Obesity in Early Adulthood Associated With Increased Risk of Psoriatic Arthritis

For information about bariatric surgery abroad please do not hesitate to contact Sublimis Argentina.

Chicago — Among persons with psoriasis, those who reported being obese at age 18 had an increased risk of developing psoriatic arthritis, according to a report in the July 19 issue of Archives of Dermatology, one of the JAMA/Archives journals.

Psoriatic arthritis is a specific type of arthritis that develops in the joints of some patients who have psoriasis. According to background information in the article, “obesity has emerged as a significant risk factor for psoriasis,” and “psoriatic arthritis affects 6 percent to 42 percent of people with psoriasis.” Additionally, “psoriatic arthritis shares some clinical features with rheumatoid arthritis, both leading to joint destruction and significant morbidity.”

Razieh Soltani-Arabshahi, M.D., of the University of Utah School of Medicine, Salt Lake City, and colleagues studied a volunteer sample of patients with dermatologist-diagnosed psoriasis enrolled in the Utah Psoriasis Initiative from November 2002 to October 2008. Of the 943 participants, 50.2 percent were women and psoriatic arthritis was present in 26.5 percent of participants with psoriasis (250 persons).

The study found that body mass index (BMI) at age 18 was predictive of psoriatic arthritis. Other predictors included younger age at psoriasis onset, being female and having larger body surface areas affected with psoriasis. Additionally, the findings show “the obese group having an earlier onset of psoriatic arthritis, followed by the overweight group and finally the normal BMI group.” Twenty percent of the overweight or obese group developed psoriatic arthritis by age 35 years while 20 percent of those individuals in the normal BMI group developed psoriatic arthritis by age 48.

The authors conclude that their findings, “support a growing concept that patients more prone to psoriatic arthritis might benefit from more frequent and meticulous screening measures for early detection and treatment of psoriatic arthritis, i.e., before the development of irreversible joint destruction.”

Genetic Basis of Alopecia Areata Established

Among the Most Common Forms of Hair Loss, Alopecia Areata Affects 5.3 Million in U.S.

New York – A team of investigators led by Columbia University Medical Center has uncovered eight genes that underpin alopecia areata, one of the most common causes of hair loss, as reported in a paper in the July 1, 2010 issue of Nature. Since many of the genes are also implicated in other autoimmune diseases, including rheumatoid arthritis and type 1 diabetes – and treatments have already been developed that target these genes – this discovery may soon lead to new treatments for the 5.3 million Americans suffering from hair loss caused by alopecia areata.

According to the National Alopecia Areata Foundation, alopecia areata is a common autoimmune skin disease resulting in the loss of hair on the scalp and elsewhere. It affects approximately two percent of the population overall. While it affects both men and women equally, it is diagnosed more often in women, since they are more likely to seek treatment.

Among the eight genes, one stands out for its potential role in the onset of alopecia areata. The gene, called ULBP3, is known to act as a homing beacon for cytotoxic cells that can invade and quickly destroy an organ. Normally, ULBP3 is not present in hair follicles, but the ULBP3 proteins are abundant in hair follicles affected by alopecia areata. The proteins attract cells marked by a killer cell receptor, known as NKG2D. In addition to ULBP3, two other genes are expressed in the hair follicle, while the five remaining genes are involved in the immune response.

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CNN’s Brian Byrnes explains why Argentina has become a magnet for cosmetic surgery tourism.

In August, James Brandon traveled 5500 miles (8,800 kilometers) south from Toronto to Buenos Aires for liposuction, a nose job and eye lift — all at a fraction of Canadian costs.

“For what I’m getting done probably, it would have cost me about $50,000 dollars back home and here [in Argentina] it’s about $10,000 or $11,000,” he said.

