Prediabetes is more than a pre-disease: additional evidences supporting the importance of its early diagnosis and appropriate treatment

AIM

To identify Prediabetes (PreD) as early and serious diabetes step using clinical-biochemical characteristics in the population of the Primary Prevention Diabetes Buenos Aires (PPDBA) study.

METHODS

PPDBA Study evaluated benefits of adopting healthy lifestyles to prevent T2D. It recruited people 45-75 years of age with PreD (impaired fasting glycaemia [IFG], impaired glucose tolerance [IGT] or both, American Diabetes Association criteria), using an opportunistic approach. They completed a FINDRISC questionnaire, and those with a score ≥13 points were invited to participate. When they accepted, we performed an oral glucose tolerance test (OGTT) with a complete lipid profile and HbA1c while physicians completed a clinical history. We recruited 367 persons, and depending on OGTT results, the sample was divided into normals (NGT), PreD, or with diabetes (last one was excluded in our analysis). Data were statistically analyzed using parametric and nonparametric tests and logistic regression to identify parameters associated with PreD.

RESULTS

From the recruited (n = 367) 47.7% have NGT, 48.5% PreD and 3.8% unknown T2D (excluded). People with PreD were significantly older, with a higher percentage of overweight/obesity, BMI, and larger waist circumference than NGT. They also showed significantly higher fasting and 2 h post glucose load, HbA1c, and triglyceride levels. No significant differences were recorded in the blood pressure, lipid profile though both groups had abnormally high LDL-c values. They also had a larger percentage of TG/HDL-c ratios (insulin resistance indicator) (55% vs. 37.5%). Logistic regression analysis showed that PreD was significant associated with age, waist circumference, and triglyceride above target values.

CONCLUSION

Our findings showed that clinical and biochemical parameters were significantly different between people with PreD and those with NGT. This evidence supports the concept that PreD is a serious dysfunction, which should be early diagnosed and treated properly to prevent its transition to T2D and its complications.

Quantification and Stereochemical Composition of R-(−) and S-(+)-Clenbuterol Enantiomers in Bovine Urine by Liquid Chromatography–Tandem Mass Spectrometry

Clenbuterol (4-amino-α-[(tert-butylamino)methyl]-3,5-dichlorobenzylalcohol) is a β2-adrenergic agonist. The consumption of meat contaminated with clenbuterol can lead to increased heart rate, blood pressure, anxiety, palpitations and skeletal muscle tremors. Several analytical methods have been developed to identify and quantify clenbuterol in different biological matrices. In this report, we have developed a specific and sensitive analytical method for quantifying clenbuterol and performed an in-depth enantiomeric analysis in bovine urine. The method was evaluated in accordance with international guidelines, and we used an isotopically labeled analog as an internal standard. The extraction efficiency for clenbuterol in bovine urine was > 98%, the limit of detection was 0.05 ng/mL and the limit of quantification was 0.10 ng/mL. Our assay showed high specificity, no carryover was observed and the assay was linear in the range 0.10–8.0 ng/mL. Fifteen bovine urine samples were analyzed (containing clenbuterol), and an enantiomeric analysis was performed. The clenbuterol concentration range was 0.10–10.56 ng/mL across these samples. The levorotatory enantiomer was detected at greater concentrations than the dextrorotatory enantiomer, the ratio being 1.7 ± 0.6 (n = 15), and a statistical difference was observed (P < 0.05) using the Wilcoxon test.

Use of Torulaspora delbrueckii and Saccharomyces cerevisiae in semi-industrial sequential inoculation to improve quality of Palomino and Chardonnay wines in warm climates

AIMS

We have evaluated for the first time the impact of two commercial yeast strains (Torulaspora delbrueckii TD291 and Saccharomyces cerevisiae QA23) inoculated sequentially in musts of Chardonnay and Palomino Fino grape varieties grown under warm climate (South-west of Spain).

METHODS AND RESULTS

Semi-industrial scale alcoholic fermentations (AF) were performed during the 2011 and 2012 harvests. Implantation analyses demonstrated that T. delbrueckii is the predominant strain until the end of the AF phase. Wines with sequential inoculation (SI) resulted in the production of low levels of acetic acid (which gives wine an undesirable 'vinegary' character), low acetaldehyde in Chardonnay and high in Palomino wines. The most salient attributes that contribute to the quality of the Chardonnay and Palomino wines produced were aroma intensity, fresh and tropical fruit character.

