Abstract Purpose: To analyze diabetes mellitus (DM) in a multifactorial manner with the consumption of sugar-sweetened beverages (SSB) and variables like nutritional status, sex, genetic predisposition, age and ethnicity; in order to determine the relationship between BGA and DM in the Mazahua Otomí (MO) community. Methodological design: This quantitative survey on social and nutritional variables was designed, validated and applied. A logistic model was developed to find the relationship of DM in relation to the variables: SSB consumption, sex, genetic predisposition, age, body mass index and ethnicity. Results: The Mazahua otomi community has a monthly family income below the extreme poverty line; they do not have disease control: 68% are obese or overweight and SSB consumption is medium to high in 90% of the population. In a multifactorial manner and according to the model, there is a probability of manifesting DM depending on the variables mentioned above; while, with the exception of nutritional status and age, the others are the most significant. In taste and preferences, 52% opt for the Coca-Cola SSB brand. Research limitations: The results found should be complemented in other case studies in communities with similar characteristics and a broader probabilistic population sample. Finding: In the MO community there is a relationship between BGA consumption and DM and there is no control of the disease. This work contributes to the design of public policies to prevent health damage because of excessive consumption of SSB and its relationship with DM; likewise, those policies that rescue and promote good nutritional practices of the communities of indigenous peoples.

Resumen Objetivo: Analizar en forma multifactorial la diabetes mellitus (DM) con el consumo de las bebidas gaseosas azucaradas (BGA) y de las variables estado nutricional, sexo, predisposición genética, edad y etnia, para determinar la relación de las BGA y la DM en la comunidad Mazahua Otomí (MO). Diseño Metodológico: El estudio fue cuantitativo. Se diseñó, validó y aplicó una encuesta estructurada sobre variables sociales y nutricionales. Se elaboró un modelo logístico para encontrar la relación de DM con las variables: consumo de BGA, sexo, predisposición genética, edad, índice de masa corporal y etnia. Resultados: En la comunidad MO que se investigó un padre de familia promedio tiene un ingreso mensual por debajo de la línea de pobreza extrema y no existe control de la enfermedad de estudio: 68% tiene obesidad o sobrepeso y el consumo de BGA es entre medio y alto en 90% de la población. En forma multifactorial, hay probabilidad de manifestar la DM en función de las variables antes señaladas; mientras que, a excepción de estado nutricional y la edad, las demás son las más significativas. En gustos y preferencias, 52% opta por la marca de BGA Coca-Cola. Limitaciones de la investigación: Los resultados encontrados deberán complementarse con estudios de caso en comunidades con características similares y una muestra poblacional probabilística más amplia. Hallazgos: En la comunidad MO existe una relación entre el consumo de BGA y la DM y no hay control de la enfermedad. Este trabajo aporta al diseño de políticas públicas de prevención del daño a la salud por el consumo excesivo de BGA y su relación con la DM. De igual manera aquellas políticas públicas que rescaten y fomenten las buenas prácticas nutritivas entre las comunidades de los pueblos originarios.

Abstract Introduction: The nursing process is the method that allows us to administer care to people with chronic diseases through the disease stages, that is, assessment, diagnostic reasoning, nursing care plan and evaluation. Objective: Evaluate a nursing care plan for an older adult with type 2 diabetes mellitus and osteoporosis with a focus on therapeutic health education. Methodology: Observational, descriptive, and longitudinal clinical case study of a 63-year-old patient with diabetes mellitus and osteoporosis; the Marjory Gordon instrument was used for assessment, and standardized language was used for diagnostic reasoning, planning, execution and evaluation. Under bioethical principles, this is a minimal risk research, and the privacy and data of the elderly are protected. Results: Alteration was found in the pattern of perception/maintenance of health, nutritional/metabolic, exercise activity and coping with stress; with the establishment of activities to control glucose, priority was given to prescribed diet, exercise, adherence to treatment and coping with stress. Acceptance of the disease, learning to take capillary glucose and glycemic control was achieved, as well as adherence to the prescribed diet and exercise. Conclusions: Therapeutic health education achieved adherence to pharmacological and non-pharmacological treatment, as well as the acceptance of the health status, which allows acquiring self-control of the disease. Continuous and long-term follow-up is important due to the pathological progress, age and general deterioration of the patient.

Abstrato Introdução. O processo de enfermagem é o método que nos permite administrar a assistência a pessoas com doenças crônicas por meio dos estágios da doença, ou seja, avaliação, raciocínio diagnóstico, plano de assistência de enfermagem e avaliação. Objetivo: Avaliar um plano de cuidados de enfermagem para um adulto mais velho com diabetes mellitus tipo 2 e osteoporose com foco na educação terapêutica em saúde. Metodologia: Estudo de caso clínico observacional, descritivo e longitudinal de uma paciente de 63 anos com diabetes mellitus e osteoporose; para a avaliação foi utilizado o instrumento Marjory Gordon para raciocínio diagnóstico, planejamento, execução e avaliação, para raciocínio diagnóstico, planejamento, execução e avaliação, foi utilizada a linguagem padronizada. De acordo com os princípios bioéticos, essa é uma pesquisa de risco mínimo, e a privacidade e os dados dos idosos são protegidos. Resultados: Foi encontrada alteração no padrão de percepção/manutenção da saúde, nutricional/metabólico, atividade física e enfrentamento do estresse; com o estabelecimento de atividades para controlar a glicose, a prioridade foi dada à dieta prescrita, aos exercícios, à adesão ao tratamento e ao enfrentamento do estresse. Houve aceitação da doença, aprendizado da medição da glicose capilar e controle glicêmico, além de adesão à dieta e aos exercícios prescritos. Conclusões: A educação terapêutica em saúde conseguiu a adesão ao tratamento farmacológico e não farmacológico, bem como a aceitação do estado de saúde, que permite adquirir o autocontrolo da doença, sendo importante a monitorização contínua e a longo prazo da evolução patológica, da idade e da deterioração geral do paciente.

