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Background: In Mexico less than half of the treated hypertensive patients reach blood pressure (BP) targets. Most hypertensive individuals rely on the standard medical care (SMC) to achieve the BP control goals; however, the efficacy of BP telemonitoring (BPT) to achieve BP targets has been poorly studied. Aim: To compare the efficacy of BPT versus SMC to achieve BP goals in patients with uncontrolled hypertension. Methods: A two-arm, open-label clinical trial was conducted in patients ≥18 years with uncontrolled hypertension. The participants were randomized to 2 arms (BPT vs SMC) and followed for 12 weeks. For the statistical analysis, the chi-squared test and covariance were used. Results: One hundred and seventy-eight participants were included, BPT (n = 94) and SMC (n = 84), after 12 weeks of follow up, we observed a baseline-adjusted reduction in systolic BP with both BPT (−13.5 [1.3] mmHg) and the SMC (−5.9 [1.4] mmHg; p < 0.001) but a greater decrease with BPT (p < 0.001). Likewise, we found a baseline-adjusted reduction of diastolic BP with BPT (−6.9 [0.9] mmHg) and SMC (−2.7 [0.9] mmHg) (p = 0.007) with a more significant percentage change from baseline with BPT (−6.8% [1.0] vs 2.5% [1.1]; p = 0.007). In the BPT arm, a larger proportion of patients achieved the BP target versus SMC (30.5% vs 12.8%; p = 0.005). Conclusion: BPT showed a greater proportion of patients achieving office BP control goals (<140/90 mmHg), compared to standard medical care. [ABSTRACT FROM AUTHOR]

Aim: To assess the acute effect of empagliflozin versus dapagliflozin administration on flow-mediated vasodilation in patients with type 2 diabetes mellitus., Design: A double-blind clinical trial, at the Experimental and Clinical Therapeutics Institute, University Health Sciences Center, at the Universidad de Guadalajara, in inpatients with T2D according to the 2023 ADA criteria., Methods: Thirty patients (15 males and 15 females), aged between 35 and 65 years, were included in this study, according to the 2023 ADA criteria. The eligible patients were randomly assigned to three groups: empagliflozin 25 mg once daily, dapagliflozin 10 mg once daily, or placebo once daily. Anthropometric parameters were taken using validated techniques. FMD was measured using a high-resolution semiautomatic ultrasound UNEX-EF 38G (UNEX Co., Ltd., Nagoya, Japan). Arterial tension was determined with the OMRON electronic digital sphygmomanometer (HEM 907 XL, Kyoto, Japan)., Results: The group of patients who received empagliflozin had a significantly lower baseline flow-mediated dilation (FMD) compared to the group receiving dapagliflozin ( p = 0.017); at the end of this study, the empagliflozin group achieved a comparable FMD to the dapagliflozin group ( p = 0.88)., Conclusion: After the treatment period, the empagliflozin and dapagliflozin groups achieved similar FMD, suggesting a class effect.

Cinnamomum cassia is a medicinal plant whose use has demonstrated benefits on body weight, blood pressure, glucose, and lipids. This study aimed to evaluate the effect of C. cassia on arterial stiffness and endothelial dysfunction (ED) in patients with type 2 diabetes mellitus (T2DM). A randomized, double-blind, placebo-controlled clinical trial was carried out in 18 subjects aged 40-65 years, with a diagnosis of T2DM of one year or less since diagnosis and treated with Metformin 850 mg daily. Patients were randomly assigned to receive either C. cassia or a placebo in 1000 mg capsules, thrice a day, before each meal for 12 weeks. At baseline and after 12 weeks of intervention, brachial-ankle pulse wave velocity and Flow Mediated Dilation were measured, as well as body weight, body mass index (BMI), blood pressure (BP), fasting glucose (FG), glycated hemoglobin A 1 c (HbA 1 c), total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, and very low density lipoprotein cholesterol, respectively, triglycerides, creatinine, and transaminases. The Mann-Whitney U test for differences between groups and the Wilcoxon signed-rank test for intragroup differences were used, and a P  ≤ .05 was considered statistically significant. After C. cassia administration, statistically significant reductions in body weight (81.4 ± 10.4 kg vs. 79.9 ± 9.0 kg, P  = .037), BMI (30.6 ± 4.2 kg/m 2 vs. 30.1 ± 4.2 kg/m 2 , P  = .018), and HbA 1 c (53 ± 5.4 mmol/mol vs. 45 ± 2.1 mmol/mol, P  = .036) were observed. No changes statistically significant on arterial stiffness, ED, FG, BP, and lipids were observed. C. cassia administration decreases body weight, BMI, and HbA 1 c without statistically significant changes on arterial stiffness, ED, FG, BP, and lipids. CTR Number: NCT04259606.

