Ludwig's angina and ketoacidosis as a first manifestation of diabetes mellitus

Ludwig?s angina is a serious and rapidly progressive infectious process that spreads through the floor of the mouth and neck. In this paper we present an infrequent case of a patient who suffered an odontogenic infection with poor response to the previous treatment, which evolved towards a Ludwig?s angina combined with ketoacidosis in the context of a diabetes mellitus not known before. According to the literature reviewed, this case report represents the first contribution of a Ludwig?s angina and ketoacidosis as an initial manifestation of a diabetes mellitus. The airway management, the antibiotic prescription and the surgical drainage allowed the healing of the patient without medical complications. Factors of co-morbidity like the diabetes mellitus together with focus tooth of infection may eventually turn into serious medical complications as the diabetic ketoacidosis and develop potentially lethal cervical infections

Learning and Memory Impairments in Patients with Minimal Hepatic Encephalopathy are Associated with Structural and Functional Connectivity Alterations in Hippocampus

Patients with minimal hepatic encephalopathy (MHE) show mild cognitive impairment associated with alterations in attentional and executive networks. There are no studies evaluating the relationship between memory in MHE and structural and functional connectivity (FC) changes in the hippocampal system. This study aimed to evaluate verbal learning and long-term memory in cirrhotic patients with (C-MHE) and without MHE (C-NMHE) and healthy controls. We assessed the relationship between alterations in memory and the structural integrity and FC of the hippocampal system. C-MHE patients showed impairments in learning, long-term memory, and recognition, compared to C-NMHE patients and controls. Cirrhotic patients showed reduced fimbria volume compared to controls. Larger volumes in hippocampus subfields were related to better memory performance in C-NMHE patients and controls. C-MHE patients presented lower FC between the L-presubiculum and L-precuneus than C-NMHE patients. Compared to controls, C-MHE patients had reduced FC between L-presubiculum and subiculum seeds and bilateral precuneus, which correlated with cognitive impairment and memory performance. Alterations in the FC of the hippocampal system could contribute to learning and long-term memory impairments in C-MHE patients. This study demonstrates the association between alterations in learning and long-term memory and structural and FC disturbances in hippocampal structures in cirrhotic patients

Characteristics of patients with type 2 diabetes mellitus newly treated with GLP-1 receptor agonists (CHADIG Study): a cross-sectional multicentre study in Spain

Objective: Several glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1Ra) have been made recently available in Spain for type 2 diabetes mellitus (DM2) treatment. There are no published data on the clinical and sociodemographic profile of patients initiating treatment with GLP-1Ra in Spain. Our objective was to understand these patients' characteristics in a real-world clinical practice setting. Design: Cross-sectional observational study. Setting: Spanish specialist outpatient clinics. Participants: 403 adults with DM2 initiating GLP-1Ra treatment were included. Primary and secondary outcome measures: Sociodemographic and DM2-related clinical data, including treatment at and after GLP-1Ra initiation and comorbidities, were collected. Results: Evaluable patients (n=403; 50.9% female) were included ( July 2013 to March 2014) at 24 centres by 53 specialists (47 endocrinology, 6 internal medicine), with the following profile (value±SD): age (58.3±10.4 years), diabetes duration (9.9±7 years), body mass index (BMI; 36.2±5.5) and glycated haemoglobin (HbA1c; 8.4±1.4%); 14% had HbA1c≤7%. Previous antidiabetic treatment: 53.8% only oral antidiabetic drugs (OADs), 5.2% insulin and 40% insulin and OAD; of those receiving OAD, 35% single drug, 38.2% 2 drugs and 24% 3 drugs. Concomitant to GLP-1Ra, 55.3% were only on OAD, 36.2% on insulin and OAD, and 7.2% only on insulin. Of those receiving OAD, the GLP-1Ra was mainly associated with 1 drug (65%) or 2 drugs (31.8%). GLP-1Ra are frequently added to existing antidiabetic drugs, with dipeptidyl peptidase-4 inhibitors being the OAD most frequently switched (45% receiving 1 before starting GLP-1Ra, only 2.7% receiving it concomitantly). Conclusions: In Spain, GLP-1Ra therapy is usually started in combination with OADs or OADs and insulin. These drugs are used in relatively young patients often not reaching therapeutic goals with other treatment combinations, roughly a decade after diagnosis and with a relatively high BMI. The latter could be explaine

