Association of Polymorphisms in the Interleukin 6 Receptor Complex with Obesity and Hyperandrogenism

10 pages, 5 tables.Objective: Interleukin-6 (IL-6), is an inflammatory cytokine that may influence the pathogenesis of obesity and hyperandrogenism. IL-6 exerts its actions through a heterodimeric receptor consisting of two membrane-bound glycoproteins: an 80-kDa IL-6 binding unit (IL6R-alpha) and a 130-kDa IL-6 signal transducer (gp130). Genetic variability at these loci might contribute to explain the development of obesity and hyperandrogenism. Research Methods and Procedures: We have evaluated the possible association of several polymorphisms in the IL6R-alpha and gp130 genes with obesity and/or hyperandrogenism in a case-control study involving 143 hyperandrogenic patients and 45 healthy women from Spain. Results: A microsatellite CA-repeat polymorphism in the IL6R-alpha locus was associated with obesity. The frequency of the common 149-bp allele was markedly increased in obese women compared with controls when considering patients and controls as a whole (0.41 vs. 0.29, chi2 = 17.085, p < 0.050). On the other hand, the uncommon Arg148 allele of the Gly148Arg polymorphism in the gp130 gene was more frequent in controls compared with hyperandrogenic patients (0.17 vs. 0.08, chi2 = 5.605, p = 0.026). Controls carrying Arg148 alleles had lower 11-deoxycortisol and 17-hydroxyprogesterone concentrations, a lower response of androstenedione to 1–24 adrenocorticotropin, and an almost significant decrease in free testosterone levels, suggesting that Arg148 alleles in the gp130 gene have a protective effect against androgen excess and adrenal hyperactivity. Discussion: Polymorphisms in the gp130 and IL6R-alpha loci influence hyperandrogenism and obesity, respectively. Our present results further suggest that proinflammatory genotypes are involved in the pathogenesis of these common metabolic disorders.This work was supported by grants from the Consejería de Educación, Comunidad de Madrid, Spain (Proyectos 08.6/0022/1998, 08.6/0024.2/2000, and 08.6/0010/2001), and from the Fondo de Investigación Sanitaria, Ministerio de Sanidad y Consumo, Spain (Proyectos FIS 00/0414 and 02/0741 to H.F.E.-M.Peer reviewe

Association of the polycystic ovary syndrome with genomic variants related to insulin resistance, type 2 diabetes mellitus, and obesity

7 pages, 2 tables.-- Results from this work were presented at the 85th Annual Meeting of The Endocrine Society, Philadelphia, PA, June 2003.We have evaluated the possible association of polycystic ovary syndrome (PCOS) with 15 genomic variants previously described to influence insulin resistance, obesity, and/or type 2 diabetes mellitus. Seventy-two PCOS patients and 42 healthy controls were genotyped for 15 variants in the genes encoding for paraoxonase (three variants), plasma cell differentiation antigen glycoprotein, human sorbin and SH3 domain containing 1, plasminogen activator inhibitor-1, peroxisome proliferator-activated receptor-gamma2, protein tyrosine phosphatase 1B (two variants), adiponectin (two variants), IGF1, IGF2, IGF1 receptor, and IGF2 receptor. Compared with controls, PCOS patients were more frequently homozygous for the -108T variant in paraoxonase (36.6% vs. 9.5%; P = 0.002) and homozygous for G alleles of the ApaI variant in IGF2 (62.9% vs. 38.1%; P = 0.018). Paraoxonase is a serum antioxidant enzyme and, because -108T alleles result in decreased paraoxonase expression, this increase in oxidative stress might result in insulin resistance. G alleles of the ApaI variant in IGF2 may increase IGF2 expression, and IGF2 stimulates adrenal and ovarian androgen secretion. In conclusion, the paraoxonase -108 C-->T variant and the ApaI polymorphism in the IGF2 gene are associated with PCOS and might contribute to increased oxidative stress, insulin resistance, and hyperandrogenism in this prevalent disorder.This work was supported by grants from the Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Spain (FIS 00/0414, 02/0741, and 02/0578 and RGDM G03/212) and from the Consejería de Educación, Comunidad de Madrid, Spain (CAM 08.6/0024/2000 and 08.6/0010/2001).Peer reviewe

La laminoartrectomía en el tratamiento de la estenosis de canal lumbar

Los autores presentan una revisión de 42 pacientes, 33 varones y 9 mujeres, con estenosis del canal lumbar, tratados quirúrgicamente y con un seguimiento medio de 3 años y 8 meses. El tratamiento quirúrgico empleado ha sido la laminoartrectomía a uno o varios niveles, combinada o no con artrodesis. Los mejores resultados se obtuvieron en los pacientes tratados con laminoartrectomía, artrodesis e instrumentación vertebral.The authors present a review of 42 patients, 33 male and 9 female, with lumbar spinal canal stenosis, treated surgically and with a mean follow-up of 3 years-8 months. The surgical treatment was wide laminoarthrectomy involving one o more levels, combined in some cases with spinal fusion. The best results were obtained in patients treated with laminoarthrectomy, arthrodesis and vertebral instrumentation

