HOMA metabolic assessment in normoglycemic and diabetic canines.

Introducción: La Diabetes Mellitus es una patología producida por un aumento en los niveles de glucosa a nivel sanguíneo, fenómeno mediado por factores ambientales y genéticos. Esta alza en los niveles de glicemia se puede deber a una falla en la producción, ya sea parcial o absoluta de insulina, así como también por una pérdida en la sensibilidad a la insulina por parte de los tejidos. Dado que los pacientes diabéticos solo responden a manejos de insulinización, y que son en su mayoría delgados, estos caninos pueden tener insulinoresistencia, sin llegar a desarrollar intolerancia a la glucosa o diabetes. Objetivo: El objetivo de este trabajo fue evaluar la insulinoresistencia por medio del modelo matemático HOMA en pacientes con distinta condición corporal. Métodos: Se determinaron los niveles de insulina a través de ensayo IRMA y el análisis estadístico utilizó prueba de X2 y análisis de varianza ANOVA. Resultados: El análisis de varianza ANOVA entre los grupos, no mostró diferencias estadísticamente significativas entre el grupo HOMA normoglicémico del paciente obeso y normopeso, así como tampoco entre el grupo HOMA diabético y normopeso. El índice de correlación X2 no mostró una asociación significativa entre la condición corporal y el índice HOMA alterado, (X2 =3,056; p = 0.08). Los niveles de insulina fueron mayores en pacientes obesos respecto a normopeso, aunque esta diferencia no fue estadísticamente significativa (F = 1.004; p = 0.394). Conclusión: El estudio realizado no mostró diferencias significativas en los niveles HOMA asociada a aumentos en su condición corporal, lo cual se podría relacionar a un mayor estado de insulinodeficiencia por sobre el estado de insulinoresistencia.Introduction: Diabetes mellitus is caused by an increase in blood glucose levels, a phenomenon mediated by environmental and genetic factors. This increase in blood glucose levels may be due to a partial or absolute failure to produce insulin as well as a loss in tissue sensitivity to insulin. Given that diabetic patients respond only to insulin therapy and are mostly thin, canines can develop insulin resistance, without developing glucose intolerance or diabetes. Aims: We aim to evaluate insulin resistance using the mathematical model homeostatic model assessment (HOMA) in patients with different body condition. Insulin levels were determined using the IRMA assay, and X2 test and analysis of variance (ANOVA) were used for the statistical analysis. Results: ANOVA between the groups showed no significant differences between the normoglycemic HOMA group of the obese and normal weight patients and between the diabetic and normal weight HOMA group. The X2 correlation index did not show a significant association between the body condition and the altered HOMA index (X2 = 3.056, p = 0.08). Insulin levels were higher in obese patients than in those with normal weight, although the difference was not significant (F = 1.004, p = 0.394). Conclusion: In addition, there were no significant differences in HOMA levels associated with increases in the body condition, which could be related with a higher state of insulin deficiency over the state of insulin resistance

El impacto de la pandemia del COVID-19 en la educación médica: adaptabilidad y experiencia con enseñanza a distancia de la Sociedad Médica Peruano Americana

The COVID-19 pandemic had a significant impact on medical care and medical education in Peru.  In response, the Peruvian American Medical Society (PAMS), a charitable medical organization based in the USA, pursued its medical and educational missions in Peru by adopting virtual learning technology. We developed closer collaborative relationships with several medical schools and the Peruvian Association of Medical Schools (ASPEFAM) while offering a faculty panel of twenty-four members to provide lectures and multidisciplinary webinars in Spanish. We conducted 19 webinars including COVID -19 and non-COVID-19 related topics that over the last two years attracted 14,489 participants from 23 countries. They were the foundation for twenty publications in Peruvian medical journals. Our clinical investigations competition was positively received as was our pilot project on research mentorship. The COVID -19 pandemic had a positive effect on the educational mission of PAMS in Peru.La pandemia del COVID-19 tuvo un impacto significativo en el cuidado y la educación médicos en el Perú. En respuesta, la Sociedad Médica Peruano Americana (PAMS), una organización médica benéfica con sede en los EE. UU., adoptó sus misiones médicas y educativas en Perú usando estrategias virtuales. Desarrollamos colaboración con varias facultades de medicina y la Asociación Peruana de Facultades de Medicina (ASPEFAM) y ofrecimos un panel de veinte y cuatro miembros para brindar conferencias y seminarios multidisciplinarios en español. Hicimos 19 seminarios, incluyendo temas relacionados y no relacionados al COVID-19, que en los últimos dos años atrajo a 14 489 participantes de 23 países. Ellas fueron la base de 20 publicaciones en revistas médicas peruanas. Nuestro concurso de investigaciones clínicas y nuestro proyecto piloto de mentoría de investigación fueron recibidos positivamente. La pandemia del COVID-19 tuvo un efecto positivo en la misión educativa de PAMS en Perú

