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PURPOSE: To determine whether the 30-s sit-to-stand (30STS) test can be a valid tool for estimating and stratifying peak oxygen uptake (VO2peak) and 6-min walking distance (6MWD) in women with breast cancer. METHODS: This cross-sectional study uses data from the ONCORE randomized controlled trial, including 120 women aged 18-70 years with early-stage breast cancer under treatment with anthracycline and/or anti-HER2 antibodies. Participant characteristics were collected at baseline and pooled data from functional assessment (30STS test, relative and absolute VO2peak, and 6MWD) were collected at baseline and post-intervention (comprehensive cardio-oncology rehabilitation program vs. usual care). Bivariate correlations and multivariate linear regression analyses were performed to study the relationship between functional test variables. RESULTS: The number of repetitions in the 30STS test showed (i) a moderate correlation with relative VO2peak (ml/kg/min) (r = 0.419; p < 0.001; n = 126), (ii) a weak correlation with absolute VO2peak (ml/min) (r = 0.241; p = 0.008; n = 120), and (iii) a moderate correlation with the 6MWD (r = 0.440; p < 0.001; n = 85). The ONCORE equations obtained from the multivariate regression models allowed the estimation of VO2peak and 6MWD (r2 = 0.390; r2 = 0.261, respectively) based on the 30STS test, and its stratification into tertiles (low, moderate, and high). CONCLUSION: The 30STS test was found to be a useful tool to estimate VO2peak and/or 6MWD in women with early-stage breast cancer. Its use may facilitate the assessment and stratification of functional capacity in this population for the implementation of therapeutic exercise programs if cardiopulmonary exercise testing (CPET) or 6MWT are not available. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03964142. Registered on 28 May 2019. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT03964142.
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Neoplasias de la Mama , Tolerancia al Ejercicio , Antraciclinas/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Estudios Transversales , Prueba de Esfuerzo , Femenino , Humanos , Oxígeno , Consumo de Oxígeno , CaminataRESUMEN
BACKGROUND: Anthracyclines and monoclonal antibodies against human epidermal growth factor receptor-2 (HER2) are frequently used to treat breast cancer but they are associated with risk of developing cardiotoxicity. Implementation of cardioprotective strategies as part of breast cancer treatment are needed. To date, a limited number of studies have examined the effectiveness of cardiac rehabilitation programs or exercise programs in the prevention of cardiotoxicity through an integral assessment of cardiac function. The ONCORE study proposes an exercise-based cardiac rehabilitation program as a non-pharmacological tool for the management of chemotherapy-induced cardiotoxicity. METHODS: The study protocol describes a prospective, randomized controlled trial aimed to determine whether an intervention through an exercise-based CR program can effectively prevent cardiotoxicity induced by anthracyclines and/or anti-HER2 antibodies in women with breast cancer. Three hundred and forty women with breast cancer at early stages scheduled to receive cardiotoxic chemotherapy will be randomly assigned (1:1) to participation in an exercise-based CR program (intervention group) or to usual care and physical activity recommendation (control group). Primary outcomes include changes in left ventricular ejection fraction and global longitudinal strain as markers of cardiac dysfunction assessed by transthoracic echocardiography. Secondary outcomes comprise levels of cardiovascular biomarkers and cardiopulmonary function through peak oxygen uptake determination, physical performance and psychosocial status. Supervised exercise program-related outcomes including safety, adherence/compliance, expectations and physical exercise in- and out-of-hospital are studied as exploratory outcomes. Transthoracic echocardiography, clinical test and questionnaires will be performed at the beginning and two weeks after completion of chemotherapy. DISCUSSION: The growing incidence of breast cancer and the risk of cardiotoxicity derived from cancer treatments demand adjuvant cardioprotective strategies. The proposed study may determine if an exercise-based CR program is effective in minimizing chemotherapy-induced cardiotoxicity in this population of women with early-stage breast cancer. The proposed research question is concrete, with relevant clinical implications, transferable to clinical practice and achievable with low risk. Trial registration ClinicalTrials.gov Identifier: NCT03964142. Registered on 28 May 2019. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT03964142.