Aim: To determine the percentage of change and increment in glucose levels after a normal oral glucose tolerance test between 24 and 28 weeks of pregnancy., Methods: We studied 3510 pregnant women who attended their obstetric delivery at a tertiary care hospital in Guadalajara, Mexico in 2018, according to characteristics and risk 1647 (47%) patients were screened for diabetes diagnosis using the oral glucose tolerance test, 501 patients reported normal values between their 24th and 28th week of pregnancy, only 400 patients had their fasting glucose level measured on the same day of their obstetric delivery, to be compared., Results: Average age was 30 years, with an average of 25.3 weeks of pregnancy. The fasting serum glucose levels taken after 28 weeks of pregnancy and before the obstetrical delivery showed an increase of 1.1 mmol/L in women who develop gestational diabetes mellitus, in contrast to women who did not develop gestational diabetes mellitus after 28 weeks their blood glucose only increased on average 0.4 mmol/L. The incidence of gestational diabetes mellitus in the study population during 2018 was 32.7%. Patients who developed gestational diabetes mellitus after a normal oral glucose tolerance test had greater body mass index before the pregnancy and newborns had a higher weight than babies born to mothers without gestational diabetes mellitus., Conclusion: Changes in glucose levels after the oral tolerance test of normal glucose require strict monitoring, in that it was demonstrated that 3% of patients developed gestational diabetes mellitus after week 28 of gestation., (© 2022 Japan Society of Obstetrics and Gynecology.)

Netrin 1 (Ntn1) is a cell migration protein with an anti-inflammatory effect, which may play a key role in the pathological development of type 2 diabetes (T2D). In this study, we evaluate the relationships between the serum concentrations of Ntn1, glucose, and high-sensitivity C-reactive Protein (hsCRP). We carried out a cross-sectional study including 90 individuals divided into three groups (n = 30): healthy subjects, individuals with obesity without glucose alterations, and individuals with newly diagnosed T2D. Serum concentrations of Ntn1 and hs-CRP were determined by enzyme-linked immunosorbent assay (ELISA). The serum concentration of Ntn1 was higher in individuals with newly diagnosed T2D (0.33 ± 0.22 ng/mL), in comparison to healthy subjects and individuals with obesity (0.13 ± 0.06 and 0.15 ± 0.07 ng/mL, respectively). In addition, we observed a positive association between the levels of Ntn1 and hsCRP (rho = 0.443; p < 0.001) as well as with serum glucose (rho = −0.110; p = 0.05). The serum concentration of Ntn1 was higher in individuals with T2D, in comparison with the other groups in this study, and presented a positive correlation with hsCRP. Therefore, Ntn1 can be considered a promising risk biomarker and a potential therapeutic target for T2D.

