have been minimally changed by selective breeding, thus they are resistant to pests and environmental adversities and have stood out as a healthy food for consumption. This article aimed to review Peruvian Andean maize (PAM), which despite being used in local cuisine, little information has been found in literature about its characteristics and bioactive properties. The highest yielding varieties of PAM include Chullpi, Piscorunto, Sacsa, Giant Cuzco, and Purple, which differs from the commercial maize by their greater variety of color, size, and higher levels of protein, lipids, and bioactive compounds. The genetic characteristics of PAM associated with a geographical origin allow for the production of agricultural products with higher added value, without exhausting the existing plantations and maintaining the sustainability of the Andean region.

Higher Acuity Resource Utilization With Older Age and Poorer HIV Control in Adolescents and Young Adults in the HIV Research Network.

BACKGROUND: Adolescents and young adults (AYA) with HIV experience poorer health outcomes compared with adults. To improve care for AYA with HIV, information about patterns of costly health care resource utilization is needed. METHODS: Among 13-30 year olds in the US HIV Research Network, we stratified outpatient visits, emergency department (ED) visits, and inpatient days/person-year (PY) by HIV acquisition model [perinatal (PHIVY) and nonperinatal (NPHIVY)], age (13-17, 18-23, and 24-30 years), CD4 strata (<200, 200-499, and ≥500 cells/µL), and viral load (VL) suppression (<, ≥400 copies/mL [c/mL]) combined with antiretroviral (ARV) use. RESULTS: Among 4540 AYA (PHIVY: 15%; NPHIVY: 85%), mean follow-up was 2.8 years. Among PHIVY, most person-time (PT) was spent between ages 13 and 23 years (13-17 years: 43%; 18-23 years: 45%), CD4 ≥500/µL (61%), and VL <400 c/mL (69%). Among NPHIVY, most PT was spent between ages 24 and 30 years (56%), with CD4 ≥500/µL (54%), and with VL <400 c/mL (67%). PT spent while prescribed ARVs and with VL ≥400 c/mL was 29% (PHIVY) and 24% (NPHIVY). For PHIVY and NPHIVY, outpatient visit rates were higher at younger ages (13-17 years and 18-23 years), lower CD4 (<200 and 200-499/µL), and among those prescribed ARVs. Rates of ED visits and inpatient days were higher during PT spent at older ages (18-23 years and 24-30 years), lower CD4 (<200 and 200-499/µL), and VL ≥400 c/mL. Utilization was higher among PHIVY than NPHIVY (outpatient: 12.1 vs. 6.0/PY; ED: 0.4 vs. 0.3/PY; inpatient: 1.5 vs. 0.8/PY). CONCLUSIONS: More ED visits and inpatient days were observed during time spent at older ages, lower CD4 count, and VL ≥400 c/mL. Interventions to improve virologic suppression and immune response may improve outcomes, and thus decrease costly resource utilization, for AYA with HIV.

Establishment of partner preference in male rats: Effect of prenatal letrozole and sexual experience.

Repeated testing for masculine sexual behavior influences female sex preference in males. Males perinatally treated with aromatase inhibitors show male preference, but also copulate with the receptive female. Such copulation modifies sex preference most likely because of its rewarding properties. In this study, we intended to equal the incentive value of both stimuli -in the sex preference test- by using receptive females with vaginal occlusion. Vehicle and letrozole-treated (0.56 µg/kg, gestation days 10-21) males were repeatedly tested for sex preference at 40, 55, 70, 85 and 100 days of age. These ages were selected because males of 40 days are unable to copulate, while by 100 days of age almost all males show the complete repertoire of masculine sexual behavior. At 40 days of age, males of all groups fail to show sex preference and none of them was able to copulate. In controls of 100 days of age all males showed female-sex preference and all intromitted the female. A large proportion (44%) of vehicle-treated males that could not copulate the female showed male preference. Twenty to 30% of the prenatally letrozole treated males also had same-sex preference even if they could copulate; and most of them (67%) had a male preference when copulation was precluded. These data support the idea that copulation is crucial for developing a female preference in control animals. The results suggest that brain changes produced by estrogens along early development and stimuli coming from the partner are essential for shaping sex preference.

Sex and age differences in the antidepressant-like effect of fluoxetine in the forced swim test.

