Seasonal and Morphology Effects on Bioactive Compounds, Antioxidant Capacity, and Sugars Profile of Black Carrot (Daucus carota ssp. sativus var. atrorubens Alef.).

Black carrot (Daucus carota ssp. sativus var. atrorubens Alef.) is widely recognized for its bioactive compounds and antioxidant properties. The black carrot of Cuevas Bajas (Málaga) is a local variety characterized by a black/purple core, which differs from other black carrot varieties. Therefore, this autochthonous variety was characterized according to the root size and the harvesting season by means of a study of its antioxidant capacity analyzed by three methods, its total carotenoids content, and its sugars and phenolic compounds profile by ultra-high performance liquid chromatography coupled to high-resolution mass spectrometry (UHPLC-MS). A total of 20 polyphenolic compounds were quantified in 144 samples analyzed. The anthocyanidins group was observed to be the most abundant, followed by the hydroxycinnamic acids group. Moreover, pelargonidin 3-sambubioside was observed in black carrot for the first time. The medium-sized carrots presented the highest content of phenolic compounds, largely due to their significantly higher anthocyanidins content. Comparatively, the small carrots showed a higher content of simple sugars than the large ones. Regarding the influence of season, significantly higher quantities of glucose and fructose were observed in the late-season carrots, while sucrose was the main sugar in early-season samples. No significant differences were observed in the total carotenoid content of black carrot.

Colon-available mango (poly)phenols exhibit mitigating effects on the intestinal barrier function in human intestinal cell monolayers under inflammatory conditions.

This study investigated the impact of in vivo available colon-mango (poly)phenols on stress-induced impairment of intestinal barrier function. Caco-2/HT29-MTX cells were incubated with six extracts of ileal fluid collected pre- and 4-8 h post-mango consumption before being subjected to inflammatory stress. (Poly)phenols in ileal fluids were analysed by UHPLC-HR-MS. Epithelial barrier function was monitored by measurement of trans-epithelial electrical resistance (TEER) and the production of selected inflammatory markers (interleukin-8 (IL-8) and nitric oxide (NO)) and the major mucin of the mucosal layer (MUC2). Post-mango intake ileal fluids contained principally benzoic acids, hydroxybenzenes and galloyl derivatives. There was a high interindividual variability in the levels of these compounds, which was reflected by the degree of variability in the protective effects of individual ileal extracts on inflammatory changes in the treated cell cultures. The 24 h treatment with non-cytotoxic doses of extracts of 4-8 h post-mango intake ileal fluid significantly reduced the TEER decrease in monolayers treated with the inflammatory cytomix. This effect was not associated with changes in IL-8 expression and secretion or claudine-7 expression. The mango derived-ileal fluid extract (IFE) also mitigated cytomix-dependent nitrite secretion, as a proxy of NO production, and the MUC2 reduction observed upon the inflammatory challenge. These insights shed light on the potential protective effect of mango (poly)phenols on the intestinal barrier exposed to inflammatory conditions.

Exposición a la violencia e ideación suicida en estudiantes universitarios de Santa Marta, Colombia

Introducción: La exposición a la violencia afecta la salud mental. Sin embargo, existen pocos estudios sobre este fenómeno en estudiantes universitarios. Objetivo: Establecer la asociación entre la exposición a la violencia e ideación suicida en universitarios de Santa Marta, Colombia. Metodología: Se realizó un estudio cuantitativo, analítico y transversal. Participaron 1647 estudiantes entre 16 y 24 años (M=20,58, DT=1,715), quienes completaron la Escala de Exposición a la Violencia (α = 0,87) y la Escala de Ideación Suicida de Roberts (α =0,74). Resultados: El modelo de regresión logística ajustado indicó que la exposición directa a la violencia en el colegio (OR=2,02; IC95 %=1,28-3,16) y casa (OR=1,53; IC95 %=1,02-2,29), e indirecta en colegio (OR=1,34; IC95 %= 11,06-1,70) y casa (OR=1,91; IC95 %=1,27-2,88), incrementan la ideación suicida. Conclusiones: La exposición a la violencia en el colegio y en la casa, de forma directa e indirecta, son factores de riesgo para la ideación suicida en estudiantes universitarios.