Source: CNN

Oocytes Cryopreserved as good as Fresh Oocytes

On-going pregnancy rates from vitrified eggs as good as those from fresh, finds randomised trial

Rome, Italy – Embryos derived from oocytes (eggs) cryopreserved by the vitrification method are just as likely to produce an on-going pregnancy as those involving fresh oocytes, the 26th annual meeting of the European Society of Human Reproduction and Embryology heard today. Dr. Ana Cobo, Cryobiology Unit director at Institut Universitari – IVI Valencia, Valencia, Spain, told delegates that the results of her team’s research would make egg donation both easier and safer in the future.

The scientists carried out a randomised clinical trial involving 600 recipients of either freshly-harvested oocytes or those preserved by the vitrification method, where oocytes are flash-frozen after the extraction of water, hence avoiding ice formation. Analysis of the results found that the on-going pregnancy rate in women who had received vitrified oocytes was 43.7% as opposed to 41.7% in the fresh oocyte group. The proportion of top-quality embryos was similar between the two groups, and there was also no difference in age or other demographic characteristics and the incidence of male factor infertility.

“Because we were able to show that there were no differences between the two groups before embryo implantation,” said Dr. Cobo, “we can be certain that the on-going pregnancy rates in both groups were not influenced by any factor other than the method of oocyte preservation. Although there has been considerable circumstantial evidence that cryopreservation by the vitrification method produces results as good as those with freshly-harvested oocytes, until this trial there was still a lack of large randomly-controlled studies in the field.”

The researchers say that their results will have a significant effect on the practice of egg-banking in the future. “Many patients will be able to benefit,” said Dr. Cobo. “For example, there are cancer patients who will be able to preserve their fertility before undergoing treatment that can make them sterile, patients who would be at risk of ovarian hyperstimulation, and those where a semen sample is not immediately available.”

Once an egg donor is recruited and screened she undergoes ovarian stimulation to produce a number of oocytes, which are then retrieved. The oocytes then need to be fertilised by the sperm of the male partner of the recipient and the best embryos thus produced are placed in the uterus of the recipient, whose uterine lining has been previously prepared to be ready to receive the embryo.

When using fresh oocytes, the need for synchronisation of all these procedures is paramount, but not always possible. Egg banking precludes the need to synchronise these timings, which can also be the cause of long delays

“As well as being able to shorten or even eliminate the current long waiting lists, egg banking also offers a safer donation process because it allows oocytes to be quarantined while the absence of any contagious disease in the donor is confirmed,” said Dr. Cobo. “Until now we have been unable to do this with any certainty.”

The scientists now intend to continue their research by following up the progress of babies born after oocyte vitrification. “We need to ascertain that there are no adverse effects on children conceived from cryopreserved oocytes,” said Dr. Cobo, “so we will compare obstetric and neonatal data from babies born after oocyte vitrification with those resulting from the replacement of embryos originating from fresh oocytes. Having made sure that the pregnancies are safe, it is important to ensure that pregnancy outcomes are also free from harm.”

Estudios muestran la actitud de las mujeres ante la congelación “social” de sus ovocitos

Estudios sobre la actitud de las mujeres ante la congelación “social” de sus ovocitos indican que las mujeres trabajadoras anteponen su carrera a la maternidad, mientras que las mujeres más mayores siguen esperando al hombre ideal.

Roma, Italia – Las mujeres de diferentes edades tienen motivos distintos para desear congelar sus ovocitos, según indican dos estudios presentados hoy (lunes) ante la 26ª Conferencia Anual de la Sociedad Europea de Reproducción Humana y Embriología. Un gran número de estudiantes universitarias estarían dispuestas a someterse a la congelación de ovocitos en un intento por combinar el éxito profesional con la maternidad, dice la Dra. Srilatha Gorthi, investigadora del Centro de Medicina Reproductiva de Leeds, Reino Unido, y añade que los resultados de la investigación realizada por su equipo han subrayado la importancia de educar a las jóvenes sobre sus relojes biológicos de manera que puedan tomar decisiones informadas sobre su reproducción futura.

