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Human adenovirus 36 (HAdV-36) has been associated with obesity and changes in glucose and lipid metabolism. The virus has been reported to increase insulin sensitivity and paradoxically promote weight gain. Because of its effects on metabolism, infection with the virus could alter the response to several drugs used to treat type 2 diabetes (DM2), such as metformin. The aim of this study was to test whether HAdV-36 affects the response to metformin in a group of obese patients with DM2. METHODS: In a prospective cohort study, 103 obese patients with newly diagnosed DM2 were divided into two groups based on their HAdV-36 seropositivity (+HAdV-36 and -HAdV-36). Weight, glucose, cholesterol, triglycerides, body mass index, body fat percentage, and waist and hip circumference were measured and compared in both groups at baseline and after 45 days of metformin treatment. RESULTS: Only glucose was significantly lower in the +HAdV-36 group at baseline, while all other variables were similar between the two study groups. After 45 days of follow-up, it was observed that the effect of metformin did not differ between the groups, but the variables improved significantly after treatment. CONCLUSIONS: In this study, we did not find that HAdV-36 had an effect on the response to metformin in obese patients with DM2.
Assuntos
Adenovírus Humanos , Diabetes Mellitus Tipo 2 , Metformina , Humanos , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Metformina/uso terapêutico , Hipoglicemiantes/efeitos adversos , Estudos Prospectivos , Obesidade/complicações , Obesidade/tratamento farmacológico , GlucoseRESUMO
RESUMEN Introducción: Las estrategias didácticas, en su conjunto, demandan establecer una relación dialógica, constante y triangular entre educadores, educandos y metodologías, aunque el educando ignore o no las metodologías que utiliza el docente para tal fin. Objetivo: validar un manual para el diseño y elaboración de una estrategia didáctica para potenciar el nivel de información sobre COVID-19 en estudiantes de Medicina. Método: Se elaboró un manual sobre el diseño de una estrategia didáctica empleada para incrementar el conocimiento de los estudiantes de Medicina del segundo año de la Universidad de Ciencias Médicas de Sancti Spíritus, Cuba, sobre los signos, síntomas y métodos de prevención de la COVID-19 durante el inicio de la pandemia en el país. Treinta expertos nacionales en ciencias de la educación médica emitieron sus dictámenes sobre la pertinencia de la estrategia didáctica y del manual sobre su diseño, y fueron analizados por el método Delphi. El éxito de la aplicación de la estrategia didáctica se valoró mediante la aplicación de exámenes a la población del estudio antes y después de la introducción de la estrategia didáctica en el período 2021-2022. Resultados: El consenso general de los expertos fue de Muy de acuerdo para los fundamentos que sustentan la estrategia didáctica para la educación médica superior y la calidad del manual propuesto. Conclusiones: Tanto la estrategia educativa como el manual sobre su elaboración fueron validadas por los expertos para su aplicación en la educación médica superior y, particularmente, para la detección y contención de la COVID-19.
ABSTRACT Introduction: Didactic strategies, as a whole, demand the establishment of a dialogical, constant and triangular relationship between educators, learners and methodologies, even though the learner is unaware or not of the methodologies used by the professor for purpose required. Objective: To validate a manual for designing and elaborating a didactic strategy to enhance the information level for medical students concerning COVID-19. Method: A manual based on a didactic strategy structural design was elaborated with the porpuse of increase the knowledge for the second year medical students at the Universidad de Ciencias Médicas de Sancti Spíritus, Cuba, on the signs, symptoms of COVID-19 and the prevention methods used at the beginning of the pandemic in the country. Thirty national experts in medical education sciences gave their opinions on the relevance of the didactic strategy and about the structural design of the manual, which were analyzed by the Delphi method. The success of the strategy implementation was assessed implementing tests to the studied population before and after the introduction of the didactic strategy in the period 2021- 2022. Results: The experts' opinion concerning the fundamentals underpinning the didactic strategy for higher medical education and the quality of the proposed manual was highly favorable in general consensus. Conclusions: Both the educational strategy and the elaboration of the manual were validated by the experts for its application in higher medical education and in particularly for the detection and containment of COVID-19.