Insulin Resistance in Chileans of European and Indigenous Descent: Evidence for an Ethnicity x Environment Interaction

<p><b>Background:</b> Effects of urbanisation on diabetes risk appear to be greater in indigenous populations worldwide than in populations of European origin, but the reasons are unclear. This cross-sectional study aimed to determine whether the effects of environment (Rural vs. Urban), adiposity, fitness and lifestyle variables on insulin resistance differed between individuals of indigenous Mapuche origin compared to those of European origin in Chile.</p> <p><b>Methodology/Principal Findings:</b> 123 Rural Mapuche, 124 Urban Mapuche, 91 Rural European and 134 Urban European Chilean adults had blood taken for determination of HOMA-estimated insulin resistance (HOMA(IR)) and underwent assessment of physical activity/sedentary behaviour (using accelerometry), cardiorespiratory fitness, dietary intake and body composition. General linear models were used to determine interactions with ethnicity for key variables. There was a significant "ethnicity x environment" interaction for HOMA(IR) (Mean +/- SD; Rural Mapuche: 1.65 +/- 2.03, Urban Mapuche: 4.90 +/- 3.05, Rural European: 0.82 +/- 0.61, Urban European: 1.55 +/- 1.34, p((interaction)) = 0.0003), such that the effect of urbanisation on HOMA(IR) was greater in Mapuches than Europeans. In addition, there were significant interactions (all p<0.004) with ethnicity for effects of adiposity, sedentary time and physical activity on HOMA(IR), with greater effects seen in Mapuches compared to Europeans, an observation that persisted after adjustment for potential confounders.</p> <p><b>Conclusions/Significance:</b> Urbanisation, adiposity, physical activity and sedentary behaviour influence insulin resistance to a greater extent in Chilean Mapuches than Chileans of European descent. These findings have implications for the design and implementation of lifestyle strategies to reduce metabolic risk in different ethnic groups, and for understanding of the mechanisms underpinning human insulin resistance.</p&gt

Desafíos y estrategias para la traducción del texto de Matemática Álgebra y Teoría de Números de L. Koulikov y sus posibles soluciones

La Matemática es una de las ciencias más antiguas que el ser humano ha estudiado e investigado y está presente en todos los ámbitos de nuestra vida cotidiana. Los traductores además de enfrentarse a las dificultades que presenta la traducción, sus marcas (lexicales, gramaticales y fonológicas) así como el estilo del texto, deben tener en cuenta que las marcas estilísticas en una lengua, pueden no serlo en otra, y mucho más en el campo de la Matemática ya que ésta debe ser completamente clara, puesto que es un tema complejo , y el no interpretar de manera correcta el sentido del texto puede distorsionar el sentido original del autor, una mala explicación puede variar el sentido de todo, por lo que debe cuidar que la calidad de la traducción sea equivalente a las del texto original, sin desatender por ello la integridad de su contenido. Así que uno de los desafíos al traducir este texto de Álgebra es encontrar en nuestra propia lengua términos que expresen con mayor grado de fidelidad posible el sentido de éste, lo cual es muy difícil sino se tiene un dominio correcto de los términos que se utilizan en el campo de la Matemátic

Uso de los modelos 3D de los corazones fetales en la docencia multidisciplinar del diagnóstico tratamiento y pronóstico de las cardiopatías congénitas

Depto. de Salud Pública y Materno - InfantilFac. de MedicinaFALSEsubmitte

Origin and pathways of the mineral dust transport to two Spanish EARLINET sites: Effect on the observed columnar and range-resolved dust optical properties

