Low-Temperature Vacuum Drying on Broccoli: Enhanced Anti-Inflammatory and Anti-Proliferative Properties Regarding Other Drying Methods.

Low-temperature vacuum drying (LTVD) has shown great potential for drying vegetables. It could avoid excessive degradations of active compounds with potential therapeutic agents. In this study, the effect on several relevant bioactive compounds, anti-inflammatory activity, and anti-proliferative activity of broccoli (Brassica oleracea var. italica) were evaluated. Effects of other drying methods, including vacuum drying (VD), convective drying (CD), infrared drying (IRD), and freeze drying (FD), were also comparatively evaluated. The results of all dried samples showed high polyunsaturated fatty acid contents (of up to 71.3%) and essential amino acid contents (of up to 8.63%). The LTVD method stands out above the other drying methods, since it obtained the highest content of total phenols, chlorogenic acid, and ferulic acid. Both the LTVD and CD samples demonstrated high anti-inflammatory and anti-proliferative activities. These CD and LTVD samples were also the most active against the breast carcinoma MDA-MB-23 cell line. Due to the good retention of bioactive compounds via LTVD, the obtained dried broccoli here can be used in a near time as an ingredient for the development of novel natural products with anti-inflammatory and anti-proliferative effects.

Comparative analysis of the myoglobin gene in whales and humans reveals evolutionary changes in regulatory elements and expression levels.

Cetacea and other diving mammals have undergone numerous adaptations to their aquatic environment, among them high levels of the oxygen-carrying intracellular hemoprotein myoglobin in skeletal muscles. Hypotheses regarding the mechanisms leading to these high myoglobin levels often invoke the induction of gene expression by exercise, hypoxia, and other physiological gene regulatory pathways. Here we explore an alternative hypothesis: that cetacean myoglobin genes have evolved high levels of transcription driven by the intrinsic developmental mechanisms that drive muscle cell differentiation. We have used luciferase assays in differentiated C2C12 cells to test this hypothesis. Contrary to our hypothesis, we find that the myoglobin gene from the minke whale, Balaenoptera acutorostrata, shows a low level of expression, only about 8% that of humans. This low expression level is broadly shared among cetaceans and artiodactylans. Previous work on regulation of the human gene has identified a core muscle-specific enhancer comprised of two regions, the "AT element" and a C-rich sequence 5' of the AT element termed the "CCAC-box". Analysis of the minke whale gene supports the importance of the AT element, but the minke whale CCAC-box ortholog has little effect. Instead, critical positive input has been identified in a G-rich region 3' of the AT element. Also, a conserved E-box in exon 1 positively affects expression, despite having been assigned a repressive role in the human gene. Last, a novel region 5' of the core enhancer has been identified, which we hypothesize may function as a boundary element. These results illustrate regulatory flexibility during evolution. We discuss the possibility that low transcription levels are actually beneficial, and that evolution of the myoglobin protein toward enhanced stability is a critical factor in the accumulation of high myoglobin levels in adult cetacean muscle tissue.

Transplantation-based screen identifies inducers of muscle progenitor cell engraftment across vertebrate species.

Stem cell transplantation presents a potentially curative strategy for genetic disorders of skeletal muscle, but this approach is limited by the deleterious effects of cell expansion in vitro and consequent poor engraftment efficiency. In an effort to overcome this limitation, we sought to identify molecular signals that enhance the myogenic activity of cultured muscle progenitors. Here, we report the development and application of a cross-species small-molecule screening platform employing zebrafish and mice, which enables rapid, direct evaluation of the effects of chemical compounds on the engraftment of transplanted muscle precursor cells. Using this system, we screened a library of bioactive lipids to discriminate those that could increase myogenic engraftment in vivo in zebrafish and mice. This effort identified two lipids, lysophosphatidic acid and niflumic acid, both linked to the activation of intracellular calcium-ion flux, which showed conserved, dose-dependent, and synergistic effects in promoting muscle engraftment across these vertebrate species.