Bioavailability and systemic transport of oleanolic acid in humans, formulated as a functional olive oil

14 Páginas.-- 6 Figuras.-- 2 TablasEvidence of the pharmacological activity of oleanolic acid (OA) suggests its potential therapeutic application. However, its use in functional foods, dietary supplements, or nutraceuticals is hindered by limited human bioavailability studies. The BIO-OLTRAD trial is a double-blind, randomized controlled study with 22 participants that received a single dose of 30 mg OA formulated as a functional olive oil. The study revealed that the maximum serum concentration of OA ranged from 500 to 600 ng mL-1, with an AUC0-∞ value of 2862.50 ± 174.50 ng h mL-1. Furthermore, we discovered a physiological association of OA with serum albumin and triglyceride-rich lipoproteins (TRL). UV absorption spectra showed conformational changes in serum albumin due to the formation of an adduct with OA. Additionally, we demonstrated that TRL incorporate OA, reaching a maximum concentration of 140 ng mL-1 after 2-4 hours. We conjecture that both are efficient carriers to reach target tissues and to yield high bioavailability.This research is part of the R+D+i project PID2019-107837RB-I00, funded by the Spanish Ministry of Science and Innovation/Spanish National Research Agency, grant number MCIN/AEI/10.13039/501100011033/. A. G.-G. is grateful for funding received from the “Next Generation EU” funds, the European Union through the Recovery, Transformation and Resilience Plan and by the Ministry of Universities, in the framework of the Margarita Salas, Maria Zambrano grants for the Requalification of the Spanish University System 2021–2023, organized by the Pablo de Olavide University, Seville. J. J. R.-M. obtained an Erasmus+ scholarship (No. 2021-1-IT02-KA131-HED-000008483) from the University of Sassari (ITALY), for a stay at the Department of Food and Health of the Instituto de la Grasa-CSIC. The authors especially thank the ACESUR Group (Dos Hermanas, Seville, Spain), which donated the commercial olive oil for the trial. This collaborator had no role in the design, collection, analysis or interpretation of the data or in the decision to submit the manuscript for publication.Peer reviewe

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Description of a Cohort of Type 1 Diabetes Patients: Analysis of Comorbidities, Prevalence of Complications and Risk of Hypoglycemia.

Despite major medical advances, Type 1 Diabetes (T1D) patients still have greater morbimortality than the general population. Our aim was to describe our cohort of T1D patients and identify potential risk factors susceptible to prevention strategies. Cross-sectional, observational study, including T1D patients treated at our center, from 1 March 2017 to 31 March 2020. T1D, age > 14 years and signed informed consent. diabetes other than T1D, age Study population n = 2181 (49.8% females, median age at enrollment 41 years, median HbA1c 7.7%; 38.24% had at least one comorbidity). Roughly 7.45% had severe hypoglycemia (SH) within the prior year. Macro/microvascular complications were present in 42.09% (5.83% and 41.14%, respectively). The most frequent microvascular complication was diabetic retinopathy (38.02%), and coronary disease (3.21%) was the most frequent macrovascular complication. The risk of complications was higher in males than in females, mainly macrovascular. Patients with SH had a higher risk of complications (OR 1.42; 1.43 in males versus 1.42 in females). Our T1D population is similar to other T1D populations. We should minimize the risk of SH, and male patients should perhaps be treated more aggressively regarding cardiovascular risk factors

Atención sanitaria a personas transexuales adultas : proceso asistencial integrado

YesEl PAI Atención Sanitaria a Personas Transexuales Adultas se realiza con el fin de disminuir la variabilidad de la practica asistencial en los diferentes ámbitos de atención, incorporando el conocimiento disponible y el consenso profesional, con la participación de las Asociaciones implicadas en dos momentos distintos: al inicio para garantizar su enfoque y en la revisión externa con el objetivo de proporcionar mayor calidad, confianza y aceptación