In this paper, is presented a method for estimation of the effect of the transport process to aerosol optical properties. Aerosol optical data retrieved by lidars and sun-photometer measurements, are applied to Saharan dust events observed simultaneously at the two EARLINET/AERONET sites of Barcelona and Granada during the periods of June–September of 2012 and 2013. For this purpose, elastic lidar profiles and sun-photometer columnar retrievals are analyzed together with satellite observations and dust forecast models. Granada presents more than twice Saharan dust outbreaks compared to Barcelona. The scenarios favoring the Saharan dust outbreaks are identified in both places. The mineral dust originating in the Sahara region and arriving at both stations is usually transport wither over the Atlas Mountains or through an Atlantic pathway. Analyses of dust events affecting both stations reveal how differences in the transport process lead to differences in the aerosol optical properties measured at each station. Mean dust related Ångström exponent is 1.8 times higher in Barcelona than in Granada. This difference is a result of the additional contribution of anthropogenic aerosol, mainly in the aerosol fine mode, during the transport of the mineral dust plume over the Iberian Peninsula.Andalusia Regional Government through the project P12-RNM-2409Spanish Ministry of Economy and Competitiveness through the project CGL2013-45410-

Methionine Cycle Rewiring by Targeting miR-873-5p Modulates Ammonia Metabolism to Protect the Liver from Acetaminophen

Drug-induced liver injury (DILI) development is commonly associated with acetaminophen (APAP) overdose, where glutathione scavenging leads to mitochondrial dysfunction and hepatocyte death. DILI is a severe disorder without effective late-stage treatment, since N-acetyl cysteine must be administered 8 h after overdose to be efficient. Ammonia homeostasis is altered during liver diseases and, during DILI, it is accompanied by decreased glycine N-methyltransferase (GNMT) expression and S-adenosylmethionine (AdoMet) levels that suggest a reduced methionine cycle. Anti-miR-873-5p treatment prevents cell death in primary hepatocytes and the appearance of necrotic areas in liver from APAP-administered mice. In our study, we demonstrate a GNMT and methionine cycle activity restoration by the anti-miR-873-5p that reduces mitochondrial dysfunction and oxidative stress. The lack of hyperammoniemia caused by the therapy results in a decreased urea cycle, enhancing the synthesis of polyamines from ornithine and AdoMet and thus impacting the observed recovery of mitochondria and hepatocyte proliferation for regeneration. In summary, anti-miR-873-5p appears to be an effective therapy against APAP-induced liver injury, where the restoration of GNMT and the methionine cycle may prevent mitochondrial dysfunction while activating hepatocyte proliferative response.We thank Ministerio de Ciencia e Innovación, Programa Retos-Colaboración RTC2019- 007125-1 (for J.S. and M.L.M.-C.); Instituto de Salud Carlos III: Proyectos de Investigación en Salud DTS20/00138 (for J.S. and M.L.M.-C.), PI20/00690 (for R.J.) and PT20/000127 (for M.I.L.); CIBERehd: EHD21TRF01/2022 (to M.L.M.-C.); Departamento de Industria del Gobierno Vasco (for M.L.M.-C.); Ministerio de Ciencia, Innovación y Universidades MICINN: PID2020-117116RB-I00 and RTI2018- 096759-1-100 integrado en el Plan Estatal de Investigación Cientifica y Técnica y Innovación, cofinanciado con Fondos FEDER (for M.L.M.-C. and T.C.D., respectively); BIOEF (Basque Foundation for Innovation and Health Research); Asociación Española contra el Cáncer (AECC) (to M.L.M.-C., T.C.D.); AECC: GCTRA18006CARR (to A.C.); Fundación Científica de la Asociación Española Contra el Cancer (AECC Scientific Foundation) Rare Tumor Calls 2017 (for M.L.M.); La Caixa Foundation Program (for M.L.M.); BFU2015-70067-REDC, BFU2016-77408-R and BES-2017-080435 (MINECO/FEDER, UE); Ministerio de Ciencia, Innovación y universidades PID2019-108787RB-100 (to A.C.), PID2019- 109055RB-I00 (L.A.M.-C.), PID2020-117941RB-100 (to F.J.C.); Spanish Ministry of Economy and Competitiveness Grants BFU2013-47531-R and BFU2016-77408-R (L.A.M.-C.) and the FIGHT-CNNM2 project from the EJP RD Joint Transnational Call (JTC2019) (Ref. AC19/00073) (for L.A.M.-C.); Comunidad de Madrid: EXOHEP-CM S2017/BMD-3727 and NanoLiver-CM Y2018/NMT-4949 co-funded by European Structural and Investment Fund and COST Action CA17112 (to F.J.C.); Vencer el Cáncer Foundation (to A.C.); European Research Council: Consolidator Grant 819242 (to A.C.); CIBERONC and CIBERehd were funded by the Instituto de Salud Carlos III and Cofunded by FEDER funds. Partial funding for open access charge: Universidad de Málag

