Treatment of patients with BRAFV600E-mutated metastatic colorectal cancer after progression to encorafenib and cetuximab: data from a real-world nationwide dataset.

BACKGROUND: Targeted therapy (TT) with encorafenib and cetuximab is the current standard for patients with BRAFV600E-mutated metastatic colorectal cancer (mCRC) who received one or more prior systemic treatments. However, the median progression-free survival (mPFS) is ∼4 months, and little is known about the possibility of administering subsequent therapies, their efficacy, and clinicopathological determinants of outcome. METHODS: A real-world dataset including patients with BRAFV600E-mutated mCRC treated with TT at 21 Italian centers was retrospectively interrogated. We assessed treatments after progression, attrition rates, and outcomes. RESULTS: Of the 179 patients included, 85 (47%), 32 (18%), and 7 (4%) received one, two, or three lines of treatment after TT, respectively. Those receiving TT in the second line were more likely to receive at least one subsequent therapy (53%), as compared with those treated with TT in the third line or beyond (30%; P < 0.0001), and achieved longer postprogression survival (PPS), also in a multivariate model (P = 0.0001). Among 62 patients with proficient mismatch repair/microsatellite stable (pMMR/MSS) tumors receiving one or more lines of treatment after second-line TT, combinatory chemotherapy ± anti-vascular endothelial growth factor (anti-VEGF) was associated with longer PFS and PPS as compared with trifluridine-tipiracil or regorafenib (mPFS: 2.6 versus 2.0 months, P = 0.07; PPS: 6.5 versus 4.4 months, P = 0.04). CONCLUSIONS: Our real-world data suggest that TT should be initiated as soon as possible after the failure of first-line treatment in BRAFV600E-mutated mCRC. Among patients with pMMR/MSS tumors, combinatory chemotherapy ± anti-VEGF appears the preferred treatment choice after TT failure.

Fractional order controllers increase the robustness of closed-loop deep brain stimulation systems.

We studied the effects of using fractional order proportional, integral, and derivative (PID) controllers in a closed-loop mathematical model of deep brain stimulation. The objective of the controller was to dampen oscillations from a neural network model of Parkinson's disease. We varied intrinsic parameters, such as the gain of the controller, and extrinsic variables, such as the excitability of the network. We found that in most cases, fractional order components increased the robustness of the model multi-fold to changes in the gains of the controller. Similarly, the controller could be set to a fixed set of gains and remain stable to a much larger range, than for the classical PID case, of changes in synaptic weights that otherwise would cause oscillatory activity. The increase in robustness is a consequence of the properties of fractional order derivatives that provide an intrinsic memory trace of past activity, which works as a negative feedback system. Fractional order PID controllers could provide a platform to develop stand-alone closed-loop deep brain stimulation systems.

De la definición al impacto social de la eyaculación precoz. Consenso de experto / From the definition to the social impact of premature ejaculation. Expert consensus

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European Respiratory Society guidelines for the diagnosis of primary ciliary dyskinesia

The diagnosis of primary ciliary dyskinesia is often confirmed with standard, albeit complex and expensive, tests. In many cases, however, the diagnosis remains difficult despite the array of sophisticated diagnostic tests. There is no "gold standard" reference test. Hence, a Task Force supported by the European Respiratory Society has developed this guideline to provide evidence-based recommendations on diagnostic testing, especially in light of new developments in such tests, and the need for robust diagnoses of patients who might enter randomised controlled trials of treatments. The guideline is based on pre-defined questions relevant for clinical care, a systematic review of the literature, and assessment of the evidence using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. It focuses on clinical presentation, nasal nitric oxide, analysis of ciliary beat frequency and pattern by high-speed video-microscopy analysis, transmission electron microscopy, genotyping and immunofluorescence. It then used a modified Delphi survey to develop an algorithm for the use of diagnostic tests to definitively confirm and exclude the diagnosis of primary ciliary dyskinesia; and to provide advice when the diagnosis was not conclusive. Finally, this guideline proposes a set of quality criteria for future research on the validity of diagnostic methods for primary ciliary dyskinesia

