Teratoma inmaduro de ovario Reporte de un caso / Ovarian immature teratoma:case report

Introducción: El teratoma inmaduro de ovario es una patología poco frecuente que se lo encuentra en mujeres jóvenes. Son tumores compuestos a partir de las capas germinales en la que los estudios de imagen son de ayuda diagnóstica, pero el examen histopatológico establece el diagnóstico definitivo. Existe controversia en el pronóstico y dependiendo del estadio se elije tratamiento quirúrgico o quimioterapia. Caso: Presentamos el caso de una paciente de 11 años que acude a emergencia con dolor abdominal, fluido transvaginal, presencia de masa en fosa iliaca izquierda de aproximadamente 20 cm. La biopsia reporta Teratoma Inmaduro. Se realiza exéresis total del tumor coadyuvante quimioterapia, con evolución favorable. Discusión: Este es un caso poco frecuente de teratoma inmaduro con limitada información respecto al pronóstico y tratamiento. Se trata de una paciente joven con una tumoración de alto grado (Grado II), considerado un factor pronóstico adverso con un índice de sobrevida a los dos años del 50%. Sin embargo, la paciente tuvo una excelente respuesta a la quimioterapia y evolución.

Introduction: The immature ovarian teratoma is a rare disease that affects young women. These tumors grow up from germ layers, therefore, histopathologic reports make the final diagnosis. There is still controversy regarding prognosis. Depending on the stage, surgery and chemotherapy are the treatment options. Case report: We report the case of a 11 year-old patient who came to the emergency room complaining of abdominal pain, transvaginal fluid discharge and a 20 cm mass located in the left lower quadrant abdomen. Pathology reported Immature teratoma. The excision of the tumor with adjuvant chemotherapy was performed with a good outcome. Discusion: This is rare case of immature teratoma with limited references in the medical literature regarding prognosis and treatment, this is a young patient with a high grade tumor (Grade II) that is considered an adverse prognostic factor, with 50% survival rate within two years. Our patient had an excellent response to chemotherapy.

The FTO gene is associated with adulthood obesity in the Mexican population.

Common polymorphisms in the fat mass and obesity-associated gene (FTO) have shown strong association with obesity in several populations. In the present study, we explored the association of FTO gene polymorphisms with obesity and other biochemical parameters in the Mexican population. We also assessed FTO gene expression levels in adipose tissue of obese and nonobese individuals. The study comprised 788 unrelated Mexican-Mestizo individuals and 31 subcutaneous fat tissue biopsies from lean and obese women. FTO single-nucleotide polymorphisms (SNPs) rs9939609, rs1421085, and rs17817449 were associated with obesity, particularly with class III obesity, under both additive and dominant models (P = 0.0000004 and 0.000008, respectively). These associations remained significant after adjusting for admixture (P = 0.000003 and 0.00009, respectively). Moreover, risk alleles showed a nominal association with lower insulin levels and homeostasis model assessment of B-cell function (HOMA-B), and with higher homeostasis model assessment of insulin sensitivity (HOMA-S) only in nonobese individuals (P (dom) = 0.031, 0.023, and 0.049, respectively). FTO mRNA levels were significantly higher in subcutaneous fat tissue of class III obese individuals than in lean individuals (P = 0.043). Risk alleles were significantly associated with higher FTO expression in the class III obesity group (P = 0.047). In conclusion, FTO is a major risk factor for obesity (particularly class III) in the Mexican-Mestizo population, and is upregulated in subcutaneous fat tissue of obese individuals.

High adiponectin concentrations are associated with the metabolically healthy obese phenotype.

CONTEXT: In the ob/ob mice, keeping adiponectin concentrations in the physiological range (through overexpression of this gene in the adipose tissue) results in expansion of fat mass and protection against metabolic co-morbidities. OBJECTIVE: The aim of the study was to test in humans whether plasma adiponectin levels, similar to those found in lean subjects, are associated with the metabolically healthy obese phenotype. DESIGN AND SETTING: A cross-sectional analysis was performed of a cohort of obese and nonobese subjects aged 18-70 yr. A medical history was taken, and glucose, plasma lipids, and total adiponectin were measured. PARTICIPANTS: We studied 189 men and 527 women. The majority were obese (n = 470, 65.6%). The metabolically healthy obese phenotype was found in 38 men and 133 women. This is defined as a body mass index (BMI) above 30 kg/m(2) plus high-density lipoprotein cholesterol of at least 40 mg/dl in the absence of type 2 diabetes and arterial hypertension. RESULTS: Twenty percent of the cases with a BMI above 40 kg/m(2) had adiponectin concentrations above the median value of normal BMI subjects. Adiponectin levels above 12.49 mg/liter in obese women (odds ratio, 3.02; 95% confidence interval, 1.95-4.67; P < 0.001) and above 8.07 mg/liter in obese men (odds ratio, 2.14; 95% confidence interval, 1.1-4.06; P = 0.01) increased the probability of being metabolically healthy. The association remained significant (beta, 0.673 +/- 0.205, P < 0.001) in a logistic regression model (r(2) = 0.25, P < 0.001) after controlling for the confounding effect of age, insulin, and waist circumference. CONCLUSIONS: Certain obese individuals have adiponectin levels similar to those found in normal BMI subjects; this is associated with the metabolically healthy obese phenotype.