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Antraciclinas/efectos adversos , Antineoplásicos Inmunológicos/efectos adversos , Neoplasias de la Mama/tratamiento farmacológico , Rehabilitación Cardiaca , Terapia por Ejercicio , Cardiopatías/prevención & control , Adolescente , Adulto , Anciano , Neoplasias de la Mama/inmunología , Neoplasias de la Mama/metabolismo , Cardiotoxicidad , Femenino , Cardiopatías/inducido químicamente , Cardiopatías/diagnóstico por imagen , Cardiopatías/fisiopatología , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , Receptor ErbB-2/antagonistas & inhibidores , Receptor ErbB-2/inmunología , Receptor ErbB-2/metabolismo , España , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: Recent evidence has shown adverse oncological outcomes when minimally invasive surgery is used in early-stage cervical cancer. The objective of this study was to compare disease-free survival in patients that had undergone radical hysterectomy and pelvic lymphadenectomy, either by laparoscopy or laparotomy. METHODS: We performed a multicenter, retrospective cohort study of patients with cervical cancer stage IA1 with lymph-vascular invasion, IA2, and IB1 (FIGO 2009 classification), between January 1, 2006 to December 31, 2017, at seven cancer centers from six countries. We included squamous, adenocarcinoma, and adenosquamous histologies. We used an inverse probability of treatment weighting based on propensity score to construct a weighted cohort of women, including predictor variables selected a priori with the possibility of confounding the relationship between the surgical approach and survival. We estimated the HR for all-cause mortality after radical hysterectomy with weighted Cox proportional hazard models. RESULTS: A total of 1379 patients were included in the final analysis, with 681 (49.4%) operated by laparoscopy and 698 (50.6%) by laparotomy. There were no differences regarding the surgical approach in the rates of positive vaginal margins, deep stromal invasion, and lymphovascular space invasion. Median follow-up was 52.1 months (range, 0.8-201.2) in the laparoscopic group and 52.6 months (range, 0.4-166.6) in the laparotomy group. Women who underwent laparoscopic radical hysterectomy had a lower rate of disease-free survival compared with the laparotomy group (4-year rate, 88.7% vs 93.0%; HR for recurrence or death from cervical cancer 1.64; 95% CI 1.09-2.46; P=0.02). In sensitivity analyzes, after adjustment for adjuvant treatment, radical hysterectomy by laparoscopy compared with laparotomy was associated with increased hazards of recurrence or death from cervical cancer (HR 1.7; 95% CI 1.13 to 2.57; P=0.01) and death for any cause (HR 2.14; 95% CI 1.05-4.37; P=0.03). CONCLUSION: In this retrospective multicenter study, laparoscopy was associated with worse disease-free survival, compared to laparotomy.
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Histerectomía/métodos , Laparoscopía/métodos , Neoplasias del Cuello Uterino/cirugía , Adulto , Estudios de Cohortes , Supervivencia sin Enfermedad , Femenino , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Retrospectivos , Resultado del Tratamiento , Neoplasias del Cuello Uterino/mortalidad , Adulto JovenRESUMEN
BACKGROUND: In general, academic but not community endoscopists have demonstrated adequate endoscopic differentiation accuracy to make the 'resect and discard' paradigm for diminutive colorectal polyps workable. Computer analysis of video could potentially eliminate the obstacle of interobserver variability in endoscopic polyp interpretation and enable widespread acceptance of 'resect and discard'. STUDY DESIGN AND METHODS: We developed an artificial intelligence (AI) model for real-time assessment of endoscopic video images of colorectal polyps. A deep convolutional neural network model was used. Only narrow band imaging video frames were used, split equally between relevant multiclasses. Unaltered videos from routine exams not specifically designed or adapted for AI classification were used to train and validate the model. The model was tested on a separate series of 125 videos of consecutively encountered diminutive polyps that were proven to be adenomas or hyperplastic polyps. RESULTS: The AI model works with a confidence mechanism and did not generate sufficient confidence to predict the histology of 19 polyps in the test set, representing 15% of the polyps. For the remaining 106 diminutive polyps, the accuracy of the model was 94% (95% CI 86% to 97%), the sensitivity for identification of adenomas was 98% (95% CI 92% to 100%), specificity was 83% (95% CI 67% to 93%), negative predictive value 97% and positive predictive value 90%. CONCLUSIONS: An AI model trained on endoscopic video can differentiate diminutive adenomas from hyperplastic polyps with high accuracy. Additional study of this programme in a live patient clinical trial setting to address resect and discard is planned.
