Dementia Care in Times of COVID-19: Experience at Fundació ACE in Barcelona, Spain.

BACKGROUND: Fundació ACE is a non-profit organization providing care based on a holistic model to persons with cognitive disorders and their families for 25 years in Barcelona, Spain. Delivering care to this vulnerable population amidst the COVID-19 pandemic has represented a major challenge to our institution. OBJECTIVE: To share our experience in adapting our model of care to the new situation to ensure continuity of care. METHODS: We detail the sequence of events and the actions taken within Fundació ACE to swiftly adapt our face-to-face model of care to one based on telemedicine consultations. We characterize individuals under follow-up by the Memory Unit from 2017 to 2019 and compare the number of weekly visits in 2020 performed before and after the lockdown was imposed. RESULTS: The total number of individuals being actively followed by Fundació ACE Memory Unit grew from 6,928 in 2017 to 8,147 in 2019. Among those newly diagnosed in 2019, most patients had mild cognitive impairment or mild dementia (42% and 25%, respectively). Weekly visits dropped by 60% following the suspension of face-to-face activity. However, by April 24 we were able to perform 78% of the visits we averaged in the weeks before confinement began. DISCUSSION: We have shown that Fundació ACE model of care has been able to successfully adapt to a health and social critical situation as COVID-19 pandemic. Overall, we were able to guarantee the continuity of care while preserving the safety of patients, families, and professionals. We also seized the opportunity to improve our model of care.

Sesamum indicum L. Oil and Sesamin Induce Auditory-Protective Effects Through Changes in Hearing Loss-Related Gene Expression.

Changing consumption patterns and increasing health awareness, especially in Europe, are resulting in an increased demand for sesame seeds. In 2016, Asia imported the highest quantity of sesame seeds, followed by Europe and North America. We examined, for the first time, the effects of treatment with sesame oil and sesamin in hearing impairment models. Sesame oil exhibited an ameliorative effect on auditory impairment in a hair cell line in zebrafish and mice. In ototoxic zebrafish larvae, neuromasts and otic cells increased in numbers because of sesame oil. Furthermore, auditory function in noise-induced hearing loss (NIHL) was studied through auditory brainstem response to evaluate the therapeutic effects of sesame oil. Sesame oil reduced the hearing threshold shift in response to clicks and 8, 16-kHz tone bursts in NIHL mice. Auditory-protective effect of sesame oil was seen in zebrafish and mice; therefore, we used chromatographic analysis to study sesamin, which is the major effective factor in sesame oil. To investigate its effects related to auditory function, we studied the hearing-related gene, Tecta, using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazoliumbromide (MTT) assay. Auditory cell proliferation was induced by treatment with sesame oil and sesamin using Tecta (Tectorin Alpha) regulation. The expression of Tecta increases in the apex area of the cochlear hair cells as they grow, and their activity is enhanced by sesame oil and sesamin. These results provide a novel mechanistic insight into the sesame oil activities and suggest that sesamin, the key constituent in sesame oil, is responsible for its auditory function related benefits, including protection of auditory cells and reversal of their impairments.

Steamed Ginger May Enhance Insulin Secretion through KATP Channel Closure in Pancreatic ß-Cells Potentially by Increasing 1-Dehydro-6-Gingerdione Content.

Ginger (Zingiber officinale Roscoe) and its active compounds (gingerols, shogaols and paradols) have been reported as having beneficial functions for several diseases, including diabetes. In this study, we revealed that the steaming process could enhance the anti-diabetic potential of ginger. To confirm the anti-diabetic effect of steamed ginger extract (GG03), we assessed pancreatic islets impaired by alloxan in zebrafish and demonstrated anti-hyperglycemic efficacy in a mouse model. The EC50 values of ginger extract (GE) and GG03 showed that the efficacy of GG03 was greater than that of GE. In addition, LC50 values demonstrated that GG03 had lower toxicity than GE, and the comparison of the Therapeutic Index (TI) proved that GG03 is a safer functional food. Furthermore, our data showed that GG03 significantly lowered hyperglycemia in a diabetic mouse model. HPLC was performed to confirm the change in the composition of steamed ginger. Interestingly, GG03 showed a 375% increase in 1-dehydro-6-gingerdione (GD) compared with GE. GD has not yet been studied much pharmacologically. Thus, we identified the protective effects of GD in the damaged pancreatic islets of diabetic zebrafish. We further assessed whether the anti-diabetic mechanism of action of GG03 and GD involves insulin secretion. Our results suggest that GG03 and GD might stimulate insulin secretion by the closure of KATP channels in pancreatic ß-cells.

Tratamiento acupuntural en un paciente con depresión, rash cutáneo y vitiligo / Acupuncture Treatment in a Patient with Depression, Skin Rash and Vitiligo

Las lesiones de la piel cuando se hacen visibles y se prolongan en el tiempo pueden llevar al paciente a sufrir tristeza que le afecta su calidad de vida, con el objetivo de demostrar la efectividad del tratamiento con acupuntura en un paciente con depresión, rash cutáneo y vitíligo se presenta un paciente masculino de 22 años de edad con antecedentes de rinitis alérgica, lesiones acrómicas alrededor de ojos y en ambas manos y lesiones tipo rash en brazos y abdomen, con edema de los labios en ocasiones, que le provoca tristeza y baja autoestima. Se diagnosticó síndrome de deficiencia de jing de riñón tratado con acupuntura en puntos shu antiguos durante 20 sesiones. La terapia con acupuntura fue efectiva al desaparecer la tristeza, mejora estado de ánimo y autoestima, cura del rash cutáneo y aumenta la pigmentación de las lesiones de vitiligo.

