Magnetic study on biodistribution and biodegradation of oral magnetic nanostructures in the rat gastrointestinal tract

We have undertaken a magnetic study on the oral biodistribution and biodegradation of nude maghemite nanoparticles of 10 nm average size (MNP) and probiotic bacteria, Lactobacillus fermentum, containing thousands of these same nanoparticles (MNP-bacteria). Using AC magnetic susceptibility measurements of the stomach, small intestine, cecum and large intestine obtained after rat sacrifice, and iron content determination by ICP-OES, we have monitored the biodistribution and biodegradation of the maghemite nanoparticles along the gastrointestinal tract, after oral administration of both MNP and MNP-bacteria. The results revealed that the amount of magnetic nanoparticles accumulated in intestines is sensibly higher when MNP-bacteria were administered, in comparison with MNP. This confirms our initial hypothesis that the use of probiotic bacteria is a suitable strategy to assist the magnetic nanoparticles to overcome the stomach medium, and to achieve their accumulation in intestines. This finding opens doors to different applications. Since iron absorption in humans takes place precisely in the intestines, the use of MNP-bacteria as an iron supplement is a definite possibility. We have actually illustrated how the administration of MNP-bacteria to iron-deficient rats corrects the iron levels after two weeks of treatment

Impact of sensor-augmented pump therapy with predictive low-glucose management on hypoglycemia and glycemic control in patients with type 1 diabetes mellitus : 1-year follow-up

Q2Artículo original2625-2631AIMS: To describe real-life experience with sensor-augmented pump therapy with predictive low-glucose management (SAPT-PLGM), in terms of hypoglycemia and glycemic control after one year of follow-up in T1D patients with hypoglycemia as the main indication of therapy. METHODS: Retrospective cohort study under real life conditions. Baseline and one-year follow-up variables of glycemic control, hypoglycemia and glycemic variability were compared. RESULTS: Fifty patients were included, 31 on prior treatment with SAPT with low-glucose suspend (LGS) feature and 19 on multiple dose insulin injections (MDI). Mean HbA1c decreased in the MDI group (8.24%-7.08%; p = 0.0001). HbA1c change was not significant in the SAPT-LGS group. Area under the curve (AUC) below 70 mg/dl improved in both SAPT-LGS and MDI groups while AUC, %time and events below 54 mg/dl decreased in SAPT-LGS group. Glycemic variability improved in the MDI group. Less patients presented severe hypoglycemia with SAPT-PLGM in both groups, however the change was non-significant. CONCLUSIONS: Under real life conditions, SAPT-PLGM reduced metrics of hypoglycemia in patients previously treaded with MDI and SAPT-LGS without deteriorating glycemic control in SAPT-LGS patients, while improving it in patients treated with MDI

D-index as a Risk Factor for Invasive Fungal Infections in Patients With Acute Lymphoblastic Leukemia From a Reference Hematology Center in Bogota