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Pólipos Adenomatosos/diagnóstico , Pólipos del Colon/diagnóstico , Colonoscopía , Aprendizaje Profundo , Competencia Clínica , Diagnóstico Diferencial , Humanos , Imagen de Banda Estrecha/métodos , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Grabación en VideoRESUMEN
Free radicals generated within subcellular compartments damage macromolecules which lead to severe structural changes and functional alterations of cellular organelles. A manifestation of free radical injury to biological membranes is the process of lipid peroxidation, an autooxidative chain reaction in which polyunsaturated fatty acids in the membrane are the substrate. There is considerable evidence that damage to polyunsaturated fatty acids tends to reduce membrane fluidity. However, adequate levels of fluidity are essential for the proper functioning of biological membranes. Thus, there is considerable interest in antioxidant molecules which are able to stabilize membranes because of their protective effects against lipid peroxidation. Melatonin is an indoleamine that modulates a wide variety of endocrine, neural and immune functions. Over the last two decades, intensive research has proven this molecule, as well as its metabolites, to possess substantial antioxidant activity. In addition to their ability to scavenge several reactive oxygen and nitrogen species, melatonin increases the activity of the glutathione redox enzymes, that is, glutathione peroxidase and reductase, as well as other antioxidant enzymes. These beneficial effects of melatonin are more significant because of its small molecular size and its amphipathic behaviour, which facilitates ease of melatonin penetration into every subcellular compartment. In the present work, we review the current information related to the beneficial effects of melatonin in maintaining the fluidity of biological membranes against free radical attack, and further, we discuss its implications for ageing and disease.
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Melatonina/fisiología , Fluidez de la Membrana/efectos de los fármacos , Estrés Oxidativo/efectos de los fármacos , Envejecimiento/fisiología , Animales , Antioxidantes/farmacología , Radicales Libres/metabolismo , Glutatión Peroxidasa/metabolismo , Glutatión Reductasa/metabolismo , Humanos , Membrana Dobles de Lípidos/metabolismo , Peroxidación de Lípido/efectos de los fármacos , Melatonina/metabolismo , RatonesRESUMEN
Background: Current clinical guidelines on cardiovascular disease (CVD) do not specifically address the female population. The aim of this consensus is to know the opinion of a group of experts on the management of CVD in women. Methods: Through a Delphi consensus, 31 experts in cardiology, 9 in gynecology and obstetrics, and 14 primary care physicians, showed their degree of agreement on 44 items on CVD in women divided into the following groups: (1) risk factors and prevention strategies; (2) diagnosis and clinical manifestations; and (3) treatment and follow-up. Results: After two rounds, consensus in agreement was reached on 27 items (61.4%). Most of the non-consensus items (31.8%) belonged to group 3. The lack of consensus in this group was mainly among gynecologists and primary care physicians. The panelists agreed on periodic blood pressure control during pregnancy and delivery to detect hypertensive disorders, especially in women with a history of preeclampsia and/or gestational hypertension, and diabetes mellitus control in those with gestational diabetes. Also, the panelists agreed that women receive statins at a lower intensity than men, although there was no consensus as to whether the efficacy of drug treatments differs between women and men. Conclusions: The high degree of consensus shows that the panelists are aware of the differences that exist between men and women in the management of CVD and the need to propose interventions to reduce this inequality. The low level of consensus reveals the lack of knowledge, and the need for information and training on this topic.
