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Introduction: Obesity consists in the accumulation of adipose tissue accompanied by low grade chronic inflammation and is considered a pandemic disease. Recent studies have observed that obesity affects females and males in a sex-dependent manner. In addition, several works have demonstrated that parental obesity increases the risk to develop obesity, insulin resistance, diabetes, and reproductive disorders. Considering that intergenerational effects of obesity may occur in a sex-dependent manner, we studied male Wistar rat progeny (F1) obtained from mothers or fathers (F0) fed on a high-fat diet (HFD). Methods: Five-week-old female and male Wistar rats were fed on a HFD (with 60% of calories provided by fat) for 18 weeks (F0). At the end of the treatment, animals were mated with young rats to obtain their progeny (F1). After weaning, F1 animals were fed on standard chow until 18 weeks of age. Body weight gain, fasting plasma glucose, insulin and leptin levels, glucose tolerance, insulin sensitivity, and adiposity were evaluated. In addition, beta-cell expression of nuclear p16 was assessed by immunofluorescence. Results and conclusions: HFD altered plasma fasting glucose, insulin and leptin levels, glucose tolerance, adiposity, and beta-cell expression of p16 in F0 rats. Particularly, HFD showed sexual dimorphic effects on body weight gain and insulin sensitivity. Moreover, we observed that parental HFD feeding exerts parental-sex-specific metabolic impairment in the male progeny. Finally, parental metabolic dysfunction could be in part attributed to the increased beta-cell expression of p16; other mechanisms could be involved in the offspring glucose homeostasis.
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Resistência à Insulina , Leptina , Ratos , Masculino , Feminino , Animais , Dieta Hiperlipídica/efeitos adversos , Ratos Wistar , Obesidade/metabolismo , Aumento de Peso , Insulina/metabolismo , Glucose , HomeostaseRESUMO
Due to the increased incidence of obesity, it is of great importance to identify all the possible consequences in those who suffer from it and their descendants. This study aimed to investigate how paternal obesity, resulting from an 18-week high-fat diet (HFD), affects the metabolic and reproductive health of offspring. In the fathers (F0 generation), the HFD led to significant weight gain, primarily due to increased visceral fat. It also resulted in impaired glucose control and reduced insulin sensitivity. Furthermore, F0 males from the HFD group had reduced sperm concentration and lower sperm viability but were still able to sire litters. F1 offspring were monitored during 18 weeks; F1 offspring from obese fathers displayed increased body weight during the experimental window, especially in males, without significant metabolic disturbances. Additionally, F1 males showed reduced sperm viability, indicating potential reproductive implications. On the other hand, F1 females showed normal estrous cycle patterns but had a reduced number of primordial follicles, suggesting a decrease in their follicular reserve and reproductive potential. This study highlights that metabolic and reproductive issues may be passed down to future generations through the paternal line.
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Osteoporosis is characterized by reduced bone mineral density (BMD) and quality, increasing the risk of fractures. A large number of genes involved in bone metabolism have been implicated in the genesis of osteoporosis; these include RANK and RANKL. Polymorphisms of these genes have been implicated in osteoporosis. The aim of this study was to determine the association of the RANK rs3018362 and RANKL rs12585014 polymorphisms with risk of osteoporosis. Four hundred Mexican women aged 40 years old or above were genotyped by real-time PCR and several demographic and risk factors were explored. The GA and AA genotypes of the rs3018362 polymorphism were associated with a high risk of osteoporosis in the dominant model (p=.0062; OR = 2.16, 95% CI: 1.24-3.78). In summary, the rs3018362 polymorphism in the RANK gene seems to be associated with osteoporosis of the lumbar spine while the RANKL rs12585014 is not, although more studies are needed to confirm these results.
