Does the Montreal Cognitive Assessment (MoCA) identify cognitive impairment profiles in Parkinson's disease? An exploratory study

An important proportion of patients with Parkinson's Disease (PD) present signs of cognitive impairment, although this is heterogeneous. In an attempt to classify this, the dual syndrome hypothesis distinguishes between two profiles: one defined by attentional and executive problems with damage in anterior cerebral regions, and another with mnesic and visuospatial alterations, with damage in posterior cerebral regions. The Montreal Cognitive Assessment (MoCA) is one of the recommended screening tools, and one of the most used, to assess cognitive impairment in PD. However, its ability to specifically identify these two profiles of cognitive impairment has not been studied. The aim of this study was, therefore, to analyze the capacity of the MoCA to detect cognitive impairment, and also to identify anterior and posterior profiles defined by the dual syndrome hypothesis. For this purpose, 59 patients with idiopathic PD were studied with the MoCA and a neuropsychological battery of tests covering all cognitive domains. Results of logistic regression analysis with ROC (Receiver Operating Characteristic) curves showed that MoCA detected cognitive impairment and identified patients with a profile of anterior/attentional and executive deficit, with acceptable sensibility and specificity. However, it did not identify patients with a posterior/mnesic-visuospatial impairment. We discuss the reasons for the lack of sensitivity of MoCA in this profile, and other possible implications of these results with regards the usefulness of this tool to assess cognitive impairment in PD.

Verbal emotional memory laterality effect on amygdalohippocampectomy for refractory epilepsy

OBJECTIVES

To study the brain lateralization of the verbal emotional memory and the influence of the emotional valence, we investigated a sample composed of patients with medial temporal lobe refractory epilepsy (MTLE) treated with unilateral amygdalohippocampectomy compared to a control group.

MATERIALS & METHODS

A new task (Verbal Association) was designed and implemented to assess emotional memory performance. It was applied to 62 patients with MTLE of whom 31 have been subjected to right amygdalohippocampectomy and 31 to left amygdalohippocampectomy. These patients were compared with 31 participants with no cerebral pathology, as a control group.

RESULTS

(a) The control group obtained a higher number of recalled words than the rest of the groups, while the MTLE-right group obtained better results than the MTLE-left group. (b) In the case of positive emotional valence words, the MTLE-left group performed significantly worse than the rest of the groups; whereas for negative emotional words, the MTLE-left group presented the lowest average performance and the control group obtained a higher number of recalled words compared to MTLE-right group. In the case of neutral emotional words, no significant differences were found among the groups. (c) The MTLE-left group showed poorer performance on positive and negative words than neutral; the control group demonstrated lower average performance on positive and neutral words compared to negative; the MTLE-right group did not show any significant differences on the recall of different emotional valences.

CONCLUSIONS

Patients with MTLE show a deficit in the verbal recall which is exacerbated for information with an affective component. This deficit is more prominent in the case of patients with left unilateral resection (MTLE-left group) since they lose the benefits of the emotional information for the recall.

Neuropsychological profile of adults with Down syndrome and moderate intellectual disability

BACKGROUND

The neuropsychological profile of individuals with Down syndrome (DS) has been described as being characterized by dissociations between verbal and visual abilities, as well as between verbal comprehension and production abilities (higher visual than verbal abilities and higher verbal comprehension than verbal production abilities). However, the studies that reached these conclusions based these conclusions mainly on inter-group differences in children but not on intra-group differences.

AIMS

The study explores dissociations in adults with DS, taking inter-group and intra-group differences into account.

METHOD AND PROCEDURES

The sample was composed of 40 adults with DS and 38 adults with moderate intellectual disability (ID) but without DS, matched for chronological age, sex, and intellectual level.

OUTCOMES AND RESULTS

The participants with DS, unlike the other group, exhibited similar performance in their verbal and visual abilities, as well as in their verbal comprehension and production abilities (intra-group differences). In addition, they showed worse performance in verbal general measures and verbal comprehension abilities but similar performance in visual general measures and verbal production abilities (inter-group differences) compared with those without DS with similar intellectual levels on standardized measures.

CONCLUSIONS AND IMPLICATIONS

The observed intra-group differences highlight that a lack of dissociation between verbal and visual abilities, as well as between verbal comprehension and production abilities, seems to be a specific feature of adults with DS.