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BACKGROUND: Breast cancer (BC) treatment with anthracyclines and/or anti-human epidermal growth factor receptor-2 (HER2) antibodies is associated with an increased risk of cardiovascular disease complications, including cancer therapy-related cardiac dysfunction (CTRCD). While Cardio-Oncology Rehabilitation (CORe) programs including exercise have emerged to minimize these risks, its role in preventing CTRCD is unclear. OBJECTIVES: We investigated the effectiveness of an exercise-based CORe program in preventing CTRCD [left ventricular ejection fraction (LVEF) drop ≥10% to a value <53% or a decrease >15% in global longitudinal strain (GLS)]. Secondary outcomes examined changes in cardiac biomarkers, physical performance including peak oxygen consumption, psychometric and lifestyle outcomes. Safety, adherence, and patient satisfaction were also assessed. METHODS: This is a randomized controlled trial including 122 early-stage BC women receiving anthracyclines and/or anti-HER2 antibodies, randomized to CORe (n = 60) or usual care with exercise recommendation (n = 62). Comprehensive assessments were performed at baseline and after cardiotoxic treatment completion. The average duration of the intervention was 5.8 months. RESULTS: No cases of CTRCD were identified during the study. LVEF decreased in both groups, but was significantly attenuated in the CORe group [-1.5% (-2.9, -0.1); p = 0.006], with no changes detected in GLS or cardiac biomarkers. The CORe intervention led to significant body mass index (BMI) reduction (p = 0.037), especially in obese patients [3.1 kg/m2 (1.3, 4.8)]. Physical performance and quality-of-life remained stable, while physical activity level increased in both groups. No adverse events were detected. CONCLUSIONS: This study suggests that CORe programs are safe and may help attenuate LVEF decline in BC women receiving cardiotoxic therapy and reduce BMI in obese patients.
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BACKGROUND: Reducing the dietary glycaemic response has been proposed as a means of reducing the risk of diabetes. AIM: To evaluate the effects of a new diabetes-specific formula (DSF) enriched with resistant starch type IV and fructose-free on postprandial glycaemia, insulinaemia and gastrointestinal hormones in healthy volunteers and in outpatient type 2 diabetics. METHODS: (1) Twenty-four healthy volunteers were divided into two groups: Group 1 ( n = 10) was provided 50 g of the carbohydrate (CHO) constituent of the new product and 50 g of glucose separated by 1 week; Group 2 ( n = 14) was provided 400 ml of the new DSF (T-Diet Plus(®) Diabet NP) and 400 ml of a control product separated by 1 week. (2) Ten type 2 diabetic patients received 400 ml of the new DSF and two other commercially available DSF (Glucerna(®) SR and Novasource(®) Diabet) on three occasions separated by 1 week. Venous blood samples were drawn at time 0 and at different times until 120 min. Glucose, insulin and gastrointestinal hormones were determined. Glycaemic and insulinaemic indices and glycaemic load were calculated. RESULTS: The CHO constituent and the new DSF showed low glycaemic index and glycaemic load. In healthy subjects, insulin and C-peptide release were lower after administration of the CHO constituent as well as after the new DSF (P < 0.001). Ghrelin, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) production were lower after intake of the CHO constituent (P ranging from <0.001 to 0.019) compared with glucose, and GIP was lower after ingestion of the new DSF (P = 0.002) than after the control product. In type 2 diabetic patients, glucose AUC was lower after the administration of the new DSF (P = 0.037) compared with the others. CONCLUSIONS: Our results indicate that this new product could be beneficial for diabetic patients.