Análisis del tiempo de vida útil en la elaboración de mermelada de higuerón (Cucúrbita Odorífera Vell) con zanahoria (Daucus Carota) / Time analysis of life in the development of marmalade higuerón (Cucurbita Odorifera Vell) with carrot (Daucus Carota)

The aim of this study was to determine the lifespan in making jam by higueron and carrot mixture, motivated by the lack of a number of species of tubers and vegetables, as evidenced by the low consumption of these foods and the lack of appropriate technology for processing the same. The two raw materials are high in vitamins and minerals, higueron suitable for their characteristics and chemical composition is considered a fruit-vegetable, it is possible it industrialization similar to those made with fruits, like the carrot is a food products excellent from the nutritional point of view, contributing to improve the quality of the jam. The treatments were kept under ambient conditions for 40 days when pH were recorded - soluble solids (° Brix) - Heartburn - Microbiological and organoleptic analysis in order to identify the best experimental treatment tests. According to the results obtained and microbiological analysis establishes a lifetime about 6 months.

El objetivo de este estudio fue conocer el tiempo de vida útil en la elaboración de mermelada mediante una mezcla higuerón y zanahoria, motivado por el desconocimiento de un sinnúmero de especies de tubérculos y hortalizas, evidenciado por el bajo consumo de estos alimentos y la carencia de tecnología adecuada para el procesamiento del mismo y aprovechamiento de sus nutrientes. Las dos materias primas de alto contenido de vitaminas y minerales; el higuerón se considera como fruta-hortaliza por sus características y composición química, siendo posible la industrialización en productos semejantes a los elaborados con las frutas. La zanahoria es un alimento excelente desde el punto de vista nutricional por lo que aporta al mejoramiento de la calidad de la mermelada. Los tratamientos se mantuvieron bajo condiciones ambientales durante 40 días en los que se registró pH - sólidos solubles (°Brix) - acidez - análisis microbiológicos y pruebas organolépticas con la finalidad de identificar el mejor tratamiento experimental. De acuerdo a los resultados obtenidos y al análisis microbiológico se establece un tiempo de vida útil alrededor de 6 meses.

Centripetal focusing of gyrotactic phytoplankton.

A suspension of gyrotactic microalgae Chlamydomonas augustae swimming in a cylindrical water vessel in solid-body rotation is studied. Our experiments show that swimming algae form an aggregate around the axis of rotation, whose intensity increases with the rotation speed. We explain this phenomenon by the centripetal orientation of the swimming direction towards the axis of rotation. This centripetal focusing is contrasted by diffusive fluxes due to stochastic reorientation of the cells. The competition of the two effects lead to a stationary distribution, which we analytically derive from a refined mathematical model of gyrotactic swimmers. The temporal evolution of the cell distribution, obtained via numerical simulations of the stochastic model, is in quantitative agreement with the experimental measurements in the range of parameters explored.

Sodium hyaluronate improves quality of life and nasal endoscopy features in preschool children with upper respiratory tract infections.

The aim of this prospective, randomised study was to evaluate the effects of nasal douches with sodium hyaluronate on clinical and endoscopic variables, on parental perception of their child’s health-related quality of life (HR-QoL), and on parental workdays lost in preschool recurrent upper respiratory tract infections (URTIs). Children aged 2-6 years with recurrent or persistent URTIs underwent at baseline the evaluation of upper respiratory tract symptoms in the previous two weeks, and nasal endoscopy. Parents of enrolled children were assessed for self-perception of their children’s HR-QoL using a standardised questionnaire. The same variables were reassessed after a 2-week treatment with either 9 mg sodium hyaluronate plus saline solution or saline alone by nasal douches. Forty of the 48 children enrolled completed the study (22 assigned to the combined treatment). Compared to baseline, the combined treatment resulted in a significant reduction of the prevalence of children with missed daycare days (45% vs 14%, p=0.04) and of parents with workdays lost (36% vs 5%, p=0.02), and in a significant improvement of HR-QoL score (3.7 vs 2.8, p=0.004). At endoscopy, the secretion and mucosal oedema score significantly improved after the combined treatment (6 vs 2, p < 0.001), and there was a trend towards a reduction of the adenoid hypertrophy score (p=0.06). No clinical, HR-QOL or endoscopy changes were found in the saline group. In preschool children with recurrent or persistent URTIs, sodium hyaluronate by nasal douche significantly improves endoscopic features. Additional benefits include the children’s HR-QoL and daycare attendance, and parental work.

