Prevalence of chronic rhinosinusitis without/with nasal polyps according to severity in Spain.

BACKGROUND: The worldwide prevalence range of chronic rhinosinusitis (CRS) is 5-12%; from this, 20 % have nasal polyps. Due to the little epidemiological data about CRS in the Spanish population, this study analyses the prevalence and severity of CRS with (CRSwNP) or without (CRSsNP) nasal polyps, and their connection with other coexisting type 2 inflammatory diseases in Spain. METHODOLOGY: This is a retrospective, large-scale, nationwide, epidemiological study based on the electronic medical records from the BIG-PAC® database. Patients diagnosed of CRSsNP and CRSwNP were identified using specific disease codes. The severe form of the disease was defined as patients who received at least a long course of antibiotics in CRSsNP or ≥2 short courses of systemic corticosteroids in CRSwNP in ≤12 months during the last 2 years, and/or had previous sinus surgery. Physician-diagnosed prevalence, sociodemographic and clinical characteristics, and disease severity were assessed. RESULTS: Out of a cohort of 1,012,257 patients (≥18 years old), 42,863 and 7,550 patients with diagnosed CRSsNP and CRSwNP, respectively, were analysed. The overall prevalence of diagnosed CRS was 5.1%, being 4.3% and 0.8% for CRSsNP and CRSwNP, respectively. Patients with CRSwNP and severe forms of the disease were older and had higher levels of type 2 inflammatory biomarkers than CRSsNP patients and non-severe disease. CONCLUSIONS: Although CRSsNP was more prevalent than CRSwNP, the severe forms of CRS were more frequent in patients with CRSwNP. In addition, CRSwNP patients had a higher incidence of coexisting type 2 inflammatory diseases.

Expression of neuronal nitric oxide synthase in several cell types of the rat gastric epithelium.

The aim of this study was to identify which cell types of the rat gastric epithelium express neuronal nitric oxide synthase (nNOS) because the results of the previous studies have been very divergent regarding this point. By the combination of immunohistochemical (IHC) and in situ hybridization (ISH) techniques, we detected expression of nNOS in chief and mucosecretory cells of the gastric epithelium. Moreover, some gastric endocrine cells were immunoreactive for nNOS, although they could not be distinguished in sections treated with ISH techniques. The strongest signal for all antibodies in IHC techniques was obtained when microwave (MW) heating was performed before the IHC procedure. Our results indicate that in the gastric epithelium a variety of cell types are able to produce NO. The NO produced by the different cell types (chief, mucous, and endocrine) may form a complex network of paracrine communication with an important role in gastric physiology.

Rimonabant en el tratamiento de la diabetes tipo 2. Nuevas evidencias / Rimonabant in the treatment of diabetes type 2: new evidence

El descubrimiento de los receptores cannabinoides y de sus ligandos endógenos, los endocannabinoides, ha permitido mejorar el conocimiento de diversos procesos fisiológicos y ha abierto perspectivas terapéuticas de gran interés. Estudios recientes han esclarecido el papel crucial que desempeña el sistema endocannabinoide en el control de la ingesta alimentaria y el metabolismo a través de los receptores CB1. La activación de dichos receptores promueve la ingesta y produce una amplia gama de acciones metabólicas independientes dirigidas a obtener una acumulación de energía. Estas acciones tienen lugar en los principales órganos periféricos encargados de la regulación del metabolismo, incluyendo el tejido adiposo, el hígado, el músculo esquelético y el páncreas. Los resultados obtenidos recientemente en los diferentes ensayos clínicos realizados con rimonabant, el primer antagonista del receptor CB1, sugieren un futuro prometedor para esta nueva generación de fármacos que actúan en una diana farmacológica emergente para el tratamiento de la diabetes tipo 2 y el manejo global del conjunto de factores de riesgo cardiometabólico. Los ensayos clínicos actualmente en desarrollo permitirán determinar el alcance terapéutico a largo plazo de los efectos beneficiosos que rimonabant induce sobre el metabolismo. Esta revisión recoge los hallazgos recientes que han permitido definir el papel que desempeña el sistema endocannabinoide en el control del equilibrio energético y del metabolismo lipídico e hidrocarbonado, y expone las perspectivas terapéuticas innovadoras que se han abierto con el desarrollo de los antagonistas selectivos de los receptores cannabinoides CB1, concretamente en el paciente con diabetes tipo 2 (AU)

The discovery of the cannabinoid receptors and their endogenous ligands, the endocannabinoids, has increased the knowledge of a number of physiological processes and has opened new therapeutic perspectives of interest. Recent studies have clarified the crucial role of the endocannabinoid system in controlling food intake and metabolism by means of the CB1 receptors. CB1 receptor activation promotes food intake and produces a wide range of independent metabolic actions leading to energy accumulation. These actions take place in the major peripheral organs responsible for the regulation of metabolism, including adipose tissue, liver, skeletal muscle and pancreas. Recent findings in various clinical trials with rimonabant, the first CB1 receptor antagonist, suggest a promising future forthis new generation of drugs that act on an emerging pharmacological target for the treatment of type 2 diabetes and the overall management of all cardiometabolic risk factors. Clinical trials currently under development will determine the long-term therapeutic impact of the beneficial effects on metabolism induced by rimonabant. This review reflects the recent findings that have clarified the role of the endocannabinoid system in controlling energy balance and lipid and carbohydrate metabolism, and discusses novel therapeutic perspectives that have been introduced with the development of selective antagonists of the cannabinoid CB1 receptors, specifically in type 2 diabetic patients (AU)