Impact of Surgical Site Infections on Elective Incisional Hernia Surgery: A Prospective Study

BACKGROUND

Although incisional hernia repair is classified as a clean surgery, it still has a high incidence of surgical site infection (SSI) (0.7%-26.6%). The presence of an SSI could increase early recurrence rates after incisional hernia repair.

PATIENTS AND METHODS

Patients undergoing elective incisional hernia repair with no bowel contamination between January and December 2015 were assessed prospectively. Demographic and surgical data, local post-operative complications, and one-year recurrence rates in patients with and without SSI were compared. The management of SSI was determined.

RESULTS

Patients with SSI (16/101) showed more prolonged surgical procedures (91 ± 39 vs. 63 ± 30 min, p = 0.012), more post-operative sero-hematomas (38% vs. 8%, p = 0.001), and a higher one-year recurrence rate (19% vs. 4%, p = 0.047). Multivariable analysis revealed the only identified risk factor for SSI to be post-operative sero-hematomas (p = 0.042; odds ratio [OR] = 4.17 [1.05-16.54]). Patients who developed an SSI required antibiotic agents and daily treatment from one to five months. One of these required the removal of the mesh.

CONCLUSIONS

Surgical site infection rates are high for incisional hernia surgery (16%), and associated with local complications. Surgical site infection requires long-term treatments and leads to a higher one-year recurrence rate.

Transcriptomic changes in Cucurbita pepo fruit after cold storage: differential response between two cultivars contrasting in chilling sensitivity

Background

Zucchini fruit is susceptible to chilling injury (CI), but the response to low storage temperature is cultivar dependent. Previous reports about the response of zucchini fruit to chilling storage have been focused on the physiology and biochemistry of this process, with little information about the molecular mechanisms underlying it. In this work, we present a comprehensive analysis of transcriptomic changes that take place after cold storage in zucchini fruit of two commercial cultivars with contrasting response to chilling stress.

Results

RNA-Seq analysis was conducted in exocarp of fruit at harvest and after 14 days of storage at 4 and 20 °C. Differential expressed genes (DEGs) were obtained comparing fruit stored at 4 °C with their control at 20 °C, and then specific and common up and down-regulated DEGs of each cultivar were identified. Functional analysis of these DEGs identified similarities between the response of zucchini fruit to low temperature and other stresses, with an important number of GO terms related to biotic and abiotic stresses overrepresented in both cultivars. This study also revealed several molecular mechanisms that could be related to chilling tolerance, since they were up-regulated in cv. Natura (CI tolerant) or down-regulated in cv. Sinatra (CI sensitive). These mechanisms were mainly those related to carbohydrate and energy metabolism, transcription, signal transduction, and protein transport and degradation. Among DEGs belonging to these pathways, we selected candidate genes that could regulate or promote chilling tolerance in zucchini fruit including the transcription factors MYB76-like, ZAT10-like, DELLA protein GAIP, and AP2/ERF domain-containing protein.

Conclusions

This study provides a broader understanding of the important mechanisms and processes related to coping with low temperature stress in zucchini fruit and allowed the identification of some candidate genes that may be involved in the acquisition of chilling tolerance in this crop. These genes will be the basis of future studies aimed to identify markers involved in cold tolerance and aid in zucchini breeding programs.

Electronic supplementary material

The online version of this article (10.1186/s12864-018-4500-9) contains supplementary material, which is available to authorized users.

Randomized clinical trial of mesh fixation with glue or sutures for Lichtenstein hernia repair

BACKGROUND

Pain is the most likely reason for delay in resuming normal activities after groin hernia repair. The primary aim of this study was to determine whether the use of glue to fix the mesh instead of sutures reduced acute postoperative pain after inguinal hernia repair. Secondary objectives were to compare postoperative complications, chronic pain and early recurrence rates during 1-year follow-up.

METHODS

Some 370 patients who underwent Lichtenstein hernia repair were randomized to receive either glue (Histoacryl®) or non-absorbable polypropylene sutures for fixation of lightweight polypropylene mesh. Postoperative complications, pain and recurrence were evaluated by an independent blinded observer.

RESULTS

Postoperative pain at 8 h, 24 h, 7 days and 30 days was less when glue was used instead of sutures for all measures (P < 0·001). The operation was significantly quicker using glue (mean(s.d.) 35·3(8·7) min versus 39·9(11·1) min for sutures; P < 0·001). There were no significant differences between the groups in terms of postoperative complications, chronic pain and early recurrence at 1-year follow-up.