One of the proposed mechanisms for the development of diabetic nephropathy (DN) is the increase of end products of advanced glycosylation (AGEs), which bind to its receptor (RAGE), favoring nephron cellular damage. An isoform of this receptor is soluble RAGE (sRAGE), which can antagonize AGE-altered intracellular signaling. It has known that green tea extract (GTE) increases the expression of sRAGE, but it is unknown whether this could improve kidney function. The objective of this study was to evaluate the effect of the administration of GTE on the concentrations of sRAGE, renal function, and metabolic profile in patients with type 2 diabetes mellitus (T2DM) and DN. A randomized, double-blinded, placebo-controlled clinical trial was carried out in 39 patients who received GTE (400 mg every 12 h) or placebo for 3 months. sRAGE levels, renal function, and metabolic parameters were determined before and after the intervention. In the GTE group, there were statistically significant increase on sRAGE (320.55 ± 157.63 pg/mL vs. 357.59 ± 144.99 pg/mL; P  = .04) and glomerular filtration rate (GFR; 66.44 ± 15.17 mL/min/1.73 m 2 vs. 71.70 ± 19.33 mL/min/1.73 m 2 ; P  = .04), and a statistically significant decrease in fasting serum glucose (7.62 ± 3.00 mmol/L vs. 5.86 ± 1.36 mmol/L; P  ≤ .01) and triacylglycerols (1.91 ± 0.76 mmol/L vs. 1.58 ± 0.69; P  = .02). Administration of GTE increases the serum concentration of sRAGE and the GFR and decreases the concentration of fasting serum glucose and triacylglycerols. The study was registered in ClinicalTrials.gov with the identifier NCT03622762.

The use of herbarium mixture has been empirical, and the properties are not yet known. The aim of this study was to evaluate the effect of oral administration of herbarium mixture ( Guazuma ulmifolia [G. ulmifolia]/Tecoma stans [T. stans] ) on metabolic profile in patients with type 2 diabetes mellitus (T2DM). A randomized, double-blind, placebo-controlled, clinical trial was carried out in 40 patients with T2DM. They were between 40 and 65 years of age, with body mass index (BMI) between 25.0 and 34.9 kg/m 2 and HbA1c >7.0%. BMI, waist circumference, fasting glucose, HbA1c, lipids, kidney, and liver function were measured. The patients were randomly assigned to receive the herbarium mixture ( G. ulmifolia/T. stans ) 400 mg before each meal, or placebo for 90 days. Herbarium mixture group showed decreased waist circumference (99 ± 14 vs. 98 ± 15 cm; P  = .019), fasting glucose (12.0 ± 5.7 vs. 10.3 ± 5.1 mM; P  = .019), and HbA1c (9.9% ± 2.7% vs. 8.9% ± 2.5%, P  = .002). In conclusion, the administration of herbarium mixture ( G. ulmifolia/T. stans ) improved the glycemic profile in patients with T2DM. ClinicalTrial registration: NCT03313856 ClinicalTrials.gov.

Type 2 diabetes mellitus (T2DM) is associated with premature atherosclerosis and arterial stiffening due to the accumulation of advanced glycation end-products in vessel walls. Green tea polyphenols are considered cardio-protective substances. In this randomised double-blind placebo-controlled trial (NCT02627898), we evaluated the effect of Green tea extract on arterial stiffness parameters, lipids, body composition and sRAGE levels. Twenty normotensive patients with T2DM treated with the standard therapy and statins, mean age 53.2 ± 9.4 years and mean BMI 30.1 ± 4.5 kg/m 2 , were randomised to receive a daily dose of 400 mg of green tea extract (polyphenols ≥90%, EGCG ≥45%) or placebo for 12 weeks. Compared to placebo, administration of green tea extract decreased central augmentation index (-3.05 ± 10.8% vs. 6.7 ± 0.1%, p  = .04). These findings suggest that green tea extract could be used as an adjunct to the standard therapy to improve arterial stiffness in T2DM.