Oleanolic acid bioavailability in human serum

[Description of methods used for collection/generation of data] 1. Extraction and GC-MS determination (DOI 10.1002/bmc.3480); 2. UV Spectrophotometry method for OA-HSA association (DOI 10.1021/jf1039537); 3. Enzymatic methods were used to determine serum glucose, total cholesterol, HDL and triglycerides, whereas LDL was estimated by the Friedewald formula (14). Total lipoprotein Apo B (Apo B48 + Apo B100) was quantified by an immunoturbidimetric assay (Tinaquant; Roche Diagnostics, Mannheim, Germany), and serum insulin using an ELISA kit (Diaclone, Besançon, France).[Methods for processing the data] The variables were expressed as mean ± standard deviation (SD), unless otherwise stated. Differences between the study groups were evaluated by one- or two-way ANOVA, following by Bonferroni´s multiple-comparison test or Kruskal-Wallis test.Evidence of the pharmacological activity of oleanolic acid (OA) suggests its potential therapeutic application. However, its use in functional foods, dietary supplements, or nutraceuticals is hindered by limited human bioavailability studies. The BIO-OLTRAD trial is a double-blind, randomized controlled study with 22 participants that received a single dose of 30 mg OA formulated as a functional olive oil. The study revealed that the maximum serum concentration of OA ranged from 500 to 600 ng/mL, with an AUC0–∞ value of 2862.50 ± 174.50 ng·h/mL. Furthermore, we discovered a physiological association of OA with serum albumin and triglyceride-rich lipoproteins (TRL). UV absorption spectra showed conformational changes in serum albumin due to the formation of an adduct with OA. Additionally, we demonstrated that TRL incorporate OA, reaching a maximum concentration of 140 ng/mL after 2-4 hours. We conjecture that both are efficient carriers to reach target tissues and to yield high bioavailability. This dataset includes the raw data used in the elaboration of the results reported in the article (DOI).This research is part of the R+D+i project PID2019-107837RB-I00, funded by the Spanish Ministry of Science and Innovation/Spanish Research Agency, grant number MCIN/AEI/10.13039/501100011033/.1.Row data OA pharmacokinetics in human serum; 2. Raw data OA-HSA association; 3. Row data OA in TRL; 4. Raw data blood biochemistryPeer reviewe

