Pioderma gangrenosa en un paciente diabético tipo 2: reporte de un caso

We are presenting a case of patient with type 2 diabetes mellitus that was diagnosed with a soft tissue infection in the lower extremity. This was initially treated as cellulitis and antibiotic treatment was initiated. Due to a poor clinical response, the diagnosis of pyoderma gangrenosum was proposed as part of the differential diagnosis. Skin biopsies and pathology confirmed the diagnosis of pyoderma gangrenosum that had a satisfactory response to steroid treatment.Se presenta el caso de una paciente diabética tipo 2 que inicialmente fue diagnosticada como una celulitis complicada del miembro inferior izquierdo, pero ante la pobre respuesta con el tratamiento antibiótico, se consideró el diagnóstico de pioderma gangrenosa, confirmado anatomopatológicamente, con respuesta satisfactoria al tratamiento esteroideo tópico

Dyslipidemia: Genetics, lipoprotein lipase and HindIII polymorphism [version 2; referees: 2 approved]

The direct link between lipid metabolism alterations and the increase of cardiovascular risk are well documented. Dyslipidemias, including isolated high LDL-c or mixed dyslipidemia, such as those seen in diabetes (hypertriglyceridemia, high LDL-c or low HDL-c), correlate with a significant risk of cardiovascular and cerebrovascular disease worldwide.  This review analyzes the current knowledge concerning the genetic basis of lipid metabolism alterations, emphasizing lipoprotein lipase gene mutations and the HindIII polymorphism, which are associated with decreased levels of triglycerides and LDL-c, as well as higher levels of HDL-c. These patterns would be associated with decreased global morbidity and mortality, providing protection against cardiovascular and cerebrovascular diseases

Carta abierta condenando la crisis en curso y abordando los impactos ambientales y humanitarios en Palestina

Nosotres, biólogues, ecologistas y otres profesionales dedicados a proteger la vida, les escribimos con una solicitud urgente. Les pedimos muy comedidamente que su organización o institución emita un comunicado oficial condenando la crisis en curso y abordando los impactos ambientales y humanitarios en Palestina

Explorando el rol central de la metformina en el tratamiento del síndrome de ovarios poliquísticos

El síndrome de ovarios poliquísticos (SOP) es un trastorno endocrino poligénico que afecta a las mujeres en edad reproductiva, íntimamente relacionado con otras comorbilidades como la obesidad y la insulinorresistencia (IR). Asimismo, las alteraciones hormonales del SOP, como el hiperandrogenismo, pueden verse implicadas en el desarrollo de la IR. Debido a ello, fármacos antidiabéticos y promotores de la sensibilidad a la insulina como la metformina han sido propuestos como una piedra angular en el tratamiento del SOP. El uso de la metformina en el SOP está avalado por gran cantidad de evidencia científica, resaltando no sólo su capacidad de modular los desórdenes hormonales observados en esta patología, sino también su rol en la resolución de las manifestaciones clínicas y comorbilidades del SOP. Además, se recomienda que el tratamiento con metformina en estas pacientes sea acompañado de cambios en el estilo de vida, como una alimentación saludable y actividad física, con el fin de conseguir mejores resultados. En vista de ello, el objetivo del presente artículo es explicar los mecanismos fisiopatológicos del SOP y su relación bidireccional con la IR y obesidad, así como explorar la evidencia clínica que soporta el uso de la metformina en estas pacientes

Coronary Risk Estimation according to the Framingham-Wilson Score and Impaired Fasting Glucose in Adult Subjects from Maracaibo city, Venezuela

Introduction: Type 2 Diabetes Mellitus (T2DM) is an independent risk factor for coronary artery disease. Nevertheless, the coronary risk rendered by pre-diabetes states such as Impaired Fasting Glucose (IFG) has not been thoroughly explored. The purpose of this study was to evaluate the influence of glycemic status on coronary risk estimated by the recalibrated Framingham-Wilson equation in our population.&nbsp;Materials and Methods: A total 1,378 of subjects were selected from the Maracaibo City Metabolic Syndrome Prevalence Study. A complete medical history was taken, next to laboratory workup and anthropometric measurement. All subjects were classified according to glycemic status in normal fasting glucose (NG), impaired fasting glucose (IFG), and T2DM. Coronary risk estimation was calculated using the Framingham-Wilson equation recalibrated for our population.&nbsp;Results: An increase in coronary risk was observed in IFG (p=3.78x10-6) and DM (p=4.34x10-13) when compared to NG; pattern also observed within genders: men (p=1.57x10-4) and women (p=2.37x10-4). Coronary risk also increased according to age in all categories of glycemic status. Within the IFG group, occupational status (p=0.004), smoking (p=2.29x10-5) and alcohol consumption (p=0.013) were associated with higher coronary risk. Finally, subjects with IFG exhibited greater probability for allocation in high coronary risk categories [OR: 1.46 (1.06 - 2.14); p=0.05].Conclusions: Coronary risk scores from the recalibrated Framingham-Wilson equation were significantly higher in subjects with IFG. In our population, this increase may be influenced by sociodemographic and psychobiological traits, such as marital and occupational status, smoking and alcohol consumption.</p