Validación de las escalas de Braden y EMINA en pacientes de atención domiciliaria incluidos en programa de inmovilizados / Validity of Braden and EMINA’s scales for patients at home, include in the immobilized patients programmee

Objetivo: comprobar la validez de las escalas Braden y EMINA y seleccionar puntos de corte cuantitativos para discriminar el riesgo de úlcera por presión (UPP) en pacientes domiciliarios. Método: estudio longitudinal o de seguimiento de una cohorte de 6 meses de duración, con cuatro valoraciones, una cada 2 meses. Ámbito de estudio: áreas de gestión sanitaria Este de Málaga-Axarquía y Serranía, de Málaga. Sujetos de estudio: pacientes en programa de inmovilizados sin UPP. Cuestionario confeccionado por los autores que incluye entre otros: datos demográficos, ingreso hospitalario, escalas de Braden y EMINA. Muestra: 353 pacientes, usando muestreo aleatorio simple. Resultado: las escalas originales mantienen consistencia interna con alpha superior a 0,7. Se han establecido nuevos puntos de corte, discriminando pacientes con riesgo de UPP o sin él, resultando una sensibilidad del 61-89% y una especificidad del 64-70%. Las escalas categorizadas tienen exactitud como método diagnóstico igual o superior al 65%. Las odds ratio (OR) son significativas e indican que existen diferencias en el riesgo de UPP en función de nuevos puntos de corte. La determinación de los puntos de corte resultaron: riesgo alto: sensibilidad ≤ 10%, especificidad ≥ 95%, puntuación en la escala de Braden ≤ 10, EMINA 12-15; riesgo moderado: sensibilidad entre el 10% y el 83%, especificidad entre el 64% y el 95%, Braden 11-15 y EMINA 7-11; riesgo bajo: sensibilidad entre el 83% y el 100%, especificidad entre el 0% y el 64%, Braden 16-22 y EMINA 1-6; riesgo nulo: sensibilidad 100%, especificidad 0%, Braden 23, EMINA 0

Aim: Verifying Braden and EMINA's validity and select quantitative cut-off points to differentiate Ulcer by Pressure threat in home-care patients. Method: group monitor progress and longitudinal examination of a cohort of patients during 6 months, evaluating three times, once every two months. Scope of application: Health Care Administration Este Málaga-Axarquía and Serranía, Málaga. Subject of study: Immobilized Programme patients without UPP. Resources: Authors’ questionnaire including among others: demographic data, hospital admission date, Braden and EMINA scales. Sample: 353 patients, simple random sampling. Result: The original scales support internal consistency with alpha superior to 0.7. Establishing new cut-off points discriminating patients with or without UPP threat, resulting sensitivity of 61%- 89% and specificity 64%-70%. The classified scales have a precisions as a diagnostic method equal or superior to 65%. OR are significant, indicating existing differences under threat of UPP according to new cut-off points. Cut-off points’ selected resulted in: High sensitivity threat ≤10% ≥ 95%, Braden’s scale average ≤ 10, EMINA 12-15. Moderate threat 10%,

Desempenho produtivo e econômica de surubins (pseudoplatystoma sp) alimentados com níveis de proteína e estocados em tanque-rede / Growth performance and economic of pseudoplatystoma sp fed with protein levels reared in net cages