Background A correct blood pressure (BP) measurement is essential for the diagnosis and control of high BP., Aim: To evaluate the agreement and repeatability of BP measurements with the OMRON HEM-7320-LA device compared to a mercury sphygmomanometer., Material and Methods: A cross-sectional study comparing BP measurements made by two randomly selected trained nurses and an automatic oscillometric device. The mercurial sphygmomanometer was connected to the automated device via a "T" type connector and a dual-head stethoscope was used, allowing simultaneous measurements. The results were analyzed with one-factor analysis of variance, Bland-Altman's test, repeatability coefficient (RC), and intra-class correlation coefficient (ICC)., Results: Forty-nine participants aged 56 ± 19 years were included. Nineteen had hypertension (38%). We did not observe a significant difference in either systolic (SBP) or diastolic blood pressure (DBP) pressure measurements between the observers and the device. The mean difference was -0.09 mmHg (95% confidence intervals (CI)-0.9 to 0.7) for SBP and -0.9 mmHg (95% CI -1.7 to -0.13) for DBP. The RC for SBP (6.2, 5.2 and 5.8 mmHg) and DBP (4.7, 4.2 y 5.2 mmHg) was similar between the observers and the device. The ICC for SBP was 0.990 (95% CI 0.983 to 0.995, p < 0.01) and 0.986 (95% CI 0.977 to 0.991, p < 0.01) for DBP., Conclusions: There was a high level of agreement and similar measurement repeatability in the measurements performed by the automatic device and the mercurial sphygmomanometer. No differences in BP measurements were observed.

Objective: The aim of this study was to determine the accuracy of the Omron HEM-7320-LA with Intelli Wrap technology cuff HEM-FL1 for self-measurement and clinic blood pressure (BP) measurement according to the European Society of Hypertension International Protocol revision 2010., Participants and Methods: The evaluation was performed in 39 individuals. The mean age of the participants was 47.9±14 years; systolic BP was 145.2±24.3 mmHg (range: 97-190), diastolic BP was 90.9±12.9 mmHg (range: 68-120), and arm circumference was 30.8±4 cm (range: 25-38.5)., Results: The device successfully fulfilled the established criteria of the validation protocol. The device overestimated systolic BP by 0.6±5.7 mmHg and diastolic BP by 2.2±5.1 mmHg. The specially designed cuff HEM-FL1 to cover a broad range of arm circumferences and self-placement fulfilled the requirements of the International Protocol.

Diabetic nephropathy (DN) is the leading cause of ESRD worldwide. Reduced bioavailability or uncoupling of nitric oxide in the kidney, leading to decreased intracellular levels of the nitric oxide pathway effector molecule cyclic guanosine monophosphate (cGMP), has been implicated in the progression of DN. Preclinical studies suggest that elevating the cGMP intracellular pool through inhibition of the cGMP-hydrolyzing enzyme phosphodiesterase type 5 (PDE5) might exert renoprotective effects in DN. To test this hypothesis, the novel, highly specific, and long-acting PDE5 inhibitor, PF-00489791, was assessed in a multinational, multicenter, randomized, double-blind, placebo-controlled, parallel group trial of subjects with type 2 diabetes mellitus and overt nephropathy receiving angiotensin converting enzyme inhibitor or angiotensin receptor blocker background therapy. In total, 256 subjects with an eGFR between 25 and 60 ml/min per 1.73 m 2 and macroalbuminuria defined by a urinary albumin-to-creatinine ratio >300 mg/g, were randomly assigned 3:1, respectively, to receive PF-00489791 (20 mg) or placebo orally, once daily for 12 weeks. Using the predefined primary assessment of efficacy (Bayesian analysis with informative prior), we observed a significant reduction in urinary albumin-to-creatinine ratio of 15.7% (ratio 0.843; 95% credible interval 0.73 to 0.98) in response to the 12-week treatment with PF-00489791 compared with placebo. PF-00489791 was safe and generally well tolerated in this patient population. Most common adverse events were mild in severity and included headache and upper gastrointestinal events. In conclusion, the safety and efficacy profile of PDE5 inhibitor PF-00489791 supports further investigation as a novel therapy to improve renal outcomes in DN., (Copyright © 2016 by the American Society of Nephrology.)