CONCLUSION

Atraumatic mesh fixation with glue was quicker and resulted in less acute postoperative pain than sutures for Lichtenstein hernia repair. Registration number: NCT02632097 (http://www.clinicaltrials.gov).

Face-to-face emotion interaction studies in Down syndrome infants

Infants with Down syndrome constitute an ideal population for analysing the development of emotional expression from the first months of life, due basically to the fact that this chromosomal alteration is identifiable from birth and results in well-known difficulties of cognitive development and in basic learning processes. Taking into account the functional aspects of facial expression during initial social interaction, in this review we present a series of studies which, although based on different theoretical approaches and different methodologies, have the common objective of analysing the emotional behaviour of young infants with and without Down syndrome during face-to-face interaction with their mothers. The main conclusions emerging from these studies are: (a) that, as in the case of typically developing infants, Down syndrome infants and their mothers present a series of coordinated and interdependent expressive interchanges; (b) that, despite the differences found between infants with and without Down syndrome in quantitative parameters of expressive behaviour, such as frequency, duration and intensity of the different emotional expressions or their point of initiation in development, what seems to be most significant is the clear functional similarity observed in the two groups of subjects during initial mother-infant interaction; and (c) that these differences may be understood by considering different psychobiological explanations as well as the known cognitive deficits.

Facial Emotion Processing in Aviremic HIV-infected Adults

The emotional processing in human immunodeficiency virus-seropositive individuals (HIV+) has been scarcely studied. We included HIV+ individuals (n = 107) on antiretroviral therapy (≥2 years) who completed 6 facial processing tasks and neurocognitive testing. We compared HIV+ and healthy adult (HA) participants (n = 40) in overall performance of each facial processing task. Multiple logistic regressions were conducted to explore predictors of poorer accuracy in those measures in which HIV+ individuals performed poorer than HA participants. We separately explored the impact of neurocognitive status, antiretroviral regimen, and hepatitis C virus (HCV) coinfection on the tasks performance. We found similar performance in overall facial emotion discrimination, recognition, and recall between HIV+ and HA participants. The HIV+ group had poorer recognition of particular negative emotions. Lower WAIS-III Vocabulary scores and active HCV predicted poorer accuracy in recognition of particular emotions. Our results suggest that permanent damage of emotion-related brain systems might persist despite long-term effective antiretroviral therapy.

Pattern of neurocognitive function in patients receiving boosted protease inhibitor monotherapy: a detailed neuropsychological study

It is unknown if, compared to a triple drug antiretroviral therapy, boosted protease inhibitor monotherapy leads to worse results in specific neuropsychological processes. In our study, we included patients virologically suppressed (≥1 year), on antiretroviral therapy, without concomitant major neurocognitive confounders, receiving boosted lopinavir or darunavir as monotherapy (n = 96) or as triple therapy with two nucleoside reverse transcriptase inhibitors (n = 95). All patients underwent a comprehensive neuropsychological test battery (14 neuropsychological measures, covering seven domains). Both groups were compared in average score distributions and rates of neuropsychological deficits. Similar comparisons were conducted only for patients with neurocognitive impairment. In the adjusted analysis, we found only small differences between groups in the entire sample: better verbal learning (p = 0.02; d = 0.28) and verbal recall scores (p < 0.01; d = 0.25) in patients on boosted protease inhibitor monotherapy and slightly better motor skills with dominant hand (p = 0.02; d = 0.23) scores in patients on triple therapy. No greater proportion of deficits in the protease inhibitor monotherapy group was found in any neuropsychological measure. In neurocognitively impaired patients, we found similar outcomes in verbal learning, verbal recall, and motor skills with dominant hand but with larger effect sizes. Close similarities in the neurocognitive pattern between groups question the clinical relevance of the number of neuroactive drugs included in the regimen. These results also suggest that peripheral viral load control may be a good indicator of brain protection.

Cloning and characterisation of a putative pollen-specific polygalacturonase gene (CpPG1) differentially regulated during pollen development in zucchini (Cucurbita pepo L.)