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Diabetes Mellitus Tipo 2/dietoterapia , Suplementos Dietéticos , Nutrición Enteral , Fructosa/administración & dosificación , Periodo Posprandial , Almidón/administración & dosificación , Adulto , Área Bajo la Curva , Glucemia/metabolismo , Péptido C/metabolismo , Diabetes Mellitus Tipo 2/sangre , Carbohidratos de la Dieta/administración & dosificación , Grasas Insaturadas en la Dieta/administración & dosificación , Ácidos Grasos Omega-3/administración & dosificación , Femenino , Polipéptido Inhibidor Gástrico/sangre , Ghrelina/sangre , Péptido 1 Similar al Glucagón/sangre , Índice Glucémico , Voluntarios Sanos , Humanos , Insulina/sangre , Lípidos/sangre , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Cardiovascular disease (CVD) is the leading cause of death worldwide affecting both sexes equally. However, in comparison to men, in women, it often is underrecognized and undertreated in both primary and secondary prevention settings. It is clear, that in the healthy population, there are profound differences both anatomically and biochemically between women and men, and this may impact how both groups present when they become ill. Moreover, some diseases affect more frequently women than men such as myocardial ischemia or infarction without obstructive coronary disease, Takotsubo syndrome, some atrial arrhythmias, or heart failure with preserved ejection fraction. Therefore, diagnostic and therapeutic strategies that have been established largely on the basis of clinical studies with a predominantly male population must be adapted before being applied to women. There is a paucity of data regarding cardiovascular disease in women. It is inadequate to only perform a subgroup analysis evaluating a specific treatment or invasive technique when women constitute fifty percent of the population. In this regard, this may affect the time of clinical diagnosis and severity assessments of some valvulopathies. In this review, we will focus on the differences in the diagnosis, management, and outcomes for women with the most frequent cardiovascular pathologies including coronary artery disease, arrhythmia, heart failure, and valvopathies. In addition, we will describe diseases that exclusively affect women that are related to pregnancy, and some of them are life-threatening. Although the lack of research on women plays a role in the poorer outcomes in women, especially in ischemic heart disease, some techniques such as transcatheter aortic valve implantation and transcatheter edge-to-edge therapy seem to have better outcomes in women.
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Enfermedades Cardiovasculares , Enfermedad de la Arteria Coronaria , Insuficiencia Cardíaca , Isquemia Miocárdica , Humanos , Masculino , Femenino , Factores de RiesgoRESUMEN
INTRODUCTION: According to current classifications, the metabolite of greatest clinical interest to evaluate vitamin D(3) dosage is 25-hydroxyvitamin D(3) with a reference interval of approximately 10-70ng/ml, although many authors consider values of approximately 40ng/ml or 100nmol/l to be desirable. According to these definitions, three out of four people in Spain would have vitamin D(3) deficiency. MATERIAL AND METHOD: The RIA-CT technique was used for diagnosis of 25(OH)D(3) to determine the population status. Subsequently, a case-control study was performed to evaluate the relationship between distinct diseases and vitamin D(3) deficiency. RESULTS: A total of 73.2% of the cases were found to be within the range considered acceptable, according to the present classification. One hundred percent of the control group and healthy menopausal women who did not receive any kind of vitamin supplement had levels of 40 ng/ml or more. DISCUSSION AND CONCLUSIONS: Our results indicate that the prior situation of a high prevalence of vitamin D(3) deficiency has improved and that levels are now acceptable in 26.8% of the population, with a mean value of 46.2 ng/ml, considering 10-70 ng/ml as the reference range.
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Colecalciferol/sangre , Colecalciferol/deficiencia , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , España , Adulto JovenRESUMEN
INTRODUCTION AND OBJECTIVES: Most clinical trials that demonstrated the negative impact of renal failure on survival in patients with congestive heart failure (CHF) included a relatively small proportion of subjects with a high creatinine level and were performed in patients with depressed left ventricular systolic function. Our aim was to investigate the clinical characteristics and prognosis of hospitalized CHF patients with depressed or preserved systolic function and different degrees of renal dysfunction. PATIENTS AND METHOD: The study included 552 consecutive CHF patients admitted to a hospital department of cardiology between 2000-2002. Renal function was determined from the estimated glomerular filtration rate (GFR), and patients were divided into three groups: GFR>60, GFR 30-60, and GFR<30 mL.min per 1.73 m2 (severe renal failure), containing 56.5%, 35.5%, and 8.0% of patients, respectively. RESULTS: Patients with severe renal failure had the worst cardiovascular risk profile: older age, higher prevalence of cardiovascular risk factors, anemia, inflammatory markers in plasma, and less prescription of angiotensin-converting enzyme (ACE) inhibitors. Survival in this patient group was significantly poorer than in other groups (relative risk or RR=2.4; 95% CI, 1.3-4.4) in those with either depressed (RR=3.8; 95% CI, 1.4-10.6) or preserved (RR=2.9; 95% CI, 1.2-6.9) systolic function, independent of other prognostic factors. The negative impact of severe renal failure on prognosis was reduced by ACE inhibitor use. CONCLUSIONS: Renal failure is common and a strong predictor of mortality in hospitalized CHF patients with or without depressed systolic function. It is associated with a worse risk profile.