Objective: To investigate the effects of raloxifene on the insulin sensitivity and lipid profile in insulin-sensitive and insulin-resistant postmenopausal women., Study Design: This placebo-controlled, double-blind, randomized study involved 64 postmenopausal women aged between 45 and 55 years. All subjects were screened with the insulin resistance homeostasis model assessment (IR-HOMA) and those patients in the lowest quartile (n = 16) were assigned as insulin sensitive and those in the highest quartile as insulin resistant (n = 16). Patients in both groups received either raloxifene hydrochloride (60 mg/day) or a placebo for a period of 12 weeks. Insulin sensitivity, the serum lipid profile and anthropometric measurements were established before and after therapy., Results: Women with the highest IR-HOMA scores were associated with a significantly higher weight, body mass index, waist and waist-to-hip ratio (p < 0.05). Raloxifene significantly reduced the IR-HOMA scores from 5.76 ± 2.91 to 1.93 ± 0.96 (p = 0.02) and modified the lipid profile in insulin-resistant patients when compared with the placebo group and those patients receiving raloxifene in the insulin-sensitive group., Conclusion: Raloxifene reduced insulin resistance and modified the lipid profile in insulin-resistant postmenopausal women.

Unlabelled: The endothelium plays an integral role in the regulation of vascular tone, platelet activity, leukocyte adhesion, and thrombosis and is intimately involved in the development of atherosclerosis. Endothelial dysfunction has been observed in patients with established coronary artery disease or coronary risk factors, both in the coronary and peripheral vasculature. Therapeutic interventions with lipid-lowering drugs, ACE inhibitors, physical activity, and antioxidant agents have been shown to improve endothelial function in coronary and peripheral vessels. This systemic manifestation and improvement of endothelial function suggests that a common mechanism may contribute to endothelial dysfunction in the coronary and peripheral circulation., Target Audience: Internist, Cardiologists, Family physicians., Learning Objectives: After completion of this article, the reader should be able to define the participation of cardiovascular risk factors in the various complications associated with endothelial dysfunction.

A randomized clinical trial is a prospective experiment to compare one or more interventions against a control group, in order to determine the effectiveness of the interventions. A clinical trial may compare the value of a drug vs. placebo. It may compare surgical with medical interventions. The principles apply to any situation in which the issue of who is exposed to which condition is under the control of the experimenter, and that the method of assignment is through randomization. A negative clinical trial is that in which no significant difference is found between the comparison groups. Results without statistical difference may be useful either to discard useless treatments or to demonstrate that one intervention is as effective as the one it was compared with. Eliminating useless treatments may be adequate. However, if this is the result of studies with methodological errors, new interventions that are actually useful may not be available for patients. In this review we present some of the possible methodological errors that may lead to false negative results in clinical trials.

Unlabelled: Sildenafil citrate has shown to display beneficial cardiovascular effects, suggesting that it may have other systemic benefits involving the endothelium. There is little data regarding the long-term use of this drug and the effects of this on different organs., Objective: The primary aim of this study was to determine whether sildenafil citrate diminishes concentrations of microalbuminuria and percentage of A1c in patients with type 2 diabetes., Design: A double-blind, randomized, controlled trial in 40 male patients, age 35-50, with type 2 diabetes. Subjects received sildenafil citrate 50 mg daily (n=20) or placebo (n=20) for 30 days. Levels of hs-CRP, microalbuminuria, homocysteine, A1c and erectile function were measured at baseline and to the end of the study., Results: Men that received sildenafil citrate displayed a significant decrease in the microalbuminuria concentrations (p<0.01) versus baseline, (p=0.02) versus placebo and A1c (p<0.01) versus baseline, (p=0.01) versus placebo. In addition, we observed a significant increase in the total IIEF score after 30 days of treatment (p<0.01) versus baseline, (p<0.01) versus placebo., Conclusions: The administration of 50mg of sildenafil citrate for 30 consecutive days diminishes microalbuminuria and the percentage of A1c in patients with type 2 diabetes.