La Dra. Gorthi entrevistó a 98 estudiantes de medicina (grupo A) y a 97 estudiantes de educación y deporte (grupo B) de la Universidad de Leeds. Se les facilitó información sobre la congelación de ovocitos, incluido el hecho de que deberían financiar ellas mismas la congelación de sus ovocitos. El promedio de edad era de 21 años, con edades que iban de los 18 a los 30 años en ambos grupos. El 63,3% de las estudiantes de medicina no tenía una relación en ese momento, frente a un 25,8% del grupo B, lo cual probablemente refleje el nivel de compromiso y de tiempo necesario para cursar sus estudios respectivos.

Mientras que el 85,7% de las mujeres del grupo A afirmaron que estarían dispuestas a aplazar la formación de una familia, sólo un 49,5% del grupo B dijo que lo consideraría. Ocho de cada diez mujeres del grupo A dijeron que se someterían a la extracción y congelación de ovocitos, frente a sólo la mitad (cuatro de cada diez) del grupo B. En el grupo A, un 85,3% estaban dispuestas a someterse a hasta tres ciclos de extracción de ovocitos para conservar un número suficiente de ellos que les ofrezca una posibilidad realista de embarazo. En cambio, la mayoría (79%) de las mujeres del grupo B que conservarían sus ovocitos dijeron estar dispuestas a someterse solamente a un único
ciclo de extracción de ovocitos.

“Las razones profesionales fueron las más citadas para retrasar la creación de una familia en el grupo A, seguidas de la estabilidad financiera y el matrimonio o una relación estable,” dice la Dra. Gorthi. “Sin embargo, en el grupo B la estabilidad financiera fue la primera razón, seguida de una relación estable, y los motivos profesionales, en último lugar. Pensamos que es la primera vez que se han estudiado de ese modo las actitudes de las jóvenes ante la congelación de ovocitos.”

La congelación de ovocitos sigue siendo una tecnología relativamente nueva; la mujer se tiene que someter a un ciclo de tratamiento de FIV, que dura de dos a cuatro semanas y conlleva ciertos riesgos: hiperestimulación ovárica, hemorragia, infección, y posible, aunque reducido, efecto sobre la fertilidad natural futura.

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Studies show Women’s attitudes to social egg freezing

Studies of women’s attitudes to ‘social egg freezing’ find that young professionals put career ahead of motherhood, while older women are still waiting for Mr. Right

Rome, Italy – Women of different ages differ in their reasons for wishing to undergo egg freezing, show two studies presented to the 26th annual meeting of the European Society of Human Reproduction and Embryology today (Monday). A large number of female university students would be prepared to undertake egg freezing in an attempt to combine career success and motherhood, said Dr. Srilatha Gorthi, a research fellow at the Leeds Centre for Reproductive Medicine, Leeds, UK, adding that her team’s research emphasised the importance of educating young women about their biological clocks in order that they could take informed decisions about future reproduction.

Dr. Gorthi surveyed 98 medical students (group A) and 97 students of education and sports studies (group B) from the University of Leeds. Information regarding egg freezing was provided, including the fact that they would have to finance their own egg freezing. The average age was 21 with age range from 18-30 years in both the groups; 63.3% of the medical students were not in a relationship, as opposed to 25.8% in group B, probably reflecting the level of commitment and time needed for their courses.

While 85.7% in group A said that they would be prepared to delay starting a family, only 49.5% in group B said they would consider this. Eight out of ten from group A said they would undergo egg collection and freezing, compared with only half as many (four out of ten) from group B. In group A, 85.3% were prepared to undergo up to three cycles of egg collection to bank enough eggs to give them a realistic chance of pregnancy. In contrast, the majority (79%) of those who would bank their eggs from group B said they would be prepared to undergo only one cycle of egg collection.

“Career considerations were given as the commonest reason to delay starting a family in group A, followed by financial stability and marriage or a stable relationship,” said Dr. Gorthi. “However, in group B, financial stability came first, followed by a stable relationship and then career reasons. We think that this is the first time that young women’s attitudes to egg freezing have been studied in this way.”