Introduction: Exposure to violence affects mental health; however, there are few studies on this phenomenon in university students. Objective: To establish the association between exposure to violence and suicidal ideation in university students from Santa Marta, Colombia. Methodology: A quantitative, analytical, and cross-sectional study was carried out involving 1,647 students between 16 and 24 years old (M=20.58, SD=1.715), who completed the violence exposure Scale (α =0.87) and the Roberts suicidal ideation scale (α =0.74). Results: The adjusted logistic regression model indicated that direct exposure to violence at school (OR=2.02; 95% CI=1.28-3.16) and home (OR=1.53; 95% CI=1.02 -2.29), and indirect exposure at school (OR=1.34; CI95%= 1.06-1.70) and home (OR=1.91; CI95%=1.27-2.88), increased suicidal ideation. Conclusion: Direct and indirect exposure to violence at school and at home are risk factors for suicidal ideation in university students.

Jaguar conservation in the American continent: the role of protected landscape and human-impacted biomes

Introduction: Worldwide, expanding human activities continue to be a threat to many large-bodied species, including jaguars. As these activities continue, it is critical to understand how home range sizes will be impacted by human-modified landscapes. Objective: To evaluate the importance of protected and unprotected land on home-range size across their range. Methods: We used home range data from 117 jaguars in several habitat protection categories and human biome types. We used a Generalized Linear Mixed Model to test home range and spatial overlap with conservation categories and human biomes. Results: Most home-ranges were in Jaguar Conservation Units (62 %), followed by Protected Areas (21 %), Indigenous People's Lands (10 %) and Jaguar Movement Corridors (3 %), where 76 % of the jaguars lived inside one the first three conservation types. However, outside of conserved land, Rangeland, Cropland, Seminatural land and other human biomes were also important (24 % of the individuals). Jaguars in Rangeland, Cropland and Seminatural land had the largest home ranges. Conclusions: Although conservation land was dominant, human-impacted lands appear to play a considerable role in satisfying the spatial requirements of jaguars.

Introducción: A nivel mundial, la expansión de actividades humanas continúa teniendo un riesgo para muchas especies de cuerpo grande, tal como los jaguares. Conforme continúen estas actividades, es crucial entender el impacto de paisajes modificados sobre el tamaño de su territorio. Objetivo: Evaluar la importancia de terrenos protegidos y no protegidos sobre el tamaño de su territorio a lo largo de su rango. Métodos: Usamos datos de tamaño de los territorios de 117 jaguares en varias categorías de protección de hábitats y biomas humanos. Usamos un Modelo Mixto Lineal Generalizado para probar traslapes espaciales y de territorios con categorías de conservación y biomas humanos. Resultados: La mayoría de los territorios estaban en Unidades de Conservación de Jaguares (62 %), seguido por Áreas protegidas (21 %), Tierras de Pueblos Indígenas (10 %) y Corredores de Movimiento de Jaguares (3 %), en donde el 76 % de los jaguares vivían dentro de alguna de las primeras tres modalidades de conservación. Sin embargo, fuera de áreas protegidas, pastizales, tierras de cultivo, terrenos seminaturales y otros biomas humanos también fueron importantes (24 % de individuos). Jaguares en pastizales, tierras de cultivo, y terrenos seminaturales tuvieron territorios más grandes. Conclusiones: Aunque las áreas de conservación fueron dominantes, áreas con impacto humano parecieron jugar un rol considerable en satisfacer los requerimientos espaciales de los jaguares.

Predictors of Multi-Vessel Identification, Outcome, and Optimal Surgical Timing for Microvascular Decompression in Hemifacial Spasm.