O surubim (Pseudoplatystoma sp.) é uma das espécie de peixe mais apreciadas para o consumo. Por ser uma espécie carnívora, exige atenção especial no que tange às suas exigências nutricionais. Até o momento, poucos estudos foram realizados para estabelecê-las na fase de engorda, em especial em sistema de cultivo intensivo. O objetivo do presente estudo foi avaliar os desempenhos zootécnico e econômico de surubins (Pseudoplatystoma sp.) na fase final de crescimento, estocados em tanque-rede e alimentados com dietas com diferentes níveis de proteína. Os peixes, com peso de 356,6±40,3g, foram acondicionados em 12 tanques-rede de 18m3, nos quais permaneceram por cinco meses até adquirirem o peso comercial para abate. O tratamento experimental foi constituído por três dietas extrusadas comerciais, com os níveis de proteína bruta (36, 38, 40%PB) sendo substituídos gradativamente por carboidratos. Foram avaliados os parâmetros de crescimento, rendimento de filé, enzimas metabólicas e desempenho econômico. O ganho de peso, o ganho de peso diário, o consumo de dieta, a taxa de eficiência proteica, a sobrevivência e o rendimento de filé não apresentaram diferença significativa. A conversão alimentar foi melhor para os peixes alimentados com a dieta com 38 e 40%PB. Não foram observadas diferenças significativas para os parâmetros de índice hepatossomático e de enzimas hepáticas. Apesar dos maiores gastos com a ração contendo 38%PB em comparação à dieta com 36%PB, esta foi a que apresentou o melhor índice de custo por kg de peixe produzido. Os melhores índices de crescimento e o menor custo de arraçoamento foram obtidos pelos peixes alimentados com a dieta 38%PB, sendo esta, portanto recomendada para o arraçoamento na fase final de surubins em tanque-rede.

The Pseudoplatystoma sp. is one of the most appreciated fish species for consumption. Being a carnivorous species, the painted requires special attention regarding their nutritional requirements. To date, few studies have been conducted to establish them in their stage of fattening especially in intensive cultivation systems. The aim of the present study was to evaluate the growth and economic performance of Pseudoplatystoma sp fed with protein levels reared in net cages. The fish weighing from 356.6 ± 40.3g were packed in twelve net cages in 18 m3 in which they remained for five months until acquiring the commercial weight for slaughter. The experimental treatment was constituted by three commercial extruded diets with different crude protein levels (36, 38, 40% CP) gradually being replaced with carbohydrate. Growth parameters, metabolic enzymes, fillet yield and economic performance were evaluated. The gain in weight, daily weight gain, diet consumption, protein efficiency rate, survival and fillet yield did not show significant difference. The feed conversion was best for fish fed a diet with 38 and 40% CP. No significant differences were observed for the hepatossomatic index parameters and liver enzymes. There were larger expenditures on rations containing 38% PB compared to the diet with 36% CP, this presented the best index of cost per kg of fish produced. The best growth rates and lower cost of feeding were obtained by fish fed with a 38% CP diet, which is, therefore, recommended for feeding in the final phase of surubins monitored via net cages.

Nanoparticle assisted photothermal deformation of individual neuronal organelles and cells.

Stimulation of the localized surface plasmon of metallic nanoparticles has been shown to be an effective mechanism to induce photothermal damage in biological tissues. However, few studies have focused on single cell or subcellular ablation. Our results show that, upon incubation, gold nanostars are internalized by neurons of acute mouse cerebellar brain slices, clustering inside or close to the nucleus. By stimulating the nanostars' surface plasmon using a femtosecond laser, we show deformation of single nuclei and single cells. Given its precision and extremely localized effect, this is a promising technique for photothermal therapy in areas sensitive to collateral thermal damage such as the nervous system.

[Health consequences of obesity in children and adolescents]. / Conseguenze dell'obesità sulla salute del bambino e dell' adolescente.