Rehabilitación cardiaca en mujeres y hombres después de un infarto agudo del miocardio

Fundamento: la rehabilitación cardiovascular favorece la recuperación de los pacientes que sufren de infarto del agudo del miocardio. Objetivo caracterizar la rehabilitación cardiovascular en mujeres y hombres con un primer infarto agudo de miocardio no complicado con elevación del segmento ST. Métodos: se realizó un estudio descriptivo y transversal en el Centro de Atención Cardiovascular del Hospital Provincial Docente Clínico Quirúrgico Manuel Ascunce Domenech de Camagüey en el período comprendido entre septiembre de 2015 hasta septiembre del 2016. La muestra estuvo constituida por 65 pacientes a los que se realizó una prueba ergométrica y ecocardiograma pre-alta y 6 semanas después de rehabilitados. A los cinco años se evaluó supervivencia. Se realizó prueba de ergométrica máxima limitada por síntomas para determinar estratificación de riesgo, capacidad funcional, prescripción de la actividad y proporcionar información al paciente. Resultados: hubo mayor incidencia de infarto rehabilitado en el sexo masculino, el grupo de edad más afectado fue el de 50-59 años y la hipertensión arterial fue el factor de riesgo cardiovascular predominante. Hubo notable mejoría en los parámetros ergométricos y hemodinámicos después de las 6 semanas de la rehabilitación. La reacción hipertensiva y la disnea, disminuyeron en la mayoría de los casos al final del estudio. Los pacientes que comenzaron el estudio mejoraron su clase funcional a las 6 semanas de rehabilitados y hubo un incremento de la categoría riesgo bajo a expensas del riesgo moderado. La supervivencia a los cinco años fue del 89,9 %. Conclusiones: se obtuvo una significativa mejoría de parámetros clínicos y ergométricos, así como la reincorporación a las labores cotidianas en los pacientes que participaron en el programa. Las mujeres recibieron menos beneficios de este programa que los hombres.

Background: cardiovascular rehabilitation favors the recovery of patients suffering from acute myocardial infarction. Objective: to characterize cardiovascular rehabilitation in women and men with a first uncomplicated acute myocardial infarction with ST-segment elevation. Methods: a descriptive and cross-sectional study was carried out at the Cardiovascular Care Center of the Manuel Ascunce Domenech Teaching Clinical Surgical Provincial Hospital in Camagüey in the period from September 2015 to September 2016. The sample consisted of 65 patients. who underwent a stress test and echocardiogram before discharge and 6 weeks after rehabilitation. Survival was evaluated at five years. Symptom-limited maximal stress test was performed to determine risk stratification, functional capacity, activity prescription and provide information to the patient. Results: there was a higher incidence of rehabilitated infarction in males, the most affected age group was 50-59 years, and arterial hypertension was the predominant cardiovascular risk factor. There was notable improvement in the ergometric and hemodynamic parameters after 6 weeks of rehabilitation. The hypertensive reaction and dyspnea decreased in most cases at the end of the study. The patients who began the study improved their functional class 6 weeks after rehabilitation and there was an increase in the low risk category at the expense of moderate risk. Five-year survival was 89.9 %. Conclusions: a significant improvement of clinical and ergometric parameters was obtained, as well as the return to daily tasks in the patients who participated in the program. Women received fewer benefits from this program than men.

Drying Kinetic Modeling and Assessment of Mineral Content, Antimicrobial Activity, and Potential α-Glucosidase Activity Inhibition of a Green Seaweed (Ulva spp.) Subjected to Different Drying Methods.

The green algal genus Ulva grows widely on all continents and is used for several applications such as functional foods, cosmeceuticals, nutraceuticals, and pharmaceuticals due to its nutritional characteristics. However, to increase its shelf-life and retain its bioactive components, it is necessary to apply some conservation technology, such as drying. The aim of this work is to describe the drying kinetic behavior of the green seaweed Ulva spp. by applying three dehydration methods: convective drying (CD), vacuum drying (VD), and solar drying (SD) by mathematical modeling and determining the retention of mineral content by atomic absorption spectroscopy and the antimicrobial potential against four strains such as Staphylococcus aureus, Escherichia coli, Saccharomyces cerevisiae, and Penicillium sp. by measurement of inhibition zones and α-glucosidase activity inhibition, as reported by IC50 determination. A freeze-dried sample was used as the control. The equilibrium moisture values calculated using the Guggenheim-Anderson-de Boer model were 0.0108, 0.0108, and 0.0290 g water/g d.m., for CD, VD and SD, respectively. The Midilli and Kucuk model showed robustness to fit all the experimental data of drying kinetic modeling. Ulva spp. is an important source of potassium with a ratio of Na/K < 0.29. Inhibition halos were observed in all samples against S. cerevisiae and Penicillium sp. with higher values than fluconazole action. An inhibitory effect on α-glucosidase activity was observed in all samples, mainly in the freeze-dried sample. Finally, dried Ulva spp. is a rich source of macro- and microminerals with antimicrobial activity and is a potential α-glucosidase inhibitor. Thus, it can be considered as a potential functional ingredient for food manufacturing.

