Effects of Growth Hormone and Pioglitazone in Viscerally Obese Adults with Impaired Glucose Tolerance: A Factorial Clinical Trial

OBJECTIVE: Recombinant human growth hormone (GH) and pioglitazone (PIO) in abdominally obese adults with impaired glucose tolerance were evaluated under the hypothesis that the combination attenuates GH-induced increases in glucose concentrations, reduces visceral adipose tissue (VAT), and improves insulin sensitivity over time. DESIGN: Randomized, double-blind, placebo-controlled, 2 × 2 factorial design. SETTING: Veterans Affairs Palo Alto Health Care System, Palo Alto, California, United States. PARTICIPANTS: 62 abdominally obese adults aged 40–75 with impaired glucose tolerance. INTERVENTIONS: GH (8 μg/kg/d, or placebo) and pioglitazone (30 mg/d, or placebo) for 40 wk. OUTCOME MEASURES: Baseline and after 40 wk of treatment, VAT content was quantified by CT scan, glucose tolerance was assessed using a 75-g oral glucose tolerance test, and insulin sensitivity was measured using steady-state plasma glucose levels obtained during insulin suppression test. RESULTS: Baseline: body mass index (BMI), plasma glucose, and visceral fat content were similar. 40 wk: visceral fat area declined 23.9 ± 7.4 cm(2) in GH group, mean difference from placebo: −28.1 cm(2) (95% CI −49.9 to −6.3 cm(2); p = 0.02). Insulin resistance declined 52 ± 11.8 mg/dl with PIO, mean difference from placebo of −58.8 mg/dl (95% CI −99.7 to −18.0 mg/dl; p = 0.01). VAT and SSPG declined with GH and PIO combined, mean differences from placebo of −31.4 cm(2) (95% CI −56.5 cm(2) to −6.3 cm(2); p = 0.02) and −55.3 mg/dl (95% CI −103.9 to −6.7 mg/dl; p = 0.02), respectively. Fasting plasma glucose increased transiently in GH group. No significant changes in BMI were observed. CONCLUSIONS: Addition of PIO to GH attenuated the short-term diabetogenic effect of GH; the drug combination reduced VAT and insulin resistance over time. GH plus PIO may have added benefit on body composition and insulin sensitivity in the metabolic syndrome

Construcciones verbales del Espanol Andino: Interaccion Quechua - Espanola en la frontera Colombo - Ecuatoriana. (Spanish text);

Ever since the Spanish influx into the Colombian-Ecuadorian border region (the area chosen for this study), the Spanish language has been in contact with Quechua, the ancient language of the Incas. The result is a local dialect of both Spanish and of Quechua (the latter called Quichua). This study gives special attention to the historical background, intermingling, and consequences of the language-contact in this Andean region. The specific focus of this thesis is variant Spanish verbal constructions which have been classified into two main categories: (1) periphrases with the gerund using dar, dejar, mandar, poner and venir as the auxiliaries, and (2) verbal constructions known to have been current in Castilian at the time of the Conquest, to have survived in this region, but to have disappeared subsequently from other parts of the Hispanic world (i.e. the synthetic future used as a softened command and saber + infinitive used instead of the verb soler). Analogous constructions are equally anomalous in the local Quechua. Data were collected in situ through participant observation in different parts of the region, eliciting casual speech from both monolingual and bilingual speakers. Supplementary data were collected on both sides of the Colombian-Ecuadorian border through more formal interviews with 60 informants. A constrastive analysis of the local Quechua and Spanish reveals Quechua influence in both widespread gerundial usages and in the specific semantic changes to which the Spanish periphrases of Category 1 were subjected. The equivalent construction of auxiliary + gerund has developed in tandem in both languages in this frontier speech community as a whole. Moreover, the use of the synthetic future as a softened command and the survival of saber + infinitive, both traditionally attributed to Quechua influence, seem not to result from substratum influence. Thus, in contrast to the anticipated pattern, neither the substratum nor the superstratum has been exclusively dominant.Ph.D.Language, Literature and LinguisticsLinguisticsUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/128279/2/8907117.pd

El habla del gamin bogotano

No page 59En este trabajo se describe el habla del gamín bogotano. Con el nombre de "gamín" se designa en Colombia al niño y al muchacho de la calle quien carece de todo y en su lucha por la sobrevivencia rompe toda clase de normas sociales, se inicia en el robo, la violencia y el uso de drogas. El Corpus está formado por material "vivo" obtenido durante tres meses de interacción con los informantes, por vía directa (entrevistas grabadas) e indirecta (observación sin que los informantes lo supieran). La muestra de 22 sujetos ha sido tomada del universo de la calle. En la descripción se consideran la morfosintaxis y el léxico. Como punto de referencia en el análisis morfosintáctico se ha tomado el uso culto peninsular (español standard) como la pauta más conocida y documentada. Al mismo tiempo se hace la comparación con otros dialectos para determinar los puntos de contacto con ellos. El estudio revela que, aunque el español de los gamines presenta modalidades típicas, morfosintácticamente es semejante a los dialectos populares del resto del mundo hispano. El léxico del gamín está formado por la jerga del delincuente y términos vulgares de la lengua popular. Se señalan aquí la procedencia del término y las relaciones con las jergas delictivas de otros países. El léxico es difícil de descodificar para quien no conoce las nuevas correspondencias respecto a las usuales del código. De modo que las diferencias a nivel léxico constituyen su rasgo sobresaliente, y permiten catalogar el habla del gamín como jerga. Este es, en resumen, la esencia de este trabajo

Predicting 5-year survival after kidney transplantation in Colombia using the survival benefit estimator tool.

IntroductionA complex relationship between donor and recipient characteristics influences kidney transplant (KT) success. A tool developed by Bae S. et al. (Survival Benefit Estimator, SBE) helps estimate post-KT survival. We aim to evaluate the predictive performance of the SBE tool in terms of 5-year patient survival after a kidney transplant.MethodsA retrospective cohort study of all deceased-donor KT recipients between January 2009 to December 2021. A descriptive analysis of clinical and sociodemographic characteristics was performed. The SBE online tool was used to calculate the predicted patient survival (PPS) and the survival benefit at five years post-KT. Comparisons between predictive vs. actual patient survival were made using quintile subgroups. Three Cox regression models were built using PPS, EPTS, and KDPI.ResultsA total of 1145 recipients were evaluated. Mortality occurred in 157 patients. Patient survival was 86.2%. Predictive survival for patients if they remained on the waiting list was 70.6%. The PPS was 89.3%, which results in a survival benefit (SB) of 18.7% for our population. Actual survival rates were lower than the predicted ones across all the quintiles. In unadjusted analysis, PPS was a significant protective factor for mortality (HR 0.66), whereas EPTS (HR 8.9) and KDPI (HR 3.25) scores were significant risk factors. The discrimination of KDPI, PPS, and EPTS scores models were 0.59, 0.65, and 0.66, respectively.ConclusionSBE score overestimated actual survival rates in our sample. The discrimination power of the score was moderate, although the utility of this tool may be limited in this specific population