Obesity in childhood is associated with the presence of complications that can undermine health immediately or in the long term. Several conditions, such as pulmonary or orthopedic complications are strictly associated with the severity of overweight, since they are directly associated to the mechanic stress of fat tissue on the airways or on the bones. Other conditions, such as metabolic or liver complications, although increasing with the extent of overweight, are associated with insulin resistance, which can be modulated by different other factors (ethnicity, genetics, fat distribution) and can occur in overweight children as well. No less important are psychological correlates, such as depression and stigma, which can seriously affect the health related quality of life. Pediatric services for the care of childhood obesity need to be able to screen overweight and obese children for the presence of physical and psychological complications, which can be still reversed by weight loss. This article provides pediatricians a comprehensive update on the main complications in obese children and adolescents and their treatment.

Fiabilidad de las escalas de Braden y EMINA en pacientes de atención domiciliaria incluidos en programa de inmovilizados / Reliability in Braden and EMINA's scales for patients in domiciliary, included in the immobilized patients' programme

Objetivo: comprobar la fiabilidad de las escalas de Braden y EMINA (escalas de valoración del riesgo de úlceras por presión) en atención domiciliaria. Método: estudio observacional de tipo transversal. Ámbito de estudio: Área de Gestión Sanitaria Este de Málaga-Axarquía y Área de Gestión Sanitaria Serranía, ambas de Málaga. Sujetos de estudio: pacientes incluidos dentro del Programa de Inmovilizados sin úlceras por presión. Instrumentos: escalas de Braden y EMINA. Muestra: 30 pacientes, usando una técnica de muestreo aleatorio simple. Resultados: Escala de Braden: Alfa de Cronbach de 0,78 para ambos observadores. Coeficiente de correlación intraclase (CCI) para la puntuación total de la escala, 0,968. El índice kappa ponderado para cada uno de los 6 ítems de la escala oscila entre 0,685 que es el más bajo y corresponde a fricción y deslizamiento y 1,00 para el más alto, que corresponde a percepción sensorial. Escala EMINA: el Alfa de Cronbach oscila entre 0,69 y 0,73 entre observadores. Coeficiente de correlación intraclase para la puntuación total de la escala, 0,974. El índice kappa ponderado para cada uno de los 5 ítems de la escala oscila entre 0,750, el más bajo que corresponde a la actividad, y 1,00 para el más alto, que corresponde a nutrición. Conclusiones: la escala de Braden tiene mayor consistencia interna, aunque el grado de acuerdo cuando se utilizan las escalas de manera categórica es superior en la EMINA. Ambas escalas son instrumentos fiables para el uso en atención domiciliaria, aunque sería conveniente establecer nuevos puntos de corte, para definir o categorizar el riesgo en esta población

Objective: Assessing reliability of the Braden and EMINA scales (Rating Scales for the Risk of pressure sores) in-home care. Method: Cross-sectional study. Population of study from Málaga: area of Heath Management East Málaga-Axarquia and mountainous region. Subjects of study: Patients entered in the programme of immobilize persons without pressure sore. Questionnaires: Braden and EMINA. Sample: 30 patients selected by simple randomisation. Results: Braden Scale: Cronbach's coefficient alpha 0.78 for both ratters. The Intraclass correlation coefficient (ICC) is 0.968. Kappa values for each of the 6 items vary from 0.685 for the friction and slipping item and 1 for the sensorial perception item. EMINA Scale: Cronbach's coefficent alpha 0.69 and 0.73 for each of the two raters, respectively. The Intraclass correlation coefficient (ICC) is 0.974. Kappa values for each of the 6 items vary from 0.750 for the activity item and 1 for the nutrition item Conclusions: The internal consistency of Braden scales is higher than the consistency of the EMINA scale. However, when the individual item agreement between raters was higher for the EMINA than for the Braden. Both scales, as continuous, are reliable instruments to be used for in-home care, although it would be convenient to establish new cut-off points for the scales in order to categorise the risk of pressure sores for this type of population

Obesity and pulmonary disease: unanswered questions.