Influencia de los padres sobre las preferencias alimentarias en niños de dos escuelas primarias con diferente estrato económico: estudio ESFUERSO / Parental influence in children's food preferences: the ESFUERSO study in two primary schools with different socioeconomic gradients

Objetivo: La mayoría de programas de prevención de obesidad en escuelas primarias fracasan. En este estudio investigamos la influencia de las preferencias alimentarias de los padres en las de sus hijos, de acuerdo con el sexo de los padres y el estrato económico de la familia. Consideramos que esta información será una herramienta útil para elaborar programas de prevención. Material y métodos: Participaron 300 niños de una escuela primaria del Estado (EPE) y 368 de una escuela privada (EPP). Cada pareja de padre y madre contestó dos cuestionarios: uno acerca de ellos mismos y otro sobre sus hijos. El cuestionario incluyó preguntas sobre el consumo de alimentos específicos, analizados por correlación canónica (CC). Resultados: Las escuelas estudiadas no mostraron diferencias en el índice de masa corporal de los padres y sus hijos, sólo en las madres (EPP 24 ± 4 vs. EPE 26 ± 4, p < 0.001). La CC indicó que las madres influyen 30% en las preferencias de sus hijos; esta asociación fue mayor en EPE. La preferencia por alimentos ricos en hidratos de carbono simples se observó sólo en los niños, sin mayor influencia de los padres. Los refrescos regulares mostraron alta preferencia en ambas escuelas; el refresco de dieta es preferido por EPP, pero ambas escuelas prefieren no dar refresco de dieta a los niños. Conclusiones: Existen diferencias de estrato económico y sexo de los padres, que influyen en las preferencias alimentarias de los niños. Los programas de prevención de obesidad deberán considerar las preferencias alimentarias de los padres para aumentar el impacto en los niños.

OBJECTIVE: Programs aimed at obesity prevention among elementary school age children have failed. In the present study, we analyzed the association between parental and child food preferences and determined whether this is influenced by the parents' gender and socio-economic status. MATERIAL AND METHODS: We invited 300 children from a state elementary school (SES) and368 from a private middle class school (PMCS) to participate. A questionnaire was given to each parent to complete together with another questionnaire asking questions about their child. The questionnaire included items on consumption of specific foods. Canonical correlation coefficients (CC) were calculated to assess the association between children's food preferences and their parents' food preferences. RESULTS: Mothers from the PMCS group had lower Body Mass Index (BMIs) than mothers from the SES (24 +/- 4 vs. 26 +/- 4, p < 0.001). Fathers and children from the PMCS group were taller and weighed more than those from the SES but their BMI's were similar. CC indicate that mothers influence their children's food preferences by 30%, and this association is stronger in the SES group. Preference for simple carbohydrates was observed among children without parental supervision. Regular soft drinks were preferred by children in both schools, but diet sodas were more common among PMCS. All families avoided giving their children diet soft drinks. CONCLUSIONS: Socio-economic status and gender diferentially influence children's meal preferences. Obsesity prevention programs should take into account parental food preferences as an important factor that determines obesity during childhood. We expect that our results will contribute to the design of more appropriate prevention programs.

[Parental influence in children's food preferences. The ESFUERSO study in two primary schools with different socioeconomic gradients]. / Influencia de los padres sobre las preferencias alimentarias en niños de dos escuelas primarias con diferente estrato económico. Estudio ESFUERSO.

OBJECTIVE: Programs aimed at obesity prevention among elementary school age children have failed. In the present study, we analyzed the association between parental and child food preferences and determined whether this is influenced by the parents' gender and socio-economic status. MATERIAL AND METHODS: We invited 300 children from a state elementary school (SES) and368 from a private middle class school (PMCS) to participate. A questionnaire was given to each parent to complete together with another questionnaire asking questions about their child. The questionnaire included items on consumption of specific foods. Canonical correlation coefficients (CC) were calculated to assess the association between children's food preferences and their parents' food preferences. RESULTS: Mothers from the PMCS group had lower Body Mass Index (BMIs) than mothers from the SES (24 +/- 4 vs. 26 +/- 4, p < 0.001). Fathers and children from the PMCS group were taller and weighed more than those from the SES but their BMI's were similar. CC indicate that mothers influence their children's food preferences by 30%, and this association is stronger in the SES group. Preference for simple carbohydrates was observed among children without parental supervision. Regular soft drinks were preferred by children in both schools, but diet sodas were more common among PMCS. All families avoided giving their children diet soft drinks. CONCLUSIONS: Socio-economic status and gender diferentially influence children's meal preferences. Obsesity prevention programs should take into account parental food preferences as an important factor that determines obesity during childhood. We expect that our results will contribute to the design of more appropriate prevention programs.