Skin lesions, when they become visible and last over time, can lead patients to suffer sadness that affects their quality of life. With the objective of demonstrating the effectiveness of acupuncture treatment in a patient with depression, skin rash and Vitiligo, the case is presented of a 22-year-old male patient with a history of allergic rhinitis, achromic lesions around the eyes and on both hands, and rash-like lesions on the arms and abdomen, with lip edema at times, which causes sadness and low self-esteem. Kidney Jing deficiency syndrome was diagnosed and treated with acupuncture at ancient shu points for twenty sessions. Acupuncture therapy was effective insofar sadness disappeared, mood and self-esteem improved, skin rash was cured, the pigmentation of vitiligo lesions increased.

Synergistic Effect of Two Major Components of Malva verticillata in the Recovery of Alloxan-Damaged Pancreatic Islet Cells in Zebrafish.

Malva verticillata (Chinese mallow) has long been used in traditional medicines and herbal teas in Asia. The n-BuOH fraction (Fr) from M. verticillata promoted significant recovery of alloxan-damaged (AXD) pancreatic islets (PIs) in zebrafish (ZF). Two major components were isolated from M. verticillata through repeated-column chromatography. Based on several spectroscopic methods, including nuclear magnetic resonance (NMR), infrared spectroscopy (IR), and fast atom bombardment-mass spectrometry (FAB-MS), the chemical structures of compounds 1 and 2 were determined. In addition, the quantity of both compounds in the n-BuOH Fr was investigated through high-performance liquid chromatography (HPLC) and the quantities of compounds 1 and 2 in the n-BuOH Fr were determined to be 5.58% ± 0.16% and 2.85% ± 0.13%, respectively. The n-BuOH Fr, compounds 1 and 2, and the mixture of compounds 1 and 2 (MX, 1 and 2, the ratio of both compounds in n-BuOH Fr, 1.96:1) were evaluated for their ability to recover AXD PIs and for their KATP channel-blocking mechanism using diazoxide in ZF. The n-BuOH Fr (10 µg/mL) and compounds 1 and MX (1 µg/mL) exhibited a recovery effect on AXD PIs. The n-BuOH Fr (10 µg/mL) and MX (1 µg/mL) were also confirmed to be useful KATP channel activators. A synergistic effect of MX in the recovery of AXD PIs was first confirmed in ZF, and it was discovered that 2 acted as an insulin sensitivity activator that increased the activity of compound 1.

Avocado Oil Extract Modulates Auditory Hair Cell Function through the Regulation of Amino Acid Biosynthesis Genes.

Sensorineural hearing loss (SNHL) is one of the most common causes of disability, affecting over 466 million people worldwide. However, prevention or therapy of SNHL has not been widely studied. Avocado oil has shown many health benefits but it has not yet been studied in regards to SNHL. Therefore, we aimed to investigate the efficacy of avocado oil on SNHL in vitro and in vivo and elucidate its mode of action. For the present study, we used enhanced functional avocado oil extract (DKB122). DKB122 led to recovery of otic hair cells in zebrafish after neomycin-induced otic cell damage. Also, DKB122 improved auditory sensory transmission function in a mouse model of noise induced-hearing loss and protected sensory hair cells in the cochlea. In addition, RNA sequencing was performed to elucidate the mechanism involved. KEGG pathway enrichment analysis of differentially expressed genes showed that DKB122 protected House Ear Institute-Organ of Corti 1 (HEI-OC1) cells against neomycin-related alterations in gene expression due to oxidative stress, cytokine production and protein synthesis.

Implementación de la terapia miofuncional orofacial en una clínica de posgrado de Ortodoncia / Implementation of orofacial myofunctional therapy in a graduate education dental clinic

Introducción: la terapia miofuncional orofacial es el conjunto de técnicas que intervienen en los desórdenes miofuncionales que afectan el comportamiento de la dinámica del sistema estomatognático, su equilibrio y su funcionamiento integrando sus acciones durante un tratamiento de ortopedia maxilar y ortodoncia. Objetivo: desarrollar la implementación del servicio de terapia miofuncional en una Clínica de Ortodoncia y Ortopedia Maxilar como una estrategia de intervención ante la presencia de desórdenes miofuncionales. Métodos: se consideraron dos momentos metodológicos. En el primer momento, se estableció el diagnóstico situacional asistencial con una investigación descriptiva transversal a una muestra de 68 informes fonoaudiológicos de pacientes. Igualmente, para el establecimiento del diagnóstico académico y profesional se realizó una encuesta a 35 personas, 83 por ciento estudiantes de posgrado y 17 por ciento docentes. En el segundo momento, se realizó una revisión documental como soporte teórico de las guías de manejo. Resultados: las fases de diagnóstico situacional confirman la pertinencia de implementar un servicio de terapia miofuncional dado que el 100 por ciento de los pacientes presentaron un diagnóstico de desorden miofuncional, deglución atípica completa en el 60 por ciento y la deglución atípica anterior en el 29 por ciento. En lo referente al diagnóstico profesional, el 91 por ciento de los encuestados presentó una experiencia positiva con la terapia miofuncional tanto en la fase evaluativa como terapéutica. Se consolidaron las guías de manejo que rigen el servicio tanto en acciones evaluativas, diagnósticas y terapéuticas. Conclusiones: se justifica la pertinencia de la implementación de la terapia miofuncional no solo desde los efectos bucofaciales, sino desde la prevención de estos. El desarrollo de programas de intervención clínico educativo en el marco legal de promoción y prevención deben ser contundentes en las clínicas de Ortodoncia y Ortopedia Maxilar, donde se ejecuten actividades de protección específica, detección temprana y atención oportuna en la salud bucal(AU)