Obesity is associated with risk of pulmonary disease, and adversely affects lung function. The parallel increase in obesity and asthma suggests the two conditions are linked; indeed, they can worsen each other. Obesity and inadequate asthma control are associated with poor quality of life, and place a high economic burden on public health. Although the obesity-lung interaction is a major issue for basic research and clinical studies, various questions remain unanswered. Do intrauterine and early life factors impact on the development of obesity and lung disease? If so, can this be prevented? Asthma is generally more severe in obese subjects, but is adiposity a driver of a new asthma phenotype that features greater morbidity and mortality, worse control and decreased response to medications? Obese individuals have small lung volumes, hence their airway calibre is reduced and airway resistance is increased. What puzzles physicians is whether peripheral airways undergo remodelling, which would increase bronchoconstriction. Obese asthmatics respond suboptimally to anti-inflammatory treatment, which raises the question: 'what drug for what patient?' Life expectancy is decreased in obesity and in chronic pulmonary disorders, but does obesity protect against or trigger chronic obstructive pulmonary disease? The time has come to find answers to these questions.

Actualización sobre el trastorno del deseo sexual hipoactivo femenino / Update on hypoactive sexual desire disorder in women

El deseo sexual hipoactivo (DSH) es la disfunción sexual femenina más común. Los autores han escogido las publicaciones más relevantes para analizar este tema. El diagnóstico de DSH requiere la presencia de malestar o dificultades interpersonales asociadas a un deseo sexual disminuido que no puede explicarse por otra afección psiquiátrica, y que no se debe exclusivamente a una enfermedad o sustancia. El DSH puede afectar gravemente al bienestar emocional y a las relaciones y sucede en mujeres premenopáusicas y posmenopáusicas. Hasta hace poco, el diagnóstico de DSH requería un extenso examen de un médico experimentado en diagnósticos de disfunción sexual femenina (DSF). La prueba del deseo sexual inhibido (PDSI) es un método de diagnóstico abreviado concebido para ayudar a los médicos que no son especialistas en DSF a diagnosticar el DSH adquirido en las mujeres. Es necesario profundizar en el estudio del DSH para comprender mejor la etiología y valorar las distintas opciones terapéuticas (AU)

Hypoactive sexual desire disorder (HSDD) is the most common type of female sexual dysfunction (FSD). A diagnosis of HSDD requires evidence of personal distress or interpersonal difficulty associated with low sexual desire that cannot be better accounted for by another psychiatric condition and is not due exclusively to a medical condition or substance. HSDD can have a major impact on women's emotional wellbeing and relationships and occurs in both pre- and post-menopausal women. Until recently, diagnosis of HSDD required an extensive diagnostic interview conducted by a clinician with experience in the diagnosis of FSD. The decreased sexual desire screener (DSDS) is a brief diagnostic instrument that has been developed to aid clinicians who are not experts in FSD to diagnose generalized acquired HSDD in women. There is a need for greater understanding of the etiology of HSDD and for more therapeutic options (AU)

Near-unity quantum yields of biexciton emission from CdSe/CdS nanocrystals measured using single-particle spectroscopy.

Biexciton photoluminescence (PL) quantum yields (Q(2X)) of individual CdSe/CdS core-shell nanocrystal quantum dots with various shell thicknesses are derived from independent PL saturation and two-photon correlation measurements. We observe a near-unity Q(2X) for some nanocrystals with an ultrathick 19-monolayer shell. High Q(2X)'s are, however, not universal and vary widely among nominally identical nanocrystals indicating a significant dependence of Q(2X) upon subtle structural differences. Interestingly, our measurements indicate that high Q(2X)'s are not required to achieve complete suppression of PL intensity fluctuations in individual nanocrystals.

Nano-engineered electron-hole exchange interaction controls exciton dynamics in core-shell semiconductor nanocrystals.