Studies in zucchini (Cucurbita pepo L. spp. pepo) pollen have been limited to the viability and morphology of the mature pollen grain. The enzyme polygalacturonase (PG) is involved in pollen development and pollination in many species. In this work, we study anther and pollen development of C. pepo and present the cloning and characterisation of a putative PG CpPG1 (Accession no. HQ232488) from pollen cDNA in C. pepo. The predicted protein for CpPG1 has 416 amino acids, with a high homology to other pollen PGs, such as P22 from Oenothera organensis (76%) and PGA3 from Arabidopsis thaliana (73%). CpPG1 belongs to clade C, which comprises PGs expressed in pollen, and presents a 34 amino acid signal peptide for secretion towards the cell wall. DNA-blot analysis revealed that there are at least another two genes that code for PGs in C. pepo. The spatial and temporal accumulation of CpPG1 was studied by semi-quantitative- and qRT-PCR. In addition, mRNA was detected only in anthers, pollen and the rudimentary anthers of bisexual flowers (only present in some zucchini cultivars under certain environmental conditions that trigger anther development in the third whorl of female flowers). However, no expression was detected in cotyledons, stem or fruit. Furthermore, CpPG1 mRNA was accumulated throughout anther development, with the highest expression found in mature pollen. Similarly, exo-PG activity increased from immature anther stages to mature anthers and mature pollen. Overall, these data support the pollen specificity of this gene and suggest an involvement of CpPG1 in pollen development in C. pepo.

Is a neutral expression also a neutral stimulus? A study with functional magnetic resonance

Although neutral faces do not initially convey an explicit emotional message, it has been found that individuals tend to assign them an affective content. Moreover, previous research has shown that affective judgments are mediated by the task they have to perform. Using functional magnetic resonance imaging in 21 healthy participants, we focus this study on the cerebral activity patterns triggered by neutral and emotional faces in two different tasks (social or gender judgments). Results obtained, using conjunction analyses, indicated that viewing both emotional and neutral faces evokes activity in several similar brain areas indicating a common neural substrate. Moreover, neutral faces specifically elicit activation of cerebellum, frontal and temporal areas, while emotional faces involve the cuneus, anterior cingulated gyrus, medial orbitofrontal cortex, posterior superior temporal gyrus, precentral/postcentral gyrus and insula. The task selected was also found to influence brain activity, in that the social task recruited frontal areas while the gender task involved the posterior cingulated, inferior parietal lobule and middle temporal gyrus to a greater extent. Specifically, in the social task viewing neutral faces was associated with longer reaction times and increased activity of left dorsolateral frontal cortex compared with viewing facial expressions of emotions. In contrast, in the same task emotional expressions distinctively activated the left amygdale. The results are discussed taking into consideration the fact that, like other facial expressions, neutral expressions are usually assigned some emotional significance. However, neutral faces evoke a greater activation of circuits probably involved in more elaborate cognitive processing.

Processing of facial expressions of emotions by adults with Down syndrome and moderate intellectual disability

The processing of facial expressions of emotions by 23 adults with Down syndrome and moderate intellectual disability was compared with that of adults with intellectual disability of other etiologies (24 matched in cognitive level and 26 with mild intellectual disability). Each participant performed 4 tasks of the Florida Affect Battery and an original task in which they had to match facial expressions after observing the complete face or one of its halves. Adults with Down syndrome did not show any specific difficulties in recognizing facial expressions in spite of showing a poorer discrimination between facial expressions and tended to take more notice of the lower half of the face.

Field evaluation of a self-propelled sprayer and effects of the application rate on spray deposition and losses to the ground in greenhouse tomato crops

BACKGROUND

In the greenhouses of south-eastern Spain, plant protection products are applied using mainly sprayers at high pressures and high volumes. This results in major losses on the ground and less than uniform spray deposition on the canopy. Recently, self-propelled vehicles equipped with vertical spray booms have appeared on the market. In this study, deposition on the canopy and the losses to the ground at different spray volumes have been compared, using a self-propelled vehicle with vertical spray booms versus a gun sprayer. Three different spray volumes have been tested with a boom sprayer, and two with a spray gun.

RESULTS

The vehicle with the vertical spray boom gave similar depositions to those made with the gun, but at lower application volumes. Also, the distribution of the vertical spray boom was more uniform, with lower losses to the ground.

CONCLUSIONS

The vertical spray booms used in tomato crops improve the application of plant protection products with respect to the spray gun, reducing the application volumes and the environmental risks of soil pollution.