OBJECTIVES AND BACKGROUND: Hemifacial spasm (HFS) is a disabling condition that imposes significant burden upon patients. Microvascular decompression (MVD) surgery is the most effective and long-lasting treatment for HFS, but outcomes following this surgery may vary based on a variety of clinical and operative factors. A more thorough understanding of the variables that impact patient outcome after MVD surgery is needed. METHODS: A systematic review and meta-analysis of Medline, Embase, and Central was conducted (n = 2108 screened; n = 86 included) with the goal of determining the impact of the following variables on outcome: duration of disease, geographic location, intraoperative use of an endoscope, and intraoperative finding of single versus multi-vessel neurovascular compression. RESULTS: Most cases of hemifacial spasm occur on the left side (53.9%, p < 0.001) and are more common in women than men (66.5% versus 33.5%, p < 0.0001). The offending vessel frequencies were: 40.8% anterior inferior cerebellar artery [AICA], 24.9% posterior inferior cerebellar artery [PICA], 17.2% multiple vessels, and 4.7% vertebral artery [VA]. Multiple vessel combinations involved: 26.5% PICA + AICA, 24.6% PICA + VA, 23.1% AICA + VA, and 4.7% AICA + PICA + VA. Relative to the Americas, AICA was less frequent in Europe (p = 0.005), while PICA more frequent in Europe (p = 0.009) and Asia (p < 0.0001). With endoscope assistance, frequency of multiple vessels identified was 31.7% (versus 14.7% with non-endoscopic, p = 0.005), and 27.4% for AICA (43.5% with non-endoscopic, p = 0.003). Spasm improvement was 94.1% near discharge and 96.0% at maximum follow-up. Complications occurred in 16.5% of cases, with spasm recurrence in 2.4%. Greatest frequency of spasm improvement (p < 0.0001) and lowest spasm recurrence rates (p = 0.0005) were reported in series from Asia. For every additional month of pre-operative spasm, the effect size of post-operative improvement decreased (p = 0.04). With every subsequent postoperative month, the effect size of spasm improvement increased (p = 0.0497). The frequency of spasm improvement was significantly higher in series published after 2005 (94.4% versus 97.4%, p = 0.005). CONCLUSION: Clinical outcomes following MVD for HFS have improved since 2005. Consideration should be given to earlier operation (shorter disease duration) and use of an endoscope may increase detection of multiple offending vessels. Further studies are needed to understand regional differences in culprit vessel incidence and surgical outcomes in the Americas, Europe, and Asia.

Effects of Different Heating Treatments on the Antioxidant Activity and Phenolic Compounds of Ecuadorian Red Dacca Banana.

The banana is a tropical fruit characterized by its composition of healthy and nutritional compounds. This fruit is part of traditional Ecuadorian gastronomy, being consumed in a wide variety of ways. In this context, unripe Red Dacca banana samples and those submitted to different traditional Ecuadorian heating treatments (boiling, roasting, and baking) were evaluated to profile their phenolic content by ultra-high-performance liquid chromatography coupled to high-resolution mass spectrometry (UHPLC-HRMS) and the antioxidant activity by ORAC, ABTS, and DPPH assays. A total of sixty-eight phenolic compounds were identified or tentatively identified in raw banana and treated samples, highlighting the content in flavonoids (flavan-3-ols with 88.33% and flavonols with 3.24%) followed by the hydroxybenzoic acid family (5.44%) in raw banana samples. The total phenolic compound content significantly decreased for all the elaborations evaluated, specifically from 442.12 mg/100 g DW in fresh bananas to 338.60 mg/100 g DW in boiled (23.41%), 243.63 mg/100 g DW in roasted (44.90%), and 109.85 mg/100 g DW in baked samples (75.15%). Flavan-3-ols and flavonols were the phenolic groups most affected by the heating treatments, while flavanones and hydroxybenzoic acids showed higher stability against the heating treatments, especially the boiled and roasted samples. In general, the decrease in phenolic compounds corresponded with a decline in antioxidant activity, evaluated by different methods, especially in baked samples. The results obtained from PCA studies confirmed that the impact of heating on the composition of some phenolic compounds was different depending on the technique used. In general, the heating processes applied to the banana samples induced phytochemical modifications. Even so, they remain an important source of bioactive compounds for consumers.

Elastography of the thyroid nodule, cut-off points between benign and malignant lesions for strain, 2D shear wave real time and point shear wave: a correlation with pathology, ACR TIRADS and Alpha Score.