The cervical pregnancy is a rare clinical illness among the ectopic pregnancies; the diagnosis at the moment is made by means of ultrasonography, which shows an empty uterus and a gestation in cervical channel. At the moment the preservative treatment can be made with methotrexate, without determining of precise way the factors of fault for this handling, leaving the single surgical treatment in emergency situations, avoiding the uncontrollable haemorrhage. This paper reports the case of a patient with a cervical pregnancy of nine weeks, live, with initial determination of corionic gonadotrophin hormone of 68,919 mUl/mL; reason why it is decided to interrupt the gestation being applied two doses of methotrexate; first IV of 85 mg and second with intraamniotic application. The evolution of the gestation was towards the involution and absorption of the gestational coat, the sub-unit concentrations corionic gonadotrophin hormone beta presented decrement, until undetectable, with good clinical and functional results. The gestational coat was reduced, the embryo lost beat and the gonadotrophin were in decrement until zero, with clinical evolution with stained solely haematic, without haematological and functional repercussions. Criteria of fault of the preservative treatment with methotrexate are not defined, although due the peculiarity of this illness, it is not possible to make a more extensive study, but by the reproductive benefit in young patients, it would be adapted to take it in to account like option instead of the hysterectomy.

The aim of this study was to compare the serum complement C3 concentration between non-obese young insulin-sensitive and insulin-resistant Mexicans. A cross-sectional study was carried out in 28 healthy, non-obese [Body mass index (BMI) < 26 kg/m2] young (age 19-25 yr), male volunteers to measure the serum C3 concentration. In accordance with the constant for rate serum glucose disappearance (KITT) obtained from the insulin tolerance test, the subjects were divided into quartiles, considering as insulin-resistant individuals those in quartile 1, and insulin-sensitive subjects those in quartile 4. Serum C3c concentration was measured by a nephelometric method. Other biochemical characteristics were measured, like lipid profile and uric acid using enzymatic techniques. The serum C3 concentrations were similar (p = 0.949) between insulin-resistant and insulin-sensitive groups respectively (1.4 +/- 0.2 vs 1.3 +/- 0.1 g/l). There were no significant correlations between serum C3 concentrations and serum glucose, insulin levels, KITT and lipid profile. In conclusion, the serum complement C3c concentrations were similar between non-obese young insulin-sensitive and insulin-resistant Mexicans.

Background: The cardiovascular protective properties of hormone replacement therapy can be hampered when a progestin is used., Aim: To assess the effects of hormone replacement therapy with progestins on insulin sensitivity and lipid profile., Patients and Methods: Twelve healthy postmenopausal women aged 45 to 55 years old were studied. Blood lipids and insulin sensitivity, determined using the insulin tolerance test, were measured at baseline and after three months of hormone replacement therapy using conjugated estrogens, 0.625 mg/day and medroxyprogesterone acetate, 5 mg/day., Results: The glucose disappearance constant was higher after the treatment period than at baseline (5.3 +/- 0.8 and 4.7 +/- 0.8%/min respectively, p = 0.005). Serum LDL cholesterol was also lower at the end of treatment period (124.5 +/- 30.2 and 140 +/- 25.4 mg/dl respectively, p = 0.019)., Conclusions: In this group of postmenopausal women, a period of three months of hormone replacement therapy with a progestin improved insulin sensitivity and lowered LDL cholesterol levels.

The aim of this study was to compare the renal handling of uric acid by means of pyrazinamide and probenecid tests between obese and non-obese women. A cross-sectional study was carried out in 8 obese women and in 8 non-obese women as control group. Metabolic profile and renal handling of uric acid including clearance, fractional excretion and excretion rates, were assessed. Due to technical problems, pyrazinamide and probenecid tests were performed only in 5 women of each group to evaluate presecretory reabsorption, secretion and post-secretory reabsorption of uric acid. Uric acid clearance had a tendency to be lower in the obese women than in the control group. There were no significant differences between the groups in fractional excretion and excretion uric acid rates. Pre- and post-secretory reabsorptions of uric acid did not differ between the obese and the non-obese women. Tubular secretion of uric acid was significantly lower in the obese women compared with the control group (6.4 vs 13.6%; p=0.02). Tubular secretion of uric acid negatively correlated with body mass index (r=-0.73; p<0.05). In conclusion, tubular secretion of uric acid possibly plays an important role in uric acid homeostasis in obese women.