Anales de Edafología y Agrobiología Tomo 40 Número 11-12

Suelos. Características de los suelos forestales del valle de El Jerte, por J. E. Gallardo, S. Cuadrado y M.I.M. González. III. Procesos de alteración de minerales en suelos de la Sierra de Guadarrama (Xerochrept y Xerumbrept), por T. Aleixandre, A. Pinilla y M. T. García-González.-- Estudio experimental de la alteración de biotitas de la fracción arena gruesa de los suelos empardecidas desarrollados sobre granodioritas, por A. Hoyos de Castro, J. Hernando Costa, J.A. Egido Rodríguez y A. Moro Valverde.- Contribución al estudio de los suelos del Calar del mundo (Albacete) I. Características generales de los Haploxerolls cumúlicos de dolinas y de los Xerorthents líticos circundantes, por L. J. Alias Pérez, Ma. T. Fernández Tapia y J. Hernández Bastida.-- Estudio de los suelos de la Sierra del Barbanza (Galicia). I. Factores de formación, por F. Gil Sotres y F. Diaz-Fierros Viqueira.-- Estudio de los suelos de la Sierra del Barbanza (Galicia). II Propiedades y distribución de los suelos en el espacio, por F. Gil Sotres y F. Diaz-Fierros Viqueira.-- Estudio de los suelos de la Sierra del Barbanza (Galicia). III Procesos edáficos y discusión global, por F. Gil So tres y F. Diaz-Fierros Viqueira.-- Estudio de los suelos de la Sierra del Barbanza ( Galicia). IV Condiciones de fertilidad de los suelos, por F. Gil Sotres y F. Diaz-Fierros Viqueira.-- Estudio sobre la caracterización, génesis y evolución de suelos desarrollados en la Alcarria conquense.I Entisoles, por J. L. Martín de Vidales, R. Jiménez Ballesta y A. Guerra Delgado.-- Estudio sobre la caracterización, génesis y evolución de suelos en la Alcarria conquense. Il. In ceptisoles, por J. L. Martín de Vida/es y R. Jiménez Ballesta.-- Estudio sobre la caracterización, génesis y evolución de suelos en la Alcarria conquense. III Mollisoles, por J. L. Martín de Vidales y R. Jiménez Ballesta.-- Estudio sobre la caracterización, génesis y evolución de suelos en la Alcarria conquense. IV Al fisoles, por J. L. Martín de Vidales y R. Jiménez Ballesta.-- Influencia de los factores formadores en la génesis de suelos de montaña en la provincia de Teruel I. Características generales, por A. Hoyos, Ma. L. Palomar, A. Ma. Moreno y C. Fernández Bermejo.-- Influencia de los factores formadores en la génesis de suelos de montaña en la provincia de Teruel. II Mineralogía de la fracción arena, por A. Hoyos, Ma. L. Palomar, A. Moreno y C. Fernández Bermejo.-- Influencia de los factores formadores en la génesis de suelos de montaña en la provincia de Teruel. III Estudio químico y físico-químico de los suelos, por A. Hoyos, M.L. Palomar, A. Moreno y C. Fernandez Bermejo.-- Influencia de los factores formadores en la génesis de suelos de montaña en la provincia de Teruel. IV Estudio de la montaña orgánica, por A. Hoyos, M. Palomar, A. Moreno y C. Fernández Bermejo.-- Influencia del catión asociado en la cinética de la reacción del ión fluoruro con arcillas alofanicas, por J.M. Hernández Moreno, A. González Batista, O. G. Cabrera y E. Fernández Galdos. Predicción de Parametros climáticos de interés ecológico en Galicia. I. Relación Clima Topografía, por A. Carballeira, J. Juste, A.M. Molina, R. Retuerto y F. Ucieda.-- Aportación al estudio de suelos con horizonte textura en las facies Madrid, por J.B. Alvarez Martín, J. Gumuzzio Fernández y J. Batlle Sales.-- Observaciones sobre algunas malas hierbas recogidas en el Valle del Tietar (A vila), por M. L. Martín Mateo y E. Laborda.-- Sorción interlaminar de aminas alifáticas en minerales interestratificados Mica-Montmorillonita II., Por A. Ruiz Ami/, M. R. de Miguel Rodríguez y F. Aragón de la Cruz.-- IV Procesos de alteración en suelos caracterizados por fenómenos de empardecimiento y movi• lización de arcilla (Haploxeralf), por T. Aleixandre, M. T. García-González y A. Pinilla.-- Modelo experimental de alteración de magnetita. Aplicación al reconocimiento microscopico de minerales opacos, por A. Hoyos de Castro, l. Hernando Massanet, J. Hernando Costa y C. Cañas Alcocer.-- Modelo experimental de alteración de Ilmenita. Aplicación al reconocimiento microscopico de minerales opacos, por A. Hoyos de Castro, J. Hernando Costa, l. Hernando Massanet y C. Cañas Alcocer.—Fertilidad de Suelo. Propiedades físico-químicas de los suelos de aguacates de las Islas Canarias occidentales por V. García, J. Bravo Rodríguez, A. Rodríguez y C.E. Alvarez. Tolerancia del girasol (Helianthus Annus L.) Al boro, por A. Cerda, R.M. Salinas y M. Romero.-- Nutrición y Fisilogía Vegetal. Composición mineral y relaciones fisiológicas en pastizales de zona semiárida, por M.. Montalvo y B. García.-- La composición química mineral del trigo de un campo de experimentación, por L. Sánchez de la Puente y V. J. Mangas Martín.-- La composición química mineral del trigo de un campo de experimentación, por L. Sánchez de la Puente y V. J. Mangas Martín.-- Nota previa. Visual a id for the estimation of grain sizes in thin sections, por G. Stoops.—Trabajo recapitulativos. Perspectivas actuales de la cartografía y evaluación de suelos, por D. de la Rosa.-- La química agrícola en España (1979-1980), por O. Carpena y C. Cadahia. Ciclo del fósforo. l. Formas el elemento en los suelos y su disponibilidad para plantas y microorganismos, por F. Borie y J. M. Barea.-- Ciclo del fósforo. Il. Papel de los microorganismos y su repercusión en nutrición vegetal, por F. Borie y J. M. Barea.-- Estudios básicos de fertilidad por un sistema de electro-ultrafiltración (EUF), por O. Carpena, C. Cadahia, A. Gárate y J. Sánchez Andreu.-- Notas.--BibliografíaPeer reviewe