Resumen Introducción: El proceso de enfermería es el método que nos permite administrar los cuidados a personas con enfermedades crónicas a través de sus etapas: valoración, razonamiento diagnóstico, plan de cuidados de enfermería y evaluación. Objetivo: Evaluar un plan de cuidados de enfermería a una adulta mayor con diabetes mellitus tipo 2 y osteoporosis con enfoque a la educación para la salud terapéutica. Metodología: Estudio de caso clínico, observacional, descriptivo y longitudinal, a paciente de 63 años con diabetes mellitus y osteoporosis; para la valoración se empleó el instrumento de Marjory Gordon, para el razonamiento diagnóstico, planeación, ejecución y evaluación se utilizó el lenguaje estandarizado de enfermería. Bajo los principios bioéticos es una investigación de riesgo mínimo, se protege la privacidad y datos del adulto mayor. Resultados: Se encontró alteración en el patrón percepción / mantenimiento de la salud, nutricional / metabólico, actividad ejercicio y afrontamiento del estrés; estableciendo actividades para el control de su glucosa, se priorizó en dieta prescrita, ejercicio, adherencia al tratamiento y afrontamiento al estrés. Se logró aceptación de la enfermedad, aprendizaje de toma de glucosa capilar y control glucémico, además del apego a dieta y ejercicio prescrito. Conclusiones: La educación para la salud terapéutica logró el apego al tratamiento farmacológico y no farmacológico, así como la aceptación del estado de salud le permite adquirir el autocontrol de su enfermedad, es importante el seguimiento continuo y a largo plazo por el avance patológico, edad y deterioro general de la paciente.

Abstract Introduction: Vascular and neuropathic complications of diabetes cause diabetic foot, being the main risk factor for non-traumatic amputations. Objective: To analyze the available scientific evidence on lifestyle and self-care of patients at risk of diabetic foot. Methodology: Literature review using the preferred reporting items for systematic reviews and meta-analyses methodology; published in EBSCO host, Google academic, PubMed, Scielo and Elsevier; in English and Spanish from 2016 to 2022. Nursing articles were included, mentioning two or more variables of interest: diabetes mellitus, lifestyle, diabetic foot, and self-care; duplicates, no access, and gray literature were eliminated. From a total of 1,080 articles, 14 were included that met the inclusion criteria. Checklists were used to assess the quality of the manuscripts used. Results: Systematic reviews, observational, experimental and qualitative studies showed evidence that self-care can be influenced by culture, context and knowledge deficit, being this a risk factor for the development of diabetic foot. An association was found between the risk of diabetic foot with years of diagnosis, inadequate self-care of the feet and advanced age. Conclusion: The association between the self-care deficit and the risk of diabetic foot in the elderly was evidenced. It is recommended to broaden the search and include people under 40 years of age in order to establish effective preventive measures and reduce the risk of diabetic foot.

Abstrato Introdução: As complicações vasculares e neuropáticas da diabetes causam o pé diabético, sendo o principal fator de risco para amputações não traumáticas. Objetivo: Analisar a evidência científica disponível sobre o estilo de vida e o autocuidado dos doentes em risco de pé diabético. Metodologia: Revisão da literatura utilizando a metodologia preferred reporting items for systematic reviews and meta-analyses; publicada no EBSCO host, Google Scholar, PubMed, Scielo e Elsevier; em inglês e espanhol de 2016 a 2022. Foram incluídos artigos de enfermagem que mencionavam duas ou mais variáveis de interesse: diabetes mellitus, estilo de vida, pé diabético e autocuidado; foram removidos os duplicados, sem acesso e literatura cinzenta. De um total de 1.080 artigos, 14 que preencheram os critérios de inclusão foram incluídos. Foram utilizadas listas de verificação para avaliar a qualidade dos manuscritos utilizados. Resultados: Revisões sistemáticas, estudos observacionais, experimentais e qualitativos mostraram evidências de que o autocuidado pode ser influenciado pela cultura, contexto e défices de conhecimento, que são factores de risco para o desenvolvimento da doença do pé diabético. Foram encontradas associações entre o risco de pé diabético e os anos de diagnóstico, o autocuidado inadequado dos pés e a idade avançada. Conclusão: Verificou-se a associação entre défices de autocuidado e o risco de doença do pé diabético em idosos. Recomendamos o alargamento da pesquisa a pessoas com menos de 40 anos de idade, de forma a estabelecer medidas preventivas eficazes e reduzir o risco de doença do pé diabético.

Resumen Introducción: Las complicaciones vasculares y neuropáticas de la diabetes causan el pie diabético, siendo el principal factor de riesgo para amputaciones no traumáticas. Objetivo: Analizar la evidencia científica disponible sobre el estilo de vida y autocuidado de los pacientes con riesgo de pie diabético. Metodología: Revisión de la literatura mediante la metodología preferred reporting items for systematic reviews and meta-analyses; publicada en EBSCO host, Google académico, PubMed, Scielo y Elsevier; en inglés y español desde 2016 a 2022. Se incluyeron artículos de enfermería, que mencionaran dos o más variables de interés: diabetes mellitus, estilo de vida, pie diabético y autocuidado; se eliminaron duplicados, sin acceso abierto y literatura gris. De un total de 1,080 artículos se incluyeron 14 que reunieron los criterios de inclusión. Se emplearon listas de verificación para evaluar la calidad de los manuscritos utilizados. Resultados: Las revisiones sistemáticas, estudios observacionales, experimentales y cualitativos mostraron evidencias de que el autocuidado puede verse influenciado por la cultura, contexto y déficit de conocimientos, siendo este factor de riesgo para el desarrollo de pie diabético. Se encontró asociación entre el riesgo de pie diabético con años de diagnóstico, autocuidado inadecuado de los pies y edad avanzada. Conclusión: Se evidenció asociación entre déficit de autocuidado y riesgo de pie diabético en el adulto mayor. Se recomienda ampliar la búsqueda e incluir personas menores de 40 años para establecer medidas preventivas eficaces y reducir el riesgo de pie diabético.