CONCLUSIONS

This study demonstrated that SI of T. delbrueckii and S. cerevisiae contribute significantly to the improvement of Chardonnay wine aromas and the creation of new styles of wine for Palomino.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study has generated new knowledge about the biotechnological potential of T. delbrueckii (TD219) and S. cerevisiae (QA23) for improving the organoleptic properties of Chardonnay and Palomino wines.

Mutant Escherichia coli penicillin acylase with enhanced stability at alkaline pH

Increased stability at alkaline pH should be a valuable attribute for the utilization of penicillin acylase in bioreactors employed to convert penicillins into 6-aminopenicillanic acid, a precursor of semisynthetic penicillins. In these systems, base is added for pH control, which results in local alkaline conditions that promote enzyme inactivation. Hydrolysis and synthesis reactions are also pH dependent. Here, we report work in which the gene coding for Escherichia coli penicillin acylase was subjected to oligonucleotide-directed random mutagenesis at regions coding for amino acids predicted to be at the surface of the enzyme. The resulting mutant library, cloned in E. coli, was screened by a filter paper assay of the colonies for the presence of penicillin acylase activity with enhanced stability at alkaline pH. Characterization of one of the selected clones revealed the presence of a mutation, Trp431-Arg, which would presumably alter the surface charge of the protein. In vitro experiments demonstrated a near twofold increase in the half-life of the mutant enzyme when stored at pH 8.5 as compared with the wild-type enzyme, with a comparable specific activity at several pH values. In general, the mutant displayed increased stability toward the basic side in the pH-stability profile. (c) 1995 John Wiley & Sons, Inc.

MicroRNA signatures in B-cell lymphomas

Accurate lymphoma diagnosis, prognosis and therapy still require additional markers. We explore the potential relevance of microRNA (miRNA) expression in a large series that included all major B-cell non-Hodgkin lymphoma (NHL) types. The data generated were also used to identify miRNAs differentially expressed in Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL) samples. A series of 147 NHL samples and 15 controls were hybridized on a human miRNA one-color platform containing probes for 470 human miRNAs. Each lymphoma type was compared against the entire set of NHLs. BL was also directly compared with DLBCL, and 43 preselected miRNAs were analyzed in a new series of routinely processed samples of 28 BLs and 43 DLBCLs using quantitative reverse transcription-polymerase chain reaction. A signature of 128 miRNAs enabled the characterization of lymphoma neoplasms, reflecting the lymphoma type, cell of origin and/or discrete oncogene alterations. Comparative analysis of BL and DLBCL yielded 19 differentially expressed miRNAs, which were confirmed in a second confirmation series of 71 paraffin-embedded samples. The set of differentially expressed miRNAs found here expands the range of potential diagnostic markers for lymphoma diagnosis, especially when differential diagnosis of BL and DLBCL is required.

Mantle cell lymphoma: transcriptional regulation by microRNAs

Mantle cell lymphoma (MCL) pathogenesis is still partially unexplained. We investigate the importance of microRNA (miRNA) expression as an additional feature that influences MCL pathway deregulation and may be useful for predicting patient outcome. Twenty-three MCL samples, eight cell lines and appropriate controls were screened for their miRNAs and gene expression profiles and DNA copy-number changes. MCL patients exhibit a characteristic signature that includes 117 miRNA (false discovery rate <0.05). Combined analysis of miRNAs and the gene expression profile, paired with bioinformatics target prediction (miRBase and TargetScan), revealed a series of genes and pathways potentially targeted by a small number of miRNAs, including essential pathways for lymphoma survival such as CD40, mitogen-activated protein kinase and NF-kappaB. Functional validation in MCL cell lines demonstrated NF-kappaB subunit nuclear translocation to be regulated by the expression of miR-26a. The expression of 12 selected miRNAs was studied by quantitative PCR in an additional series of 54 MCL cases. Univariate analysis identified a single miRNA, miR-20b, whose lack of expression distinguished cases with a survival probability of 56% at 60 months. In summary, using a novel bioinformatics approach, this study identified miRNA changes that contribute to MCL pathogenesis and markers of potential utility in MCL diagnosis and clinical prognostication.