Objective: A prospective cross-sectional investigation of 170 thyroid nodules (TN) between January 2020 and December 2021 at Alpha Imagen was conducted to determine cut-off points (C/O) for elastography measurements and their diagnostic accuracy. Methods: Nodules were categorized by ACR TI-RADS, Alpha Score (AS), and Bethesda; all were evaluated using 2D Shear Wave Real Time Elastography (RT-SWE), point Shear Wave (pSWE), and Strain Elastography (SE). Data was assessed with ROC curves, the Shapiro-Wilk test, T test, Chi-square test, and ANOVA. Results: C/O were as follows: RTSWE Emax of 115kPa and 6.5 m/s, Emean of 47.5 kPa and 4.1 m/s, pSWE (average) of 52.4 kpa and 4.15 m/s; sensitivity of 81.2% and specificity of 57.6%, with a PPV of 72.4% and NPV of 70.0%. SE Value A had a C/O of 0.20%, with a sensitivity of 84%, specificity of 57%, PPV of 72.4% and NPP of 73.6%. The Strain Ratio nodule/tissue C/O was calculated as 2.69, with a sensitivity of 84%, specificity of 57%, PPV of 72.3%, and NPV of 73.5%. The RLBIndex quality control must be at least 92%; for pSWE, we suggest a mean interquartile ratio of ≤15.7% for kPa and 8.1% for m/s. The recommended depth is between 1.2 and 1.5 cm, and commonly used ROI boxes were 3x3 and 5x5mm. Conclusion: 2D-SWE and pSWE with Emax and Emean demonstrated C/O with excellent diagnostic accuracy. To maximize the correct classification of TN, we suggest combining ACR TI-RADS and AS with any of the elastography measurements assessed here.

UHPLC-HRMS Spectrometric Analysis: Method Validation and Plasma and Urinary Metabolite Identification after Mango Pulp Intake.

After an acute intake of 300 g of mango purée by 10 subjects, 0 and 24 h urine and plasma samples were analyzed by high-performance liquid chromatography-high-resolution mass spectrometry. The method was first validated for 44 reference polyphenols in terms of linearity, specificity, limits of detection and quantification, intra-day and inter-day precision, recovery, and matrix effects in two biological matrices. After method validation, a total of 94 microbial-derived phenolic catabolites, including 15 cinnamic acids, 3 phenylhydracrylic acids, 14 phenylpropanoic acids, 12 phenylacetic acids, 28 benzoic acids, 2 mandelic acids, 15 hydroxybenzenes, and 5 hippuric acid derivatives, were identified or tentatively identified in urine and/or plasma. These results establish the value of the UHPLC-HRMS protocol and the use of authentic standards to obtain a detailed and accurate picture of mango polyphenol metabolites, together with their phase II conjugated metabolites, in human bioavailability studies.

Rendimiento Biomecánico de las Placas de Tibia Proximal Utilizadas en Fracturas de Platillos Tibiales evaluado a través de Modelos de Elementos Finitos: Protocolo de Revisión Sistemática / A systematic Review Protocol Examining the Biomechanical Performance of Proximal Tibial Plates used in Tibial Plate Fractures assessed by Finite Element Analysis

Objetivo. Analizar el rendimiento biomecánico de las placas de tibia proximal utilizadas en fracturas de platillos tibiales evaluado a través de modelos de elementos finitos. Métodos. Se realizará una búsqueda exhaustiva en PubMed/Medline, Embase, Lilacs, Web of Science y Google Scholar. No se utilizará ninguna restricción de idioma o estado de publicación. Dos revisores examinarán de forma independiente los posibles artículos elegibles, de acuerdo con los criterios de selección predefinidos. Se incluirán los estudios que evalúen el rendimiento de los platillos tibiales proximales utilizados en las fracturas del platillo tibial evaluadas mediante el análisis de elementos finitos. La extracción de datos sobre las características del estudio, los métodos, los resultados y la evaluación del riesgo de sesgo se realizará mediante un formulario estandarizado. Considerando el diseño de estudio no se requiere evaluación por comité de ética. Los resultados de esta revisión se difundirán a través de la publicación en revistas revisadas por pares, redes sociales y congresos de la especialidad. Se espera que los resultados de esta revisión permitan optimizar los resultados del manejo quirúrgico de las fracturas de platillos tibiales. Número de registro PROSPERO: CRD42023396015.