Abstract Purpose: To analyze diabetes mellitus (DM) in a multifactorial manner with the consumption of sugar-sweetened beverages (SSB) and variables like nutritional status, sex, genetic predisposition, age and ethnicity; in order to determine the relationship between BGA and DM in the Mazahua Otomí (MO) community. Methodological design: This quantitative survey on social and nutritional variables was designed, validated and applied. A logistic model was developed to find the relationship of DM in relation to the variables: SSB consumption, sex, genetic predisposition, age, body mass index and ethnicity. Results: The Mazahua otomi community has a monthly family income below the extreme poverty line; they do not have disease control: 68% are obese or overweight and SSB consumption is medium to high in 90% of the population. In a multifactorial manner and according to the model, there is a probability of manifesting DM depending on the variables mentioned above; while, with the exception of nutritional status and age, the others are the most significant. In taste and preferences, 52% opt for the Coca-Cola SSB brand. Research limitations: The results found should be complemented in other case studies in communities with similar characteristics and a broader probabilistic population sample. Finding: In the MO community there is a relationship between BGA consumption and DM and there is no control of the disease. This work contributes to the design of public policies to prevent health damage because of excessive consumption of SSB and its relationship with DM; likewise, those policies that rescue and promote good nutritional practices of the communities of indigenous peoples.

Resumen Objetivo: Analizar en forma multifactorial la diabetes mellitus (DM) con el consumo de las bebidas gaseosas azucaradas (BGA) y de las variables estado nutricional, sexo, predisposición genética, edad y etnia, para determinar la relación de las BGA y la DM en la comunidad Mazahua Otomí (MO). Diseño Metodológico: El estudio fue cuantitativo. Se diseñó, validó y aplicó una encuesta estructurada sobre variables sociales y nutricionales. Se elaboró un modelo logístico para encontrar la relación de DM con las variables: consumo de BGA, sexo, predisposición genética, edad, índice de masa corporal y etnia. Resultados: En la comunidad MO que se investigó un padre de familia promedio tiene un ingreso mensual por debajo de la línea de pobreza extrema y no existe control de la enfermedad de estudio: 68% tiene obesidad o sobrepeso y el consumo de BGA es entre medio y alto en 90% de la población. En forma multifactorial, hay probabilidad de manifestar la DM en función de las variables antes señaladas; mientras que, a excepción de estado nutricional y la edad, las demás son las más significativas. En gustos y preferencias, 52% opta por la marca de BGA Coca-Cola. Limitaciones de la investigación: Los resultados encontrados deberán complementarse con estudios de caso en comunidades con características similares y una muestra poblacional probabilística más amplia. Hallazgos: En la comunidad MO existe una relación entre el consumo de BGA y la DM y no hay control de la enfermedad. Este trabajo aporta al diseño de políticas públicas de prevención del daño a la salud por el consumo excesivo de BGA y su relación con la DM. De igual manera aquellas políticas públicas que rescaten y fomenten las buenas prácticas nutritivas entre las comunidades de los pueblos originarios.

ABSTRACT Introduction: Robotic Radical Prostatectomy using the Da-Vinci Single-Port (SP) robot can provide comparable functional and oncological outcomes with potential advantages pertaining to peri-operative morbidity, especially in patients with an extensive history of prior abdominal surgeries (1, 2). Materials and Methods: Our case is a 74-year-old male with a history of diabetes, cardiac bypass, hypertension, and hyperlipidemia, presenting with a PSA of 7.2. His MRI showed a PIRADS-5 lesion in the left apex and mid-gland peripheral zone, and he was diagnosed with unfavorable intermediate-risk prostate cancer after MRI guided fusion biopsy. His BMI was 31, and past surgical history was pertinent for two exploratory laparotomies due to gunshot wounds and a colostomy creation followed by reversal. The standardized steps of robotic radical prostatectomy were carried out using SP robotic platform performed by author SH (3, 4). Results: Total operative time and estimated blood loss were 210 minutes and 150mL respectively. The patient was discharged on postoperative day one and final pathology showed adenocarcinoma of the prostate Gleason score 4+3=7, pT2NxR0 and negative surgical margins. The patient was continent four weeks after surgery and the PSA continues to be undetectable after three months. Conclusion: Transvesical Radical prostatectomy using the single port platform provides acceptable oncological and functional outcomes and quicker recovery given decreased risk of ileus and peritoneal irritation. Given that the abdominal cavity is not violated, the risk of bowel or vascular injury is mitigated, especially in patients with a hostile abdomen. Introduction DaVinci Da Vinci SinglePort Single Port (SP perioperative peri morbidity 1, 1 (1 2. 2 . 2) Methods 74yearold yearold 74 year old diabetes bypass hypertension hyperlipidemia 72 7 7.2 PIRADS5 PIRADS 5 PIRADS- midgland mid gland zone intermediaterisk intermediate biopsy 31 reversal 3, 3 (3 4. 4 4) Results 21 mL respectively 437 4+3=7 pTNxR pT NxR pT2NxR margins months Conclusion irritation violated mitigated abdomen ( 7. 43 4+3= 4+3 4+

Abstract Type 2 Diabetes Mellitus (T2DM) is a set of metabolic disorders that increase the risk of multisystemic diseases. In Mexico, Clinical Practice Guidelines (CPG) have been proposed for the healthcare of people with T2DM, from prevention to rehabilitation. However, although these guidelines emphasize the active participation of patients in their treatment to enhance treatment adherence, the necessary information on the procedures has not been provided. Therefore, the aim of this paper is to propose Human-Centered Design Thinking (HCDP) as a strategy for this purpose. The steps that constitute this methodology are described, as well as the results found in the international literature. The coherence of the HCDP with Mexican CPG recommendations is discussed, as is the importance of the methodological clarity provided by this model to improve treatment adherence in people with T2DM.