The objective was to identify the association of adiposity with the beta-cell function, insulin resistance and leptin concentrations in non-obese subjects. Twenty-eight healthy, non-obese volunteers were recruited, 14 male and 14 female. Body mass index (BMI) and waist hip ratio (WHR) were calculated. Blood pressure was measured. Adiposity was estimated by means of near-infrared (NIR) interactance method predicting the percentage of body fat (% BF). All subjects were divided into adipose and non-adipose individuals. Serum glucose, insulin and leptin levels were measured. Formulas of the homeostasis model analysis were used to assess the insulin resistance and the beta-cell function. Clinical characteristics and laboratory profile were similar between both groups. There were no significant differences between both groups in beta-cell function, insulin resistance and leptin concentrations. There was a positive significant correlation of % BF with BMI in women (r= .82, P< .001) and in men (r= .85, P< .001). Adiposity was not associated with the beta-cell function, insulin resistance and leptin concentrations in non-obese subjects, and only percent body fat was positive correlated with BMI.

The aim of the present research was to compare the uric acid, sodium and potassium excretions among patients with mild preeclampsia and normotensive pregnancy and to determine their behavior towards an acute physiologic state of hyperglycemia-hyperinsulinemia. It was carried out a cuasi-experimental study with parallel group in 25 patients with mild preeclampsia and in 25 patients with normotensive pregnancy all of them in the third trimester of gestation. The intervention consisted in administering an oral load of 50 grams of glucose in order to achieve a physiologic state of hyperglycemia-hyperinsulinemia. The seric levels of glucose, insulin, creatine, uric acid, sodium and potassium were measured, as well as the last four in urine before the oral load (with at least 6 hours fasting) and 60 minutes after the load, besides that, the urinary excretions of solutes were calculated with standard formulas. The urinary excretions of uric acid, sodium and potassium in fasting, and so after the oral glucose load were lower in the group of preeclampsia patients than in the normotensive gestation group. Upon analyzing the influence of a physiologic state of hyperglycemia-hyperinsulinemia, after the oral glucose load on determined solutes and their urinary excretion, we found that there was a significant decrease in the seric potassium level, without modifying its urinary excretion, as much as in the preeclampsia group as in the normotensive group. The seric uric acid and sodium levels diminished in the preeclampsia group and in normotensive group respectively, without modifying their urinary excretion. In conclusion, in the current study the urinary excretion of sodium, potassium and uric acid were lower in the preeclampsia patients than the women with normotensive pregnancy and a physiologic state of hyperglycemia-hyperinsulinemia didn't modify these excretions.

In developing countries, the cost of antihypertensive medications is one of the principal limiting factors when trying to treat patients with high blood pressure. To determine the changes in cost (in US dollars) of these medications and in the percentage of the minimum wage needed to purchase them, two cost studies (1990 and 1996) done in Mexico were compared. The yearly cost of a treatment with hydrochlorothiazide was US $13.80 in 1990; in 1996 it was US $10.92. Both figures represent 1.1% of the minimum wage that was in effect at the time. Propranolol hydrochloride cost US $50.52 for a year's treatment in 1990, and US $66.12 for the same in 1996. These figures represented, respectively, 4.2% and 6.7% of the minimum wage of 1990 and 1996. The annual cost for nifedipine was US $176.76 in 1990 (14.7% of the minimum wage) and US $242.16 in 1996 (24.8% of the minimum wage). The yearly cost of enalapril was US $233.04 in 1990 and US $433.20 in 1996; these costs represented, respectively, 19.4% and 44.2% of the minimum wage. The comparison of these two cost studies (1990 and 1996) shows why Mexico's population is finding it more difficult to purchase antihypertensive medications. Higher costs and reduced purchasing power seem to be the two principal factors causing this. This is probably affecting the population's health, as it is more difficult to control high blood pressure without proper treatment.