Introduction: orofacial myofunctional therapy is the set of techniques used to treat myofunctional disorders affecting the dynamics of the stomatognathic system, its balance and operation, integrating their actions during maxillary orthopedics and orthodontics treatment. Objective: implement the myofunctional therapy service in a maxillary orthopedic / orthodontic clinic as an intervention strategy for myofunctional disorders. Methods: Methodologically, the study was structured into two stages. In the first stage situational care diagnostics was established via a cross-sectional descriptive study of a sample of 68 phonoaudiological reports about patients. Academic and professional diagnostics was based on a survey applied to 35 people, 83 percent of whom were post-graduate students and 17 percent were teachers. The second stage consisted in a document review to provide theoretical foundation to the management guides. Results: the situational diagnostics stages confirm the relevance of implementing a myofunctional therapy service, since 100 percent of the patients were diagnosed with myofunctional disorder, with total atypical deglutition in 60 percent and anterior atypical deglutition in 29 percent. Professional diagnostics showed that 91 percent of respondents had had a positive experience with myofunctional therapy in either its evaluative or therapeutic stage. Consolidation was conducted of the management guides governing the service in terms of evaluative, diagnostic and therapeutic actions. Conclusions: pertinence of the implementation of myofunctional therapy is justified, not only by orofacial effects, but also by their prevention. Development of clinical educational intervention programs within the legal framework for promotion and prevention should be forcefully conducted in maxillary orthopedic / orthodontic clinics, where actions will be performed aimed at specific protection, early detection and timely care in dental practice(AU)

Implementación de la terapia miofuncional orofacial en una clínica de posgrado de Ortodoncia / Implementation of orofacial myofunctional therapy in a graduate education dental clinic

Introducción: la terapia miofuncional orofacial es el conjunto de técnicas que intervienen en los desórdenes miofuncionales que afectan el comportamiento de la dinámica del sistema estomatognático, su equilibrio y su funcionamiento integrando sus acciones durante un tratamiento de ortopedia maxilar y ortodoncia. Objetivo: desarrollar la implementación del servicio de terapia miofuncional en una Clínica de Ortodoncia y Ortopedia Maxilar como una estrategia de intervención ante la presencia de desórdenes miofuncionales. Métodos: se consideraron dos momentos metodológicos. En el primer momento, se estableció el diagnóstico situacional asistencial con una investigación descriptiva transversal a una muestra de 68 informes fonoaudiológicos de pacientes. Igualmente, para el establecimiento del diagnóstico académico y profesional se realizó una encuesta a 35 personas, 83 por ciento estudiantes de posgrado y 17 por ciento docentes. En el segundo momento, se realizó una revisión documental como soporte teórico de las guías de manejo. Resultados: las fases de diagnóstico situacional confirman la pertinencia de implementar un servicio de terapia miofuncional dado que el 100 por ciento de los pacientes presentaron un diagnóstico de desorden miofuncional, deglución atípica completa en el 60 por ciento y la deglución atípica anterior en el 29 por ciento. En lo referente al diagnóstico profesional, el 91 por ciento de los encuestados presentó una experiencia positiva con la terapia miofuncional tanto en la fase evaluativa como terapéutica. Se consolidaron las guías de manejo que rigen el servicio tanto en acciones evaluativas, diagnósticas y terapéuticas. Conclusiones: se justifica la pertinencia de la implementación de la terapia miofuncional no solo desde los efectos bucofaciales, sino desde la prevención de estos. El desarrollo de programas de intervención clínico educativo en el marco legal de promoción y prevención deben ser contundentes en las clínicas de Ortodoncia y Ortopedia Maxilar, donde se ejecuten actividades de protección específica, detección temprana y atención oportuna en la salud bucal(AU)