Evaluación y comparación de dos sistemas de predicción meteorológica en las costas mediterráneas de la Península Ibérica

Ponencia presentada en: XXIX Jornadas Científicas de la AME y el VII Encuentro Hispano Luso de Meteorología celebrado en Pamplona, del 24 al 26 de abril de 2006.Este proyecto ha sido financiado por la Comisión Europea, proyecto FUMAPEX – EVK4-CT-2002-00097; y por el Ministerio de Educación y Ciencia, REN2002-10681-E/CLI

Deformidad vertebral y mielomeningocele: actitud terapéutica y resultados

Presentamos nuestra experiencia en el tratamiento quirúrgico de la deformidad vertebral relacionada con el mielomeningocele entre los años 1972 y 1995. En ese período un total de 48 pacientes fueron intervenidos. Se han evaluado las condiciones generales previas, el estado prequirúrgico, las diversas modalidades de instrumentación y el resultado de las mismas, así como el tipo y número de complicaciones. Durante el período posquirúrgico inmediato hemos encontrado un porcentaje de infecciones del 68%. Sin embargo, el resultado final, tanto del equilibrio pélvico como del vertebral conseguido, no estuvo influenciado significativamente por esta complicación. El tipo de patología, las complicaciones generales derivadas de la misma, el tiempo quirúrgico empleado y las pérdidas sanguíneas, son condiciones estrechamente relacionadas con el número de infecciones encontradas.We present our experience on the surgical treatment of myelomeningocelelinked vertebral deformity between 1972 and 1995. We evaluated the previous general condition, the presurgical status, the instrument modalities and their outcome, as well as the type and number of complications in a series of 48 patients. During the immediate postoperative period, we found a 68% infection rate. However, the end result for pelvic as well as vertebral balance was not influenced significantly by this complication. The number of infections found is closely linked to the specific pathology, the complications, duration of operation, and blood loss

Glauconite and phosphate peloids in Mesozoic carbonate sediments (eastern Subbetic Zone, Betic Cordilleras, SE Spain)

13 páginas, 4 figuras, 3 tablas.Glauconite and Ca phosphate peloids occur in Jurassic and Cretaceous bioclastic carbonate rocks from pelagic swell sequences of the Algayat-Crevillente Unit (Subbetic Zone). The size and morphology of the peloids are controlled by the bioclasts. The glauconite in both stratigraphic positions is K rich (>0.69 atoms p.f.u.) and shows well-defined 10 Aa lattice fringes. Poorly crystalline areas with a composition of Fe-smectite are found within the peloids, indicating the nature of the glauconitic precursor. This precursor would be formed in the shielded microenvironments of the bioclast and later transformed to glauconite by equilibration of peloids with sea water that culminated with the crystallization of a phosphatic phase. The greater presence of smectite areas in the Jurassic peloids and the lower K contents (0.69-0.81) of these glauconites, compared with the Cretaceous glauconites (0.81-0.89) can be explained by the calcitic early diagenetic cementation which stopped the process of glauconitization.Financial support was provided by the Research Groups 4065 and 4135 of the Junta de Andalucía and the Projects PB92-0961 and PB93-1150-CO2 of DGICYT.Peer reviewe

Reliability of 4-m and 6-m walking speed tests in elderly people with cognitive impairment

[Abstract] The purpose of this study was to evaluate the interrater and test–retest reliability of 4-m and 6-m walking speed tests in elderly people with cognitive impairment. 50 subjects aged 65 and over with cognitive impairment were selected from an adult day-care centre and a nursing home. To examine interrater reliability, 21 people were evaluated independently by two researchers who administered the 4-m and 6-m walking tests in each evaluation. For test–retest reliability, two observers administered the tests to the same 29 subjects, with a time interval of one week. Intraclass correlation coefficients (ICCs) were calculated to examine interrater and test–retest reliability. The ICCs for interrater reliability reached values of 0.96 and 0.88 for the 4-m and 6-m walking tests, respectively. In the test–retest study, the time interval was 7.4 1.17 days. The ICCs were 0.91 for the 4-m test and 0.86 for the 6-m test. The results support the use of walking tests in elderly people with cognitive impairment

Tratamiento de la escoliosis idiopática mediante artrodesis anterior e instrumentación de Zielke