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Vértebras Lombares , Osteoporose/genética , Ligante RANK/genética , Receptor Ativador de Fator Nuclear kappa-B/genética , Doenças da Coluna Vertebral/genética , Idoso , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Humanos , México , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo ÚnicoRESUMO
BACKGROUND: Musculoskeletal Ultrasonography (MSUS) is an important tool for the clinical assessment in Juvenile Idiopathic Arthritis (JIA). The objective of this study was to evaluate the reliability of MSUS to detect elementary lesions: synovitis, tenosynovitis, cartilage damage and bone erosions in the wrist and metacarpal (MCP) joints of patients with JIA. METHODS: Thirty children in various subgroups of JIA according to ILAR criteria, were included in this cross-sectional study. Clinical data including painful, swollen and limited joints were recorded. Five rheumatologist ultrasonographers, blinded to the clinical evaluation, evaluated the presence of elementary lesions in the wrist and MCP 2 and 3 joints bilaterally. The synovitis was graded in B-Mode and Power Doppler (PD). In addition to descriptive statistics intra- and inter-observer reliability was calculated using Cohen's kappa according to Landis and Koch. RESULTS: US detected more synovitis than the clinical examination (62% vs 28%, 30% vs 23% and 22% vs 17% in the wrist, second and third MCP joints respectively). The intra-observer concordance for synovitis in all joints was excellent in B-Mode (k 0.84 .63-1.0 p = 0.001), except for MCP 2, where it was good (0.61, IC 95% .34-89, p = 0.001). For both modalities (PD, B-Mode) tenosynovitis, cartilage damage and bone erosions it was also excellent. Regarding synovitis grading the concordance was excellent for all grades (0.83-1.0, IC 95% 0.51.1.0, p = 0.001), except for grade 1 where it was good (0.61, IC 95% 0.43-.83, p = 0.001). Reliability inter-observer for grayscale synovitis (0.67-0.95, IC 95% 0.67-1.0, p = 0.001), tenosynovitis grayscale (0.89, IC 95% 0.78-0.99, p.001), damage cartilage (0.89, IC 95% 0.78-0.99, p = 0.001), PD (0.66, IC 95% 0.39-1.0, p = 0.001). The concordance for grading synovitis was excellent, but for grayscale grade 1 and 2 (.66, IC 95% .53-.74, p = 0.007) and PD grade 1 and 2 (0.63, IC 95% .58-.91, p = 004) was good. CONCLUSIONS: The intra- and inter-observer reliability of MSUS for inflammatory and structural lesions is good to excellent for the wrist and MCP in patients with JIA.
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Artrite Juvenil/diagnóstico por imagem , Articulação Metacarpofalângica/diagnóstico por imagem , Ultrassonografia/métodos , Articulação do Punho/diagnóstico por imagem , Artrite Juvenil/patologia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Articulação Metacarpofalângica/patologia , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Articulação do Punho/patologiaRESUMO
This study addresses a topic that was previously unaddressed in the literature: the normal sonographic appearance of the Hoffa's fat pad (HFP) in young, asymptomatic subjects. The aim of the study is to describe the sonoanatomical features of HFP, including its echostructure, echogenicity, elasticity, and vascularization, in subjects without knee pathology. Knees of healthy subjects were examined with grayscale ultrasound (US) to determine the sonographic characteristics of the HFP. Echogenicity was assessed by pixel intensity quantification. Vascularity was evaluated by color Doppler (CD) US. Elasticity of the adipose tissue was examined by sonoelastography. The absence of HFP pathology was confirmed clinically in all participants and by magnetic resonance imaging in randomly selected participants. Seventy-two knees from 36 subjects were assessed. The HFP presented a characteristic well-defined two-layered echostructure: the superficial adipose tissue was hypoechoic with respect to the nearby patellar tendon and contained septae, whereas the deeper layer was homogeneously hypoechoic and lacked connective tissue septae. Echogenicity differed between the superficial and deeper layers (the deeper layer was brighter), suggesting that the degree of acoustic impedance differed between layers. CD detected blood flow in 55.5% of HFPs. The superficial HFP layer presented greater elasticity than the deeper HFP layer (88.8 vs. 75.3 Kpa; p < .001). Our study provides a comprehensive description of the normal sonographic features of the HFP, which is useful to increase the potential of US for the discrimination of pathological findings involving this anatomical area.