Objetive. To analyze the biomechanical performance of proximal tibial plates used in tibial plate fractures evaluated through finite element modeling. Methods. A comprehensive search will be conducted in PubMed/Medline, Embase, Lilacs, Web of Science, and Google Scholar. No language or publication status restrictions will be used. Two reviewers will independently review potential eligible articles according to predefined selection criteria. Studies evaluating the performance of proximal tibial splints used in tibial splint fractures assessed by finite element analysis will be included. Data extraction on study characteristics, methods, results, and risk of bias assessment will be performed using a standardized form. Considering the study design, evaluation by an ethics committee is not required. The results of this review will be disseminated through publication in peer-reviewed journals, social networks and specialty congresses. It is expected that the results of this review will allow optimizing the results of the surgical management of tibial plate fractures. PROSPERO registration number: CRD42023396015.

Urinary excretion of organosulfur compounds after acute ingestion of black onion.

Onion (Allium cepa L.) and its newly derived product "black onion" are characterised by the presence of compounds with potential bioactivity, particularly organosulfur compounds (OSCs). However, little is known about the metabolism, distribution, and excretion of these compounds as they pass through the gastrointestinal tract. This study monitored healthy subjects after an acute intake of black onion and analysed the excretion of OSCs using UHPLC-HRMS. A total of 31 OSCs were detected in urine after the acute ingestion of black onion, the main components being S-methyl-L-cysteine sulfoxide (methiin) (13.6 ± 3.9 µmol), isoalliin (12.4 ± 4.7 µmol) and S-propyl-L-cysteine (deoxypropiin) (3.1 ± 0.7 µmol). Moreover, N-acetylated metabolites of the major OSCs detected in black onion, namely, N-acetyl-S-(1-propenyl)-L-cysteine sulfoxide (NAS1PCS) and N-acetyl-S-(1-propenyl)-L-cysteine (NAS1PC), were found in urine after black onion consumption. The N-acetylation reaction takes place in the kidneys and liver, and metabolism pathways are proposed to explain the excretion of OSCs in urine. The basis of the identification of OSCs as urinary metabolites after black onion consumption is described for the first time and provides the basis for further research.

Bioavailability of Organosulfur Compounds after the Ingestion of Black Garlic by Healthy Humans.

The consumption of black garlic has been related to a decreased risk of many human diseases due to the presence of phytochemicals such as organosulfur compounds (OSCs). However, information on the metabolization of these compounds in humans is limited. By means of ultra-high-performance liquid chromatography coupled with high-resolution mass spectrometry (UHPLC-HRMS), this study aims to determine the OSCs and their metabolites excreted in urine 24 h after an acute intake of 20 g of black garlic by healthy humans. Thirty-three OSCs were identified and quantified, methiin (17,954 ± 6040 nmol), isoalliin (15,001 ± 9241 nmol), S-(2-carboxypropyl)-L-cysteine (8804 ± 7220 nmol) and S-propyl-L-cysteine (deoxypropiin) (7035 ± 1392 nmol) being the main ones. Also detected were the metabolites N-acetyl-S-allyl-L-cysteine (NASAC), N-acetyl-S-allyl-L-cysteine sulfoxide (NASACS) and N-acetyl-S-(2-carboxypropyl)-L-cysteine (NACPC), derived from S-allyl-L-cysteine (SAC), alliin and S-(2-carboxypropyl)-L-cysteine, respectively. These compounds are potentially N-acetylated in the liver and kidney. The total excretion of OSCs 24 h after the ingestion of black garlic was 64,312 ± 26,584 nmol. A tentative metabolic pathway has been proposed for OSCs in humans.

Effect of In Vitro Gastrointestinal Digestion and Colonic Fermentation on the Stability of Polyphenols in Pistachio (Pistacia Vera L.).