Life-history characteristics of the large Amazonian migratory catfish Brachyplatystoma rousseauxii in the Iquitos region, Peru

The main life-history traits of the dorado Brachyplatystoma rousseauxii, a large Amazonian catfish undertaking the largest migration known for a freshwater fish species (from the nursery area in the estuary of the Amazon to the breeding zones in the head waters of the western Amazon basin close to the Andes), were determined from a 5 year sampling of >15,000 specimens in the Peruvian Amazon. The breeding season occurred during the falling and low-water periods, which is hypothesized to be an adaptation to maximize the chances of young stages to reach the estuary. The size at first sexual maturity was slightly larger for females than males, c. 91 and 83 cm standard length (L(S)), respectively. Both males and females reproduce for the first time at >3 years old. The fecundity per spawning event ranged from 481,734 to 1,045,284 oocytes for females weighing 25 and 34 kg, respectively. Seasonal variations of body condition were similar among sexes, but differed between immature specimens that had a higher condition during the low-water period and lower condition during rising waters, and mature individuals that showed the opposite pattern. The growth characteristics were estimated by L(S) frequency analysis. For females, the best fitting models gave a mean birth date in August, during the height of the breeding cycle, with the following von Bertalanffy growth function parameters: L(Sinfinity) = 153.3, K = 0.29 and t(0) =- 0.37 years. For males, the best fitting model gave a mean birth date in July, also during the height of the breeding period, with L(Sinfinity) = 142, K = 0.30 and t(0) =- 0.36 years. At a given age, females were systematically larger than males and the size difference increased with age. The largest females sampled (148 cm L(S)) was 11 years old and the largest male (134 cm L(S)) was 9 years old. The mortality estimates were higher for males total (Z) = 1.34, natural (M) = 0.52 and fishing (F) = 0.82 than for females (Z = 0.98, M = 0.50, F = 0.48). The life-history patterns of B. rousseauxii are discussed in light of the available knowledge about this species and the understanding of its complex life cycle.

Perception and recall of faces and facial expressions following temporal lobectomy

The perception of and memory for faces, with or without emotional content, were studied in 43 patients with temporal lobe epilepsy who had undergone unilateral resection of the hippocampus and the amygdala and in 43 healthy participants for comparison. Each participant performed four tasks from the Florida Affect Battery (Facial Discrimination, Affect Discrimination, Affect Naming, Affect Selection) and two memory tasks (in one case of a face and in the other of a facial expression). Findings indicated that, although patients with unilateral temporal lobectomy (right or left) showed no difficulty in discriminating faces, they were not as good at remembering faces. Also, patients who had had a left temporal lobectomy showed impairment in discriminating facial expressions, in the memory of a facial expression and/or in naming facial expressions.

Time course of biochemical and behavioural effects of a single high dose of chlorpyrifos

The purpose the present study was to determine if tolerance is developed to all behavioural effects produced by a single high dose of chlorpyrifos (CPF). For this, the study was divided in two phases; in the first phase, we studied the time course of the effects produced by treatment with a high dose of CPF (250 mg/kg s.c.) on rat locomotor activity and anxiety behaviours recorded on an open-field, as well as on AChE inhibition. Results showed that CPF produced a maximum inhibition of AChE (72% of inhibition) 2 days after its administration, exhibiting a partial recovery of its activity by day 30 (55% of inhibition). On locomotor activity CPF produced a biphasic effect; a reduction only on day 2, and an increase on day 30. An anxiolytic-like effect was only observed within 2 and 5 days after CPF treatment. These results indicate that the tolerance has been developed to the behavioural effects produced by s.c. administration of CPF, but with a different time course. In the second phase, since disturbances in cholinergic system might trigger dopaminergic dysfunctions, we tested the locomotor activity following challenge with amphetamine (1mg/kg i.p.) at 11 and 30 days after CPF treatment. Data obtained showed that amphetamine produced an increase in total distances and rearing in vehicle and CPF groups on days 11 and 30. However, CPF group exhibited lower increase relative to vehicle group in both days. This effect is independent of the percentage of AChE inhibition and therefore, of change in the cholinergic system. Data are discussed under the light of the adaptative mechanisms underlying the recovery of the cholinergic overstimulation after s.c. exposure to high doses of CPF.