Introduction: orofacial myofunctional therapy is the set of techniques used to treat myofunctional disorders affecting the dynamics of the stomatognathic system, its balance and operation, integrating their actions during maxillary orthopedics and orthodontics treatment. Objective: implement the myofunctional therapy service in a maxillary orthopedic / orthodontic clinic as an intervention strategy for myofunctional disorders. Methods: Methodologically, the study was structured into two stages. In the first stage situational care diagnostics was established via a cross-sectional descriptive study of a sample of 68 phonoaudiological reports about patients. Academic and professional diagnostics was based on a survey applied to 35 people, 83 percent of whom were post-graduate students and 17 percent were teachers. The second stage consisted in a document review to provide theoretical foundation to the management guides. Results: the situational diagnostics stages confirm the relevance of implementing a myofunctional therapy service, since 100 percent of the patients were diagnosed with myofunctional disorder, with total atypical deglutition in 60 percent and anterior atypical deglutition in 29 percent. Professional diagnostics showed that 91 percent of respondents had had a positive experience with myofunctional therapy in either its evaluative or therapeutic stage. Consolidation was conducted of the management guides governing the service in terms of evaluative, diagnostic and therapeutic actions. Conclusions: pertinence of the implementation of myofunctional therapy is justified, not only by orofacial effects, but also by their prevention. Development of clinical educational intervention programs within the legal framework for promotion and prevention should be forcefully conducted in maxillary orthopedic / orthodontic clinics, where actions will be performed aimed at specific protection, early detection and timely care in dental practice(AU)

Trigonelline promotes auditory function through nerve growth factor signaling on diabetic animal models.

BACKGROUND: Protection of cochlear function and reconstruction of neuronal networks in damaged auditory sensory structures is crucial for therapeutic treatment of diabetic hearing loss. Nerve growth factor (NGF) has been used as a novel therapeutic target to protect against the neurodegenerative effects of Diabetes Mellitus (DM). PURPOSE: We aimed to evaluate the potential effect of trigonelline (TRG) on reducing auditory damage produced by DM using NGF as a potential marker. METHOD: Docking simulations were carried out using Autodock Vina software and visualized using Discovery Studio. Morphological analysis of hair cells and neuromasts was performed on alloxan-induced diabetic zebrafish by fluorescence and scanning electron microscopy. Blockage of NGF receptor phosphorylation with K-252a was used to evaluate TRG and NGF action. Further assessment of NGF by ELISA on a primary culture of spiral ganglion cells was performed as a marker of neuronal function on the hearing system. Finally, auditory function was assessed in LepR(db/db) mice using auditory brainstem response (ABR) and transient evoked otoacoustic emission (TEOAE) during 8 weeks. RESULTS: Docking simulations showed that TRG binds to the active site of NGF through molecular interactions with Lysine88 (Lys88) and Tyrosine52 (Tyr52). TRG treatment significantly reduced hair cell loss and neuromast damage in diabetic zebrafish (P < .05). Further evaluation revealed a significant increase in the number of neuromasts after NGF administration (P < .001). TRG and NGF action was suppressed during blockage of NGF receptor phosphorylation. Moreover, spiral ganglion cells revealed significant elevation on NGF values after TRG treatment (P < .05). In vivo evaluation of LepR(db/db) mice revealed a significant reduction in the auditory damage produced under diabetic progression, characterized by reduced ABR hearing threshold shifts and increased signal-to-noise ratio in TEOAE (P < .05). CONCLUSIONS: This study suggests that the enhanced hearing function produced by TRG may be mediated by NGF, providing a potential therapeutic strategy for diabetic hearing loss.

Bioconversion of Scutellaria baicalensis extract can increase recovery of auditory function in a mouse model of noise-induced hearing loss.

In noise-induced hearing loss (NIHL), noise exposure damages cochlear sensory hair cells, which lack the capacity to regenerate. Following noise insult, intense metabolic activity occurs, resulting in a cochlear free radical imbalance. Oxidative stress and antioxidant enzyme alterations, including lipoxygenase upregulation, have been linked to chronic inflammation, which contributes to hearing impairment. We previously proposed Scutellaria baicalensis (SB) extract as an alternative therapeutic for preventing NIHL and attributed its pharmacological effects to baicalein. Although baicalein was most effective, its concentration in SB extract is much lower compared to baicalin. In this study, we performed enzymatic bioconversion using an Sumizyme (SM) enzyme to increase baicalein concentration in SB extract and consequently improve its therapeutic efficacy. HPLC analysis revealed that baicalein concentration in SB extract after bioconversion (BSB) was significantly increased. Moreover, BSB-treated mice exhibited significantly improved auditory function compared with control mice and tended to have improved auditory function compared with SB-treated mice. We also demonstrated that BSB effectively stimulates hair cell regeneration compared to SB that did not achieve the same effect in a zebrafish model. Finally, when compared the abilities of SB and BSB to inhibit lipoxygenase (LOX), BSB showed a greater efficacy. Cumulatively, our data suggest that BSB exhibits improved pharmacological properties for treating NIHL compared with SB.

Direct inhibition of osteoblastic Wnt pathway by fibroblast growth factor 23 contributes to bone loss in chronic kidney disease.