Resumen La diabetes mellitus tipo 2 (DMT2) es un conjunto de desórdenes metabólicos que aumenta el riesgo de afecciones multisistémicas. En México se han propuesto Guías de Práctica Clínica (GPC) para la atención de la salud en personas con DMT2, que van desde la prevención hasta la rehabilitación. Sin embargo, a pesar de enfatizar la participación activa de los pacientes en sus tratamientos para mejorar la adherencia al tratamiento, no cuenta con procedimientos claros. Por ello, el objetivo de este trabajo es proponer el pensamiento de diseño centrado en la persona (PDCP) como una estrategia para esta meta. Se describen los pasos que integran esta metodología, así como los resultados observados en la literatura internacional. Se discute la coherencia del PDCP con las recomendaciones de las GPC mexicanas, y la importancia de la claridad metodológica que brinda este modelo para mejorar la adherencia al tratamiento en personas con DMT2.

Resumen Objetivo: recopilar información de factores de riesgo de la enfermedad arterial coronaria en población adulta evidenciados mediante estudios de aleatorización mendeliana. Métodos: de acuerdo con las recomendaciones de la escala para la Evaluación de Artículos de Revisión Narrativa (SANRA), se realizó una revisión desde el usuario de la Universidad Militar Nueva Granada en las bases de datos de PubMed, EMBASE y BIREME. Resultados: se obtuvieron 757 artículos, luego se aplicaron los criterios de inclusión y exclusión, y se eligieron 29 artículos en los que se investiga la asociación de la enfermedad arterial coronaria con la apolipoproteína B, colesterol LDL, triglicéridos, colesterol total, apolipoproteina C3, proteína de transferencia de ésteres de colesterol, HDL, omega 6, lipoproteína (a), obesidad, hemoglobina A1C, diabetes mellitus tipo 2, glucosa en ayunas, inicio del hábito de fumar, presión arterial, hormona paratiroidea sérica, niveles de fosfato sérico, enfermedad del hígado graso no alcohólico, síndrome de ovario poliquístico, globulina fijadora de hormonas sexuales, testosterona, filoquinona circulante, proteína gla de la matriz inactiva, antioxidantes circulantes derivados de la dieta, glicina, homocisteína, ácido úrico, marcadores inflamatorios, hemoglobina, hematocrito y recuento de glóbulos rojos. Conclusión: esta revisión sugiere nuevos estudios con información genética colombiana para respaldar los factores de riesgo aquí presentados, teniendo en cuenta que en ninguno de los estudios evaluados se utilizó información genética latinoamericana, lo cual puede limitar la extrapolación de los resultados.

Summary: Objective: To compile information on risk factors for coronary artery disease in the adult population evidenced by Mendelian randomization studies.. Methods: A search was carried out from the user of the Nueva Granada Military University in the databases of PubMed, EMBASE and BIREME and a narrative review of the literature was carried out in accordance with the recommendations of the scale for the Evaluation of Narrative Review Articles (SANRA). Results: 757 articles were obtained, after the application of inclusion and exclusion criteria, 29 articles were chosen that investigated the association of apolipoprotein B, LDL cholesterol, triglycerides, total cholesterol, apolipoprotein C3, cholesterol ester transfer protein, HDL, omega 6, lipoprotein (a), obesity, hemoglobin A1C, type 2 diabetes mellitus, fasting glucose, smoking initiation, blood pressure, serum parathyroid hormone, serum phosphate levels, non-alcoholic fatty liver disease, polycystic ovary syndrome , sex hormone-binding globulin, testosterone, circulating phylloquinone, inactive matrix protein gla, circulating dietary-derived antioxidants, glycine, homocysteine, uric acid, inflammatory markers, hemoglobin, hematocrit, and red blood cell count, with coronary artery disease. Conclusion: This review suggests new studies with Colombian genetic information to support the risk factors presented here, considering that none of the studies evaluated used Latin American genetic information, which may limit the extrapolation of the results.

Resumo A doença renal do diabetes (DRD) permanece como a principal causa de doença renal crônica (DRC) mundialmente. A patogênese da DRD é influenciada por mecanismos funcionais, histopatológicos e imunológicos, incluindo a atividade do inflamassoma NLRP3 e estresse oxidativo. Os inibidores do cotransportador de sódio-glicose 2 (iSGLT2) demonstraram benefícios metabólicos e a capacidade de retardar a progressão da DRD em diversos estudos clínicos ao longo dos anos. Estudos recentes sugerem que a atividade antidiabética também se estende à inibição da resposta inflamatória, incluindo modulação do inflamassoma NLRP3, redução de marcadores pró-inflamatórios e redução do estresse oxidativo. Aqui, avaliamos a eficácia dos iSGLT2 no tratamento da DRC e discutimos o papel da resposta inflamatória no desenvolvimento da DRD, incluindo sua relação com o inflamassoma NLRP3 e o estresse oxidativo. (DRD (DRC mundialmente funcionais imunológicos NLRP oxidativo sódioglicose sódio glicose iSGLT (iSGLT2 anos próinflamatórios pró inflamatórios Aqui (iSGLT

Abstract Diabetic kidney disease (DKD) remains the leading cause of chronic kidney disease (CKD) worldwide. The pathogenesis of DKD is influenced by functional, histopathological, and immune mechanisms, including NLRP3 inflammasome activity and oxidative stress. The sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown metabolic benefits and the ability to slow the progression of DKD in several clinical studies over the years. Recent studies suggest that the antidiabetic activity also extends to inhibition of the inflammatory response, including modulation of the NLRP3 inflammasome, reduction of pro-inflammatory markers and reduction of oxidative stress. Here we review the efficacy of SGLT2i in the treatment of CKD and discuss the role of the inflammatory response in the development of DKD, including its relationship to the NLRP3 inflammasome and oxidative stress. (DKD (CKD worldwide functional histopathological mechanisms NLRP stress sodiumglucose sodium glucose SGLTi SGLT i (SGLT2i years proinflammatory pro