Advances in the Structural Strategies of the Self-Assembly of Photoresponsive Supramolecular Systems.

Photosensitive supramolecular systems have garnered attention due to their potential to catalyze highly specific tasks through structural changes triggered by a light stimulus. The tunability of their chemical structure and charge transfer properties provides opportunities for designing and developing smart materials for multidisciplinary applications. This review focuses on the approaches reported in the literature for tailoring properties of the photosensitive supramolecular systems, including MOFs, MOPs, and HOFs. We discuss relevant aspects regarding their chemical structure, action mechanisms, design principles, applications, and future perspectives.

Riesgos y complicaciones asociados al embarazo en la adolescencia / Risks and complications associated with pregnancy in adolescent ages

RESUMEN Introducción: el embarazo en la adolescencia constituye un problema de salud en el mundo, repercute en la sociedad y compromete la salud de la madre y del feto. Objetivo: describir los factores de riesgos y complicaciones asociados al embarazo en la adolescencia. Métodos: se realizó una revisión bibliográfica sobre el embarazo en la adolescencia. Se expresó criterios de autores y resultados de investigaciones disponibles en las bases de datos SciELO, Medline, PubMED. Se empleó un total de 30 referencias bibliográficas, más del 75 % de la literatura consultada corresponde a los últimos cinco años. Desarrollo: el embarazo en la adolescencia no tiene causa específica. En su desarrollo inciden factores de riesgos individuales, familiares y socioeconómicos. Las complicaciones del embarazo en edades tempranas son frecuentes, constituyen un alto riesgo obstétrico pues compromete la vida de la madre y el feto. Las complicaciones se asocian fundamentalmente a las características biológicas de la madre y a la edad gestacional que presenta. Conclusiones: los principales factores de riesgos asociados con el embarazo adolescente están relacionados con el inicio precoz de las relaciones sexuales, la deficiente educación sexual y los conflictos con la familia. Las complicaciones más significativas asociadas a gestantes adolescentes son la enfermedad hipertensiva gestacional, los traumas obstétricos del parto, el recién nacido pretérmino y el bajo peso. La prevención de los factores de riesgos, desarrollar una correcta educación sexual por la familia, la sociedad y los profesionales de la salud, favorecerá a la disminución de los embarazos en edades tempranas.

ABSTRACT Introduction: pregnancy in adolescent age constitutes a health problem all over the world, having repercussion throughout the society and affecting the health of the mother and the fetus. Objective: to describe the risk factors and complications associated with pregnancy in adolescent age. Methods: a bibliographic review with reference to pregnancy in adolescent age was carried out. The criteria of the authors and the results of the available researches in SciELO, Medline, PubMED databases were expressed; using a total of 30 bibliographic references, more than 75 % of the consulted literature corresponded to the last 5 years. Development: pregnancy in adolescent ages has not a specific cause. In its increase individual, familial and socioeconomic risk factors influence. Complications in pregnancy at early ages are frequent, and constitute a high obstetric risk affecting the life of the mother and the fetus. Complications are mainly associated with the biological characteristics of the mother and her gestational age. Conclusions: the main risk factors associated with pregnancy in adolescent ages are related to early initiation of sexual relations, poor sexual education and conflicts with the family. The most significant complications associated with pregnancy in adolescent ages are gestational hypertensive disease, obstetric trauma of delivery, preterm newborn and low birth weight (LBW). The prevention of risk factors, to develop a correct sexual education by the family, the society and the healthcare professionals will favor to decrease the rates of pregnancy in early ages.