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Tecido Adiposo/diagnóstico por imagem , Articulação do Joelho/diagnóstico por imagem , Joelho/diagnóstico por imagem , Ultrassonografia , Adolescente , Adulto , Feminino , Humanos , Masculino , Ligamento Patelar/diagnóstico por imagem , Adulto JovemRESUMO
Resumen La escoliosis idiopática del adolescente (EIA) consiste en una deformidad tridimensional de la estructura de la columna vertebral en los planos coronal, sagital y rotacional, que afecta a sujetos sanos a partir de los 10 años de edad hasta la madurez ósea o al término del crecimiento. Esta enfermedad puede comprometer el estado físico, emocional y, por lo tanto, la calidad de vida de quienes la padecen, por lo que debe ser considerada un problema de salud significativo. La EIA se puede sospechar con un examen físico de columna, mediante el cual se evalúa el nivel de los hombros, el nivel de las escápulas, el nivel de la pelvis, la prueba de Adams y el signo de Pitres. A pesar de que en México no se han establecido oficialmente programas para la detección temprana de la enfermedad, la prueba de Adams puede ser la pauta para identificar y prevenir el desarrollo de esta deformidad. La aplicación de esta prueba de tamizaje está al alcance de todos. A pesar de que se podría considerar que su detección oportuna desde etapas tempranas sería la mejor estrategia para combatirla a tiempo, existen grupos de investigación a nivel internacional que opinan distinto, lo que ha colocado a la detección temprana como un tema controversial. Por lo anterior, el objetivo de este trabajo es ofrecer al lector un panorama general y actualizado de las diferentes perspectivas del tema, esperando que sea de utilidad para la práctica profesional.
Abstract Adolescent idiopathic scoliosis (EIA), consists of a three-dimensional deformity of the structure of the spine in the coronal, sagittal and rotational planes affecting healthy subjects ranging from 10 years of age until skeletal maturity or term of growing. This disease can compromise physical and emotional state, therefore, the quality of life of those who suffer it, so the EIA must be considered as significant health problem. The EIA can be suspected by a physical examination of the spine on whichshoulders level, shoulder blades level, pelvis level, Adams Test and Pitres sign are evaluated. Even though, it hasn't been officially established a program for an early detection of the disease in Mexico, evidence through Adams Test can be a guideline to identify and prevent the development of this deformity. The application of this screening test is available to all. Although it could be considered that early detection of this deformity at young ages would be the best strategy to get on time for treatment, there are international research groups that have a different opinion, which has placed early detection of EIA as a controversy topic. Therefore, the aim of this paper is to provide a general and updated overview of the different perspectives of this issue, hoping it will be useful for the professional practice.
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Ultrasound (US) is increasing its potential in the assessment of several rheumatic disorders. Recently, different applications of this imaging technique have emerged. Interesting data supporting its utility and validity in the assessment of the lung to detect and quantify interstitial pulmonary fibrosis in rheumatic diseases, even in subclinical phases, have been reported. The main purpose of this review is to provide an overview of the role of US in the assessment of interstitial pulmonary fibrosis in rheumatic disorders and to discuss the current evidence supporting its clinical relevance in daily clinical practice.
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Doenças Pulmonares Intersticiais/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Fibrose Pulmonar/diagnóstico por imagem , Doenças Reumáticas/diagnóstico por imagem , Humanos , Doenças Pulmonares Intersticiais/complicações , Fibrose Pulmonar/complicações , Doenças Reumáticas/complicações , Avaliação de Sintomas , UltrassonografiaRESUMO
INTRODUCTION: We need to evaluate the efficacy and safety of the use of dynamic fixation in patients with narrow lumbar through comparing the assessment of two years with 4 years of follow-up. METHODS: Prospective, longitudinal, autocontrol deliberately and sequential intervention, in lumbar stenosis patients who made treatment with dynamic stabilization posterior type Acuflex. An evaluation of four of final follow-up. RESULTS: 18 patients who completed follow-up two years results as a basis for comparison: 18 patients, 14 female and 4 male, average age 44.05 years. Pain evaluated with numerical visual scale was found in the lower back at 24 months in an average of 2.84 and 48 months in 3.26. We measured the functional level of Oswestry at two years to be 24% and at four years 22.44%, with a p = 0.373. In the magnetic resonance for classification of patients 15 Pfirrmann without changes and three with increase of a degree. According to patients 2 Modic changes one of type 0 to type III and another to type I. We have observed that five patients have required second surgery for removal of material findings. CONCLUSIONS: There is no change between 2 and 4 years in the scale of Oswestry and pain with visual numerical scale functionality. The average height in discs had change with statistical significance, in the comparative period. The intervertebral discs had changes in 3 patients with direct relationship between scale of Pfirrmann and Modic. The rest of patients keep rehydration and normal disc height.