RESUMO Introdução: As estratégias didáticas, como um todo, demandam estabelecer uma relação dialógica, constante e triangular entre educadores, educandos e metodologias, independentemente de o educando ignorar ou não as metodologias utilizadas pelo professor para esse fim. Objetivo: Submeter um manual para a concepção e desenvolvimento de uma estratégia didática para melhorar o nível de informação sobre COVID-19 em estudantes de medicina para validação. Método: Foi elaborado um manual sobre o desenho de uma estratégia didática utilizada para aumentar o conhecimento dos alunos do segundo ano de Medicina da Universidad de Ciencias Médicas de Sancti Spíritus, Cuba, sobre os sinais, sintomas e métodos de prevenção da COVID. -19 durante o início da pandemia no país. Trinta especialistas nacionais em ciências da educação médica emitiram suas opiniões sobre a relevância da estratégia didática e do manual sobre seu desenho, e foram analisados pelo método Delphi. O sucesso da aplicação da estratégia didática foi avaliado por meio da aplicação de testes à população do estudo antes e após a introdução da estratégia didática no período 2021-2022. Resultados: O consenso geral dos especialistas foi Fortemente concordante para os fundamentos que sustentam a estratégia didática para a formação médica superior e a qualidade do manual proposto. Conclusões: Tanto a estratégia educativa como o manual sobre a sua elaboração foram validados por especialistas para a sua aplicação no ensino superior médico e, em particular, para a deteção e contenção da COVID-19.
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Background and Objectives: The commissural nucleus of the tractus solitarius (cNTS) not only responds to glucose levels directly, but also receives afferent signals from the liver, and from the carotid chemoreceptors (CChR). In addition, leptin, through its receptors in the cNTS, regulates food intake, body weight, blood glucose levels, and brain glucose retention (BGR). These leptin effects on cNTS are thought to be mediated through the sympathetic-adrenal system. How these different sources of information converging in the NTS regulate blood glucose levels and brain glucose retention remains largely unknown. The goal of the present study was to determine whether the local administration of leptin in cNTS alone, or after local anoxic stimulation using sodium cyanide (NaCN) in the carotid sinus, modifies the expression of leptin Ob-Rb and of c-Fos mRNA. We also investigated how leptin, alone, or in combination with carotid sinus stimulation, affected brain glucose retention. Materials and Methods: The experiments were carried out in anesthetized male Wistar rats artificially ventilated to maintain homeostatic values for pO2, pCO2, and pH. We had four groups: (a) experimental 1, leptin infusion in cNTS and NaCN in the isolated carotid sinus (ICS; n = 10); (b) experimental 2, leptin infusion in cNTS and saline in the ICS (n = 10); (c) control 1, artificial cerebrospinal fluid (aCSF) in cNTS and NaCN in the ICS (n = 10); (d) control 2, aCSF in cNTS and saline in the ICS (n = 10). Results: Leptin in cNTS, preceded by NaCN in the ICS increased BGR and leptin Ob-Rb mRNA receptor expression, with no significant increases in c-Fos mRNA in the NTSc. Conclusions: Leptin in the cNTS enhances brain glucose retention induced by an anoxic stimulus in the carotid chemoreceptors, through an increase in Ob-Rb receptors, without persistent changes in neuronal activation.
Assuntos
Corpo Carotídeo , Leptina , Receptores para Leptina , Núcleo Solitário , Animais , Glicemia/metabolismo , Corpo Carotídeo/metabolismo , Glucose/metabolismo , Hipóxia , Leptina/metabolismo , Masculino , RNA Mensageiro/metabolismo , Ratos , Ratos Wistar , Receptores para Leptina/metabolismo , Núcleo Solitário/metabolismoRESUMO
Colorectal cancer (CRC) is the third most common cancer and one of the main causes of death around the world. Multiple lines of evidence have suggested the role of the corticotropin-releasing hormone (CRH) family in CRC induction, including the low expression of corticotropin-releasing hormone receptor 2 (CRHR2), which is an angiogenesis inhibitor and inflammatory modulator. Previous research suggests that CRHR2 expression in colonic intestinal cells can regulate migration, proliferation and apoptosis through the modulation of several pathways. The aim of this study was to analyze the association of the rs10250835, rs2267716 and rs2267717 variants of CRHR2 gene with CRC in the Mexican population in order to consider its predictive value in CRC. This cross-sectional study included a group of 187 unrelated patients with sporadic CRC and a control group of 191 healthy blood donors. DNA extraction from peripheral blood was carried out using the Miller method. Identification of the rs10250835 variant was performed using PCR-restriction fragment length polymorphism (RFLP) and the rs2267716 and rs2267717 variants using TaqMan allelic discrimination assay. The minor allele homozygous CC of the rs2267716 variant of CRHR2 showed significant difference between CRC and control group (p=0.025), as well as the GCA haplotype (p=0.007), corresponding to the rs10250835, rs2267716 and rs2267717 variants, respectively. Our results suggest that the rs2267716 variant and GCA haplotype of CRHR2 represent a risk factor for CRC development in Mexican patients.