The role of the amygdala in facial emotional expression during a discrimination task

A total of 50 patients with temporal lobe epilepsy with unilateral resection of the hippocampus and the amygdala were studied: --27 with left lobectomy (LTL group) and 23 with right lobectomy (RTL group)--; and 28 healthy control participants (HC group). The task consisted of identifying the dissimilar photograph from a group of photographs of the same face. The difference could correspond to the identity of the model or the facial expression (happiness, anger, sadness and fear). The results showed that when the difference in the photograph resided in the identity of the model, the RTL group made more mistakes than the HC group. When the facial expression was the distinguishing feature, mean response latency was longer in the LTL group than in the HC group. Comparison of the emotions revealed that the greatest differences were obtained with the fear expression, in all three participant groups. The dissociation of neural circuits responsible for processing facial expressions is discussed and, especially, the role of the left amygdala to discriminate between facial expressions.

Judgements of facial and vocal signs of emotion in infants with down syndrome

We address how adults perceive facial and vocal signs of emotions in infants with and without Down syndrome. A set of naturalistic data from infants with trisomy 21 and typically developing infants (joy expression of young infants, 3.8-4.4 months, and anger and neutral expressions of older infants, 6.8-12.8 months) was rated by adult judges categorically or dimensionally. Facial signs alone, vocal signs alone, and both facial and vocal signs were presented for each expression. Raters were university students who did not have regular contact with infants, nor with people with mental retardation. Young infants' joy expressions were correctly recognized more frequently for typically developing infants than for infants with Down syndrome and, specifically, joy vocalizations in infants with Down syndrome were not identified. Facial signs were also more communicative than vocal signs in the case of older infants' anger and neutral expressions. These results are relevant to the way infant emotion is perceived by others, and may be particularly useful in facilitating interaction between adults and infants with Down syndrome.

Neuroanatomical Targets of the Organophosphate Chlorpyrifos by c-fos Immunolabeling

Chlorpyrifos (CPF) is an organophosphate widely used as an insecticide in agriculture which elicits short- and long-term neurobehavioral deficits after acute administration. Because little is known about the specific brain areas targeted by CPF, investigating for the location of its neuroanatomical targets could help to describe the brain systems involved in the neurobehavioral toxicity developed in CPF-exposed organisms. To meet this objective, in the present study we evaluated CPF-induced c-fos expression. In addition, locomotor behavior and cerebral cholinesterase level were evaluated. We found two main sets of results. First, no significant c-fos expression was found in cholinoceptive regions in CPF-treated rats 2 h or 24 h post-administration, despite the fact that 41% and 62% acetylcholinesterase inhibition, respectively, were present in brain homogenates. These results are consistent with previous reports showing CPF-induced activation of adaptive neural mechanisms re-establishing cholinergic tone. Second, 24 h post-intoxication CPF elicited c-fos expression in cytokine-related areas. Cytokines have been involved in anxiety-like responses and psychiatric stress syndromes. Taking into account that CPF triggers the synthesis of peripheral cytokines, the present data stress the need to further clarify functional relations between organophosphate-triggered peripheral cytokines and emotional disturbances reported in intoxicated organisms.

Differential effect of fetal, neonatal and treatment variables on neurodevelopment in infants with congenital hypothyroidism

OBJECTIVES

To identify the influence of fetal, neonatal and treatment variables on neurodevelopment in children with congenital hypothyroidism.

METHODS

A multiple regression analysis was performed in the neurodevelopmental scores of 26 children with CH who were assessed at 3, 6, 12 and 18 months for postural control, fine eye-hand coordination and language. The independent variables were: duration of fetal hypothyroidism, initial biochemical severity, days at starting treatment, initial dose, and efficiency of treatment.

RESULTS

Postural control was predicted by duration of fetal hypothyroidism and language by the biochemical severity of the disease at birth. Fine eye-hand coordination was not predicted by any variable.

CONCLUSION

This pattern of influences suggests that fetal and neonatal hypothyroidism have different effects on brain maturation sites during the first 2 years of life and that some subtle neurocognitive deficits are probably unavoidable.

Prevalence of Type II diabetes mellitus and insulin resistance in parents of women with polycystic ovary syndrome

AIMS/HYPOTHESIS

Insulin resistance with increased risk of Type II (non-insulin-dependent) diabetes is a common feature of polycystic ovary syndrome (PCOS). To investigate antecedents of metabolic disorders in family members of patients with PCOS, we evaluated glucose tolerance and insulin resistance in parents of patients with PCOS compared to parents of healthy women.