The aim of this study was to evaluate the impact of in vitro gastrointestinal digestion and colonic fermentation on the polyphenol compounds from different varieties of pistachio by UHPLC-HRMS analysis. The total polyphenol content decreased significantly, mostly during oral (recoveries of 27 to 50%) and gastric digestion (recoveries of 10 to 18%), with no significant changes after the intestinal phase. After in vitro digestion, the hydroxybenzoic acids and the flavan-3-ols were the main compounds found in pistachio, with respective total polyphenol contents of 73 to 78% and 6 to 11%. More specifically, the main compounds determined after in vitro digestion were 3,4,5-trihydroxybenzoic acid, vanillic hexoside and epigallocatechin gallate. The colonic fermentation affected the total phenolic content of the six varieties studied, with a recovery range of 11 to 25% after 24 h of fecal incubation. A total of twelve catabolites were identified after fecal fermentation, the main compounds being the 3-(3'-hydroxyphenyl)propanoic, 3-(4'-hydroxyphenyl)propanoic, 3-(3',4'-dihydroxyphenyl)propanoic, 3-hydroxyphenylacetic acids and 3,4-dihydroxyphenyl-É£-valerolactone. Based on these data, a catabolic pathway for colonic microbial degradation of phenolic compounds is proposed. The catabolites identified at the end of the process are potentially responsible for the health properties attributed to pistachio consumption.

Efficiency and Safety of CyberKnife Robotic Radiosurgery in the Multimodal Management of Patients with Acromegaly.

OBJECTIVE: To analyze, in a cohort of acromegalic patients, the results of the efficiency and safety of radiosurgery (CyberKnife), as well as the prognostic factors associated with disease remission. MATERIAL AND METHODS: Observational, retrospective, longitudinal, and analytical study that included acromegalic patients with persistent biochemical activity after initial medical-surgical treatment, who received treatment with CyberKnife radiosurgery. GH and IGF-1 levels at baseline after one year and at the end of follow-up were evaluated. RESULTS: 57 patients were included, with a median follow-up of four years (IQR, 2-7.2 years). The biochemical remission rate was 45.6%, 33.33% achieved biochemical control, and 12.28% attained biochemical cure at the end of follow-up. A progressive and statistically significant decrease was observed in the comparison of the concentrations of IGF-1, IFG-1 x ULN, and baseline GH at one year and at the end of follow-up. Both cavernous sinus invasion and elevated baseline IGF-1 x ULN concentrations were associated with an increased risk of biochemical non-remission. CONCLUSION: Radiosurgery (CyberKnife) is a safe and effective technique in the adjuvant treatment of GH-producing tumors. Elevated levels of IGF x ULN before radiosurgery and invasion of the cavernous sinus by the tumor could be predictors of biochemical non-remission of acromegaly.

Bioavailability of orange juice (poly)phenols: ß-glucan-rich oat bran decreases urinary excretion of flavanone phase II metabolites and enhances excretion of microbiota-derived phenolic catabolites.

The impact of ß-glucan-rich oat bran on the bioavailability of orange juice (OJ) flavanones was investigated. Volunteers consumed 500 mL of OJ with and without 22 g of oat bran containing 6 g of ß-glucan (OB-6). Urine collected 12 h prior to and over a 0-24 h period post-supplementation was analysed by UHPLC-HRMS. Sixteen flavanone metabolites and thirty-nine colon-derived phenolic catabolites were identified and quantified. The major compounds were hesperetin-3'-glucuronide, along with hippuric acids and the C6-C3 phenolic acids 3-(3'-hydroxy-4'-methoxyphenyl)hydracrylic acid and 3-(4'-hydroxy-3'-methoxyphenyl)propanoic acid. A marked reduction in the 0-24 h excretion of flavanone metabolites from 29.7 µmol (9.3% recovery) to 9.3 µmol (2.9% recovery), occurred following consumption of OB-6 compared to OJ. This appeared not to be an effect of fiber on the rate of transport in the upper gut. After consumption of OJ there was a 163 ± 15 µmol excretion of colon-derived phenolic catabolites, equivalent to 43% of (poly)phenol intake and following OB-6 intake there was a further significant 30% increase. The ß-oat bran in OB-6 contained 5.8 µmol of free and 52 µmol of bound phenolic derivatives compared to 371 µmol of OJ (poly)phenols. The elevated excretion of phenolics after OB-6 consumption appears not to be due to bound phenolics in the bran, rather it is consequence, principally, of a bran-mediated increase in the quantities of flavanones passing from the upper to the lower bowel where they were subjected to microbiota-mediated catabolism. CLINICAL TRIAL REGISTRATION NUMBER: This trial was registered at clinicaltrials.gov as NCT04867655.

Treatment of neovascular age-related macular degeneration within 48 h from diagnosis improves long-term functional outcome.