Resumen Introducción: la organización mundial de la salud estima que 2000 millones de personas padecen anemia, mientras que la pre-diabetes y la diabetes afectan aproximadamente a 352 y 460 millones de personas, respectivamente. La anemia es una complicación frecuente en la diabetes mellitus (DM). Objetivo: evaluar la asociación y probabilidad de alteraciones de la hemoglobina en pre-diabéticos y diabéticos. Metodología: estudio descriptivo, retorspectivo y transversal, la población fue de 1103 pacientes (211 prediabéticos, 223 diabéticos y 669 normoglucémicos), la muestra fue el total de la población que cumplió con los criterios de inclusión y exclusión: adultos normoglucémicos y pre-diabéticos sin presencia de enfermedad aguda o crónica al momento del examen. La asociación entre variables se realizó por medio de la prueba de chi-cuadrado y la probabilidad fue determinada por la prueba de Odds Ratio. Resultados: las mujeres pre-diabéticas tuvieron una probabilidad 1.72 mayor de anemia que mujeres no diabéticas. Los hombres pre-diabéticos tuvieron una probabilidad 2.80 veces mayor de anemia que los no diabéticos. Las mujeres diabéticas tuvieron una probabilidad 2,37 más alta de tener anemia, mientras que los hombres diabéticos tuvieron una probabilidad 4,41 veces más alta que lo hombres no diabéticos de padecer anemia. Conclusiones: pacientes pre-diabéticos tienen mayor probabilidad de anemia que en no diabéticos. Es posible que la hiperglucemia persistente en pre-diabéticos se asocie a cambios en la concentración de esta hemoproteína años antes del desarrollo de diabetes por mecanismos similares, pero de forma incipiente.

Abstract Introduction: The World Health Organization estimates that 2 billion people suffer from anemia, while pre-diabetes and diabetes affect approximately 352 and 460 million people, respectively. Anemia is a frequent complication in diabetes mellitus. Objective: To evaluate the association and probability of hemoglobin alterations in pre-diabetics and diabetics. Methodology: Descriptive, retrospective and cross-sectional study, the population was 1103 patients (211 prediabetics, 223 diabetics and 669 normoglycemics), the sample was the total population that met the inclusion and exclusion criteria: normoglycemic and prediabetic adults without presence of acute or chronic disease at the time of examination. The association between variables was performed using the chi-square test and the probability was determined by the Odds Ratio test. Results: Pre-diabetic women had a 1.72 higher probability of anemia than non-diabetic women. Pre-diabetic men were 2.80 times more likely to have anemia than non-diabetics. Diabetic women were 2.37 times more likely to have anemia, while diabetic men were 4.41 times more likely than non-diabetic men to have anemia. Conclusions: Pre-diabetic patients are more likely to have anemia than non-diabetics. It is possible that persistent hyperglycemia in pre-diabetics is associated with changes in the concentration of this hemoprotein years before the development of diabetes by similar mechanisms, but in an incipient manner.

Abstract Heart disease and diabetes are the leading causes of death in Mexico. These diseases affect not only the patient but also their environment, which includes their partners. In this context, variables such as warmth and shared empathy can influence the optimism of both members of a couple, helping them improve their physical health. Therefore, the objectives of this study were to examine the relationship between warmth and empathy in diabetic patients (A) or with heart disease (A') and the optimism of their healthy partner (B and B’ respectively) and vice versa. For this, 218 couples in which one diagnosed diabetic partner and 203 couples with a partner diagnosed with heart disease participated. The results show that there is a difference between the participants due to the characteristics of each disease, in turn, it was observed that warmth and empathy in paired patient (A and A') had a greater influence on the optimism of their healthy partner (B and B') than vice versa. Finally, it was found that warmth rather than empathy developed optimism in the participants.

Resumen En México, las cardiopatías y la diabetes son de las principales causas de muerte. Estas enfermedades no solo afectan al paciente, sino también a su entorno, incluyendo a su pareja. En este contexto, variables como la calidez y la empatía compartida pueden tener un efecto en el optimismo de los miembros de la pareja, ayudándolos a mejorar su salud física. Por ello, el objetivo de este estudio fue examinar la relación de la calidez y empatía del paciente diabético (A) o con cardiopatía (A’) con el optimismo de su pareja sana (B y B’) y viceversa. Para ello, participaron 218 parejas donde uno de los miembros tuviera diabetes, y 203 parejas con un miembro diagnosticado con alguna cardiopatía. Los resultados demuestran que existe una diferencia entre los participantes debido a las características de cada enfermedad; a su vez, se observó que la calidez y la empatía del paciente (A y A’) influyen más en el optimismo de su pareja sana (B y B’) que a la inversa. Por último, se encontró que la calidez, más que la empatía, desarrolló optimismo en los participantes.

Resumo O acúmulo de produtos finais de glicação avançada (AGEs, do inglês advanced glycation end-products) provoca comprometimento morfofuncional dos rins. Os níveis de AGEs podem ser estimados de forma não invasiva por autofluorescência da pele (sAF). Exploramos se a sAF elevada prediz desfechos renais em indivíduos com diabetes tipo 2 (DT2). O estudo foi realizado como uma análise predefinida do Estudo Brasileiro sobre Diabetes, uma coorte prospectiva de centro único de adultos com DT2. Foram considerados os dados de 155 indivíduos acompanhados por até 1.716 dias. A incidência de eventos renais adversos maiores (MAKE, por sua sigla em inglês) foi de 9,6%. Indivíduos com sAF acima da mediana apresentaram maior incidência de MAKEs (4,6% vs. 21%; p = 0,002), com HR de 3,39 [IC 95%: 1,06–10,85; p = 0,040] após ajuste por idade e sexo. A alteração média da TFGe ajustada foi de 1,08 unidades (EP: 1,15; IC95%: –1,20, 3,37) no grupo de baixa sAF e de –5,19 unidades [EP: 1,93; IC95%: –9,10, –1,29] no grupo de elevada sAF (diferença entre sujeitos: F: 5,62; p = 0,019). O grupo sAF elevada apresentou maior prevalência de declínio rápido em comparação ao grupo sAF baixa (36,7% vs. 15,8%; p = 0,028). Em conclusão, a sAF elevada foi relacionada ao aumento da incidência de MAKEs e ao declínio mais rápido da TFGe entre indivíduos com DT2. Tal fato deve ser considerado pelos profissionais de saúde ao identificar indivíduos mais propensos a complicações renais relacionadas ao diabetes. AGEs, (AGEs endproducts end products end-products rins sAF. . (sAF) DT2 DT (DT2) Diabetes 15 1716 1 716 1.71 dias MAKE, MAKE (MAKE 96 9 6 9,6% 4,6% 46 4 (4,6 vs 21% 21 0,002, 0002 0,002 , 0 002 0,002) 339 3 39 3,3 IC 95% 95 1,06–10,85 1061085 06 10 85 0,040 0040 040 sexo 108 08 1,0 EP (EP 1,15 115 IC95% IC95 120 20 –1,20 3,37 337 37 519 5 19 –5,1 [EP 1,93 193 93 910 –9,10 –1,29 129 29 diferença sujeitos F 5,62 562 62 0,019. 0019 0,019 019 0,019) 36,7% 367 36 7 (36,7 15,8% 158 8 0,028. 0028 0,028 028 0,028) conclusão (sAF (DT2 171 71 1.7 9,6 4,6 (4, 000 0,00 00 33 3, 1,06–10,8 106108 0,04 004 04 1, 1,1 11 IC9 12 –1,2 51 –5, 1,9 91 –9,1 5,6 56 001 0,01 01 36,7 (36, 15,8 0,02 02 (DT 17 1. 9, 4, (4 0,0 1,06–10, 10610 –1, –5 –9, 5, 36, (36 15, ( 0, 1,06–10 1061 –1 – –9 (3 1,06–1 106 1,06– 1,06