A strong electron-hole exchange interaction (EI) in semiconductor nanocrystals (NCs) gives rise to a large (up to tens of meV) splitting between optically active ('bright') and optically passive ('dark') excitons. This dark-bright splitting has a significant effect on the optical properties of band-edge excitons and leads to a pronounced temperature and magnetic field dependence of radiative decay. Here we demonstrate a nanoengineering-based approach that provides control over EI while maintaining nearly constant emission energy. We show that the dark-bright splitting can be widely tuned by controlling the electron-hole spatial overlap in core-shell CdSe/CdS NCs with a variable shell width. In thick-shell samples, the EI energy reduces to <250 µeV, which yields a material that emits with a nearly constant rate over temperatures from 1.5 to 300 K and magnetic fields up to 7 T. The EI-manipulation strategies demonstrated here are general and can be applied to other nanostructures with variable electron-hole overlap.

Obesidad pregestacional y riesgo de intolerancia a la glucosa en el embarazo y diabetes gestacional / Pregestational obesity and risk of glucose intolerance in pregnancy and gestational diabetes

ANTECEDENTES: La obesidad en mujeres en edad reproductiva es cada vez más frecuente y complica el embarazo aumentando el riesgo de enfermedades como la diabetes mellitus gestacional (DMG). OBJETIVO: Determinar el riesgo de presentar DMG e intolerancia a la glucosa (ITG) de acuerdo con el índice de masa corporal pregestacional (IMCPG). MÉTODO: Muestra de 489 pacientes, se clasificaron por IMCPG y se les realizó una curva de tolerancia oral a la glucosa (CTOG) de 100 g de 120 minutos. Se definió DMG con dos valores alterados en la CTOG e ITG con un solo valor alterado. Se aplicó prueba de chi cuadrada para determinar diferencia entre grupos y se obtuvo un Odds Ratio (OR), con intervalo de confianza del 95%. RESULTADOS: 9 pacientes con bajo peso, 194 con peso normal, 158 con sobrepeso y 128 con obesidad, edad gestacional promedio 31,3 ± 5,6 semanas. El 13% de las pacientes presentaron DMG, el 10,6% ITG. Las mujeres con sobrepeso presentaron un OR de 3,81 para desarrollar ITG (IC95% 1,62-8,95) y un OR de 3,7 para DMG (IC95% 1,65-8,38), mientas que las pacientes con obesidad pregestacional presentaron un OR de 6,6 para desarrollar ITG (IC95% 2,83-15,66) y un OR de 8,8 para DMG (IC95% 4,05-19,51), comparadas con mujeres con peso pregestacional normal. CONCLUSIÓN: La población mexicana tiene mayor riesgo de DMG que otras poblaciones y mayor prevalencia de sobrepeso y obesidad, por lo que se debe realizar un diagnóstico y tratamiento oportuno de DMG, previniendo complicaciones y diabetes mellitus tipo 2.

BACKGROUND: Obesity in women in reproductive age is becoming more frequent and it self complicates preg-nancy increasing the risk of diseases such as gestational diabetes mellitus (GDM). AIMS: To determine the risk of gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) according to the pregestational body mass index (PGBMI). METHODS: Sample of 489 patients, they were classified by PGBMI and underwent an oral glucose tolerance test (OGTT) with 100 g of glucose during 120 minutes. GDM was defined with two altered valúes in the OGTT and IGT with a single altered value. A chi-square test was applied to determine difference between groups, and we obtained an Odds Ratio (OR), with a confidence level of 95%. RESULTS: 9 patients were low weight, 194 normal weight, 158 overweight and 128 obese, average gestational age 31.3 ± 5.6 weeks. 13% of the patients had GDM, 10.6% had IGT. Overweight women had an OR of 3.81 of developing IGT (95% Cl 1.62-8.95) and an OR of 3.7 of developing GDM (95% Cl 1.65-8.38), while women with prepregnancy obesity showed an OR of 6.6 of developing ITG (95% Cl 2.83-15.66) and an OR of 8.8 of developing GDM (95% Cl 4.05-19.51), all compared to women with prepregnancy normal weight. CONCLUSIONS: Mexican population has a higher risk of GDM than other populations and also a higher prevalence of overweight and obesity, so that every pregnant woman should be screening for GDM, has a diagnosis and receive treatment, preventing complications and Type 2 Diabetes.