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Search Results: 1 - 10 of 1453 matches for " Celeste; Licea Puig "
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Diabetes autoinmune del adulto en diabéticos tipo 2: frecuencia y características
Cabrera-Rode,Eduardo; Perich Amador,Pedro; Díaz Horta,Oscar; Molina Matos,Gisela; Suárez Fonseca,Leonel; Tiberti,Claudio; Arranz Calzado,Celeste; Licea Puig,Manuel; Puig Domingo,Manuel; de Leiva,Alberto; Di Mario,Umberto;
Revista Cubana de Endocrinolog?-a , 2001,
Abstract: this paper was aimed at knowing the frequency, clinico-biochemical, immunologic and genetic characteristics of autoimmune diabetes in adults (lada) in 1 000 type 2 diabetic patients aged 35 or over with different times of duration of diabetes. glycemia, anti-pancreatic islet cell antibodies (ica), anti-gad65 antibodies, anti-ica512bdc/ia2 antibodies, anti-microsomal thyroid antibodies (amt), anti-gastric parietal antibodies (agp), antinuclear antibodies (an), microalbuminuria and peptide c during fasting were determined. these patients were surveyed and some clinical characteristics were registered. they were divided into 2 groups according to the presence of ica. all the type 2 + diabetics for anti-islet cell autoantibodies (ica and/or antigad65) were identified as lada. 3.4 % of type 2 ica + were detected. 22.0 % of type 2 ica - diabetics had anti-gad65 antibodies. it was found that type 2 ica + diabetics were younger, that their diabetes was shorter, that they had lower bmi, reduced levels of fasting peptide c, less dm2 history family (parents), lower values of diastolic and systolic arterial pressure, higher presence of anti-gad65 antibodies, amt and agp in comparison with type 2 ica - diabetics. it was observed that type 2 ica+ diabetics (lada) have specific characteristics that make them similar to type 1 diabetics, which would lead to important variations in their treatment and evolution as regards type 2 ica - diabetics. among the cuban type 2 diabetics it was detected a low frequency of ica and a high frequency of gad, which were different to those found in the caucasian populations. the anti-gad65 antibodies were higher than ica to detect lada. the clinical and immunological characteristics of these patients show the slow progression of the autoimmune destruction of b-cells with therapeutic implications.
Análogos de insulina
Licea Puig,Manuel E.;
Revista Cubana de Endocrinolog?-a , 2006,
Abstract: considerable efforts have been made to develop the ideal insulin in the treatment of diabetes mellitus (dm). the recombinant technology of deoxyribonucleic acid (dna) has allowed the development of human insulin; however, this has not totally solved the problems related to immunogenecity, among other problems. therefore, the new technologies are applied to create insulin analogues. it is our purpose to review relevant pharmacological and clinical aspects related to the insulin analogues, as well as their usefulness in the treatment of dm. the insulin analogues result from biochemical modifications of human insulin. these modifications of the insulin molecule alter not only the absorption, but also the beginning and duration of the action, which offer advantages over the conventional insulins. at present, there are three rapid acting insulin analogues: insulin lispro, insulin aspart and glulisine; and three long acting analogues; glargine, detemir and albulin. albulin is the latest long acting analogue reported. at present, it is being subjected to various in vitro and in vivo studies. besides, there have been developed diverse formulations where the rapid acting insulin analogues are premixed with the long acting analogues. the rapid acting insulin analogues have showed a modest global benefit against the conventional insulins in type 1 diabetics. the long acting analogues focus their attention in those persons with dm with nocturnal hypoglycemic episodes. longer term studies are necessary to confirm the safety and benefits of these preparations, as well as to determine their effect on the micro- and macroangiopathic complications of dm.