Abstract The accumulation of advanced glycation end-products (AGEs) elicits morphofunctional kidney impairment. AGEs levels can be noninvasively estimated by skin autofluorescence (SAF). We explored whether high SAF predicts kidney outcomes in type 2 diabetes (T2D) individuals. The study was conducted as a predefined analysis of the Brazilian Diabetes Study, a prospective single-center cohort of T2D adults. Data from 155 individuals followed for up to 1716 days were considered. The incidence of major adverse kidney events (MAKE) was 9.6%. Individuals with above-median SAF had a higher incidence of MAKEs (4.6% vs. 21%; p = 0.002), with an HR of 3.39 [95% CI: 1.06–10.85; p = 0.040] after adjustment by age and gender. The mean adjusted eGFR change was 1.08 units (SE: 1.15; 95%CI: –1.20, 3.37) in the low SAF and –5.19 units [SE: 1.93; 95%CI: –9.10, –1.29] in the high SAF groups (between-subject difference: F: 5.62, p = 0.019). The high-SAF group had a greater prevalence of rapid decliners than the low-SAF group (36.7% vs. 15.8%; p = 0.028). In conclusion, high SAF was related to increased incidence of MAKEs and faster decline in eGFR among T2D subjects. This should be considered by healthcare providers when identifying individuals more prone to diabetes-related kidney complications. endproducts end products (AGEs impairment SAF. . (SAF) TD T D (T2D Study singlecenter single center adults 15 171 MAKE (MAKE 96 9 6 9.6% abovemedian above median 4.6% 46 4 (4.6 vs 21% 21 0.002, 0002 0.002 , 0 002 0.002) 339 3 39 3.3 95% 95 [95 CI 1.06–10.85 1061085 1 06 10 85 0.040 0040 040 gender 108 08 1.0 SE (SE 1.15 115 95%CI 95CI 120 20 –1.20 3.37 337 37 519 5 19 –5.1 [SE 1.93 193 93 910 –9.10 –1.29 129 29 betweensubject between subject difference F 562 62 5.62 0.019. 0019 0.019 019 0.019) highSAF lowSAF 36.7% 367 36 7 (36.7 15.8% 158 8 0.028. 0028 0.028 028 0.028) conclusion subjects diabetesrelated complications (SAF 17 9.6 4.6 (4. 000 0.00 00 33 3. [9 1.06–10.8 106108 0.04 004 04 1. 1.1 11 12 –1.2 51 –5. 1.9 91 –9.1 56 5.6 001 0.01 01 36.7 (36. 15.8 0.02 02 9. 4. (4 0.0 [ 1.06–10. 10610 –1. –5 –9. 5. 36. (36 15. ( 0. 1.06–10 1061 –1 – –9 (3 1.06–1 106 1.06– 1.06

Resumo Introdução: Disfunção erétil (DE) é um problema sexual comum entre homens com doença renal crônica (DRC). A gravidade da disfunção sexual tende a piorar com a lesão renal. Este estudo tem como objetivo avaliar função erétil e qualidade de vida sexual de pacientes homens adultos com DRC em hemodiálise (HD) em um hospital na Amazônia brasileira. Métodos: Realizou-se estudo quantitativo transversal no Setor de HD da Unidade de Nefrologia, incluindo homens com DRC ≥ 18 anos, submetidos a ≥ 3 sessões semanais de HD por ≥ 3 meses e sexualmente ativos por ≥ 6 meses. Utilizamos o Quociente Sexual Masculino (QSM) para medir satisfação sexual e o Índice Internacional de Função Erétil (IIEF5) para estabelecer função erétil. A análise estatística foi realizada com o SPSS 21.0 usando testes apropriados, como Mann-Whitney e Kruskal-Wallis (P < 0,05). Resultados: Avaliamos 98 pacientes (51,68 ± 15,28 anos). Eles eram predominantemente casados/ou vivendo com um(a) parceiro(a) (60,20%), com tempo de HD entre 1 e 5 anos (55,10%) e KTV médio de 1,17. A prevalência de DE foi 66,30% e foi associada a maior faixa etária (p = 0,01), menor renda familiar (p = 0,02), diabetes (p = 0,01), menor hemoglobina corpuscular média (p = 0,04), maior cálcio total (p = 0,04) e menor albumina (p = 0,03). Aproximadamente 75% classificaram sua vida sexual como regular a excelente. Conclusão: Apesar da elevada prevalência de DE, a maioria dos homens com DRC em HD relatou vida sexual regular a excelente. O estudo ressalta a importância de estabelecer triagem eficaz e realizar avaliações de rotina sobre questões sexuais nesses homens. Introdução (DE DRC. . (DRC) (HD brasileira Métodos Realizouse Realizou se Nefrologia QSM (QSM IIEF5 IIEF (IIEF5 210 21 0 21. apropriados MannWhitney Mann Whitney KruskalWallis Kruskal Wallis P 0,05. 005 0,05 05 0,05) Resultados 9 51,68 5168 51 68 (51,6 1528 15 28 15,2 anos. anos) casadosou casados ou uma um(a parceiroa parceiro parceiro(a 60,20%, 6020 60,20% , 60 20 (60,20%) 55,10% 5510 55 10 (55,10% 117 17 1,17 6630 66 30 66,30 p 0,01, 001 0,01 01 0,01) 0,02, 002 0,02 02 0,02) 0,04, 004 0,04 04 0,03. 003 0,03 03 0,03) 75 excelente Conclusão (DRC (IIEF 2 00 0,0 51,6 516 (51, 152 15, 602 60,20 (60,20% 55,10 551 (55,10 11 1,1 663 66,3 7 0, 51, (51 60,2 (60,20 55,1 (55,1 1, 66, (5 60, (60,2 55, (55, ( (60, (55 (60 (6