Differences of circulating Bordetella pertussis population in Argentina from the strain used in vaccine production

In Argentina, as in other countries, the number of pertussis cases has been increasing, even in highly vaccinated zones. Many reports suggest that the decline of vaccine efficacy due to antigenic shifts in the circulating Bordetella pertussis might be among the factors that contribute to pertussis re-emergence in different parts of the world. To evaluate the incidence of this factor in Argentina, we decided to characterize the circulating bacteria of an important demographic area of this country in comparison with the strain used for vaccine production. From 1997 to 2003 we collected nasopharyngeal samples from pediatric patients with signs of Bordetella infection hospitalized in the metropolitan area of Buenos Aires and La Plata, Argentina. From these samples we identified 28 B. pertussis, which were characterized by biochemical techniques, PCR, DNA fingerprint, prn and ptx genes sequencing, and lipopolysaccharides (LPS) pattern. BOX-PCR from B. pertussis isolates yielded one cluster containing 13 isolates and some smaller ones, being all fingerprints different from the vaccine strain. Differences between Argentinean circulating bacteria and the vaccine strain were also observed for the Prn and Ptx variants as well as for the LPS pattern. Moreover, this last pattern seemed to change over the years. In addition, we identified two B. bronchiseptica. The presence of this Bordetella species together with the observed differences between circulating B. pertussis and the strain used in vaccine production should be considered for the development of an improved vaccine.

Human immunodeficiency virus and other sexually transmitted diseases in Cuban women

A cross-sectional study was performed in 60 Cuban women of child-bearing age who were seropositive for human immunodeficiency virus (HIV) and 60 controls. Human papillomavirus (HPV) was identified most frequently, with oncogenic HPV serotypes 16, 33 and 58 detected in HIV-positive patients, and serotypes 11, 33 and 51 in the controls (relative risk 4.41; 95% CI 2.21-8.29). Syphilis and hepatitis B and C viruses were detected exclusively in HIV-seropositive women (p<0.05). Sexually transmitted diseases (STDs) appeared to pose a substantial health problem, especially for HIV-positive women. Clinics should consider screening and treatment for STDs as part of their HIV prevention programmes.

Screening and typing of Patagonian wine yeasts for glycosidase activities

AIMS

The purpose of this study was to select autochthonous glycosidase producer yeasts with potential use in industrial production of Patagonian red wines.

METHODS AND RESULTS

The study was carried out in oenological autochthonous yeasts from Comahue region (Argentinean North Patagonia). A set of screenable yeast phenotypic characteristics indicative of their potential usefulness in more aromatic red wine production was defined and tested in both, Saccharomyces and non-Saccharomyces populations. Twelve isolates showing six different glycosidase phenotypes were selected and they were characterized at species and strain levels using molecular methods. A close correlation between molecular and phenotypic characteristics was observed. Five strains belonging to Candida guilliermondii, C. pulcherrima and Kloeckera apiculata with highest constitutive beta-glucosidase activity levels without anthocyanase activity were discriminated. Some of them also showed constitutive beta-xylosidase and inductive alpha-rhamnosidase activities.

CONCLUSIONS

The extension of the selection of oenological yeast to non-Saccharomyces species provided strains possessing novel and interesting oenological characteristics which could have significant implications in the production of more aromatic young red wine.

SIGNIFICANCE AND IMPACT OF THE STUDY

As these non-Saccharomyces are indigenous to wine, they can be used in mixed starters at the beginning or as pure cultures at the end fermentation to contribute in enhancing the wine nuance that is typical of this specific area.

Killer behaviour in wild wine yeasts associated with Merlot and Malbec type musts spontaneously fermented from northwestern Patagonia (Argentina)

The occurrence of killer wine yeasts in Comahue Region (Patagonia, Argentina) was studied. Wild wine yeasts were isolated from spontaneously fermenting Merlot and Malbec type musts. Out of 135 isolates analyzed 37% were sensitive to some well characterized killer toxins as K1-K10 and did not show killer activity (sensitive phenotype, S), 21% showed neutral phenotype (N) and 42% demonstrated killer activity (killer phenotype, K). All but two killer strains, identified as Candida pulcherrima and Kluyveromyces marxianus, were Saccharomyces cerevisiae. Additionally, all killer strains were sensitive to some killer reference strains, showing a killer-sensitive phenotype (KS); neither Saccharomyces or non-Saccharomyces wild yeasts were phenotype killer-resistant (KR). The incidence of the killer character varied with respect to fermentation stage and grape variety, increasing throughout fermentation (13-55% to 36-90%). Irrespective of grape must type, the neutral and sensitive yeasts were ever predominant at initial stages of fermentation. All but six neutral strains, identified as Saccharomyces cerevisiae, were Kloeckera apiculata.