Bone loss and increased fractures are common complications in chronic kidney disease. Because Wnt pathway activation is essential for normal bone mineralization, we assessed whether Wnt inhibition contributes to high-phosphorus-induced mineralization defects in uremic rats. By week 20 after 7/8 nephrectomy, rats fed a high-phosphorus diet had the expected high serum creatinine, phosphorus, parathyroid hormone, and fibroblast growth factor 23 (FGF23) levels and low serum calcium. There was a 15% reduction in tibial mineral density and a doubling of bone cortical porosity compared to uremic rats fed a normal-phosphorus diet. The decreases in tibial mineral density were preceded by time-dependent increments in gene expression of bone formation (Osteocalcin and Runx2) and resorption (Cathepsin K) markers, which paralleled elevations in gene expression of the Wnt inhibitors Sfrp1 and Dkk1 in bone. Similar elevations of Wnt inhibitors plus an increased phospho-ß-catenin/ß-catenin ratio occurred upon exposure of the osteoblast cell line UMR106-01 either to uremic serum or to the combination of parathyroid hormone, FGF23, and soluble Klotho, at levels present in uremic serum. Strikingly, while osteoblast exposure to parathyroid hormone suppressed the expression of Wnt inhibitors, FGF23 directly inhibited the osteoblastic Wnt pathway through a soluble Klotho/MAPK-mediated process that required Dkk1 induction. Thus, the induction of Dkk1 by FGF23/soluble Klotho in osteoblasts inactivates Wnt/ß-catenin signaling. This provides a novel autocrine/paracrine mechanism for the adverse impact of high FGF23 levels on bone in chronic kidney disease.

Fósforo sérico en niños con desnutrición grave y su relación con el síndrome de realimentación / Serum phosphorus in malnourished children and its relationship with the syndrome of feedback

El síndrome de realimentación ocurre como consecuencia de la reintroducción de alimentos en pacientes malnutridos. Se realizó estudio de tipo observacional, prospectivo, no experimental y comparativo. Se midieron los niveles de fósforo en niños desnutridos graves y eutróficos al ingreso y al día 7 después de iniciada la alimentación con el objetivo de relacionar los niveles séricos de fósforo con el síndrome de realimentación en niños desnutridos graves atendidos en el Servicio de Emergencia de Pediatría Hospital Universitario de Maracaibo. Venezuela, desde junio 2010 hasta junio 2011. Se incluyeron 60 niños, entre 1 mes y 4 años, de ambos sexos, divididos en 2 grupos: Grupo A n=30 niños desnutridos graves y Grupo B n=30 niños eutróficos. En ambos grupos predominaron los lactantes de 1 a 23 meses con el 86,7% y el 60% respectivamente. Fueron del sexo masculino el 70% y 73% en cada grupo. El fósforo sérico en el grupo A al ingreso fue de 3,17 ± 0,98 mg/dl y a los siete días 2,48 ± 1,01 mg/dl, estadísticamente significativo p = 0,002; sin manifestaciones clínicas. En el grupo B no hubo significancia estadística con p=0,569 al comparar los valores del fósforo sérico al ingreso y al día 7. Tres niños del grupo A murieron. Se observo en el presente estudio que los niños desnutridos graves presentaron disminución del fósforo sérico al ser realimentados. Nuevas líneas de investigación deben hacerse para aumentar los conocimientos actuales sobre ésta condición(AU)

Refeeding syndrome occurs as a result of the reintroduction of food in malnourished patients. Observational, prospective, non experimental and comparative study was performed. Phosphorus levels in severely malnourished children and healthy children was measured at admission and at 7 days after initiation of feeding in order to associate the concentration of serum phosphorus with refeeding syndrome in severely malnourished children hospitalized at the Pediatric Emergency Service University Hospital of Maracaibo, Venezuela, from June 2010 to June 2011. We included 60 children between 1 month and 4 years and both sexes, divided into 2 groups: Group A n = 30 serious malnourished children and Group B (control) n = 30 eutrophic children. In both groups predominated the infants 1 to 23 months with 86.7% and 60% respectively. 70% and 73% were male both group. In Group A, there was statistical significance betwee the serum phosphorus at the beginning (3.17 ± 0.98 mg/dl) and at seven days of hospitalization 2.48 ± 1.01 mg/dl, p = 0.002; without clinical manifestations. In Group B there was no statistical significance with p=0,569 to compare values of serum phosphorus income and day 7. Three children of the group A died. It was observed in this study that serious malnourished children presented the serum phosphorus decreased to be refueled. New lines of research should be expanded in this area to increase current knowledge about this condition(AU)

MicroRNAs 29b, 133b, and 211 Regulate Vascular Smooth Muscle Calcification Mediated by High Phosphorus.

Vascular calcification is a frequent cause of morbidity and mortality in patients with CKD and the general population. The common association between vascular calcification and osteoporosis suggests a link between bone and vascular disorders. Because microRNAs (miRs) are involved in the transdifferentiation of vascular smooth muscle cells into osteoblast-like cells, we investigated whether miRs implicated in osteoblast differentiation and bone formation are involved in vascular calcification. Different levels of uremia, hyperphosphatemia, and aortic calcification were induced by feeding nephrectomized rats a normal or high-phosphorus diet for 12 or 20 weeks, at which times the levels of eight miRs (miR-29b, miR-125, miR-133b, miR-135, miR-141, miR-200a, miR-204, and miR-211) in the aorta were analyzed. Compared with controls and uremic rats fed a normal diet, uremic rats fed a high-phosphorous diet had lower levels of miR-133b and miR-211 and higher levels of miR-29b that correlated respectively with greater expression of osteogenic RUNX2 and with lower expression of several inhibitors of osteoblastic differentiation. Uremia per se mildly reduced miR-133b levels only. Similar results were obtained in two in vitro models of vascular calcification (uremic serum and high-calcium and -phosphorus medium), and experiments using antagomirs and mimics to modify miR-29b, miR-133b, and miR-211 expression levels in these models confirmed that these miRs regulate the calcification process. We conclude that miR-29b, miR-133b, and miR-211 have direct roles in the vascular smooth muscle calcification induced by high phosphorus and may be new therapeutic targets in the management of vascular calcification.

