Abstract-Chronic renal failure causes left ventricular hypertrophy, but the molecular mechanisms involved remain unknown. We, therefore, investigated whether the mineralocorticoid receptor is implicated in the cardiac hypertrophy observed in uremic rats and whether mineralocorticoid receptor blockade could be protective in chronic renal failure. Experimental groups were: control rats, uremic rats (NPX) with 5/6 nephrectomy (5 weeks), and NPX rats fed with spironolactone for 5 weeks. Systolic blood pressure was increased in both NPX rats and NPX rats fed with spironolactone for 5 weeks. Echocardiography revealed concentric left ventricular hypertrophy in uremia, which was attenuated by spironolactone. Enlarged cardiomyocyte size was observed in both left and right ventricles of NPX rats, an effect that was prevented by spironolactone. Mineralocorticoid receptor antagonism attenuated the increase of ventricular brain natriuretic peptide mRNA levels induced by nephrectomy. Left ventricular gene expressions of aldosterone synthase, mineralocorticoid receptor, and hydroxysteroid dehydrogenase type 2 were the same in the 3 groups, whereas gene expression of the glucocorticoid receptor was significantly diminished in chronic renal failure rats. No significant differences in cardiac aldosterone were observed between control rats and NPX rats, although NPX rats fed with spironolactone for 5 weeks showed increased plasma aldosterone levels. However, a significant increase in serum and glucocorticoid-inducible kinase-1 mRNA expression and protein was present in the NPX group; spironolactone treatment significantly reduced serum and glucocorticoid-inducible kinase-1 mRNA and protein in the left ventricle. Uremic rats exhibited a significant increase of superoxide production and reduced nicotinamide-adenine dinucleotide phosphate oxidase subunits expression (NOX-2, NOX-4, and p47 phox ) in the left ventricle, which was prevented by the mineralocorticoid receptor antagonist. Our findings provide evidence of the beneficial effects of spironolactone in cardiac hypertrophy and cardiac oxidative stress in chronic renal failure. (Hypertension. 2008;52:295-300.) Key Words: aldosterone Ⅲ mineralocorticoid receptor Ⅲ cardiac hypertrophy Ⅲ SGK1 Ⅲ oxidative stress Ⅲ hydroxysteroid dehydrogenase type 2

We assessed the effect of zinc supplementation on growth velocity in 79 children and adolescents (48 males, 38 females) with idiopathic short stature. Their height-for-age was < 5th percentile (NCHS standards) and their weight-for-age was normal. Patients were assigned randomly to a supplemented group (S) to receive Zn 10 mg/day or to a placebo (P) group, according to gender and age, and were followed-up for 12 months using a double-blind design. Weight, height, armspan, length of lower segment and plasma and hair concentrations of Zn were measured at 0, 3, 6 and 12 months. On admission and at 6 months, energy, protein, dietary fiber and zinc intakes were similar for groups S and P; mean zinc intake was < 6.5 mg/day. No differences were found in plasma zinc, hair zinc, weight, armspan or lower segment increments. Pre-adolescent males in group S had a significantly greater increase in stature compared with group P (6.2 +/- 2.1 versus 4.5 +/- 1.2 cm/year p < 0.025); z score improved from -2.42 to -2.24 in group S and from -2.63 to -2.61 in group P. For adolescent males, the difference was also significant (8.3 +/- 1.5 versus 6.2 +/- 2.1 cm/year; p < 0.025). No differences were noted in females. In Chilean male schoolchildren and adolescents with idiopathic short stature, zinc supplementation increases growth velocity over a 12-month period.

Background: The frequency of intra-amniotic infection/inflammation (IAI/I) in patients with midtrimester cervical insufficiency is up to 50%. Our purpose was to determine the perinatal outcomes of cervical cerclage in patients with acute cervical insufficiency with bulging membranes, and to compare the admission-to-delivery interval and pregnancy outcomes according to the results of amniotic fluid (AF) analysis and cerclage placement. Methods: This was a retrospective cohort study including singleton pregnancies with cervical insufficiency between 15–26.9 weeks in two tertiary health centers. IAI/I was defined when at least one of the following criteria was present in AF: a) a WBC count >50 cells/mm3; b) glucose concentration <14 mg/dl; and/or c) a Gram stain positive for bacteria. Three different groups were compared: 1) absence of IAI/I with placement of cerclage; 2) amniocentesis not performed with placement of cerclage; and 3) IAI/I with or without cerclage. Results: Seventy patients underwent an amniocentesis to rule-out IAI/I. The prevalence of IAI/I was 19%. Forty-seven patients underwent a cerclage. Patients with a cerclage had a longer median admission-to-delivery interval (33 days vs. 2 days; p<0.001) and delivered at a higher median gestational age (27.4 weeks vs. 22.6 weeks; p=0.001) than those without a cerclage. The neonatal survival rate in the cerclage group was 62% vs. 23% in those without cerclage (p=0.01). Patients without IAI/I that underwent a cerclage had a longer median admission-to-delivery interval [43 days vs. 1 day; p<0.001], delivered at a higher median gestational age (28 weeks vs. 22.1 weeks; p=0.001), and had a higher neonatal survival rate (67% vs. 8%; p<0.001) than those with IAI/I. Conclusions: The pregnancy outcomes of patients with midtrimester cervical insufficiency and bulging membranes are poor since they have a high prevalence of IAI/I. Therefore, a pre-operative amniocentesis is key to identify the best candidates for the subsequent placement of a cerclage.

