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Ochoa J.E.,University of Milan Bicocca | Gallo J.A.,Clinical and Research Center | Gallo J.A.,University of Antioquia | Correa M.M.,Clinical and Research Center | And 6 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2015

Context: Epidemiological studies have shown a progressive increase in insulin resistance (IR) accompanying body weight gain and blood pressure (BP) increase. This has led to the consideration that hemodynamic effects of IR might depend on its relationship with body mass index (BMI) and BP. Objective: The aim of our study was to determine whether IR is associated with changes in hemodynamic indices of cardiovascular function across different categories of BMI (normal weight, overweight, and obese), and BP levels (normal, high normal, and hypertension). Design, Setting and Participants: This was a cross-sectional study conducted in a population sample of nondiabetic individuals (n = 731). Measures: Insulin resistance was evaluated with the homeostasis model assessment of insulin resistance (HOMA) and subjects were classified into quartiles according to HOMA index values. Synchronized beat-to-beat recordings of stroke volume (impedance cardiography) and R-R interval, along with repeated auscultatory BP measurements were performed. Derived hemodynamic parameters were computed and averaged. Results: Analysis of covariance adjusting for confounders showed significant differences for most hemodynamic parameters among different quartiles of HOMA index both in the general population and within each BMI and BP category. Overall, increasing values of HOMA index were associated with significantly higher BP; and reduced R-R interval, stroke index, cardiac index, pre-ejection period and left ventricular ejection time (P < .01) across different categories of BMI and BP. Conclusions: These findings suggest that even small increases in HOMA index (not necessarily in the range to define IR) may induce significant changes on indices of cardiovascular function even in normal-weight and normotensive subjects, emphasizing the importance of IR at an early stage of the cardiovascular risk continuum. Copyright © 2015 by the Endocrine Society.

Habeych E.,Corporacion para Investigaciones Biologicas | Barrios A.F.G.,University of Los Andes, Colombia | Orduz S.,National University of Colombia
International Journal of Chemical Reactor Engineering | Year: 2010

Intermittent fed-batch culture with total cell retention was evaluated during Bacillus thuringiensis serovar. kurstaki fermentations aiming to enhance biomass and spore concentration yields while maintaining toxicity. This method is derived from the already reported intermittent fed-batch culture and utilized a tangential flow filtration system for cell retention. After 4 pulses, we obtained a biomass of 74.36 g.L-1 and this biomass displayed a half lethal concentration towards neonate Spodoptera frugiperda larvae of 40.53 ng·cm-2, and spore concentration of 4.6 × 1014 CFU mL-1. On the other hand, volumetric productivity was increased seven-fold compared to batch fermentation. Interestingly, we are not aware of higher spore concentrations reported to date for B. thuringiensis cultures. © 2010 The Berkeley Electronic Press. All rights reserved.

Queiroz-Telles F.,Federal University of Parana | Nucci M.,Federal University of Rio de Janeiro | Tobon A.,Corporacion para Investigaciones Biologicas | Restrepo A.,Corporacion para Investigaciones Biologicas
Medical Mycology | Year: 2011

Implantation or subcutaneous mycoses are a frequent health problem in Latin American countries and other tropical and subtropical areas. Although such infections rarely cause disseminated or invasive disease, they have an important impact on public health, and timely diagnosis and appropriate treatment remain important. Although some implantation mycoses are found in immunocompromised persons, the immunocompetent population is the principal target in Latin America. Most etiologic agents are found in soil, vegetation, and decaying matter in tropical, subtropical, and humid environments and infection is commonly the result of penetrating injury. Infections primarily occur (1) among low socioeconomic groups, (2) among those living in rural areas or involved in farming, hunting, or other outdoor activities, and (3) particularly among adult men. This review focuses on the epidemiology of the most clinically significant implantation mycoses in Latin America, i.e., sporotrichosis, eumycetoma, chromoblastomycosis, subcutaneous phaeohyphomycosis, subcutaneous zygomycosis, and lacaziosis. Main epidemiologic findings, clinical manifestations, diagnosis, and treatment options are also discussed. © 2011 ISHAM.

Colombo A.L.,Federal University of Sao Paulo | Tobn A.,Corporacion para Investigaciones Biologicas | Restrepo A.,Corporacion para Investigaciones Biologicas | Queiroz-Telles F.,Federal University of Parana | Nucci M.,Federal University of Rio de Janeiro
Medical Mycology | Year: 2011

Although endemic mycoses are a frequent health problem in Latin American countries, clinical and epidemiological data remain scarce and fragmentary. These mycoses have a significant impact on public health, and early diagnosis and appropriate treatment remain important. The target population for endemic disease in Latin America is mostly represented by low-income rural workers with limited access to a public or private health system. Unfortunately, diagnostic tools are not widely available in medical centers in Latin America; consequently, by the time patients are diagnosed with fungal infection, many are already severely ill. Among immunocompromised patients, endemic mycoses usually behave as opportunistic infections causing disseminated rather than localized disease. This paper reviews the epidemiology of the most clinically significant endemic mycoses in Latin America: paracoccidioidomycosis, histoplasmosis, and coccidioidomycosis. The burdens of disease, typically affected populations, and clinical outcomes also are discussed. © 2011 ISHAM.

Escandon P.,Instituto Nacional Of Salud | de Bedout C.,Corporacion para Investigaciones Biologicas | Lizarazo J.,Hospital Universitario Erasmo Meoz | Agudelo C.I.,Instituto Nacional Of Salud | And 4 more authors.
Biomedica | Year: 2012

Introduction: A survey on cryptococcosis is being conducted regularly in Colombia since 1997. We present hereby the results corresponding to patients diagnosed from 2006 to 2010. Objective: To analyze the data obtained during this period. Materials and methods: Retrospective analysis of the corresponding surveys. Results: A total of 526 surveys originating from 72% of the Colombian political divisions were received during the 5-year period. Most patients (76.6%) were males and 74.9% were 21-50 years old. The most prevalent risk factor was HIV infection (83.5%) with cryptococcosis defining AIDS in 23% of the cases. In the general population the estimated mean annual incidence rate for cryptococcosis was 2.4×106 inhabitants while in AIDS patients this rate rose to 3.3×103. In 474 surveys stating clinical features, most frequent complaints were headache 84.5%, fever 63.4%, nausea and vomiting 57.5%, mental alterations 46.3%, meningeal signs 33.0%, cough 26.4% and visual alterations 24.5%. Neurocryptococcosis was recorded in 81.8% of the cases. Laboratory diagnosis was based on direct examination, culture and latex in 29.3% cases. From 413 Cryptococcus isolates analyzed, 95.6% were identified as C. neoformans var. grubii, 1% C. neoformans var. neoformans, and 3.4% C. gattii. Treatment was reported for 71.6% of the cases with amphotericin B alone or in combination with fluconazole prescribed in 28%. Conclusions: Surveys done through passive surveillance continue to be sentinel markers for HIV infection and represent a systematic approach to the study of opportunistic problems regularly afflicting AIDS patients since cryptococcosis requires no compulsory notification in Colombia.

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