Synergistic Potentials of Coffee on Injured Pancreatic Islets and Insulin Action via KATP Channel Blocking in Zebrafish.

Pancreatic islets (PIs) are damaged under diabetic conditions, resulting in decreased PI size. This study examined the regenerative effects of coffee and its components (caffeine, CFI; trigonelline, TRG; chlorogenic acid, CGA) on zebrafish larval PIs and ß-cells damaged by administration of alloxan (AX). In addition, the influence of coffee and its active components on KATP channels was investigated using diazoxide (DZ) as a KATP channel activator. PI size and fluorescence intensity were significantly increased in the coffee-treated group relative to the no-treatment group (P < 0.0001). In addition, coffee exerted significant regenerative effects on pancreatic ß-cells (p = 0.006). Treatment with TRG and CGA rescued PI damage, and the combination of TRG/CGA had a synergistic effect. In conclusion, the results indicate that coffee has beneficial effects on AX-damaged PIs and may also be useful as a blocker of pancreatic ß-cell K(+) channels.

Necesidad social de un modelo didáctico-holístico para la formación de la cultura investigativa en discentes de las carreras de ciencias médicas / Social need of a didactic-holistic model for the training for investigative culture in students of the medical sciences careers

La presente actualización bibliográfica aborda, desde una óptica de ciencia, tecnología y sociedad, cómo la necesidad social promueve la relación entre la formación de la cultura investigativa y la educación médica superior. Asimismo, se realizó un análisis basado en las contradicciones fundamentales del modelo del profesional, el plan de estudio y los programas de Metodología de la Investigación, a lo largo de las carreras de ciencias médicas, y su relación con el proceso formativo en cuanto a la cultura investigativa, lo que unido al diagnóstico fáctico, permiten revelar las fisuras en el proceso de enseñanza-aprendizaje del futuro egresado, que limitan su formación integral en los aspectos epistemológico, científico, cultural, ético, didáctico, teórico-práctico, praxiológico y dialéctico. De tales consideraciones, emerge un problema social expresado en el insuficiente desempeño de los profesionales de la salud en la esfera de la investigación, como vía de solución a los problemas inherentes a la salud humana, lo cual atenta contra un servicio de excelencia en este sector(AU)

The present literature updating approaches, from a scientific, technological and social point of view, how the social need promotes the relationship between the training in the investigative culture and the high medical education. Likewise, an analysis based on the fundamental contradictions of the professional's pattern, the curricula and the programs of the Investigation Methodology was carried out, during the careers of medical sciences, and their relationship with the training process regarding the investigative culture, which together with the factual diagnosis, allow to reveal the fissures in the teaching-learning process of the future graduate, which limit their comprehensive training in the epistemological, scientific, cultural, ethical, didactic, theoretical-practical, praxiological and dialectical aspects. From these considerations, a social problem emerges in the poor performance of the health professionals in the investigation field, as a solution to the inherent problems to the human health, that which hampers an excellence service in this sector(AU)

Necesidad social de un modelo didáctico-holístico para la formación de la cultura investigativa en discentes de las carreras de ciencias médicas / Social need of a didactic-holistic model for the training for investigative culture in students of the medical sciences careers i: en

La presente actualización bibliográfica aborda, desde una óptica de ciencia, tecnología y sociedad, cómo la necesidad social promueve la relación entre la formación de la cultura investigativa y la educación médica superior. Asimismo, se realizó un análisis basado en las contradicciones fundamentales del modelo del profesional, el plan de estudio y los programas de Metodología de la Investigación, a lo largo de las carreras de ciencias médicas, y su relación con el proceso formativo en cuanto a la cultura investigativa, lo que unido al diagnóstico fáctico, permiten revelar las fisuras en el proceso de enseñanza-aprendizaje del futuro egresado, que limitan su formación integral en los aspectos epistemológico, científico, cultural, ético, didáctico, teórico-práctico, praxiológico y dialéctico. De tales consideraciones, emerge un problema social expresado en el insuficiente desempeño de los profesionales de la salud en la esfera de la investigación, como vía de solución a los problemas inherentes a la salud humana, lo cual atenta contra un servicio de excelencia en este sector.

The present literature updating approaches, from a scientific, technological and social point of view, how the social need promotes the relationship between the training in the investigative culture and the high medical education. Likewise, an analysis based on the fundamental contradictions of the professional's pattern, the curricula and the programs of the Investigation Methodology was carried out, during the careers of medical sciences, and their relationship with the training process regarding the investigative culture, which together with the factual diagnosis, allow to reveal the fissures in the teaching-learning process of the future graduate, which limit their comprehensive training in the epistemological, scientific, cultural, ethical, didactic, theoretical-practical, praxiological and dialectical aspects. From these considerations, a social problem emerges in the poor performance of the health professionals in the investigation field, as a solution to the inherent problems to the human health, that which hampers an excellence service in this sector.

