Blood methylation pattern reflects epigenetic remodelling in adipose tissue after bariatric surgery.

BACKGROUND: Studies on DNA methylation following bariatric surgery have primarily focused on blood cells, while it is unclear to which extend it may reflect DNA methylation profiles in specific metabolically relevant organs such as adipose tissue. Here, we investigated whether adipose tissue depots specific methylation changes after bariatric surgery are mirrored in blood. METHODS: Using Illumina 850K EPIC technology, we analysed genome-wide DNA methylation in paired blood, subcutaneous and omental visceral AT (SAT/OVAT) samples from nine individuals (N = 6 female) with severe obesity pre- and post-surgery. FINDINGS: The numbers and effect sizes of differentially methylated regions (DMRs) post-bariatric surgery were more pronounced in AT (SAT: 12,865 DMRs from -11.5 to 10.8%; OVAT: 14,632 DMRs from -13.7 to 12.8%) than in blood (9267 DMRs from -8.8 to 7.7%). Cross-tissue DMRs implicated immune-related genes. Among them, 49 regions could be validated with similar methylation changes in blood from independent individuals. Fourteen DMRs correlated with differentially expressed genes in AT post bariatric surgery, including downregulation of PIK3AP1 in both SAT and OVAT. DNA methylation age acceleration was significantly higher in AT compared to blood, but remained unaffected after surgery. INTERPRETATION: Concurrent methylation pattern changes in blood and AT, particularly in immune-related genes, suggest blood DNA methylation mirrors AT's inflammatory state post-bariatric surgery. FUNDING: The funding sources are listed in the Acknowledgments section.

Preliminary Evaluation of 2 Patient-Centered Educational Animations About Kidney Transplant Complications.

BACKGROUND Fear of kidney transplant complications and incomplete information can lower transplant acceptance and preparedness. Our group developed 2 patient-centered educational animated videos on common kidney transplant complications to complement a previously developed video-based curriculum intended to promote kidney transplant access. MATERIAL AND METHODS We preliminarily evaluated the 2 animated educational videos at a single center using mixed methods. We conducted a before-and-after single group study with 22 patients after kidney transplantation to measure the videos' acceptability and feasibility to improve patient knowledge, understanding, and concerns of kidney transplant complications. Concurrently, we individually interviewed 12 patients before kidney transplantation about their perceptions of the 2 videos and analyzed the data thematically. RESULTS Knowledge of kidney transplant complications increased 10% (7.82 to 8.59, P=0.002) from before to after video viewing. Large effect size increases for knowledge were found for different strata of age, race, and health literacy. The mean total score for perceived understanding of kidney transplant complications increased after video exposure by 7% (mean 2.48 to 2.66, P=0.184). There was no change in kidney transplant concern scores from before to after video viewing (mean 1.70 to 1.70, P=1.00). After video viewing, all patients reported positive ratings on comfort watching, understanding, and engaging. Three themes of patient perceptions emerged: (1) messages received as intended, (2) felt informed, and (3) scared but not deterred. CONCLUSIONS Two animated educational videos about kidney transplant complications were well received and promise to positively impact individuals' knowledge and understanding, without raising excessive concerns.

Conceptos actuales sobre intoxicación por monóxido de carbono / Current concepts on carbon monoxide poisoning

Informa sobre conceptos actuales de la fisiopatalogía y el correcto manejo terapéutico de esta emergencia toxicológica, para orientar en su asistencia y prevención. Se describen mecanismos por los que la intoxicacion por CO conduce a la hipoxia, así como su presentación clínica, histopatología, diagnóstico, tratamiento, y efectos cardiológicos