Flow cytometry-based phagocytosis assay for sensitive detection of opsonic activity of pneumococcal capsular polysaccharide antibodies in human sera

The development of efficient vaccines against Streptococcus pneumoniae is of major importance for public health. The efficacy of pneumococcal vaccination and induced protection are thought to be reflected by the opsonic antibody titers in sera from vaccines. We describe a novel two-color flow cytometry technique for quantification of antibody-mediated pneumococcal phagocytosis. Serum-opsonised fluorescein-isothiocyanate (FITC)-labelled S. pneumoniae were allowed to attach to neutrophils, split into two aliquots and further incubated either at 4 degrees C (to avoid phagocytosis) or 37 degrees C (to allow phagocytosis). Cell-surface residual opsonic IgG was detected by phycoerythrin (PE)-conjugated anti-human IgG in both samples. The fraction of FITC-labelled bacteria phagocytosed via antibody (F(i)) could be estimated from FITC and PE labels, and reflected the opsonic activity of sera. The technique displayed high sensitivity for the detection of opsonic antibodies, as shown by experiments using pre- and post-immune sera, which documented significantly increased phagocytosis after vaccination, and the observed increase in phagocytosis rates at higher antibody levels. The intrinsic variation of the assay was low, and could be further reduced by the use of effector cells from donors with similar IgG receptor (FcgammaR) allotypes. The method described in this study should be generally applicable to test vaccine efficacy, to evaluate the interaction of bacteria and phagocytes, and to discriminate between antibody-mediated and antibody-independent interactions between bacteria and phagocytes.

[The Health Boards in New Spain. 18th and 19th Centuries]

OBJECTIVE

To describe the function of New Spain's Boards of Health, which were created in times of emergencies as in epidemic diseases or natural catastrophes.

MATERIAL

Most of the information comes from primary sources, such as the rules, orders and reports of the Boards of Health.

RESULTS

Whenever an epidemic disease appeared in New Spain, there were not enough physicians, hospitals or medical services to fulfill the needs of society. The response was the creation of Boards of Health that functioned as charitable groups. Their purpose was to provide food, clothing and medical support to the sick, by collecting donations and distributing them among the needed, and also by assigning physicians to specific geographical sectors within cities.

CONCLUSIONS

The presence of Boards of Health was useful to fight epidemics in New Spain allowing the team work not only among physicians, but also among parish priests and neighborhood to offer assistance and help to sick people as medical, welfare work and soulful support.

Alcoholysis reactions from starch with alpha-amylases

The ability of alpha-amylases from different sources to carry out reactions of alcoholysis was studied using methanol as substrate. It was found that while the enzymes from Aspergillus niger and Aspergillus oryzae, two well-studied saccharifying amylases, are capable of alcoholysis reactions, the classical bacterial liquefying alpha-amylases from Bacillus licheniformis and Bacillus stearothermophilus are not. The effect of starch and methanol concentration, temperature and pH on the synthesis of glucosides with alpha-amylase from A. niger was studied. Although methanol may inactivate alpha-amylase, a 90% substrate relative conversion can be obtained in 20% methanol at a high starch concentration (15% w/v) due to a stabilizing effect of starch on the enzyme. As the products of alcoholysis are a series of methyl-oligosaccharides, from methyl-glucoside to methyl-hexomaltoside, alcoholysis was indirectly quantified by high performance liquid chromatography analysis of the total methyl-glucoside produced after the addition of glucoamylase to the alpha-amylase reaction products. More alcoholysis was obtained from intact soluble starch than with maltodextrins or pre-hydrolyzed starch. The biotechnological implications of using starch as substrate for the production of alkyl-glucosides is analyzed in the context of these results.

[Medical care and environmental hygiene in Mexico City from the 16th through the 18th century]

This paper deals with public health in Mexico City from the 16th to the 18th century. The first part is about sickness and epidemics; the origin of a very high concerned with death rate at that time; general and private hospitals foundations, and about the role of the Church, Medical Board and the Viceroy in Health Care and Preventive Medicine. Medical care was efficient in these aspects. The second part deals with public services concerning public health as a clean environment and streets and collecting garbage, problems that caused sickness according to the ideas of those days. A clear environment was good until the second half of the 18th century. The paper is divided as follows: introduction; sickness and epidemics; medical care; actions against epidemics; public services, and final commentary.