Importance of previous transurethral resection of the prostate before eerpe.short-term functional outcomes in a single surgeon series.

OBJECTIVES: Laparoscopic Radical Prostatectomy (LRP) is technically a very demanding procedure and potentially even more challenging in patients with previous transurethral resection (TURP). This study evaluates the impact of previous TURP on the short-term functional outcome of patients undergoing extraperitoneal LRP. METHODS: Retrospective analysis of a prospectively collected database, comprising a single-surgeon cohort of 155 consecutive LRP cases, 19 of which had previous history of TURP. Demographics, clinical and functional outcomes were evaluated and compared among patients with and without previous TURP. Multivariate analysis was performed to identify potential variables independently associated with continence outcomes. Incontinence was defined as the need of more than 1 pad/day. Potency was defined as the ability for sexual intercourse with or without the use of phosphodiesterase inhibitors. RESULTS: Demographic and clinical variables were comparable among the two study groups. Neurovascular bundle preservation was possible in 26% and 37% of patients with and without previous TURP, respectively. No major complications were recorded and the incidence of minor complications was comparable. Overall continence rate at 3 months was 82,58%, for the entire cohort. Subset analysis demonstrated a 3-month continence rate of 73.7% vs. 83.8% (p>0.05) in patients with and without TURP, respectively. Multivariate analysis demonstrated age, BMI and ASA were variables independently associated with continence outcomes. In the cohort of patients with previous TURP, 2 out of 7 undergoing preservation recovered erections, with a mean follow up of 15.5 months, comparable to the 30% achieved in patients without TURP and nerve sparing procedure. CONCLUSIONS: Laparoscopic Radical Prostatectomy in patients with previous TURP is feasible, with complication rates and short-term functional outcomes comparable to those in patients without previous resection.

Relevancia de la resección transuretral de próstata en los resultados funcionales de la prostatectomía radical laparoscópica / Importance of previous transurethral resection of the prostate before eerpe. short-term functional outcomes in a single surgeon series

OBJETIVO: La dificultad del tratamiento quirúrgico del Cáncer de próstata (caP) se acentúa en los pacientes con antecedentes de resección transuretral de próstata (RTU). En este estudio valoraremos la influencia de la RTU en los resultados funcionales a corto plazo de la prostatectomía radical laparoscópica extraperitoneal. MÉTODO: Revisión retrospectiva de una base de datos de cumplimentación prospectiva de una serie de pacientes intervenidos por un solo cirujano de manera consecutiva. Se compararon las características demográficas, clínicas y patológicas de los pacientes con y sin RTU previa, para posteriormente realizar un estudio multivariante mediante regresión logística para comprobar qué variables se asociaban de manera independiente y significativa a la incontinencia según el criterio (>1 compresa/día). Se consideró potentes a aquellos pacientes capaces de penetrar con o sin la ayuda de inhibidores de la 5 fosfodiesterasa. Se dispuso de la evaluación funcional de 155 pacientes, 19 de los cuales tenían antecedentes de RTU previa. RESULTADOS: Los subgrupos no diferían en las variables relevantes para el estudio. La conservación de haces neurovasculares se realizó en un 37% de los pacientes sin RTU previa y en un 26% del grupo contrario. No se objetivaron complicaciones mayores, la frecuencia de complicaciones menores no difería. La tasa de continencia de la serie global, evaluada en los 3 primeros meses, era del 82,58%. En el subgrupo de pacientes sin antecedentes de RTU previa era del 83,8% mientras que en el subgrupo de pacientes con RTU previa era del 73,7%, p>0,05. En el análisis multivariante, se asociaron de manera independiente y significativa a la continencia la edad, el IMC y el ASA. Tampoco se observaron diferencias significativas en la proporción de pacientes que recuperaron la erección en uno y otro grupo (28 vs 30%). CONCLUSIONES: Los resultados funcionales a corto plazo son aceptables y comparables a los de los pacientes sin resección previa (AU)

OBJECTIVES: Laparoscopic Radical Prostatectomy (LRP) is technically a very demanding procedure and potentially even more challenging in patients with previous trans-urethral resection (TURP). This study evaluates the impact of previous TURP on the short-term functional outcome of patients undergoing extraperitoneal LRP. METHODS: Retrospective analysis of a prospectively collected database, comprising a single-surgeon cohort of 155 consecutive LRP cases, 19 of which had previous history of TURP. Demographics, clinical and functional outcomes were evaluated and compared among patients with and without previous TURP. Multivariate analysis was performed to identify potential variables independently associated with continence outcomes. Incontinence was defined as the need of more than 1 pad/day. Potency was defined as the ability for sexual intercourse with or without the use of phosphodiesterase inhibitors. RESULTS: Demographic and clinical variables were comparable among the two study groups. Neurovascular bundle preservation was possible in 26% and 37% of patients with and without previous TURP, respectively. No major complications were recorded and the incidence of minor complications was comparable. Overall continence rate at 3 months was 82,58%, for the entire cohort. Subset analysis demonstrated a 3-month continence rate of 73.7% vs. 83.8% (p>0.05) in patients with and without TURP, respectively. Multivariate analysis demonstrated age, BMI and ASA were variables independently associated with continence outcomes. In the cohort of patients with previous TURP, 2 out of 7 undergoing preservation recovered erections, with a mean follow up of 15.5 months, comparable to the 30% achieved in patients without TURP and nerve sparing procedure. CONCLUSIONS: Laparoscopic Radical Prostatectomy in patients with previous TURP is feasible, with complication rates and short-term functional outcomes comparable to those in patients without previous resection (AU)