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Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/mortalidad , Insuficiencia Renal/complicaciones , Factores de Edad , Anciano , Inhibidores de la Enzima Convertidora de Angiotensina/administración & dosificación , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Femenino , Tasa de Filtración Glomerular , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Cardíaca/fisiopatología , Humanos , Pacientes Internos , Masculino , Pronóstico , Insuficiencia Renal/fisiopatología , Riesgo , Factores de Riesgo , Sístole , Función Ventricular IzquierdaRESUMEN
Introducción: La pandemia de COVID-19 modifica el ambiente info-comunicativo de los ciberusuarios. Cuba, en particular, presenta un nivel considerable de desarrollo tecnológico insertado en la plataforma social de Internet, Twitter. Este soporte desempeña un rol vertebral para el debate sobre temas relacionados a las brigadas médicas cubanas, por su enfrentamiento al virus en el ámbito internacional, que coadyuva a la conformación de una opinión global favorable. Lo planteado con anterioridad se expresa desde las conversaciones online y sus discursos en este sitio. Objetivo: Caracterizar el ambiente info-comunicativo de Twitter durante las conversaciones online sobre brigadas médicas cubanas, entre el 31 de diciembre de 2020 y el 18 de enero de 2021. Material y Métodos: Se emplea el método teórico hermenéutico, para la descripción de los resultados del procesamiento estadístico de contenido, estructura y uso en la web, correspondiente a un enfoque transdisciplinar, mediante la técnica de minería de datos y la aplicación como instrumento del algoritmo no supervisado SSA-UO para el análisis de sentimientos en Twitter. Resultados: Las características del ambiente info-comunicativo de Twitter durante las conversaciones online sobre brigadas médicas cubanas evidencian un predominio de la polaridad positiva. Conclusiones: Los retuits, las menciones y la publicación de enlaces condicionan las particularidades del debate sobre el tema en la esfera de microblogging(AU)
Introduction: The COVID-19 pandemic modifies the info-communicative environment of cyber users. Cuba, in particular, presents a remarkable level of technological development inserted in the Internet social platform, Twitter. This support plays a key role in the debate about issues related to the Cuban medical delegations due to their confrontation with the virus at the international level, which contributes to the formation of a favorable global opinion. The aforementioned point is expressed from the online conversations and their speeches in this site. Objective: To characterize the info-communicative environment on Twitter during the online conversations about Cuban medical brigades between December 31, 2020 and January 18, 2021. Material and Methods: The hermeneutic theoretical method is used for the description of the results of the statistical processing of content, structure and use on the Web, corresponding to a transdisciplinary approach through the application of Data Mining Technique as an instrument of the unsupervised algorithm SSA-UO for sentiment analysis on Twitter. Results: The characteristics of the info-communicative environment on Twitter during the online conversations about Cuban medical delegations evidence a predominance of positive polarity. Conclusions: Retweets, mentions and the publication of links influence the particularities of the debate on the topic in the microblogging sphere(AU)
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Humanos , Publicaciones , Desarrollo Tecnológico , Internet , COVID-19RESUMEN
BACKGROUND AND OBJECTIVE: The search for novel and modifiable risk factors in heart failure (HF), a condition with still high mortality and morbidity rates, can open new strategies for treatment of a growing number of patients. We decided to evaluate the prevalence of anemia and determine its influence on the prognosis of hospitalized HF patients. PATIENTS AND METHOD: 557 consecutive patients hospitalized for HF between 31st January 2000 and 31st December 2002 in a Cardiology Department of a tertiary hospital were studied. Demographic and clinical characteristics, as well as treatment upon hospital discharge and survival data were obtained in May 2003. RESULTS: Mean follow-up was 1.4 years. 44.5% of the whole group of patients presented anemia with mean (standard deviation) hemoglobin levels of 111 (12) g/l, were older, with higher prevalence of ischemic cardiopathy, had higher levels of globular sedimentation rate but lower cholesterol and glomerular filtration rate levels. The prescription of angiotensin converting enzyme inhibitors and betablockers was less frequent among patients with anemia. The presence of anemia was related in a independent way with higher mortality (relative risk: 2.554; p = 0.001), the relation between survival and haemoglobin levels being direct. CONCLUSION: The prevalence of anemia among hospitalized HF patients is very high and its presence constitutes a powerful mortality determinant in this group of patients.