Análogos de insulina Insulin analogues
Manuel E. Licea Puig
Revista Cubana de Endocrinología , 2006,
Abstract: Se han realizado considerables esfuerzos para desarrollar la insulina, ideal en el tratamiento de la diabetes mellitus (DM). La tecnología recombinante del ácido desoxiribonucleico (ADN) ha permitido el desarrollo de la insulina humana; sin embargo, esta no ha resuelto totalmente los problemas relacionados con la inmunogenicidad, entre otros problemas. Por tanto, las nuevas tecnologías son aplicadas para crear los análogos de insulina. Este trabajo se propone como objetivos revisar aspectos farmacológicos y clínicos relevantes, relacionados con los análogos de insulina, así como su utilidad en el tratamiento de la DM. Los análogos de insulina surgen de modificaciones bioquímicas de la insulina humana. Estas modificaciones de la molécula de insulina alteran tanto la absorción como el inicio y la duración de la acción, lo que ofrece ventajas sobre las insulinas convencionales. En la actualidad se dispone de tres análogos de insulina de acción rápida: la insulina lispro, la aspártica y la glulisina, y de tres análogos de acción prolongada: la insulina glargina, detemir y el albulin. El albulin es el último análogo de acción prolongada comunicado, el cual se está sometiendo actualmente a variados estudios in vitro y en vivo. Además, se han desarrollado diversas formulaciones donde están premezclados los análogos de insulina de acción rápida con análogos de acción prolongada. Los análogos de insulina de acción rápida han demostrado un modesto beneficio global frente a las insulinas convencionales en los diabéticos tipo 1. Los análogos de acción prolongada centran su atención en las personas con DM con episodios hipoglucémicos nocturnos. Se necesitan estudios a más largo plazo para confirmar la seguridad y los beneficios de estos preparados, así como precisar su efecto sobre las complicaciones micro y macroangiopáticas de la DM. Considerable efforts have been made to develop the ideal insulin in the treatment of diabetes mellitus (DM). The recombinant technology of deoxyribonucleic acid (DNA) has allowed the development of human insulin; however, this has not totally solved the problems related to immunogenecity, among other problems. Therefore, the new technologies are applied to create insulin analogues. It is our purpose to review relevant pharmacological and clinical aspects related to the insulin analogues, as well as their usefulness in the treatment of DM. The insulin analogues result from biochemical modifications of human insulin. These modifications of the insulin molecule alter not only the absorption, but also the beginning and duration of the acti
Nueva definición, prevalencia, caracterización y tratamiento de la diabetes autoinmune latente del adulto
Cabrera Rode,Eduardo; Licea Puig,Manuel E;
Revista Cubana de Endocrinolog?-a , 2008,
Abstract: latent autoimmune diabetes of adult is a way of autoimmune diabetes present in some subjects erroneously classified as type 2 diabetics. progression of autoimmune damage of ? cells in this entity is slower than in children presenting with type 1 diabetes. at diagnosis, persons affected by this condition, have a greater preservation of ? cells function than those presenting with the classic type 1 diabetes. their present diagnosis is based on 3 features: age similar o greater than 30 years (however, it may be present in subjects in ages lower than 30 years); presence of at least 1 of the 5 antibodies to pancreatic antigens of islet-cells (anti-islet [ai] auto-antibodies, anti-descarboxylase of glutamic acid [agad], antibodies to phosphatase tyrosine [aia2], and to zinc-cation transporter within ? islet-cells [aznt8]), and the need of insulin requirements, at least 6 months after diagnosis. it is present in 10 % of subjects presenting with type 2 diabetes in 335 years, and in 25 % of those younger than 35 years. some genes of susceptibility for it are described, including genes hla dr3/dr4 and dqb1*0201/dqb1*0302, dqb1*0602, class i mhc related to a chain (mica), as well as class i vntr allele, among others, those similar o different of the classic type 1 diabetes or the type 2. prospective studies on function of ? cells show that subject carriers of it with multiple auto-antibodies associated to type 1 diabetes develops a failure of function above mentioned within the first 5 years of duration of diabetes, while the most of those with on agad or ica develop a failure in this function after 5 years. in these persons may to occur a failure in function of ? cells up to 12 years after diagnosis of disease, although deterioration of ? cells response to i.v. glucose or glucagon, may be detected in some subjects at diagnosis of diabetes. thus, we aren't in presence of a latent disease. there are studies suggesting that insulin-treatment is the more appropriate at diagnosis
Diabetes autoinmune latente del adulto: estamos diagnosticándola correctamente? Latent autoimmune diabetes of the adult: are we diagnosing it right?