Evaluación de la actividad antimicrobiana de los extractos de las hojas de Jatropha aethiopica (Chaya) / Evaluation of the antimicrobial activity of the extracts of Jatropa aethiopica (Chaya) leaves

Se realizó un estudio de la composición química para evaluar la acción antimicrobiana de extractos obtenidos a partir de hojas de Jatropha aethiopica (Chaya). La tintura al 20 por ciento presenta los parámetros de calidad que se especifican en las Normas Cubanas. Se realizaron extracciones sucesivas partiendo de la tintura con solventes de polaridad creciente (n-hexano, cloroformo, acetato de etilo y agua) para identificar los metabolitos secundarios presentes. En los ensayos microbiológicos in vitro presentaron actividad antibacteriana los extractos hexánico, clorofórmico y de acetato de etilo y actividad antifúngica el extracto de acetato de etilo, elaborados a partir de la tintura, frente a cepas de Staphylococcus aureus, E. coli y Candida sp.Todos los resultados biológicos fueron comparados con antibióticos modelos corroborándose la eficacia positiva de los extractos evaluados(AU)

A study of the chemical composition was performed to evaluate the antimicrobial action of the extracts obtained from the leaves of Jatropha aethiopica (Chaya). 20 percent Tincture presented quality parameters specified in the Cuban standards. There were developed successive extractions starting from the tincture with solvents of increasing polarity (hexane, chloroform, water and ethyl acetate) to identify the secondary metabolites that are presented. Microbiological tests in vitro presented antibacterial hexanic activity, chloroformic extracts and antifungal activity of ethyl acetate extract, produced from the dye against strains of Staphylococcus aureus, e. coli and Candida sp. All biological results were compared with antibiotics models corroborating the positive effectiveness of the evaluated extracts(EU)

Cannabinoides y su posible uso en el glaucoma / Cannabinoids and their possible use in the treatment of glaucoma

Aunque la planta Cannabis sativa ha sido empleada desde la más remota antigüedad con fines medicinales, uno de sus derivados, la marihuana, se ha convertido en la droga de uso ilegal más consumida en el mundo. Asimismo tanto el Cannabis como sus cannabinoides se emplean como terapéutico en pocas enfermedades generalmente neurológicas. Se realizó una revisión bibliográfica para exponer el posible uso de los cannabinoides en la terapéutica del glaucoma. Para ello se tuvo en cuenta la literatura disponible sobre el tema, durante el período enero a septiembre de 2010. Se ha comprobado el efecto hipotensor ocular de los cannabinoides al disminuir la producción de humor acuoso, y aumentar la excreción de humor acuoso a través de la malla trabecular y la vía uveoescleral, efecto compatible con el hallazgo de elevadas concentraciones de receptores de cannabinoides rCB1 y rCB2; además, el tetrahidrocannabinol ha demostrado disminuir el efecto neurodegenerativo en modelos de isquemia cerebral en ratas y se evidenció también el efecto beneficioso de los cannabinoides al disminuir la degeneración secundaria asociada al glaucoma mediada por la excitotoxicidad del glutamato. Estos hallazgos sobre el efecto beneficioso de los cannabinoides como hipotensores oculares y por su efecto neuroprotector, transmiten un mensaje esperanzador sobre la función que estos podrían desempeñar en el campo del glaucoma, aunque para mayor seguridad y eficacia serían necesarios ensayos clínicos encaminados a valorar su aplicabilidad en la práctica clínica diaria

Although the Cannabis Sativa plant has been used since the most remote ancient times for medicinal purposes, one of its derivatives, marijuana, has become the most commonly used illegal drug in the world. Similarly, both Cannabis and the cannabinoids are used therapeutically in a small number of general neurological pathologies. Literature review was made to set forth the possible use of cannabinoids in the treatment of Glaucoma. To this end, t the available literature on the subject from January to September 2010 was taken into account. The cannabinoid´s antihypertensive occular effect has been found to decrease aqueous humor production, and to increase the excretion of aqueous humor through the trabeculary mesh and the route uveoscleral pathway. This effect is compatible with the high concentrations of rCB1 and rCB2 cannabinoid receptors found. Besides, tetrahydrocannabinol has proved to reduce the neurodegenerative effect in models of cerebral ischemia in rats and the beneficial effect of cannabinoids to reduce gluthamate excitotoxicity-mediated secondary degeneration associated with glaucoma. These findings about the beneficial effect of cannabinoids as ocular antihypertensives and its neuroprotective effect convey a hopeful message about the role they could play in the treatment of glaucoma; however, it would be necessary to perform further clinical trials to assess their applicability in our daily clinical practice for greater safety and efficiency