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Anemia/complicaciones , Anemia/epidemiología , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/mortalidad , Hospitalización , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Prevalencia , Pronóstico , Factores de Riesgo , Tasa de SupervivenciaAsunto(s)
Codón sin Sentido , Mutación del Sistema de Lectura , Deficiencia de alfa 1-Antitripsina/genética , alfa 1-Antitripsina/genética , Adulto , Alelos , Femenino , Frecuencia de los Genes , Heterocigoto , Historia Medieval , Humanos , Lactante , Masculino , Portugal , Análisis de Secuencia de ADN , España , Deficiencia de alfa 1-Antitripsina/historiaRESUMEN
El linfangioma es una lesión benigna que se origina del tejido linfático. Se considera también una proliferación hematomatosa de los vasos linfáticos y tejidos asociados, por lo que representa una anomalía del desarrollo o malformación congénita que aparece en niños durante los primeros años de vida. La mayoría aparece desde el nacimiento y aproximadamente en el 90% de los casos surgen hasta los 2 años de edad. Esta lesión se presentó en el reborde alveolar inferior de una niña recién nacida, con su base en la zona de los incisivos inferiores, de 3 cm de diámetro, valorada por el cirujano maxilofacial del Hospital Pediátrico Octavio de la Concepción de la Pedraja, de Holguín, en enero del 2006. Se le realizó una intervención quirúrgica a las 16 horas de nacida, pues el linfangioma impedía su alimentación. La biopsia corroboró este diagnóstico. Se evolucionó por varios años hasta la actualidad sin presentar recidivas ni secuelas. No necesitó otros tratamientos.
Lymphangioma is a benign lesion that originates from lymphatic tissue. It is also considered a hematomatous proliferation of lymphatic vessels and associated tissues, so it is a developmental anomaly or congenital malformation that appears in children during the first years of life. Most of these lesions appear from birth and approximately 90% of cases arise up to 2 years of age. This lesion was located in the lower alveolar ridge of a newborn girl, with its base in the area of the lower incisors, 3 cm in diameter, assessed by the maxillofacial surgeon of the Pediatric Universitary Octavio de la Concepción de la Pedraja Hospital, on January 2006. Surgical intervention was carried out at 16 hours from birth, since the lymphangioma prevented its feeding. The biopsy corroborated this diagnosis. The patient was consulted for several years to date without recurrence or sequelae. The patient did not need other additional treatments.
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The advance of novel technologies that will enable the detection of large sets of biomarker proteins, to greatly improve the sensitivity and specificity of an assay, represents a major objective in biomedical research. To demonstrate the power of mass spectrometry (MS) detection for large-scale biomarker screening in cancer research, a simple, one-step approach for fast biomarker fingerprinting in complex cellular extracts is described. MCF-7 breast cancer cells were used as a model system. Fast proteomic profiling of whole cellular extracts was achieved on a linear trap quadrupole (LTQ) mass spectrometer by one of the following techniques: (a) data-dependent liquid chromatography (LC)-MS/MS of un-labeled cell extracts, (b) data-dependent LC-MS/MS with pulsed Q dissociation (PQD) detection of iTRAQ labeled samples, and (c) multiple reaction monitoring (MRM)-MS of low abundant proteins that could not be detected with data-dependent MS/MS. The data-dependent LC-MS/MS analysis of MCF-7 cells enabled the identification of 796 proteins (p<0.001) and the simultaneous detection of 156 previously reported putative cancer biomarkers. PQD detection of iTRAQ labeled cells resulted in the detection of 389 proteins and 64 putative biomarkers. MRM-MS analysis enabled the successful monitoring of a panel of low-abundance proteins in one single experiment, highlighting the utility of this technique for targeted analysis in cancer investigations. These results demonstrate that MS-based technologies relying on a one-step separation protocol have the potential to revolutionize biomarker research and screening applications by enabling fast, sensitive and reliable detection of large panels of putative biomarkers. To further stimulate the exploration of proteins that have been previously reported in the literature to be differentially expressed in a variety of cancers, an extensive list of approximately 1100 candidate biomarkers has been compiled and included in the manuscript.