Los pacientes con neoplasias hematológicas son huéspedes susceptibles al desarrollo de hongos invasivos. Infección (IFI), una de las principales complicaciones infecciosas potencialmente mortales que enfrentan estos pacientes. Actualmente, Contamos con estrategias de profilaxis antimicótica y esquemas de tratamiento antimicótico y reconocemos que el principal El factor de riesgo implicado es la neutropenia profunda y prolongada. El índice D y el índice D acumulativo son parámetros cuantitativos, que determinan la magnitud de la neutropenia, en función de la duración y profundidad y su valor se correlaciona con la aparición de IFI. material y métodos Se ingresó a un estudio de casos y controles en pacientes mayores de 18 años con leucemia linfoblástica aguda (LLA) entre 2009 y 2019 en el Instituto Nacional del Cáncer para inducción, consolidación y rescate quimioterapia. Resultados Se incluyeron un total de 167 pacientes, quienes recibieron 288 ciclos de quimioterapia, estos últimos fueron considerados la unidad de análisis. Se diseñó un modelo de ecuaciones de estimación generalizadas (GEE) para analizar datos; En este modelo se incluyeron tres variables cuantitativas y continuas de interés: edad (años), Dindex y neutropenia profunda (días). Para el índice D de la población, un odds ratio (OR) = 1,000227 (IC del 95 % 1,0002-1,0004); Se obtuvo p < 0,001. Conclusión El índice D se asocia con el desarrollo de IFI en pacientes con LLA, con un aumento exponencial del OR a medida que aumenta el valor absoluto del índice D.Patients with hematologic malignancies are susceptible hosts for the development of invasive fungal infection (IFI), one of the main life-threatening infectious complications faced by these patients. Currently, we have antifungal prophylaxis strategies and antifungal treatment schemes and we recognize that the main risk factor involved is profound and prolonged neutropenia. D-index and cumulative D-index are quantitative parameters, which determine the magnitude of neutropenia, as a function of duration and depth and their value correlates with the occurrence of IFI. Material and methods A case-control study in patients older than 18 years with acute lymphoblastic leukemia (ALL) was admitted between 2009 and 2019 at the National Cancer Institute for induction, consolidation and salvage chemotherapy. Results A total of 167 patients were included, who received 288 cycles of chemotherapy, the latter were considered the unit of analysis. A generalized estimating equations (GEE) model was designed to analyze correlated data; three quantitative and continuous variables of interest were included in this model: age (years), Dindex and deep neutropenia (days). For the population D-index, an odds ratio (OR) = 1.000227 (95% CI 1.0002-1.0004); p < 0.001 was obtained. Conclusion D-index is associated with the development of IFI in patients with ALL, with an exponential increase in OR as the absolute value of the D-index increases.Revista Internacional - No indexadaS

Direct costs involved in providing medical attention associated with traffic accidents in Bogotá

Objetivo Determinar los costos de atención médica generados por la accidentalidad vial en Bogotá. Metodología Estudio observacional prospectivo con datos de pacientes mayores de edad atendidos en la central de urgencias de 6 instituciones hospitalarias. Resultados El promedio del costo total de atención por paciente fue de $1 112 000 el costo promedio día de paciente hospitalizado fue de$1 200 000. Pacientes con atención ambulatoria tuvieron un costo promedio de $247400. El costo promedio por accidente se calculó en$2 333 700. Los costos médicos por accidentes en el periodo de análisis en Bogotá fueron aproximadamente $2 301 028 200. Cifras en pesos colombianos de 2011. Conclusiones Los costos de la atención médica de los accidentes de tránsito constituyen una carga económica considerable.Objective To determine the cost of medical attention associated with traffic accidents in Bogotá, Colombia. Methods Prospective observational study with data from adult patients attended to in the emergency centers of 6 hospitals. Results Average total cost per patient was$1 112 000 COP. Average daily cost of hospitalized patients was $1 200 000 COP. Average cost of ambulatory treated patients ascended to$247 400 COP. Cost per accident calculated was $2 333 700 COP. In the whole city during study period, total medical costs were around$2 301 028 200 COP. All data was expressed in 2011 colombian pesos. Conclusion The medical cost of transit accidents is a significant economic burden

Direct costs involved in providing medical attention associated with traffic accidents in Bogotá

Objetivo Determinar los costos de atención médica generados por la accidentalidad vial en Bogotá. Metodología Estudio observacional prospectivo con datos de pacientes mayores de edad atendidos en la central de urgencias de 6 instituciones hospitalarias. Resultados El promedio del costo totalde atención por paciente fue de $1'112.000 El costo promedio día de paciente hospitalizado fue de$1'200.000. Pacientes con atención ambulatoria tuvieron un costo promedio de $247.400. El costo promedio por accidente se calculó en$2'333.700. Los costos médicos por accidentes en el periodo de análisis en Bogotá fueron aproximadamente $2.301'028.200. Cifras en pesos de 2011. Conclusiones Los costos de la atención médica de los accidentes de tránsito constituyen una carga económica considerable.Artículo de investigación673-682Objective To determine the cost of medical attention associated with traffic accidents in Bogotá, Colombia. Methods Prospective observational study with data from adult patients attended to in the emergency centers of 6 hospitals. Results Average total cost per patient was$1'112.000 COP. Average daily cost of hospitalized patients was $1'200.000 COP. Average cost of ambulatory treated patients ascended to$247.400 COP. Cost per accident calculated was $2'333.700 COP. In the whole city during study period, total medical costs were around$2.301'028.200 COP. All data was expressed in 2011 Colombian pesos