Cierre de túnel aorto-ventricular derecho mediante un dispositivo percutáneo / Closure of the right aorto-ventricular tunnel through a percutaneous device

Resumen El túnel aorto-ventricular derecho es una anomalía congénita que consiste en un canal que conecta la aorta ascendente a la cavidad del ventrículo derecho. El diagnóstico se corrobora, en la mayoría de los casos, por ecocardiografía. El cierre quirúrgico se considera el tratamiento de elección y solo se han reportado dos casos previos en los que se ha logrado el cierre mediante intervencionismo. Se presenta el caso de una lactante con diagnóstico de túnel aorto-ventricular derecho, tratada por intervención percutánea con dispositivo de cierre percutáneo, que tuvo buena evolución clínica. La paciente, además, presentó un ductus permeable, el cual fue tratado en una segunda oportunidad por intervencionismo. La factibilidad de la técnica de cierre por procedimiento percutáneo y su baja tasa de complicaciones en comparación con el cierre por cirugía abierta pueden hacer de este el procedimiento de elección en la mayoría de los casos para esta infrecuente condición.

Abstract The aorto-right ventricular tunnel is a congenital anomaly that consists of a channel that connects the ascending aorta to the right ventricular cavity. The diagnosis is usually made by transthoracic echocardiography. Surgical closure is usually considered the treatment of choice and only two previous cases have been reported in which closure has been achieved by percutaneous intervention. We report a case of an infant with a diagnosis of aorto-right ventricular tunnel treated using a percutaneous device with good clinical evolution. The patient had also a patent ductus which was later treated by interventionism. The feasibility of the technique and its low rate of complications compared to the closure by open surgery can make it the procedure of choice in most cases for this rare condition.

Paper and Other Fibrous Materials-A Complete Platform for Biosensing Applications.

Paper-based analytical devices (PADs) and Electrospun Fiber-Based Biosensors (EFBs) have aroused the interest of the academy and industry due to their affordability, sensitivity, ease of use, robustness, being equipment-free, and deliverability to end-users. These features make them suitable to face the need for point-of-care (POC) diagnostics, monitoring, environmental, and quality food control applications. Our work introduces new and experienced researchers in the field to a practical guide for fibrous-based biosensors fabrication with insight into the chemical and physical interaction of fibrous materials with a wide variety of materials for functionalization and biofunctionalization purposes. This research also allows readers to compare classical and novel materials, fabrication techniques, immobilization methods, signal transduction, and readout. Moreover, the examined classical and alternative mathematical models provide a powerful tool for bioanalytical device designing for the multiple steps required in biosensing platforms. Finally, we aimed this research to comprise the current state of PADs and EFBs research and their future direction to offer the reader a full insight on this topic.

Precise T cell recognition programs designed by transcriptionally linking multiple receptors.

Living cells often identify their correct partner or target cells by integrating information from multiple receptors, achieving levels of recognition that are difficult to obtain with individual molecular interactions. In this study, we engineered a diverse library of multireceptor cell-cell recognition circuits by using synthetic Notch receptors to transcriptionally interconnect multiple molecular recognition events. These synthetic circuits allow engineered T cells to integrate extra- and intracellular antigen recognition, are robust to heterogeneity, and achieve precise recognition by integrating up to three different antigens with positive or negative logic. A three-antigen AND gate composed of three sequentially linked receptors shows selectivity in vivo, clearing three-antigen tumors while ignoring related two-antigen tumors. Daisy-chaining multiple molecular recognition events together in synthetic circuits provides a powerful way to engineer cellular-level recognition.

High Mannose N-Glycans Promote Migration of Bone-Marrow-Derived Mesenchymal Stromal Cells.