PURPOSE: To evaluate long-term visual and anatomical outcomes in neovascular age-related macular degeneration (nAMD) patients treated with anti-vascular endothelial growth factor (VEGF) agents depending on the time delay from confirmed diagnosis to treatment initiation. MATERIALS AND METHODS: Seventy-three nAMD patients (73 eyes) treated with anti-VEGF agents for 12 months using the pro re nata regimen were included in this retrospective longitudinal study. Patients were split into 3 groups according to the time from diagnosis to first anti-VEGF injection: < 48 h (group 1); 48 h-7 days (group 2); > 7 days (group 3). Decimal best-corrected visual acuity (VA) and macular thickness (MT) were recorded at baseline and 1-2-, 3-4-, 6- and 12-month later. Furthermore, age, gender as well as the applied treatment and number of injections after 12 months of treatment were also registered and compared. RESULTS: Long-term effect of the treatment demonstrated enhanced VA in group 1 patients compared with the rest of groups after 1-2-, 6-, and 12-month follow-up (P < 0.05). Positive effects of early treatment were additionally corroborated by the augmented percentage of patients with normal VA in the group 1 respect to the rest of groups over studied time points (P < 0.05). Moreover, the VA gain in nAMD at group 1 was obtained with a mean of 3.7 intravitreal injections over 1-year follow-up period. Regarding MT, non-significant difference was observed among groups. CONCLUSIONS: An early initial treatment with VEGF inhibitors is critical to achieve the best functional benefits of this therapy in new-onset nAMD patients.

Long-term supplementation with anthocyanin-rich or -poor Rubus idaeus berries does not influence microvascular architecture nor cognitive outcome in the APP/PS-1 mouse model of Alzheimer's disease.

Disruption of microvascular architecture is a common pathogenic mechanism in the progression of Alzheimer's disease (AD). Given the anti-angiogenic activity of berry (poly)phenols, we investigated whether long-term feeding of Rubus idaeus (raspberries) could ameliorate cerebral microvascular pathology and improve cognition in the APP/PS-1 mouse model of AD. Male C57Bl/6J mice (50 wild type, 50 APP/PS-1) aged 4-months were fed for 24-weeks, with a normal diet enriched with either 100 mg/day glucose (control diet) or supplemented with glucose and freeze-dried anthocyanin-rich (red) or -poor (yellow) raspberries (100 mg/day) and assessed/sampled post intervention. Cerebral microvascular architecture of wild-type mice was characterised by regularly spaced capillaries with uniform diameters, unlike APP/PS-1 transgenic mice which showed dysregulated microvascular architecture. Long-term feeding of raspberries demonstrated limited modulation of microbiota and no substantive effect on microvascular architecture or cognition in either mice model although changes were evident in endogenous cerebral and plasmatic metabolites.

Suplementación efectiva de vitamina D en pacientes con fractura tibial / Effective vitamin D supplementation in patients with tibial fracture

OBJETIVOS Determinar la prevalencia de déficit de vitamina D, así como evaluar la seguridad y efectividad de un nuevo método de carga con colecalciferol en pacientes adultos con fractura de tibia. MATERIALES Y MÉTODOS Se reclutaron a 56 pacientes consecutivos con edades entre 18 y 65 años con fractura de tibia ingresados en nuestro hospital durante 1 año. Se determinó el nivel de 25-hidroxivitamina D ([25(OH)-D]) al ingreso y tras suplementación con 100.000 UI semanales de colecalciferol, durante 3 o 5 semanas, en casos de insuficiencia ([25(OH)-D] entre 20 ng/mL y 29,9 ng/mL) o deficiencia ([25(OH)-D] < 20 ng/mL), respectivamente. Se determinó la prevalencia de hipovitaminosis D, el porcentaje de normalización de [25(OH)-D], y los efectos adversos. RESULTADOS Se evaluaron 56 pacientes; 98,2% presentó hipovitaminosis D, y 28 (73,7%) y 10 (26,3%) presentaron déficit e insuficiencia, respectivamente. Tras la suplementación, 92,1% alcanzaron niveles [25(OH)-D] normales. Ningún paciente presentó efectos adversos. DISCUSIÓN La prevalencia de deficiencia de vitamina D en nuestra población fue mayor a la reportada en la literatura. Comprobamos que un esquema de suplementación en altas dosis de vitamina D es seguro, y más efectivo que los previamente recomendados. Este esquema de suplementación puede ser implementado en futuros estudios randomizados. CONCLUSIÓN La prevalencia de hipovitaminosis D en pacientes adultos chilenos con fractura de tibia fue alta (98,2%). El esquema de suplementación con vitamina D propuesto fue efectivo y seguro.