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Tipo de tratamiento farmacológico y deterioro de la función pulmonar en pacientes con diabetes tipo 2: un estudio de corte transversal

Introduction: There is no clear relationship between type 2 diabetes mellitus and lung function decline; it is also unclear whether the type of treatment can modify spirometric variables and levels of inflammatory biomarkers. Objectives: To compare pulmonary function in patients with type 2 diabetes treated with an insulin-sensitizing agent (metformin) and in those treated with secretagogues, as well as combined with insulin, and to evaluate differences in inflammatory biomarkers between treatment groups. Material and methods: We conducted a cross-sectional analytic study in 196 diabetic patients with type 2 diabetic mellitus. Spirometric variables and levels of inflammatory biomarkers (ferritin, fibrinogen, C-reactive protein, interleukin 6, tumor necrosis factor-alpha), were obtained. Residual values (observed minus expected) for forced vital capacity and for forced expiratory volume were calculated and compared between treatment types. Differences in median levels of biomarkers were also compared. Results: After adjustment by known determinants of lung function, and by the control and duration of type 2 diabetes, patients treated with the insulin-sensitizing agent had statistically significant lower differences against expected values for forced vital capacity compared with secretagogues (-212.1 ml vs 270.2 ml, p=0.039), as well as for forced expiratory volume, but without statistical significance (-133.2 mL vs -174.8 mL, p&gt;0.05). In the group of patients treated with the insulin-sensitizing agent, ferritin and tumor necrosis factor-alpha levels were lower (p&lt;0.01). Conclusion: This study supports the hypothesis that insulin-sensitizing agents appear to be associated with less deterioration of lung function and less systemic inflammation in type 2 diabetes. The present study serves to formulate new hypothesis and research projects.Introducción. La relación de la diabetes mellitus de tipo 2 con el deterioro de la función pulmonar no es clara, como tampoco si el tipo de tratamiento modifica los parámetros espirométricos e inflamatorios.Objetivo. Comparar la función pulmonar de pacientes con diabetes mellitus de tipo 2 tratados con un agente de sensibilización a la insulina (metformina) y de los tratados con secretagogos, así como de estos combinados con insulinas, y evaluar las diferencias en los biomarcadores de inflamación de los grupos.Materiales y métodos. Se hizo un estudio analítico de corte transversal en 196 pacientes con diabetes mellitus de tipo 2. Se midieron las variables espirométricas y la concentración sanguínea de biomarcadores de inflamación (ferritina, fibrinógeno, proteína C reactiva, interleucina 6 y factor de necrosis tumoral alfa). Se analizaron los valores residuales (valores observados menos valores predichos) para la capacidad vital forzada y el volumen espiratorio forzado en los diferentes tipos de tratamiento. También, se compararon las diferencias en las medianas de las concentraciones de los biomarcadores, según los tipos de tratamiento.Resultados. Después de ajustar según los factores determinantes de la función pulmonar y el control y la duración de la diabetes mellitus de tipo 2, los valores esperados de la capacidad vital forzada de los pacientes tratados con agentes de sensibilización a la insulina fue menor que los de aquellos tratados con secretagogos (-212,1 ml Vs. -270,2 ml; p=0,039), y lo mismo se registró en el volumen espiratorio forzado durante el primer segundo (-133,2 ml Vs. -174,8 ml; p&gt;0,05), aunque dichas diferencias no fueron estadísticamente significativas. En el grupo de pacientes tratados con agentes de sensibilización a la insulina, las concentraciones de ferritina y del factor de necrosis tumoral alfa fueron menores (p&lt;0,01).Conclusión. Los resultados de este estudio respaldan la hipótesis de que los agentes de sensibilización a la insulina estarían asociados con un menor deterioro de la función pulmonar y una menor inflamación sistémica en los pacientes diabéticos. Asimismo, sirve como base para la formulación de nuevas hipótesis y trabajos de investigación

Tratamiento farmacológico y deterioro de la función pulmonar en pacientes con diabetes de tipo 2: Un estudio de corte transversal