Objective vs. Self-Reported Physical Activity and Sedentary Time: Effects of Measurement Method on Relationships with Risk Biomarkers

<p><b>Purpose:</b> Imprecise measurement of physical activity variables might attenuate estimates of the beneficial effects of activity on health-related outcomes. We aimed to compare the cardiometabolic risk factor dose-response relationships for physical activity and sedentary behaviour between accelerometer- and questionnaire-based activity measures.</p> <p><b>Methods:</b> Physical activity and sedentary behaviour were assessed in 317 adults by 7-day accelerometry and International Physical Activity Questionnaire (IPAQ). Fasting blood was taken to determine insulin, glucose, triglyceride and total, LDL and HDL cholesterol concentrations and homeostasis model-estimated insulin resistance (HOMAIR). Waist circumference, BMI, body fat percentage and blood pressure were also measured.</p> <p><b>Results:</b> For both accelerometer-derived sedentary time (<100 counts.min−1) and IPAQ-reported sitting time significant positive (negative for HDL cholesterol) relationships were observed with all measured risk factors – i.e. increased sedentary behaviour was associated with increased risk (all p≤0.01). However, for HOMAIR and insulin the regression coefficients were >50% lower for the IPAQ-reported compared to the accelerometer-derived measure (p<0.0001 for both interactions). The relationships for moderate-to-vigorous physical activity (MVPA) and risk factors were less strong than those observed for sedentary behaviours, but significant negative relationships were observed for both accelerometer and IPAQ MVPA measures with glucose, and insulin and HOMAIR values (all p<0.05). For accelerometer-derived MVPA only, additional negative relationships were seen with triglyceride, total cholesterol and LDL cholesterol concentrations, BMI, waist circumference and percentage body fat, and a positive relationship was evident with HDL cholesterol (p = 0.0002). Regression coefficients for HOMAIR, insulin and triglyceride were 43–50% lower for the IPAQ-reported compared to the accelerometer-derived MVPA measure (all p≤0.01).</p> <p><b>Conclusion:</b> Using the IPAQ to determine sitting time and MVPA reveals some, but not all, relationships between these activity measures and metabolic and vascular disease risk factors. Using this self-report method to quantify activity can therefore underestimate the strength of some relationships with risk factors.</p&gt

Morbid liver manifestations are intrinsically bound to metabolic syndrome and nutrient intake based on a machine-learning cluster analysis

Metabolic syndrome (MetS) is one of the most important medical problems around the world. Identification of patient ' s singular characteristic could help to reduce the clinical impact and facilitate individualized management. This study aimed to categorize MetS patients using phenotypical and clinical variables habitually collected during health check-ups of individuals considered to have high cardiovascular risk. The selected markers to categorize MetS participants included anthropometric variables as well as clinical data, biochemical parameters and prescribed pharmacological treatment. An exploratory factor analysis was carried out with a subsequent hierarchical cluster analysis using the z-scores from factor analysis. The first step identified three different factors. The first was determined by hypercholesterolemia and associated treatments, the second factor exhibited glycemic disorders and accompanying treatments and the third factor was characterized by hepatic enzymes. Subsequently four clusters of patients were identified, where cluster 1 was characterized by glucose disorders and treatments, cluster 2 presented mild MetS, cluster 3 presented exacerbated levels of hepatic enzymes and cluster 4 highlighted cholesterol and its associated treatments Interestingly, the liver status related cluster was characterized by higher protein consumption and cluster 4 with low polyunsaturated fatty acid intake. This research emphasized the potential clinical relevance of hepatic impairments in addition to MetS traditional characterization for precision and personalized management of MetS patients

Tocilizumab in refractory Caucasian Takayasu's arteritis: a multicenter study of 54 patients and literature review

Objective: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu's arteritis (TAK) in clinical practice. Methods: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZMONO) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZCOMBO) was performed. Results: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5-50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0-31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5-50.0) to 5.0 (0.0-5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0-14.0) months. Twenty-three (42.6%) patients were on TCZMONO and 31 (57.4%) on TCZCOMBO: MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). Patients on TCZCOMBO were younger [38.0 (27.0-46.0) versus 45.0 (38.0-57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0-38.0) versus 6.0 (1.0-23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7-5.6) versus 1.3 (0.3-3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. Conclusion: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin.Funding: This work was partially supported by RETICS Programs, RD08/0075 (RIER), RD12/0009/0013 and RD16/0012 from “Instituto de Salud Carlos III” (ISCIII) (Spain)