[Buruli ulcer in the Amansi West district, Ashanti Region, Ghana. The Cuban experience. I]

A study was made on 105 patients with Buruli ulcer in the Amansie West district, Ashanti Region, Ghana, representing 37.6% of the registered patients. The Tontokrom neighborhood showed the highest prevalence: 84 x 1,000 inhabitants. Predominance of females (54%) was observed. 74.8% did agricultural work and only 3 reported a previous trauma, predominantly with one lesion. Household contacts were identified. Coverage with the BCG vaccine was low. It is concluded that there has been a real increase of the prevalence of Buruli in the region during the last years, especially among children and women. This has become a serious problem due to its invalidating and irreversible sequelae. Measures of control are proposed.

[Virological diagnosis of an outbreak of fever and rashes caused by parvovirus B19, Cuba, 1995]

The results obtained in the study of an a outbreak of fever and rash occurred in Havana City in March, 1995, are reported. Dengue, measles, rubella, herpes simplex, and Epstein Barr were discarded as causal agents of the outbreak in the samples of 35 patients. Parvovirus B19 was identified as the causing agent of the outbreak by the detection of IgM antibodies and the polymerase chain reaction technique (PCR). The infection produced by this agent was confirmed in 14/18 samples (77.7%) by some of the techniques used. This study makes reference to the first outbreak of Parvovirus B19 that was proved in Cuba.

Wastes of multilayer containers as substrate in composting processes

An evaluation of the influence and degradation of ground multilayer containers, such as Tetra Brik Aseptic (TBA), in the composting process of municipal solid wastes (MSW) is presented. Two composting piles were formed by mixing, in different proportions, an organic fraction of MSW and TBA material ground as flakes or stripes. Piles were periodically aerated by mechanical mixing. Evolution of the composting was followed by frequent measurements of suitable parameters such as temperature, moisture, ashes, total organic carbon (TOC), nitrogen, C/N ratio, pH, conductivity, nutrients, and heavy metals. As expected, aluminum and polyethylene films from TBA were not degraded during the processes, but the cardboard fraction of TBA showed a partial decomposition that was more intense in the material ground as flakes. After two months of curing, the composts were refined and analyzed to determine their nutrient and heavy-metals contents. Despite their poor aesthetic properties, mainly resulting from the presence of little pieces of plastic and aluminum films, the composts contained the required amounts of nutrients; furthermore, their heavy-metals content was below the limits proposed by some official European organizations.

Effect of hydromechanical forces on the production of filamentous haemagglutinin and pertussis toxin of Bordetella pertussis

The production of Bordetella pertussis extracytoplasmic filamentous haemagglutinin (FHA) and pertussis toxin (PT) in a bioreactor under stirring conditions was studied in order to investigate the effect of hydromechanical forces on yields of both antigens. It was shown that FHA loses its haemagglutinin activity when the power transmitted by the agitator and the aerator per unit volume increases, whereas PT production is not affected. The loss of FHA activity can be explained by the action of shear forces on the filamentous structure of this antigen.

[Treatment of cutaneous leishmaniasis with CO2 laser radiation]

This paper deals with the cases of 10 patients with different clinical forms of cutaneous leishmaniasis, who were exposed to a single CO2 laser rays. They were evolutively evaluated up to two years after treatment, without relapsing in any case. Total cure of the lesion occurred without side-effects. The method described for the treatment of this disease is recommended, whenever its application should be possible instead of the other methods described in the literature.

Alcoholism among inpatients in a general hospital in Barcelona, Spain

This cross-sectional study in a general hospital revealed that 37.5% of inpatients were alcoholics, excessive drinkers, or probable alcoholics; when only males were considered, that proportion increased to 61.3%. Most of the physical disorders were associated with the amount of alcohol consumed. The age-adjusted mortality rate in the hospital was three times higher in alcoholics than in nonalcoholics. A large number of alcohol problems were not detected by the patients' medical team. An interview about alcohol and drug consumption, the CAGE, the MAST Brief, and the MALT were utilized to diagnose alcoholism; for our population, the former was shown as the most effective instrument.