Introduction: There is no clear relationship between type 2 diabetes mellitus and lung function decline; it is also unclear whether the type of treatment can modify spirometric variables and levels of inflammatory biomarkers. Objectives: To compare pulmonary function in patients with type 2 diabetes treated with an insulin-sensitizing agent (metformin) and in those treated with secretagogues, as well as combined with insulin, and to evaluate differences in inflammatory biomarkers between treatment groups. Material and methods: We conducted a cross-sectional analytic study in 196 diabetic patients with type 2 diabetic mellitus. Spirometric variables and levels of inflammatory biomarkers (ferritin, fibrinogen, C-reactive protein, interleukin 6, tumor necrosis factor-alpha), were obtained. Residual values (observed minus expected) for forced vital capacity and for forced expiratory volume were calculated and compared between treatment types. Differences in median levels of biomarkers were also compared. Results: After adjustment by known determinants of lung function, and by the control and duration of type 2 diabetes, patients treated with the insulin-sensitizing agent had statistically significant lower differences against expected values for forced vital capacity compared with secretagogues (-212.1 ml vs 270.2 ml, p=0.039), as well as for forced expiratory volume, but without statistical significance (-133.2 mL vs -174.8 mL, p>0.05). In the group of patients treated with the insulin-sensitizing agent, ferritin and tumor necrosis factor-alpha levels were lower (p less than 0.01). Conclusion: This study supports the hypothesis that insulin-sensitizing agents appear to be associated with less deterioration of lung function and less systemic inflammation in type 2 diabetes. The present study serves to formulate new hypothesis and research projects

Design of psychosocial factors questionnaires : a systematic measurement approach

Q1Artículo de investigación100-110Background Evaluation of psychosocial factors requires instruments that measure dynamic complexities. This study explains the design of a set of questionnaires to evaluate work and non‐work psychosocial risk factors for stress‐related illnesses. Methods The measurement model was based on a review of literature. Content validity was performed by experts and cognitive interviews. Pilot testing was carried out with a convenience sample of 132 workers. Cronbach's alpha evaluated internal consistency and concurrent validity was estimated by Spearman correlation coefficients. Results Three questionnaires were constructed to evaluate exposure to work and non‐work risk factors. Content validity improved the questionnaires coherence with the measurement model. Internal consistency was adequate (α = 0.85–0.95). Concurrent validity resulted in moderate correlations of psychosocial factors with stress symptoms. Conclusions Questionnaires' content reflected a wide spectrum of psychosocial factors sources. Cognitive interviews improved understanding of questions and dimensions. The structure of the measurement model was confirmed. Am. J. Ind. Med. 56:100–110, 2013. © 2012 Wiley Periodicals, Inc

Prevalence of sexual dysfunction and its association with lower urinary tract symptoms in men and women over 18 years old : results from the Colombian Overactive Bladder and Lower urinary Tract symptoms (COBaLT) study

Q1Q3Artículo original1576-1578Introduction & Objectives: There is an age-independent association between sexual dysfunction (SD) and LUTS. Few studies have been conducted in Latin America addressing these issues. We aim to determine the prevalence of SD and its association with LUTS in Colombia. Materials & Methods: This is a sub-analysis of a cross-sectional, population-based study conducted in subjects ≥18 years old to evaluate LUTS and overactive bladder (OAB). A sample size of 1,054 subjects was estimated (prevalence of LUTS/OAB 15%, CI 95%, statistical power 80%, precision 3%). We used a multi-stage probabilistic sampling technique to randomly select individuals in the community. SD was defined as ≤21 points in the SHIM and ≤19 in the FSFI-6. For LUTS, we used the 2002 ICS definitions and validated questionnaires. Descriptive and inferential statistics were employed. Results: We included 1,060 participants. Sixty-three (12%) men and 175 (33%) women were sexually inactive. The prevalence of SD was 47% (men 53%, women 39%). The most common SD symptoms were diminished erection maintenance after penetration in men (13%) and poor lubrication in women (43%). Individuals with SD had higher rates of LUTS (Figure 1). Patients with moderate-to-severe LUTS had lower sexual satisfaction rates (men 89% vs 95%, women 72% vs 88%). The multivariate logistic regression model found that diabetes (DM), menopause, urge urinary incontinence (UUI) and nocturia>2 were associated with SD in women. In men, age, depression, high-school education or less and LUTS were associated with SD (Table 1)