METHODS

A total of 200 parents of women with clinical and hormonal evidence of PCOS (PCOSp) and 120 parents of healthy normally cycling women (HWp) were studied. A 75-g OGGT was performed and subjects were classified according to the World Health Organization (WHO) criteria (1999). Serum glucose and insulin were measured before the glucose load and 30, 60 and 120 min after. C-peptide and sex hormone-binding globulin were also determined before the glucose load. Insulin resistance was assessed by HOMA model and ISI composite.

RESULTS

The prevalence of Type II diabetes was 1.89-(1.06-3.38)-fold higher in PCOSp compared to HWp. Insulin resistance, evaluated by HOMA(IR)and ISI composite was also significantly higher in the PCOSp group compared to the HWp group. After both study groups were distributed by sex, and adjusted by age and BMI, the metabolic parameters were still significantly different between PCOSp and HWp.

CONCLUSIONS/INTERPRETATION

The data suggest that parents of PCOS women exhibit insulin resistance and Type II diabetes more frequently than those of healthy women, thus constituting a high-risk group but an ideal cohort to detect and prevent the development of Type II diabetes.

[Polycystic ovary syndrome: the importance of establishing diagnosis]

Polycystic ovary syndrome (PCOS) is a very common disorder that occurs up to 10% of premenopausal women. Although PCOS is known to be associated with a higher reproductive morbility and increased risk of hormone dependent-cancer, its diagnosis is particularly important because PCOS is strongly linked to insulin resistance. This involves a major risk of early metabolic and cardiovascular complications. On the other hand, the prevalence of metabolic disorders associated with insulin resistance is higher in family members of patients with PCOS than in those of normal women, which suggests that the treatment of this syndrome should be preventive rather than symptomatic. For that reason, PCOS might be considered a signal of a family disorder, a route to diabetes and a public health problem.

Epidemiologic tools for malaria surveillance in an urban setting of low endemicity along the Colombian Pacific coast

An evaluation of 3 different methods for malaria diagnosis was carried out in an urban area of low endemicity on the Pacific coast of Colombia. Samples were collected from 833 symptomatic patients at a malaria clinic and examined by the polymerase chain reaction (PCR), quantitative buffy coat (QBC; Becton Dickinson, Franklin Lakes, NJ) method, and the traditional thick blood smear. The prevalence of Plasmodium falciparum malaria was 5.88% by thick blood smear, 7.34% by the QBC method, and 21.87% by PCR. The agreement between microscopists was 99.5%. The agreement between the QBC method and thick blood smear was 96.13% (n = 745). Samples positive by PCR but negative by thick blood smear or conversely negative by PCR and positive by thick blood smear were usually of low-level parasitemias. All 3 methods showed agreement in 76.3% of the samples. Sixty-nine (18.8%) samples were positive by PCR but negative by the other 2 methods. Ten samples were positive by both the QBC method and thick blood smear but negative by PCR; most of them had low-level parasitemias. The use of malaria diagnostic methods for epidemiologic surveillance is discussed.

Hypermasculinity and academic goal-setting: an exploratory study

The relation between gender-role percepts and academic goal-setting was explored. An inventory examining the aspects of masculinity that would facilitate or inhibit academic goal-setting was developed based on a literature review of how masculinity relates to academic behaviors. A diverse sample of students (120 male, 147 female, 14 not indicating sex) was measured on three aspects of sex and academic goal-setting behavior. Factor analysis confirmed the content validity of masculine factors having facilitative (Mastery Competitiveness) and inhibitory (Antisocial Competitiveness) academic properties. Regression analyses indicated that sex-role orientations (Competitiveness and Hypermasculinity) significantly predicted academic goal-setting behaviors (R2 = .136). Finally, men scored higher than women on the subscales measuring Hypermasculinity and Antisocial or Competitiveness, while there were no sex differences on the Mastery Competitiveness subscale. The implications of these findings and suggestions for research are discussed.

Mother and infant smiling exchanges during face-to-face interaction in infants with and without Down syndrome

We examined social smiling in infants with and without Down syndrome, aged from 3.2 to 13.6 months old. They were videotaped during an episode of spontaneous face-to-face interaction and a subsequent mother's still-face situation. Results indicated that infants smiled longer in the spontaneous face-to-face episode than in the still-face episode, even though this result was only significant in typically developing infants. Typically developing infants also smiled for a longer period than Down's syndrome infants during the spontaneous interaction episode. Moreover, infant's smile preceded the onset of the mother's smile, but in 6.2- to 13.6-month-old typically developing infants, the probability of mothers smiling before infants increased. These findings emphasize the possible existence of differences in the development of facial expression from signs to social symbols between infants with and without Down syndrome.

