Background. Lipoprotein(a) [Lp(a)] is a known risk factor for cardiovascular disease, yet its influence on metabolic syndrome (MS) is still controversial. The purpose of this study was to assess the impact generated by this diagnosis in serum Lp(a) concentrations. Materials and Methods. A total of 1807 subjects of both genders (55.3% women and 44.7% men) belonging to the Maracaibo City Metabolic Syndrome Prevalence Study were evaluated. Results were expressed as Mean ± SD, determining differences through Student's t-test and One-Way ANOVA test. Multiple logistic regression models were utilized for analyzing factors associated with elevated serum Lp(a) levels and MS. Total cholesterol and LDL-C were corrected according to Lp(a)-Cholesterol when necessary. Results. No differences were found in Lp(a) values between genders; P = 0,292. The association between MS and the classification of Lp(a) was statistically significant (χ 2 = 28.33; P < 0,0001), with greater levels in subjects with this diagnosis. In the univariate analysis, subjects with each of the separate diagnostic criteria showed higher serum Lp(a) concentrations, except for hyperglycemia. Conclusions. Lp(a) values exhibit important variations regarding MS and each of its components. Impaired fasting glucose appeared as a protecting factor against elevated Lp(a) concentrations, whereas its association with LDL-C and hs-CRP suggests a potential pro-inflammatory role.

Introduction. Insulin allergy is a rare complication of insulin therapy, especially in type 1 diabetes mellitus (T1DM). Key manifestations are hypersensitivity-related symptoms and poor metabolic control. T1DM, as well as insulin allergy, may develop in the context of autoimmune polyendocrine syndrome (APS), further complicating management. Case Report. A 17-year-old male patient, diagnosed with T1DM, was treated with various insulin therapy schemes over several months, which resulted in recurrent anaphylactoid reactions and poor glycemic control, after which he was referred to our Endocrinology and Immunology Department. A prick test was carried out for all commercially available insulin presentations and another insulin scheme was designed but proved unsuccessful. A desensitization protocol was started with Glargine alongside administration of Prednisone, which successfully induced tolerance. Observation of skin lesions typical of vitiligo prompted laboratory workup for other autoimmune disorders, which returned positive for autoimmune gastritis/pernicious anemia. These findings are compatible with APS type 4. Discussion. To our knowledge, this is the first documented case of insulin allergy in type 4 APS, as well as this particular combination in APS. Etiopathogenic components shared by insulin allergy and APS beg for further research in immunogenetics to further comprehend pathophysiologic aspects of these diseases.

Waste stabilisation ponds are an efficient means of wastewater treatment in many parts of the world wherever suitable land is available at reasonable cost and solar energy is an abundant energy resource. This study evaluated the removal of total coliforms TC, faecal coliforms FC and coliphages C in waste stabilisation ponds functioning as a pilot system in the tropical climate of Maracaibo, Venezuela. Sampling points included raw sewage and each pond effluent. Turbidity, pH and temperature were recorded. The results for raw sewage show average levels of 4.1×106 TC, 2.8×106 FC and 7.0×105 C/100mL. Temperature, pH and turbidity ranges between 26–31°C, 6.2–9.5 and 15–98 NTU respectively. Removal of microorganisms in the three systems ranged between 93–98%. Despite the high removal efficiency of microorganisms, the final effluents showed average counts of 5.4×104−1.4×105 TC, 5.2×104−1.3×105 FC and 1.6×104−4.7×104 C/100mL. This study shows that the microbiological quality of the final effluents did not achieve the WHO water quality requirement for FC (103/100mL); therefore, they cannot be used for irrigation. Additional treatments, such as slow sand filtration, are needed in order to improve the quality of the water.