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Abstract. We present a different view of secular variation of the Earth's magnetic field, through the variations in the threshold rigidity known as the variation rate of geomagnetic cutoff rigidity (VRc). As the geomagnetic cutoff rigidity (Rc) lets us differentiate between charged particle trajectories arriving at the Earth and the Earth's magnetic field, we used the VRc to look for internal variations in the latter, close to the 70 • south meridian. Due to the fact that the empirical data of total magnetic field BF and vertical magnetic field Bz obtained at Putre (OP) and Los Cerrillos (OLC) stations are consistent with the displacement of the South Atlantic magnetic anomaly (SAMA), we detected that the VRc does not fully correlate to SAMA in central Chile. Besides, the lower section of VRc seems to correlate perfectly with important geological features, like the flat slab in the active Chilean convergent margin. Based on this, we next focused our attention on the empirical variations of the vertical component of the magnetic field Bz, recorded in OP prior to the Maule earthquake in 2010, which occurred in the middle of the Chilean flat slab. We found a jump in Bz values and main frequencies from 3.510 to 5.860 µHz, in the second derivative of Bz, which corresponds to similar magnetic behavior found by other research groups, but at lower frequency ranges. Then, we extended this analysis to other relevant subduction seismic events, like Sumatra in 2004 and Tohoku in 2011, using data from the Guam station. Similar records and the main frequencies before each event were found. Thus, these results seem to show that magnetic anomalies recorded on different timescales, as VRc (decades) and Bz (days), may correlate with some geological events, as the lithosphereatmosphere-ionosphere coupling (LAIC).

BackgroundNatural disasters increase the level population stress, including pregnant women, who can experience prenatal maternal stress, affecting the fetus and triggering perinatal complications, such as low birth weight, smaller head circumference, etc. However, little is known about effects of earthquake on perinatal outcomes.ObjectiveTo evaluate the effect of earthquake occurred on February 27, 2010 and perinatal outcomes of Chilean pregnant women, and to examine these effects by timing of exposure during pregnancy and newborn gender.MethodsA register-based study was performed using data collected from women who had a vaginal delivery in a large private health center in Santiago, Chile, during 2009 and 2010. The study population was categorized according to exposure to earthquake and timing during gestation. Primary perinatal outcomes were gestational age at birth, birth weight, length and head circumference. Analyses adjusted for gender, gestational age at exposure, parity, maternal age and income.ResultsA total of 1,966 eligible vaginal deliveries occurred during 2009 and 2,110 in 2010. Birth weight was not affected by the trimester of exposure; however, length, head circumference and gestational age at birth were significantly different according to trimester of exposure and gender of newborn. In multivariable analysis, newborns were shorter by 2 mm, 5 mm and 4.5 mm, if they were exposed during their first, second and third trimester, respectively. Furthermore, newborns had a smaller head circumference by 1.2 mm and 1.5 mm if they were exposed during first and second trimester of gestation.ConclusionIn this cohort, exposure to the February 2010 earthquake resulted in earlier delivery and reduced length and head circumference in the offspring. This association varied according to trimester of exposure and fetal gender. Health workers should include exposed to high levels of stress associated with natural disasters when assessing pregnancy risk factors.

ObjectivesTo evaluate the first trimester maternal biomarkers for early pregnancy prediction of gestational diabetes mellitus (GDM).MethodsThe study was a case-control study of healthy women with singleton pregnancies at the first trimester carried out at the Obstetrics and Gynecology Unit, Clinica Davila, Santiago, Chile. After obtaining informed consent, peripheral blood samples of pregnant women under 14 weeks of gestation were collected. At 24–28 weeks of pregnancy, women were classified as GDM (n=16) or controls (n=80) based on the results of a 75-g oral glucose tolerance test (OGTT). In all women, we measured concentrations of fasting blood glucose, insulin, glycated hemoglobin, uric acid, cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), triglycerides, aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), alkaline phosphatase (AP), sex hormone-binding globulin (SHBG), adiponectin, tissue plasminogen activator (t-PA), leptin and placental growth factor (PGF).ResultsThe GDM group displayed an increased median concentration of cholesterol (P=0.04), triglycerides (P=0.003), insulin (P=0.003), t-PA (P=0.0088) and homeostatic model assessment (HOMA) (P=0.003) and an increased mean concentration of LDL (P=0.009) when compared to the control group. The receiver operating characteristic (ROC) curve for significant variables achieved an area under the curve (AUC) of 0.870, a sensitivity of 81.4% and a specificity of 80.0%. The OGTT was positive for GDM according to the IADPSG (International Diabetes in Pregnancy Study Group) criteria.ConclusionWomen who subsequently developed GDM showed higher levels of blood-borne biomarkers during the first trimester, compared to women who did not develop GDM. These data warrant validation in a larger cohort.

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