OBJETIVOS Determinar la prevalencia de déficit de vitamina D, así como evaluar la seguridad y efectividad de un nuevo método de carga con colecalciferol en pacientes adultos con fractura de tibia. MATERIALES Y MÉTODOS Se reclutaron a 56 pacientes consecutivos con edades entre 18 y 65 años con fractura de tibia ingresados en nuestro hospital durante 1 año. Se determinó el nivel de 25-hidroxivitamina D ([25(OH)-D]) al ingreso y tras suplementación con 100.000 UI semanales de colecalciferol, durante 3 o 5 semanas, en casos de insuficiencia ([25(OH)-D] entre 20 ng/mL y 29,9 ng/mL) o deficiencia ([25(OH)-D] < 20 ng/mL), respectivamente. Se determinó la prevalencia de hipovitaminosis D, el porcentaje de normalización de [25(OH)-D], y los efectos adversos. RESULTADOS Se evaluaron 56 pacientes; 98,2% presentó hipovitaminosis D, y 28 (73,7%) y 10 (26,3%) presentaron déficit e insuficiencia, respectivamente. Tras la suplementación, 92,1% alcanzaron niveles [25(OH)-D] normales. Ningún paciente presentó efectos adversos. DISCUSIÓN La prevalencia de deficiencia de vitamina D en nuestra población fue mayor a la reportada en la literatura. Comprobamos que un esquema de suplementación en altas dosis de vitamina D es seguro, y más efectivo que los previamente recomendados. Este esquema de suplementación puede ser implementado en futuros estudios randomizados. CONCLUSIÓN La prevalencia de hipovitaminosis D en pacientes adultos chilenos con fractura de tibia fue alta (98,2%). El esquema de suplementación con vitamina D propuesto fue efectivo y seguro.

Nudo verdadero como causa de taquicardia fetal persistente Reporte de un caso / True Knot as a Cause of Persistent Fetal Tachycardia. Case Report

Resumen Las anomalías del cordón umbilical están asociadas a efectos adversos durante el embarazo. El nudo verdadero del cordón umbilical está presente en el 0.3-2.1% de los embarazos y se ha asociado a muerte fetal. Dentro de los factores de riesgo se incluye, la edad materna, índice de masa corporal (IMC) elevado, multiparidad, trastornos hipertensivos, tabaquismo, polihidramnios, diabetes gestacional, sexo masculino del feto y otras malformaciones. El diagnóstico prenatal del nudo verdadero es raro y un desafío. La mayoría se diagnostica durante el nacimiento y sólo el 0.08% de los nudos verdaderos son diagnosticados de manera prenatal. El registro cardiotocográfico puede registrar trazos no tranquilizadores que reflejan que hay un estrés hipóxico o mecánico que interrumpe la oxigenación fetal. El objetivo de este reporte es mostrar un caso de nudo verdadero del cordón umbilical que presentó taquicardia fetal persistente durante el trabajo de parto con terminación del embarazo vía vaginal.

Abstract Umbilical cord abnormalities are associated with adverse effects during pregnancy. The true umbilical cord knot is present in 0.3-2.1% of pregnancies and has been associated with fetal death. Risk factors include maternal age, high BMI, multiparity, hypertensive disorders, smoking, polyhydramnios, gestational diabetes, male sex of the fetus, and other malformations. Prenatal diagnosis of the true knot is rare and challenging. Most are diagnosed at birth and only 0.08% of true knots are diagnosed prenatally. Non-reassuring cardiotocography traces may be present, reflecting hypoxic or mechanical stress disrupting fetal oxygenation. The aim of this case report is to present a case of true umbilical cord knot presenting with persistent fetal tachycardia during labor, resolved by vaginal delivery.