Variantes alélicas del gen codificante del receptor de melanocortina 4 (MC4R) y su impacto en la expresión del fenotipo obeso

La obesidad representa un problema de saludp&uacute;blica a nivel mundial, debido a su asociaci&oacute;ncon otras morbilidades como la diabetes,hipertensi&oacute;n y enfermedad cardiovascular. Se estimaque aproximadamente un 65%-80% de la variaci&oacute;n fenot&iacute;picade la obesidad se explica por variaciones gen&eacute;ticasinterindividuales. MC4R es uno de los genes para elcual mayor n&uacute;mero de mutaciones y polimorfismos se hareportado hasta el presente en individuos obesos. &Eacute;stasincluyen: codones de terminaci&oacute;n de la traducci&oacute;n, sustitucionesen dominios amino terminal y transmembrana yuna gran variedad de polimorfismos que afectan la estructuray funci&oacute;n del receptor. La asociaci&oacute;n de variantes al&eacute;licasdel gen MC4R con incremento en el &iacute;ndice de masacorporal por alteraciones en los patrones de ingesta-gastode energ&iacute;a ha sido replicada en diversos estudios. Por lotanto, el gen codificante del receptor de melanocortina esun fuerte candidato que podr&iacute;a ser incorporado en protocolosde evaluaci&oacute;n de factores de riesgo para el desarrollodel fenotipo obeso.Palabras clave: obesidad, MC4R, variantes al&eacute;licas, &iacute;ndicede masa corporal, receptor de melanocortin

Gene FTO: Aspectos históricos y su relación con enfermedades crónicas no comunicables

Alteraciones en el desarrollo de la atención y la organización conductual pueden configurar cuadros clínicos como el trastorno déficit de atención (TDA) que puede estar acompañado o no de hiperactividad (TDAH), este último parece tener una relación directa con otros diagnósticos de tipo endocrino como la obesidad. El objetivo del estudio es analizar la relación que existe entre el TDAH y la obesidad. Es por ello que se realiza una revisión sistemática de estudios científicos revelando relaciones y diferencias entre ambos trastornos desde una mirada fisiológica, cognoscitiva y comportamental. Se concluye que la relación entre el TDAH y la obesidad se da por factores genéticos, por variaciones dopaminérgicas, cambios en patrones de sueño, desajustes emocionales y por alteraciones en la regulación de la conducta; igualmente influyen factores sociales relacionados con el cuidado en el embarazo y la alimentación de las mujeres antes y durante la gestación.Alterations in the development of attention and behavioral organization can configure clinical diagnoses such as attention deficit disorder (ADD) that may not be accompanied by hyperactivity (ADHD), the latter seems to have a direct relationship with other endocrine diagnoses such as the obesity. The aim of the study is to analyze the relationship between ADHD and obesity. That is why a systematic review of scientific studies is carried out revealing relationships between both disorders from a physiological, cognitive and behavioral perspective. It is concluded that the relationship between ADHD and obesity is given by genetic factors, by dopaminergic variations, changes in sleep patterns, emotional imbalances and by alterations in the regulation of behavior; likewise, social factors related to pregnancy care and the feeding of women before and during pregnancy influence it

Prevalence, awareness, management of hypertension and association with metabolic abnormalities: the Maracaibo city metabolic syndrome prevalence study

Background: The purpose of this study was to determine the prevalence and epidemiologic behavior of Hypertension (HT) in the Maracaibo Municipality, Zulia state, Venezuela. Materials and Methods: This was a cross-sectional descriptive study, where 2,230 subjects from both genders were randomly selected as part of the Maracaibo city Metabolic Syndrome Prevalence Study (MMSPS). Complete medical examination, laboratory workup and anthropometry measurements were taken. The quantitative variables were expressed as mean&plusmn;SD, and comparisons were calculated using t Student test. The qualitative variables were represented as absolute and relative frequencies, and comparisons were obtained using Z test for proportions and associations with c2 test. Results: The prevalence of HT was 19.42% (20.92% in women and 17.75% in men). The prevalence of newly diagnosed individuals was 12.0%, with 8.71% in women and 16.90% in men. The overall percentage of HT was 32.02%, being 29.63% in women and 34.65% in men. Several variables were associated with HT, such as glycemic status (&chi;2=64.97, p&lt;0.001), insulin resistance (c2=25.58, p&lt;0.001) and body mass index (c2=209.952, p&lt;0.0001). Clinical control of blood pressure was observed in 44.7% of treated and 56.6% of untreated subjects. The most frequent anti-hypertensive drugs were: Angiotensin Converting Enzyme Inhibitors with (n=105), Beta-Blockers (n=97) and Angiotensin Receptor II Blockers (n=32). Conclusion: Even though elevated numbers of AHT are observed in our population combined with low clinical control of blood pressure, there is a lower prevalence of AHT compared to other studies at regional, national or international levels.&nbsp