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Vértebras Lombares , Estenose Espinal/cirurgia , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/métodos , Estudos Prospectivos , Fatores de Tempo , Adulto JovemRESUMO
BACKGROUND: Decompression and fusion with autograft is the gold standard technique in the treatment of cervical canal strait. Using PEEK cages or boxes of non-absorbable polymer with elasticity similar to bone, radiolucent, reduces morbidity and same degree of fusion. METHODS: A case series, prospective, longitudinal, deliberate intervention, evaluation panel before and after 2 years follow-up. Discectomy and PEEK housing placement with autologous graft. Arthrodesis were evaluated, cervical lordosis, intervertebral space height, pain evaluated with Visual Analogue Scale, Neck Disability Index, operative time, intraoperative bleeding, hospital stay and complications. Statistical analysis with t Sudent, Wilcoxon and Fisher's exact text. RESULTS: Of 17 patients studied, 9 (53%) were female. Average age 62 years. The most affected level was C5-6, C6-7 with 5 patients. Melting was found at 100%. There was no sag or migration of the box, space height was conserved, but segmental lordosis was not retained. Clinical improvement in all patients as well as disability index was seen. Bleeding was on average 187 mL. CONCLUSION: With regard to symptom improvement, conservation of interspace height and back, no segmental lordosis conservation and fusion using PEEK box is consistent with the literature. We suggest using anterior plate to maintain cervical lordosis. We found a melt index of 100%. We found clinical improvement of symptoms, pain and disability, and a global loss of cervical lordosis.
Antecedentes: la descompresión y artrodesis con auto-injerto es el patrón de referencia para el tratamiento del conducto cervical estrecho. El uso de cajas de PEEK polímero no reabsorbible, con elasticidad similar al hueso, radiolúcido, y mismo grado de fusión reduce la morbilidad. aterial y métodos: estudio de serie de casos, prospectivo, longitudinal, de intervención deliberada, evaluación en grupol antes y después, seguimiento a dos años. Discoidectomía y colocación de caja de PEEK con injerto autólogo. Se evaluaron artrodesis, lordosis cervical, altura del espacio intervertebral, dolor mediante escala visual análoga, índice de discapacidad cervical, tiempo quirúrgico, sangrado transoperatorio, estancia intrahospitalaria y complicaciones. Análisis estadístico con t de Student, Wilcoxon y exacta de Fisher. Resultados: de 17 pacientes estudiados, 9 (53%) eran del sexo femenino. La edad promedio 62 años. Sangrado promedio de 187 mL. El nivel más afectado fue C5-C6, C6-C7 en cinco pacientes. Se encontró fusión al 100% sin hundimiento ni migración de la caja, altura del espacio conservada, pero no se conservó la lordosis segmentaria. Mejoría clínica en todos los pacientes, y del índice de discapacidad. Conclusión: la disminución de los síntomas, la conservación de la altura del espacio anterior y posterior, la no conservación de la lordosis segmentaria y la fusión con caja de PEEK fueron congruentes con lo reportado en la bibliografía. Se sugiere utilizar la placa anterior para mantener la lordosis cervical. El índice de fusión encontrado fue de 100%, con disminución de los síntomas de dolor y discapacidad. Pérdida de lordosis cervical global.
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Materiais Biocompatíveis , Cetonas , Polietilenoglicóis , Fusão Vertebral/instrumentação , Espondilose/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Benzofenonas , Materiais Biocompatíveis/efeitos adversos , Matriz Óssea/transplante , Discotomia/métodos , Feminino , Humanos , Cetonas/efeitos adversos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Polietilenoglicóis/efeitos adversos , Polímeros , Estudos Prospectivos , Radiculopatia/etiologia , Radiculopatia/prevenção & controle , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/prevenção & controle , Fusão Vertebral/métodos , Espondilose/etiologia , Transplante Autólogo , Resultado do TratamentoRESUMO
OBJETIVO: Comparar resultados de biopsias vertebrales guiadas por tomografía axial computarizada, reportados por dos servicios de Anatomía Patológica distintos en pacientes con síndrome de destrucción vertebral para confirmar confiabilidad y utilidad en el diagnóstico. MÉTODOS: Se obtuvieron muestras de tejido de 21 pacientes en el periodo comprendido del 1 de marzo al 15 de julio del 2011 con el diagnóstico del síndrome de destrucción vertebral y a quienes se les realizó biopsia guiada por tomografía axial computarizada. Las muestras se enviaron en forma cegada a dos servicios de patología distintos. Los resultados fueron analizados con el método de comparación de dos proporciones. RESULTADOS: 14 pacientes fueron del género masculino (67%) y 7 del femenino (23%), edades de 28-82, con afección principalmente lumbar (48%) y torácica (38%); afectados en una vértebra en 62%, en dos en un 33% y en 3 o más niveles en 5%. Las vértebras más afectadas fueron L1, L2 y L3 (12/30 [40%]), T4 (3/30 [10%]) y T9 (3/30 [10%]). Los resultados se agruparon en categorías: 1. Osteomielitis (9/21 [43%]), 2. Tumores (7/21 [33%]), 3. Metástasis (3/21 [14%]), 4. Tejido normal (2/21 [10%]), 5. Inflamación (0/21 [0%]), 6. Muestra inadecuada (0/21 [0%]), 7. Mal de Pott (0/21 [0%]). CONCLUSIONES: De acuerdo a los valores de Z obtenidos mediante la prueba de comparación de dos proporciones no se encontró diferencia significativa entre los resultados reportados por dos los dos servicios de patología en el síndrome estudiado, determinándose que esta parte del proceso es confiable y útil en un 90%.