—Hemos revisado 16 pacientes afectos de escoliosis toracolumbar y lumbar tratados mediante artrodesis anterior e instrumentación de Zielke. La corrección de la curva en el plano anteroposterior ha sido del 68%. La escoliosis torácica asociada se ha corregido de forma espontánea un 30%. La lordosis global final ha sido de 40°, sin embargo la instrumentación provoca un aumento de la cifosis regional de 10°. Las complicaciones de la serie han sido 3 roturas de barra, una progresión de la curva torácica y un derrame pleural.The authors showed the clinical outcome of 16 patients with thoracolumbar and lumbar curvatures treated by Zielke instrumentation and anterior fusion. The correction obtained in the primary curvature was 68%. The average correction in the compensatory thoracic curvature was 30%. The average lordosis correction at follow was 40°. However the Zielke's system lead to an increase of 10° of kyphotic at the instrumented levels. Complications included 3 browen rods, a progression of the thoracic curve and one pleural spilling

Nuestra experiencia en el tratamiento de la escoliosis idiopática mediante la electroestimulación percutánea

Se presentan los resultados obtenidos en 40 pacientes con escoliosis tratadas mediante estimulador externo (Spinelectron) de corriente continua y doble canal. Se valor a el equilibrio vertebral, el valor angular de las curvas y su rotación. Los pacientes se dividieron en 2 grupos, según el valor angula r de las curvas. El primero con grados Cobb entre 20° y 29° y el segundo entre 30° y 39°. Igualmente se analizaron los resultados según el tipo de curva . La tas a de progresión par a curvas torácicas fue del 65.3%, mientras que par a curvas toracolumbares y lumbares fue del 50%. En cuanto al valor angular de las curvas observamos que el 55% de las curvas entre 20-29° aumentaron su valor angular, pasando de 24.7° a 31.5°. En cuanto a las curvas entre 30-39° el 50% de los casos necesitó artrodesis posterior. Los resultados de la electroestimulación no difieren de la evolución natural de la escoliosis por lo que el tratamiento puede considerarse ineficaz.Lateral electrical Surface Stimulation using the Spinelectron ® device was applied to 40 patients for treatment of idiopathic scoliosis.The authors value vertebra l balance , curve measurement (Cobb method ) and rotational devia tion . The patients were distributed in two groups according to the angular value of the curves; the first group between 20° an d 29° o f Cobb angle an d 30° t o 39° the second one . The results were analyzed depending on the curve pattern . The average of progression at the thoracic curve s was 65,3 %, an d a t th e thoraco - lumba r an d lumba r curve s wer e 5 0 %. In th e first group , th e 5 5 % o f th e curve s showed an increase of the Cobb angle , 24,7° at the begining of the treatment to 31,5° at the en d (averag e values). In the second group the 5 0 % o f the patients needed surgery . The results of the Electrical Stimulation do not modify the natural evolution of the scoliosis, so , the treatment can consider it ineffective

Complicaciones sépticas de la osteosíntesis lumbosacra: Análisis de 23 casos

Entre 1987 y 1995 hemos intervenido 295 pacientes afectos de patología lumbosacra realizando en todos ellos una artrodesis instrumentada. Veintitrés pacientes tuvieron como complicación una infección profunda, lo que equivale a un 7,8%. El germen más frecuentemente aislado como responsable de la infección fue el Staphylococcus aureus resistente a la meticilina. La antibioterapia más veces utilizada fue una cefalosporina de 2.a generación. La infección se resolvió en 4 ocasiones bajo tratamiento médico; sin embargo, en 19 se procedió a limpieza quirúrgica de los tejidos dañados no siendo necesaria la retirada del material de osteosíntesis. En 9 ocasiones se practicó una 2.a reintervención, y en otros 4 una tercera. En nuestra serie, fue necesario reintervenir quirúrgicamente el 50% de los pacientes a los que se practicó una limpieza quirúrgica. Dado que la profilaxis antibiótica debe de cubrir los gérmenes prevalentes en cada unidad hospitalaria, de acuerdo con su patrón de resistencia, hubiera sido más adecuado el empleo de antibióticos glucopeptídicos.Between 1987 and 1995 we performed an instrumented arthrodesis on 295 patients with lumbosacral pathology and 23 patients (7.8%) had a serious infection. Methicillin-resistent Staphylococcus aureus was the most frequently isolated causal germs. Second generation Cephalosporin was the antibiotic administered the most. The infection was cured in 4 cases with medical treatment. However, in 19 patients surgical cleaning of the damaged tissue was required, although it was not necessary to remove the osteosynthesis material. In 9 cases a second operation was performed and a third in 4 others. In our series, 50% of the patients who required surgical cleaning underwent another operation. Due to the fact that prophylactic antibiotics should cover the germs prevalent in each hospital ward, according to the resistence patterns, the use of Glycopeptid antibiotics would have been more appropriate