For hundreds of indications, mesenchymal stromal cells (MSCs) have not achieved the expected therapeutic efficacy due to an inability of the cells to reach target tissues. We show that inducing high mannose N-glycans either chemically, using the mannosidase I inhibitor Kifunensine, or genetically, using an shRNA to silence the expression of mannosidase I A1 (MAN1A1), strongly increases the motility of MSCs. We show that treatment of MSCs with Kifunensine increases cell migration toward bone fracture sites after percutaneous injection, and toward lungs after intravenous injection. Mechanistically, high mannose N-glycans reduce the contact area of cells with its substrate. Silencing MAN1A1 also makes cells softer, suggesting that an increase of high mannose N-glycoforms may change the physical properties of the cell membrane. To determine if treatment with Kifunensine is feasible for future clinical studies, we used mass spectrometry to analyze the N-glycan profile of MSCs over time and demonstrate that the effect of Kifunensine is both transitory and at the expense of specific N-glycoforms, including fucosylations. Finally, we also investigated the effect of Kifunensine on cell proliferation, differentiation, and the secretion profile of MSCs. Our results support the notion of inducing high mannose N-glycans in MSCs in order to enhance their migration potential.

Health-promoting activities of edible seaweed extracts from Chilean coasts: assessment of antioxidant, anti-diabetic, anti-inflammatory and antimicrobial potential / Actividades promotoras de la salud de extractos de algas comestibles de las costas chilenas: evaluación del potencial antioxidante, antidiabético, antiinflamatorio y antimicrobiano

ABSTRACT The aim of this study was to evaluate the antioxidant, antidiabetic, anti-inflammatory and antimicrobial activities of three edible seaweed extracts from Chilean coasts: Pyropia orbicularis, Ulva spp, and Durvillaea antarctica. Seaweed extracts in methanol and 70% acetone were performed to evaluate antioxidant and antidiabetic activities, whereas 60% methanol was used to measure anti-inflammatory and antimicrobial activities. Acetone extracts from D. antarctica had the highest total phenolic content and consequently exhibited the strongest antioxidant activity, while methanol extract of this seaweed presented the highest α-glucosidase inhibition (IC50= 0.004 mg mL-1). In the tests against E. coli and Penicillium sp., the extracts obtained from Ulva spp. were the most effective and exhibited the maximum anti-inflammatory effect against phorbol 12-myristate 13-acetate irritant agent (61.8% inhibition) in mice. Results indicated that all evaluated Chilean seaweed extracts are promising candidates for application in functional foods and in the pharmaceutical industry.

RESUMEN El objetivo de este estudio fue evaluar las actividades antioxidantes, antidiabéticas, antiinflamatorias y antimicrobianas de los extractos de tres algas marinas comestibles de las costas Chilenas (Pyropia orbicularis, Ulva spp. y Durvillaea antarctica). Se realizaron extractos de algas marinas en metanol y acetona al 70% para evaluar las actividades antioxidantes y antidiabéticas, mientras que el metanol al 60% se usó para actividades antiinflamatorias y antimicrobianas. Los extractos de acetona de D. antarctica tuvieron el mayor contenido de fenoles totales (TPC) y, en consecuencia, exhibieron la mayor actividad antioxidante, mientras que el extracto metanólico de estas algas presentó la mayor inhibición de la α-glucosidasa (IC50= 0,004 mg mL-1). En las pruebas contra E. coli y Penicillium sp., los extractos obtenidos de Ulva spp., actuaron como los más efectivos y exhibieron el máximo efecto antiinflamatorio contra el agente irritante de forbol 12-miristato 13-acetato (TPA) (inhibición del 61,8%) en ratones. Por lo tanto, los resultados indican que todos los extractos de algas chilenas evaluados pueden ser candidatos prometedores para su aplicación en alimentos funcionales y en las industrias farmacéuticas.

Author Correction: Modeling Snyder-Robinson Syndrome in multipotent stromal cells reveals impaired mitochondrial function as a potential cause for deficient osteogenesis.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Modeling Snyder-Robinson Syndrome in multipotent stromal cells reveals impaired mitochondrial function as a potential cause for deficient osteogenesis.