This study compared in males and females of three representative ages: young adults (3-5months old), middle-aged (12-15months old) and senescent (23-25months old) the antidepressant-like effect of fluoxetine (FLX, 5.0 and 10mg/kg) in the forced swim test (FST). Intact (non gonadectomized) rats were evaluated. Young adult females were chosen in proestrus/estrus or in metestrus/diestrus, while middle-aged and senescent females were selected in metestrus/diestrus. Locomotion and motor coordination were also recorded. Under basal conditions (without FLX), young adult and middle-aged females showed less immobility than males. This sex difference disappeared at senescence because males diminished their levels of immobility. Thus, senescent males showed lower immobility than middle-aged and young males. FLX (5 and 10mg/kg) produced similar actions in young females irrespective of their estrous cycle phase, therefore, these subgroups were pooled in a single one. Young adult and middle aged females clearly responded to 5 and 10mg/kg of FLX with a reduction in immobility, while young adult and middle-aged males only did to 10mg/kg. In senescent females 10mg/kg FLX reduced immobility. Remarkably, in senescent males this FLX dose did not produce an antidepressant-like effect. FLX marginally affected locomotion; however, at its highest dose (10mg/kg), and only in senescent males, interfered with motor coordination tested in the rotarod. These data show that sex and aging influence behavioral despair without treatment and after FLX.

Longitudinal analysis of participants in the KEEP Mexico's chronic kidney disease screening program.

BACKGROUND AND AIMS: The Kidney Early Evaluation Program (KEEP) is a free screening and educational program aimed at detecting chronic kidney disease (CKD) among adult individuals who are at high-risk (those with diabetes, hypertension, or family history of these conditions or CKD). Confirmation of CKD diagnosis requires persistence of albuminuria or estimated GFR <60 mL/min for at least 3 months. We undertook this study to determine in a follow-up KEEP done at least 1 year after a baseline KEEP the following: 1) CKD incidence among individuals who initially tested negative for CKD, 2) transitions between CKD stages among individuals who initially tested positive for CKD. METHODS: A random sample of KEEP participants was invited to participate in a follow-up KEEP between 2008 and 2010. Paired analyses were conducted to compare CKD stages between baseline and follow-up KEEP. RESULTS: A total of 434 individuals with a mean age of 49 years and 77% females participated in the study. Overall CKD prevalence in the baseline KEEP was 24%, and most patients were unaware of the diagnosis. In the follow-up KEEP, CKD incidence was 14%. The percentage of patients who tested positive for CKD in the baseline KEEP and who remained positive regardless of stage in the follow-up KEEP was 40% for those with stage 1 at baseline, 52% for those with stage 2, 65% for those with stage 3, and 100% for those with stages 4 or 5. CONCLUSIONS: Screening for CKD among high-risk individuals is uncommon. KEEP is an effective program for detecting CKD.

[Two clinical cases of sporadic lymphangioleiomyomatosis]. / Linfangioleiomiomatosis esporádica. Dos casos clínicos.

Lymphangioleiomyomatosis (LAM) is a rare lung disease of unknown etiology, described since 1918 associated with tuberous sclerosis complex (TSC-LAM) and are reported sporadically (S-LAM). It is classified within the group of interstitial lung diseases (ILD) and currently the European Respiratory Society (ERS) has published guidelines for diagnosis and treatment. The objective is to evaluate the clinical presentation of two patients, evolution, management, and review of current treatment. Both patients admitted in our hospital for examination, presenting with spontaneous pneumothorax. Their CT scan shows characteristic cystic lesions and thoracotomy with lung biopsy was performed because lack of expansion and to confirming the diagnosis. Despite the controversy about the optimal management of these patients, there is evidence about the use of progesterone routinely in patients with rapid deterioration of respiratory function when it was provided for a period of at least 12 months. Due to the rareness of the disease, it requires a patient registry to evaluate the use of experimental drugs or include them in research protocols to improve their prognosis.

Synergistic effect of estradiol and fluoxetine in young adult and middle-aged female rats in two models of experimental depression.

The antidepressant effect of estrogens combined with antidepressants is controversial: some preclinical data showed that estrogens facilitate the effect of antidepressants in the forced swimming test (FST) in young adult rats, while others failed to find such effect in middle-aged rats in the chronic mild stress (CMS) model. In clinics similar differences were reported and may be due to the compounds, the depression model or type of depression, the experimental design, and the age of the subjects or the women's menopause stage. The objective of this study was to analyze the antidepressant-like effect of the combination of 17ß-estradiol (E(2)) and fluoxetine (FLX) in young adults (2-4 months) and middle-aged (12-14 months) ovariectomized (OVX) rats in two experimental models: FST and CMS. E(2) (5 and 10 µg/rat) and FLX (2.5 and 10 mg/kg) per se dose-dependently reduced immobility in both age groups and, in young adults both compounds increased swimming, whereas in middle-aged rats they increased swimming and climbing. Analysis of the antidepressant-like effect of the combination of suboptimal doses of FLX (1.25 mg/kg) and E(2) (2.5 µg/rat) showed a decrease in immobility and an increase in swimming in both age groups. In the CMS, chronic E(2) (2.5 µg/rat) with FLX (1.25 mg/kg) augmented relative sucrose intake, but middle-aged rats responded 2 weeks earlier than young adults. These results show that the antidepressant-like effect of the combination of E(2) and FLX in young adult and middle-aged female rats is evidenced in the two animal models of depression: FST and CMS.