Egg freezing is still a relatively new technology; a woman has to go through an IVF treatment cycle, which takes two to four weeks and carries certain risks: ovarian hyperstimulation, haemorrhage, infection and a possible, albeit small, effect on future natural fertility. Read the rest of this entry »

Bariatric Surgery in Diabetic Adults Improves Insulin Sensitivity Better than Diet

San Diego, CA — Gastric bypass surgery improves Type 2 diabetes by other mechanisms in addition to weight loss and does so better than a low-calorie diet despite achieving equal weight loss, a new study finds. The results will be presented Monday at The Endocrine Society’s 92nd Annual Meeting in San Diego.

“Our study shows that in the short term, weight loss by diet alone does not achieve the same improvements in diabetes as gastric bypass surgery,” said the presenting author, Judith Korner, MD, PhD, assistant professor of medicine at Columbia University College of Physicians and Surgeons, New York.

Korner and her colleagues found that gastric bypass surgery better improved insulin sensitivity, the body’s ability to successfully clear glucose sugar from the bloodstream into the cells. Insulin sensitivity is impaired in people with Type 2 diabetes, and obesity adds to this problem. The result is a buildup of sugar in the blood.

The study compared the effects on diabetic adults of a low-calorie diet versus Roux-en-Y gastric bypass, the most common gastric bypass procedure. Roux-en-Y gastric bypass decreases the size of the stomach and reroutes the digestive tract to bypass most of the stomach and part of the small intestine. After gastric bypass, many diabetic patients achieve normal blood glucose control or vastly improved control, and some may no longer require diabetes medications.

In the study, seven obese patients with Type 2 diabetes received a daily 800-calorie liquid diet and no surgery, while seven other obese diabetic adults underwent gastric bypass surgery. The study ended when both groups lost the same amount of weight: an average of 8 percent of body weight. However, the surgery-treated patients lost the weight faster: in about 3.5 weeks compared with 8 weeks for the dieters.

Surgical patients were able to discontinue all of their diabetes medications by the study’s end, but the dieters reduced their medication use by 55 percent, Korner reported.

The researchers found significant improvements in the surgery group in measures of insulin sensitivity and function of beta cells, the insulin-producing cells in the pancreas. Improvements in insulin sensitivity in the low-calorie diet group were not statistically significant and beta cell function improved to a lesser extent.

Korner speculated that hormonal changes may be responsible for the improvements resulting from Roux-en-Y surgery in individuals with Type 2 diabetes.

“It will be important to understand how surgery works to produce these results so that we can develop medical therapies of equivalent efficacy,” she said.

The National Institute of Diabetes and Digestive and Kidney Diseases funded this study.

For information about bariatric surgery abroad please do not hesitate to contact Sublimis Argentina.

El Dr. Juan Sánchez Pulgar se une al equipo de Sublimis

Sublimis, organización dedicada a  servicios y tratamientos médicos de alto nivel, les informa que el Doctor Juan Sánchez Pulgar, especialista en Cirugía Traumatológica y Ortopédica, se ha incorporado a nuestro equipo médico.

El Dr. Sánchez Pulgar se egresó de la Universidad Católica de Córdoba y  ejerce su profesión desde 1980. Es Miembro Titular de la Sociedad de Ortopedia y Traumatología de Córdoba desde Agosto 1985 y Miembro Titular designado por la Asociación Argentina de Ortopedia y Traumatología desde el 2001.

Además ha sido reconocido como especialista en Ortopedia y Traumatología por la Facultad de Medicina de la Universidad Nacional de Córdoba,  la Asociación Argentina de Ortopedia y Traumatología Infantil y por la Sociedad Argentina de Ortopedia y Traumatología.  También fue ganador del “Premio Anual SAMECIPP” otorgado por la Sociedad Argentina de Medicina y Cirugía del Pie y Pierna en el año 2006.

Sánchez Pulgar  participo como panelista/relator especialista en Cirugía Traumatológica y Ortopédica en conferencias en Argentina, Brasil, Chile, Colombia, Costa Rica, México, Panamá, Perú, Uruguay, Venezuela, entre otros países.