Eduardo Cabrera Rode,Manuel E. Licea Puig
Revista Cubana de Endocrinología , 2008,
Abstract:
Nueva definición, prevalencia, caracterización y tratamiento de la diabetes autoinmune latente del adulto A new definition, prevalence, characterization, and treatment of the latent autoimmune diabetes of adult
Eduardo Cabrera Rode,Manuel E Licea Puig
Revista Cubana de Endocrinología , 2008,
Abstract: La diabetes autoinmune latente del adulto es una forma de diabetes autoinmune que está presente en algunos sujetos equívocamente clasificados como diabéticos tipo 2. La progresión del da o autoinmune de las células en esta entidad es más lenta que en los ni os con diabetes tipo 1. Las personas que la padecen, al momento del diagnóstico, presentan una mayor preservación de la función de las células que aquellos con la diabetes tipo 1 clásica. Su diagnóstico actual está basado en 3 características: edad igual o superior a 30 a os (aunque se pueda encontrar también en sujetos con edades inferiores a 30 a os); la presencia de al menos 1 de los 5 autoanticuerpos contra los antígenos pancreáticos de las células de los islotes (autoanticuerpos antiislotes [ICA], antidescarboxilasa del ácido glutámico [AGAD], anticuerpos contra la tirosina fosfatasa [AIA2] y contra el transportador del catión zinc dentro las células de los islotes [AZnT8]), y la necesidad de requerimientos de insulina, al menos 6 meses después del diagnóstico. Está presente en el 10 % de los individuos con diabetes tipo 2 con edades 335 a os y en el 25 % de los menores de 35. Se han descrito varios genes de susceptibilidad para ella, que incluyen los genes HLA DR3/DR4 y DQB1*0201/DQB1*0302, DQB1*0602, MHC clase I relacionados con la cadena A (MICA), así como del alelo VNTR clase I, entre otros, los que la asemejan o diferencian tanto de la diabetes tipo 1 clásica como de la tipo 2. Estudios prospectivos sobre la función de las células muestran que los sujetos que tienen múltiples autoanticuerpos asociados a diabetes tipo 1, desarrollan un fallo de la función de las células dentro de los primeros 5 a os de duración de la diabetes, mientras que la mayoría de aquellos con solo AGAD ó ICA desarrollan el fallo de la función de estas células después de los 5 a os. En estas personas puede ocurrir un fallo de la función de las células hasta a los 12 a os después del diagnóstico de la enfermedad, aunque el deterioro de la respuesta de las células a la glucosa intravenosa o al glucagón puede ser detectado en algunos sujetos al diagnóstico de la diabetes. Por tal razón, no estamos en presencia de una enfermedad latente. Existen varios estudios que sugieren que el tratamiento con insulina es el más indicado al momento del diagnóstico de la enfermedad para contrarrestar el da o de la función de las células . En este trabajo, se revisó lo relacionado con su definición, la genética, la presencia de autoanticuerpos antiislotes y su patogenia, así como las experiencias con la función de las células
Glucosilación no enzimática y complicaciones crónicas de la diabetes mellitus
Cruz Hernández,Jeddú; Licea Puig,Manuel Emiliano;
Revista Cubana de Endocrinolog?-a , 2010,
Abstract: introduction: hyperglycemia is nowadays considered as a fundamental pathogenic factor for development of diabetic neurovascular complications and, specifically, plays a prevailing role in phenomenon of non-enzymatic glycosylation and the formation of end-products of advanced glycosylation. objectives: to describe the mechanisms of end-products of advanced glycosylation and its relation to complications of diabetes mellitus. development: the above mentioned end-products are produced by the non-enzymatic reaction of glucose and other derivatives including glioxal, methylglioxal and 3-desoxiblucosone with amines groups of long-life proteins. the glycosylation changes the structure, the physical-chemical properties and the function of intracellular and extracellular proteins. in basal membrane of small vessels it is produced a thickening and a structure distortion provoking the elasticity of the vascular wall and its abnormal permeability to proteins (endothelial dysfunction), as well as an increase of genesis of oxygen-reactive species. the link of end-products of advanced glycosylation with its membrane receptors favor the production of cytokines and growth factors by macrophages and mesangial cells. all above mentioned favor the development of atherosclerosis. conclusions: the end-products of advanced glycosylation play a significant role in the development of microvascular and macrovascular complications in the diabetic patient. the strict metabolic control of glycemia and at present time, the pharmacologic therapeutics including agents inhibiting the formation of end-products of the advanced glycosylation have antioxidant action or are therapeutical alternatives for prevention and solution of the problem related to chronic complications of diabetes mellitus.