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Biomarcadores de Tumor/análisis , Neoplasias de la Mama/química , Cromatografía Líquida de Alta Presión/métodos , Proteómica/métodos , Espectrometría de Masa por Ionización de Electrospray/métodos , Línea Celular Tumoral , Femenino , HumanosRESUMEN
BACKGROUND: Old age is associated with an involuntary and progressive but physiological loss of muscle mass. The aim of this study was to evaluate the effects of exclusive consumption for 6 months of a protein-enriched enteral diet with a relatively high content of branched-chain amino acids on albuminemia, cortisolemia, plasma amino acids, insulin resistance, and inflammation biomarkers in elderly patients. METHODS: Thirty-two patients from the Clinical Nutrition Outpatient Unit at our hospital exclusively consumed a protein-enriched enteral diet for 6 months. Data were collected at baseline and at 3 and 6 months on anthropometric and biochemical parameters and on plasma concentrations of amino acids, cortisol, adrenocorticotropic hormone, urea, creatinine, insulin resistance, and inflammation biomarkers. RESULTS: The percentage of patients with albumin concentration below normal cut-off values decreased from 18% to 0% by the end of the study. At 6 months, concentrations of total plasma (p = 0.008) and essential amino acids (p = 0.011), especially branched-chain amino acids (p = 0.031), were higher versus baseline values, whereas 3-methylhistidine (p = 0.001), cortisol (p = 0.001) and adrenocorticotropic hormone (p = 0.004) levels were lower. CONCLUSIONS: Regular intake of specific protein-enriched enteral formula increases plasma essential amino acids, especially branched-chain amino acids, and decreases cortisol and 3-methylhistidine, while plasma urea and creatinine remain unchanged.
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El cultivar de plátano 'FHIA - 25' (AAB), posee excelente rendimiento y alta resistencia a "Sigatoka negra", pero con la limitante del bajo contenido de azúcar en su fruto, lo cual hace que sea necesario disponer de un método de regeneración de plantas a nivel celular como la embriogénesis somática, que se complemente a técnicas biotecnológicas de transformación genética para mejorar la calidad del fruto. El presente trabajo se realizó con el objetivo de establecer una metodología de regeneración vía embriogénesis somática a partir del explante inicial ápices de brotes axilares establecidos directamente en medio de cultivo líquido. Se obtuvieron suspensiones celulares embriogénicas homogéneas a partir del explante antes mencionado. Se lograron las mayores tasas de multiplicación a la densidad celular de 3,0%. La incubación de los embriones somáticos durante 30 días en el medio de cultivo de maduración permitió incrementar la germinación de los mismos. Durante la fase de aclimatización las plantas provenientes de los embriones somáticos, así como las plantas regeneradas por organogénesis, mostraron un alto porcentaje de supervivencia (98 y 97 %, respectivamente), sin la presencia de variación somaclonal.
Plantain cultivar 'FHIA - 25' (AAB) shows high yielding qualities and high resistance to Black Sigatoka disease, but its sugar content in the fruit is low, so a regeneration method at cell level is necessary, such as somatic embryogenesis supported by biotechnological tools to improve fruit quality. This work was performed with the aim of establishing a plant regeneration method via somatic embryogenesis using initial explants of shoot apices from axillary buds in liquid culture medium. Homogenous embryogenic cell suspensions were obtained from mentioned explants. The highest cellular multiplication rates were achieved at 3,0% density. The incubation of somatic embryos during 30 days in the maturation culture medium permitted to increase germination. During the acclimatization stage, plants regenerated from somatic embryos, as well as plants from organogenesis, showed a high survival percentage (98 and 97 respectively), without somaclonal variation.