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Neoplasias Colorretais , Hormônio Liberador da Corticotropina , Alelos , Estudos de Casos e Controles , Neoplasias Colorretais/genética , Hormônio Liberador da Corticotropina/genética , Estudos Transversais , Predisposição Genética para Doença , Humanos , Polimorfismo de Nucleotídeo Único/genética , Receptores de Hormônio Liberador da Corticotropina/genética , Receptores de Hormônio Liberador da Corticotropina/metabolismoRESUMO
INTRODUCTION: The present study evaluated the quality of medical care for patients diagnosed with diabetes mellitus (DM), hypertension (HBP), and both pathologies (DM+HBP) within a public health system in Mexico. METHODS: 45,498 patients were included from 2012 to 2015. All information was taken from the electronic medical record database. Each patient record was compared against the standard to test the quality of medical care. RESULTS: Glycemia with hypertension goals reached 29.6% in DM+HBP, 48.6% in DM, and 53.2% in HBP. The goals of serum lipids were reached by 3% in DM+HBP, 5% in DM, and 0.2% in HBP. Glycemia, hypertension, and LDL cholesterol reached 0.04%. 15% of patients had an undiagnosed disease. Clinical follow-up examinations reached 20% for foot examination and clinical eye examination. Specialty referrals reached 1% in angiology or cardiology. CONCLUSION: Goals for glycemic and hypertension reached 50% in the overall population, while serum lipids, clinical follow-up examinations, and referral to a specialist were deficient. Patients who had both diseases had more consultations, better control for hypertension and lipids, but inferior glycemic control. Overall, quality care for DM and/or HBP has not been met according to the standards.
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Anti-Hipertensivos/uso terapêutico , Diabetes Mellitus/terapia , Controle Glicêmico , Hipertensão/terapia , Hipolipemiantes/uso terapêutico , Atenção Primária à Saúde , Indicadores de Qualidade em Assistência à Saúde , Adulto , Idoso , Biomarcadores/sangue , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Pressão Sanguínea/efeitos dos fármacos , Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Dieta Saudável , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Hipoglicemiantes/uso terapêutico , Lipídeos/sangue , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Encaminhamento e Consulta , Estudos Retrospectivos , Resultado do TratamentoRESUMO
INTRODUCTION: Due to the coronavirus pandemic, identifying the infected individuals has become key to limiting its spread. Virus nucleic acid real-time RT-PCR testing has become the current standard diagnostic method but high demand could lead to shortages. Therefore, we propose a detection strategy using a one-step nested RT-PCR. METHODOLOGY: The nucleotide region in the ORF1ab gene that has the greatest differences between the human coronavirus and the bat coronavirus was selected. Primers were designed after that sequence. All diagnostic primers are species-specific since the 3´ end of the sequence differs from that of other species. A primer set also creates a synthetic positive control. Amplified products were seen in a 2.5% agarose gel, as well as in an SYBR Green-Based Real-Time RT-PCR. RESULTS: Amplification was achieved for the positive control and specific regions in both techniques. CONCLUSIONS: This new technique is flexible and easy to implement. It does not require a real-time thermocycler and can be interpreted in agarose gels, as well as adapted to quantify the viral genome. It has the advantage that if the coronavirus mutates in one of the key amplification nucleotides, at least one pair can still amplify, thanks to the four diagnostic primers.
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Betacoronavirus , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , RNA Viral/análise , Reação em Cadeia da Polimerase em Tempo Real/métodos , COVID-19 , Teste para COVID-19 , Vacinas contra COVID-19 , Técnicas de Laboratório Clínico , Humanos , Pandemias , SARS-CoV-2RESUMO
Adenovirus 5 (Ad-5) infection is a common cause of acute respiratory infections and the main vector used in gene therapy. There are few studies on the relationship of Ad-5 to obesity. In the present study, we evaluated the chronic effects of Ad-5 infection on golden (Syrian) hamsters fed either a balanced diet (BD) or a high-fat diet (HFD). After a single inoculation with Ad-5 (1 × 107 pfu), the body weight of the animals was measured weekly. Medium-term (22 weeks) serum biochemical analyses and long-term (44 weeks) liver morphology, adiposity, and locomotive functionality (movement velocity) assessments were carried out. In the animals fed the BD, adenovirus infection produced hyperglycemia and hyperlipidemia. In the long term, it produced a 57% increase in epididymal pad fat and a 30% body weight gain compared with uninoculated animals. In addition, morphological changes related to non-alcoholic fatty liver disease (NAFLD) were observed. The animals fed the HFD had similar but more severe changes. In addition, the hamsters presented an obesity paradox: at the end of the study, the animals that had the most morphological and functional changes (significantly reduced movement velocity) had the lowest body weight. Despite the fact that an HFD appears to be a more harmful factor in the long term than adenovirus infection alone, infection could increase the severity of harmful effects in individuals with an HFD. Epidemiological studies are needed to evaluate the effect of adenovirus as a precursor of chronic liver and cardiovascular diseases, including the chronic effects of gene therapy.