Papel del ejercicio físico en las personas con diabetes mellitus
Hernández Rodríguez,José; Licea Puig,Manuel Emiliano;
Revista Cubana de Endocrinolog?-a , 2010,
Abstract: introduction: physical exercise is one of the more ancient methods used in treatment of diabetes mellitus and it is one of its fundamental pillars together with dietary therapy, diabetes education and the use of normoglycemic and hypoglycemic drugs. objectives: to discuss on the more relevant features of the physical exercise role in persons presenting with diabetes mellitus. development: in cases of diabetes mellitus, the aerobic exercises are recommended, although nowadays the use of resistance exercises with small loads is not contraindicated in non-complicated diabetic patients. its systemic practice has many benefits for the diabetes mellitus patient including the improvement of metabolic control, as well as a delay in appearance of cardiovascular diseases and the improvement of wellbeing and quality of life of those practicing it. also, in non-diabetic persona it may to help to prevent the disease. exercise practice is not free from risks particularly in those with complications. the hypoglycemia is the more frequent observed complication, a situation that may be prevented adjusting the therapeutical regime (diet and drugs). the physical activity is contraindicated in the diabetic persons with decompensation because of it worsen the metabolic status. the practice of high danger sports is not recommended in diabetes mellitus patients. conclusions: the physical exercise is a fundamental pillar in treatment of diabetes mellitus even in its prevention.
Disfunción sexual eréctil y diabetes mellitus: Aspectos etiopatogénicos
Castelo Elías-Calles,Lizet; Licea Puig,Manuel E.;
Revista Cubana de Endocrinolog?-a , 2003,
Abstract: sexual erectile dysfunction is defined as the inability of man to reach and/or keep adequate erection to achieve satisfactory sexual activity. the frequency of sexual erectile dysfunction (sed) is significantly higher in the diabetic population when compared to general population. the objective of this paper is to make a literature review on this topic and diabetes mellitus that includes the following aspects: penis anatomy, clinical and physiological aspects and pathogenic mechanisms. different studies point out that prevalence of sed in persons suffering from diabetes mellitus ranges from 20 to 80 %, although this prevalence varies with the age of the patients. the prevalence of sed in subjects aged 20 to 19 years is 9% but increases up to 90 % in those who arrive at 70 years. sed is classified according to its causes into three groups: 1) organic, 2) psychogenic and 3) combined. among the most relevant pathogenic factors we may find the neurological, the vascular and the muscular factors. relaxation of smooth muscle of cavernous bodies and erection of penis depend on a complex balance of intracellular events and extracellular signals that control contraction and relaxation of the cavernous body smooth muscular cell tone. hemodynamic and electrophysiological measurements allow evaluating in an accurate way the sexual function. the therapeutic management demands the strict control of glycemic values. sed is a frequent complication in persons with diabetes mellitus. the etiology of this dysfunction is generally due to multiple causes. it is required to carry out clinical and epidemiological studies in a representative sample of the population to accurately find out the size of the problem. the early detection and adequate treatment of sexual erectile dysfunction will determine a significant improvement of the quality of life of the affected persons.
Andropausia
Licea Puig,Manuel E.; Castelo Elías-Calles,Lizet;
Revista Cubana de Endocrinolog?-a , 2006,
Abstract: the presence of andropause in man as an expression of the decline of testosterone secretion is still a topic of discussion. the usefulness of hormone replacement therapy in these persons is also a cause of controversy. a review is made of some aspects of interest related to the definition, clinical manifestations, impact in the quality of life, and treatment of andropause, which is an insidious and slow process resulting from a gradual reduction of testosterone secretion. biological, psychological, social, and environmental changes converge in this picture. andropause is accompanied with hormonal alterations that are considered as responsible for the symptoms and clinical signs. andropause has adverse effects on physical, mental and social health that bring about a deterioration of the quality of life. for some individuals, the hormone replacement therapy may revert the clinical manifestations and significantly improve the quality of life. however, other researchers discussed about the real indication of this therapeutic procedure, its advantages and disadvantages. it is concluded that the terms andropause and hormone replacement therapy are a topic of discussion nowadays, and it is necessary to conduct a long term study to accurately define its clinical picture and the advantages and disadvantages of hormone replacement therapy.
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