OBJETIVO: Comparar resultados de biópsias vertebrais guiadas por tomografia axial computadorizada, relatados por dois serviços de Anatomia Patológica distintos em pacientes com síndrome de destruição vertebral para confirmar a confiabilidade e a utilidade no diagnóstico. MÉTODOS: Foram obtidas amostras de tecido de 21 pacientes no período de 1 de março a 15 de julho de 2011, com diagnóstico de síndrome de destruição vertebral, que foram submetidos a biópsia guiada por tomografia axial computadorizada. As amostras foram enviadas de modo cego a dois serviços de patologia distintos. Os resultados foram analisados pelo método de comparação de duas proporções. RESULTADOS: 14 pacientes eram do sexo masculino (67%) e 7 do feminino (23%), com idades entre 28 e 82 e afecção predominantemente lombar (48%) e torácica (38%); 62% tinham comprometimento em uma vértebra, 33% em duas e 5% em três ou mais níveis. As vértebras mais afetadas foram L1, L2 e L3 (12/30 [40%]), T4 (3/30 [10%]) e T9 (3/30 [10%]). Os resultados foram agrupados em categorias: 1. Osteomielite (9/21 [43%]), 2. Tumores (7/21 [33%]), 3. Metástases (3/21 [14%]), 4. Tecido normal (2/21 [10%]), 5. Inflamação (0/21 [0%]), 6. Amostra inadequada (0/21 [0%]), 7. Mal de Pott (0/21 [0%]). CONCLUSÕES: De acordo com os valores de Z obtidos pela prova de comparação de duas proporções, não se encontrou diferença significante entre os resultados relatados pelos dois serviços de patologia na síndrome estudada, ficando determinado que essa parte do processo tem confiabilidade e utilidade de 90%.
OBJECTIVE: To compare results of vertebral biopsy guided by computerized axial tomography scan, reported by two different Departments of Pathology in patients with vertebral destruction syndrome to confirm the reliability and utility in the diagnosis. METHODS: Tissue samples from 21 patients were obtained March 1 to July 15, 2011, with a diagnosis of the vertebral destruction syndrome and who underwent computerized axial tomography-guided biopsy. The samples were blindly sent to two different pathology services. The results were analyzed using the two-proportion z-test. RESULTS: 14 patients were male (67%) and 7 females (23%), aged between 28 and 82, with condition predominantly lumbar (48%) and thoracic (38%); 62% had one vertebra affected, 33% ha two and 5% had three or more levels involved. The most affected vertebrae were L1, L2 and L3 (12/30 [40%]) and T9 (3/30 [10%]). The results were grouped into categories: 1. Osteomyelitis (9/21 [43%]), 2. Tumors (7/21 [33%]), 3. Metastases (3/21 [14%]), 4. Normal tissue (2/21 [10%]), 5. Inflammation (0/21 [0%]), 6. Inadequate sample (0/21 [0%]), 7. Pott's disease (0/21 [0%]). CONCLUSIONS: According to the values obtained by the two-proportion z-test, there was no significant difference between the results reported by the two departments of pathology for the syndrome studied, being determined that this part of the process has reliability and usefulness of 90%.