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Infecções por Adenoviridae/metabolismo , Infecções por Adenoviridae/virologia , Adenoviridae/fisiologia , Obesidade/metabolismo , Obesidade/virologia , Adenoviridae/genética , Infecções por Adenoviridae/fisiopatologia , Adiposidade , Animais , Peso Corporal , Cricetinae , Dieta Hiperlipídica/efeitos adversos , Feminino , Fígado/metabolismo , Masculino , Mesocricetus , Obesidade/fisiopatologiaRESUMO
Leptin is a protein hormone that plays a key role in the regulation of energy balance and glucose homeostasis. Leptin and all leptin receptor isoforms are present in the carotid bodies, but its precise function in glucose regulation and metabolism is not yet known. The aim of this study was to determine whether exogenous leptin, microinjected into the commissural nucleus tractus solitarii (cNTS), preceding sodium cyanide (NaCN) injection into the circulatory isolated carotid sinus (ICS), in vivo, modifies hyperglycemic reflex (HR) and brain glucose retention (BGR). In anesthetized Wistar rats (sodium pentobarbital, i.p. 3.3 mg/100 g/saline, Pfizer, Mex), arterial and venous blood samples were collected from silastic catheters implanted in the abdominal aorta and jugular sinus. Exogenous leptin (50 ng/20 nL of aCSF) or leptin vehicle (20 nL of aCSF) microinjected (stereotaxically) into the cNTS 4 min before NaCN (5 µg/100 g/50 µL saline into ICS) (experimental 1 [E1] and control 1[C1] groups, respectively) significantly increased HR and BGR compared with their basal values, but the increase was bigger in the E1 group. When leptin or aCSF were injected into the cNTS before saline (E2 and C2 groups, respectively) glucose responses did not vary when compared with their basal levels. Leptin and its receptors in the cNTS cells probably contribute to their sensitization during hypoxia.
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Corpo Carotídeo , Células Quimiorreceptoras/metabolismo , Cianetos/efeitos adversos , Glucose/metabolismo , Leptina/farmacologia , Núcleo Solitário/metabolismo , Animais , Ratos , Ratos WistarRESUMO
BACKGROUND AND OBJECTIVE: Obesity is a factor that contributes to the morbidity of certain diseases and to worldwide mortality. MGAT1 is a glycosyltransferase involved in the synthesis of protein-bound and lipid-bound oligosaccharides and its polymorphisms are possibly involved in the etiology of obesity. We investigated the association of the rs4285184 polymorphism of the MGAT1 gene with obesity in adults in the State of Colima, Mexico. METHODS: A case-control study was conducted that included 244 subjects. All of them were grouped according to their percentage of body fat, determined through bioelectrical impedance, and they were genotyped for the rs4285184 polymorphism of the MGAT1 gene through PCR-RFLP. The results were analyzed for their association with the percentage of body fat. RESULTS: The G allele had a frequency of 49.19 and 38.75% for the cases and controls, respectively (P=.020) (OR 1.53; 95% CI 1.068-2.193). The frequency of the A/G+G/G genotype was 75% in the obese patients, which was significantly higher compared with the 57.5% of the control group (P=.004) (OR 2.217; 95% CI 1.287-3.821). CONCLUSIONS: The presence of the rs4285184 polymorphism of the MGAT1 gene increased the risk for developing body fat associated with obesity in the Mexican population.
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N-Acetilglucosaminiltransferases/genética , Obesidade/genética , Polimorfismo de Nucleotídeo Único , Adolescente , Adulto , Análise do Polimorfismo de Comprimento de Fragmentos Amplificados , Estudos de Casos e Controles , Feminino , Marcadores Genéticos , Humanos , Masculino , México , Pessoa de Meia-Idade , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: Lipoprotein lipase (LPL) plays an important role in plasma lipoprotein metabolism and its polymorphisms are possibly implicated in the etiology of ischemic cerebrovascular disease (CVD). The aim of this work was to determine the association of the of D9N, N291S, and T495G polymorphisms of the LPL gene as a risk factor for the development of CVD. METHODS: A case-control study was conducted that included 100 patients with CVD and 120 healthy controls. All the subjects were genotyped for the D9N, N291S, and T495G polymorphisms of the LPL gene through polymerase chain reaction-restriction fragment length polymorphism, and the results were analyzed for their association with CVD. RESULTS: The D9N genotype was not significantly correlated with CVD; the odds ratio (OR) between the control subjects and CVD patients was .29 (95% confidence interval [CI], .03-2.66; P = .27). The N291S polymorphism was not significantly correlated with CVD either; the OR between the control subjects and CVD patients was 1.2 (95% CI, .07-19.46; P = .89). And the T495G mutation was not significantly correlated with CVD; the OR between the control subjects and the CVD patients was 1.21 (95% CI, .7-2.08; P = .48). CONCLUSIONS: In the present study, the D9N, N291S, and T495G polymorphisms of the LPL gene were not risk factors for the development of CVD.