Abstract Introduction: Erectile dysfunction (ED) is a common sexual problem among men with chronic kidney disease (CKD). The severity of sexual dysfunction tends to worsen with kidney damage. This study aims to evaluate the erectile function and sexual quality of life of adult male CKD patients undergoing hemodialysis (HD) in a hospital located in the Brazilian Amazon. Methods: A cross-sectional quantitative study was performed within the HD Sector of the Nephrology Unit including men with CKD aged ≥ 18 years, undergoing ≥ 3 weekly HD sessions for ≥ 3 months who had been sexually active for ≥ 6 months. We used the Male Sexual Quotient (MSQ) to measure sexual satisfaction and the International Index of Erectile Function (IIEF5) to establish erectile function. Statistical analysis was performed with SPSS 21.0 using appropriate tests, such as Mann-Whitney and Kruskal-Wallis (P < 0.05). Results: Ninety-eight patients (51.68 ± 15.28 years) were evaluated. They were primarily married/or living with a partner (60.20%), with HD time between 1 to 5 years (55.10%), and an average KTV of 1.17. ED prevalence was 66.30%, and it was associated with a higher age group (p = 0.01), lower family income (p = 0.02), diabetes (p = 0.01), lower mean corpuscular hemoglobin (p = 0.04), higher total calcium (p = 0.04), and lower albumin (p = 0.03). Around 75% classified their sex life as regular to excellent. Conclusion: Despite the high ED prevalence, most men with CKD in HD reported experiencing regular to excellent sex life. The study underscores the importance of establishing effective screening and conducting routine evaluations regarding sexual issues in these men. Introduction (ED CKD. . (CKD) damage (HD Amazon Methods crosssectional cross sectional MSQ (MSQ IIEF5 IIEF (IIEF5 210 21 0 21. tests MannWhitney Mann Whitney KruskalWallis Kruskal Wallis P 0.05. 005 0.05 05 0.05) Results Ninetyeight Ninety eight 51.68 5168 51 68 (51.6 1528 15 28 15.2 evaluated marriedor married or 60.20%, 6020 60.20% , 60 20 (60.20%) 55.10%, 5510 55.10% 55 10 (55.10%) 117 17 1.17 6630 66 30 66.30% p 0.01, 001 0.01 01 0.01) 0.02, 002 0.02 02 0.02) 0.04, 004 0.04 04 0.04) 0.03. 003 0.03 03 0.03) 75 Conclusion (CKD (IIEF 2 00 0.0 51.6 516 (51. 152 15. 602 60.20 (60.20% 551 55.10 (55.10% 11 1.1 663 66.30 7 0. 51. (51 60.2 (60.20 55.1 (55.10 1. 66.3 (5 60. (60.2 55. (55.1 66. ( (60. (55. (60 (55 (6

Resumo Os agonistas do receptor de GLP1 (GLP1-RAs) são medicamentos que imitam os efeitos do hormônio incretínico GLP1. Eles foram inicialmente introduzidos na medicina para o tratamento do diabetes em 2005 e para a obesidade em 2014. Com o passar do tempo, dados provenientes de objetivos secundários e exploratórios de amplos ensaios clínicos randomizados sugeriram que os GLP1-RAs também poderiam exercer ação renal ao retardar a progressão da doença renal em pacientes com e sem diabetes. Com base nesse raciocínio, o estudo Flow (semaglutida 1 mg vs. placebo) foi desenhado e o recrutamento começou em 2019, estendendo-se até maio de 2021. Os resultados publicados recentemente confirmaram o efeito da semaglutida na redução do desfecho renal composto. No entanto, assim como os inibidores do SGLT2, os mecanismos potenciais por trás dos efeitos renais dos GLP1-RAs ainda precisam ser elucidados. O objetivo desta revisão é abordar os diferentes mecanismos fisiológicos dos GLP1-RAs em nível renal, utilizando evidências de estudos experimentais e da literatura científica atual. GLP GLP1RAs GLPRAs RAs (GLP1-RAs 200 2014 tempo raciocínio vs placebo 2019 estendendose estendendo se 2021 composto entanto SGLT2 SGLT elucidados atual 20 201 202 2

Abstract GLP1 receptor agonists (GLP1-RAs) are drugs that mimic the effects of the incretin hormone GLP1 and were initially introduced in medicine for the treatment of diabetes in 2005 and for obesity in 2014. Over time, data from secondary and exploratory objectives of large randomized controlled-trials suggested that GLP1-RAs could also exert renal action by slowing the progression of kidney disease in patients with and without diabetes. Based on this rationale, the Flow study (1 mg semaglutide vs placebo) was designed and recruitment began in 2019 until May 2021. The recently published results confirmed the effect of semaglutide in reducing the composite renal outcome. However, similar to SGLT2 inhibitors, the potential mechanisms behind the renal effects of GLP1-RAs still need to be elucidated. The aim of this review is to address the different physiological mechanisms of GLP1-RAs at the renal level, using evidence from experimental studies and current scientific literature. GLP GLP1RAs GLPRAs RAs (GLP1-RAs 200 2014 time controlledtrials controlled trials rationale 1 ( placebo 201 2021 outcome However SGLT inhibitors elucidated level literature 20 202 2