[Iodine nutrition in school children of four census areas of Chile]

BACKGROUND

Although endemic goiter is an easily controlled chronic disease, it continues to be a serious global public health problem.

AIM

To study iodine nutrition in school age children from different areas of Chile.

SUBJECTS AND METHODS

Thyroid gland was palpated in 4181 school age children from Calama, Santiago, Temuco and Punta Arenas. Urinary iodine excretion was measured to 9% of these children and iodine concentration in salt for human consumption obtained in each of these areas was determined.

RESULTS

A 9% goiter prevalence in boys and 11% prevalence in girls was detected. The prevalence of goiter Ia was 6.5% and the figure in different geographic areas was similar. Iodine concentration in salt for human consumption was adequate according to Chilean legislation (82.6, 95.7, 96.8 and 93.2 micrograms ugI/g salt in Calama, Santiago, Temuco and Punta Arenas respectively). Urinary iodine excretion in boys and girls was 1695 and 1802 micrograms l/g creatinine in Calama, 680 and 732 in Santiago, 574 and 690 in Temuco, 570 and 528 in Punta Arenas. These values are well above recommendations.

CONCLUSIONS

Endemic goiter is no longer a problem in Chile. The importance of a continuous surveillance of iodine nutrition in Chile and the reduction of salt iodine concentration required by Chilean legislation is underscored.

[Endemic goiter in three census areas of Chile]

The goal of the present study was to evaluate the current status of endemic goiter in Chile. 3500 students of basic education from public schools in three censor areas of the country were studied: 1000 in Calam (North), 1000 in Temuco (South) and 1500 in Santiago (Center). Socio-economic level was evaluated according to the Graffar scale. Two trained physicians determined body weight, height and size of the goiter through palpation of the thyroid gland (according to W.H.O. classification). Iodine in urine was determined in 20% of the students. Iodine insalt was determined in samples obtained in the three areas. A goiter prevalence of goiter of 11.4% in males and 12% in females was found, with a higher prevalence in females during puberty. A higher prevalence in the medium-low and low socio-economical levels was observed (12.4% and 14.4% respectively). The level of salt iodination was variable in the three areas (1/3 with concentration > than 100 parts per million (ppm), 1/3 between 60-100 ppm and 1/3 with < 60 ppm of iodine content). According to W.H.O. criteria, Chile has presently a low goiter prevalence, but the salt iodine concentration indicate the importance of a permanent surveillance of iodine nutrition.

High density lipoprotein cholesterol in insulin-dependent diabetic children

Thirty-one insulin-dependent diabetic children were studied (11 boys and 20 girls; 22 whites, 6 mulattoes and 3 Negroes; age-range: 8-14 years; mean age 11.7 years). According to the quality of their metabolic control the children were divided into 3 groups: Group 1, children in good metabolic control; Group 2, children in poor metabolic control but without ketosis; Group 3, children in severe ketoacidosis; 15 normal children (Group 4) served as controls. No hypercholesterolemia was found. As to blood sugar and serum triglyceride levels, significant differences were found between the control group and the diabetic groups as well as between the diabetic groups. When evaluating the result of HDL-cholesterol determinations we found a significant difference between the control group and Groups 2 and 3, as well as between diabetics in good control (Group 1) compared to Groups 2 and 3. We also found a correlation in diabetics in good control between blood sugar values and high HDL-cholesterol levels, and in diabetics in poor control between high blood sugar values and low HDL-cholesterol levels. No correlation was found between HDL-cholesterol and triglycerides in diabetes in poor metabolic control. In view of these findings the importance of reaching an optimal metabolic control in insulin-dependent children is emphasized, and the role of normoglycemia in the prevention of atherosclerosis is stressed.

[Rehabilitation of the diabetic child in Cuba]

The author describes a series of important steps followed in Cuba for the rehabilitation of the diabetic child, like education of the patient and his relatives, active participation of the child in his treatment (self control), hospital attention advisable for a minimal period exclusively in severe cases, attention in office visits as ambulatory patient, participation in vocational, social and psychological orientation activities of the antidiabetic center, areas for sport and recreation, vocational camping for diabetic children, homes, education through press, television and radio of special programs on diabetes.