Abstract Background: Tillandsia recurvata collected in San Luis Potosí does not have studies focused on its use as an adjuvant in treating diabetes mellitus. Questions and / or Hypotheses: Will Tillandsia recurvata L. (Bromeliaceae) have antidiabetic activity in vitro and in vivo? Studied species: Tillandsia recurvata L. (Bromeliaceae) Study site and dates: T. recurvata was collected in Guadalcázar municipality, San Luis Potosí, Mexico, in December 2021. Methods: The antidiabetic potential of Tillandsia recurvata methanol extract (TRM) was evaluated using in vitro and in vivo models, and its secondary metabolite content was analyzed using Gas chromatography-mass spectrometry. Results: Results demonstrate that extract reduces blood glucose, triglyceride, and cholesterol levels in vivo. In addition, in vitro tests showed that extract diminished the formation of advanced glycation end products, methylglyoxal concentrations, and glycosylated hemoglobin levels. Gas chromatography-mass spectrometry analysis identified several compounds in the extract, including 2-methylbenzaldehyde, 4-hydroxy-2-methylacetophenone, 3',5' dimethoxyacetophenone, pentanoic acid, palmitic acid, linoleic acid, phytol, margaric acid, oleamide, cis-11-eicosenamide, stearic acid, 13-docosenamide, (Z), campesterol, and β-sitosterol. Conclusions: These results highlight the potential of T. recurvata collected in San Luis Potosi as an adjuvant in treatment of diabetes mellitus.

Resumen Antecedentes: Tillandsia recurvata colectada en San Luis Potosí, no cuenta con estudios enfocados a su uso como coadyuvante en el tratamiento de la diabetes mellitus. Preguntas y / o Hipótesis: ¿Tillandsia recurvata L. (Bromeliaceae), tendrá actividad antidiabética in vitro e in vivo? Especies de estudio: Tillandsia recurvata L. (Bromeliaceae) Sitio y años de estudio: T. recurvata fue colectada en el municipio de Guadalcazar, San Luis Potosí, México, en diciembre 2021. Métodos: Se evaluó el potencial antidiabético del extracto de metanol de Tillandsia recurvata (TRM) en modelos in vitro e in vivo y se realizó un perfilamiento de los metabolitos secundarios presentes mediante cromatografía de gases acoplada a espectrometría de masas. Resultados: Los resultados demuestran que el extracto reduce eficazmente los niveles de glucosa, triglicéridos y colesterol en sangre in vivo. Además, las pruebas in vitro indican que el extracto reduce la formación de productos finales de glicación avanzada, así como la concentración de metilglioxal y los niveles de hemoglobina glicosilada. El análisis por cromatografía de gases acoplada a espectrometría de masas identificó varios compuestos presentes en el extracto, incluidos: 2-metilbenzaldehído, 4-hidroxi-2-metilacetofenona, 3',5'-dimetoxiacetofenona, ácido pentanóico, ácido palmítico, ácido linoleico, fitol, ácido margárico, oleamida, cis- 11-Eicosenamida, ácido esteárico, 13-Docosenamida, (Z), campesterol y β-sitosterol. Conclusiones: Los resultados obtenidos resaltan el potencial de T. recurvata recolectada en San Luis Potosí como coadyuvante en el tratamiento de la diabetes mellitus, debido a sus propiedades antidiabéticas.

SUMMARY: Exercise and anabolic steroids are expected to promote improvements in cardiovascular structure and reduction of visceral fat and, thus, help promote health in hyperglycemic patients. The aim of this study was to verify the influence of aerobic exercise associated with the use of steroids on cardiac structure and visceral fat in hyperglycemic Wistar rats. Methods: Thirty-two young male Wistar rats were divided into four groups: control group (n=8), control with treatment (n=8), diabetic (n=8) and diabetic with treatment (n=8). All animals were subjected to intense aerobic exercise and the animals undergoing treatment received intramuscular testosterone. Body weight, visceral fat and cardiac measurements (weight, length and width) were evaluated. The groups treated with testosterone showed a smaller than expected increase in body weight for food intake. Visceral, perirenal, retroperitoneal and epididymal fats were lower in the treated groups. Heart weight was relatively greater in the treated groups and greater width and length in the untreated groups. The proposed association of testosterone administration with aerobic exercise can provide significant benefits for the metabolism of hyperglycemic individuals.

RESUMEN: Se supone que el ejercicio y los esteroides anabólicos promuevan la mejora de la estructura cardiovascular y la reducción de la grasa visceral y, por tanto, ayuden a promover la salud en pacientes hiperglucémicos. El objetivo de este trabajo fue verificar la influencia del ejercicio aeróbico asociado al uso de esteroides sobre la estructura cardíaca y la grasa visceral en ratas Wistar hiperglucémicas. Treinta y dos ratas Wistar machos jóvenes se dividieron en cuatro grupos: grupo control (n=8), control con tratamiento (n=8), diabético (n=8) y diabético con tratamiento (n=8). Todos los animales se sometieron a ejercicio aeróbico intenso y los animales en tratamiento recibieron testosterona intramuscular. Se evaluaron el peso corporal, la grasa visceral y las medidas del corazón (peso, largo y ancho). Los grupos tratados con testosterona mostraron un aumento menor de lo esperado en el peso corporal según la ingesta dietética. Las grasas visceral, perirrenal, retroperitoneal y epididimaria fueron menores en los grupos tratados. El peso del corazón fue relativamente mayor en los grupos tratados y el mayor ancho y largo en los grupos no tratados. La asociación propuesta de la administración de testosterona con el ejercicio aeróbico puede proporcionar beneficios significativos para el metabolismo de los individuos hiperglucémicos.