Patients with Snyder-Robinson Syndrome (SRS) exhibit deficient Spermidine Synthase (SMS) gene expression, which causes neurodevelopmental defects and osteoporosis, often leading to extremely fragile bones. To determine the underlying mechanism for impaired bone formation, we modelled the disease by silencing SMS in human bone marrow - derived multipotent stromal cells (MSCs) derived from healthy donors. We found that silencing SMS in MSCs led to reduced cell proliferation and deficient bone formation in vitro, as evidenced by reduced mineralization and decreased bone sialoprotein expression. Furthermore, transplantation of MSCs in osteoconductive scaffolds into immune deficient mice shows that silencing SMS also reduces ectopic bone formation in vivo. Tag-Seq Gene Expression Profiling shows that deficient SMS expression causes strong transcriptome changes, especially in genes related to cell proliferation and metabolic functions. Similarly, metabolome analysis by mass spectrometry, shows that silencing SMS strongly impacts glucose metabolism. This was consistent with observations using electron microscopy, where SMS deficient MSCs show high levels of mitochondrial fusion. In line with these findings, SMS deficiency causes a reduction in glucose consumption and increase in lactate secretion. Our data also suggests that SMS deficiency affects iron metabolism in the cells, which we hypothesize is linked to deficient mitochondrial function. Altogether, our studies suggest that SMS deficiency causes strong transcriptomic and metabolic changes in MSCs, which are likely associated with the observed impaired osteogenesis both in vitro and in vivo.

Caracterización del cáncer gástrico en Guatemala / Characterization of gastric cancer in Guatemala

Tomando en cuenta que las estadísticas del cáncer gástrico en la población guatemalteca han demostrado un aumento en los últimos años y que la prevalencia de la infección por Helicobacter pylori reportada es del 65%, se consideró importante analizar sus características y la relación con la bacteria. Para ello se obtuvo información de un número estadísticamente representativo de expedientes de pacientes con diagnóstico de cáncer gástrico que fueron atendidos en el Instituto de Cancerología y Hospital "Bernardo del Valle S" del período 2004 al 2007. Se revisaron un total de 284 expedientes, encontrando que el rango de edad más afectado es de 41 a 80 años. Por el estadio avanzado del cáncer al momento de la consulta, 107 pacientes (37%) fueron considerados como "caso fuera de tratamiento oncológico". A 248 (87%) el diagnóstico se realizó por endoscopia y únicamente a 69 (27.8%) se les investigó para H. pylori, encontrando positividad en 22 (31.9%). Se encontró 85 casos de cáncer difuso (34.3%) y 134 de tipo intestinal (54%), en los pacientes H. pylori positivo el tipo histológico más frecuente fue el intestinal (10/22, 45.4%), mientras que el tipo difuso predominó en los negativo (26/47, 55.3%). El área del estómago más afectada fue antro (69/155, 44.5%), unión esófago y estómago (24/155, 15.5%) y cuerpo (19/155, 12.3%). Con relación al género se observó un predominio del masculino, encontrando 76 (56.7%) para el tipo intestinal y 47(55.3%) para el difuso, lo que permitió establecer una relación de 1.31 y 1.26, respectivamente. La tasa de riesgo es de 1.97 (IC = 0.8251 - 4.7290, p = 0.20), lo que indica que los pacientes guatemaltecos que presentan la infección por H. pylori tienen el doble de riesgo de sufrir un cáncer tipo intestinal que uno del tipo difuso, mientras que la probabilidad conjunta que un paciente H. pylori positivo desarrolle cáncer es de 0.0058 (IC: 0.0052 ­ 0.008), la que es mayor que la probabilidad mundial reportada por la OMS.

Taking into account that gastric cancer in the Guatemalan population have shown an increase in recent years and that the prevalence of H. pylori infection reported is 65%, it was considered important to analyze the characteristics of this type of cancer and its relation to the bacteria. We obtained information from medical records of patients diagnosed with gastric cancer, statistically representative, who were treated at the Cancer Institute and "Bernardo del Valle S" Hospital during the period 2004 to 2007. A total of 284 records were reviewed and it was found that the most affected age range is 41-80 years. For the advanced stage of cancer at the time of the consultation, 107 patients (37%) were considered "case out of cancer treatment." In 248 (87%) patients, diagnosis was made by endoscopy and of them only 69 (27.8%) were investigated for H. pylori, finding 22 (31.9%) with a positive result. It was established 85 cases of diffuse cancer (34.3%) and 134 of intestinal type (54%), the most frequent histological type in H. pylori positive patients was intestinal (10/22, 45.4%), while diffuse type prevailed in the negative (26/47, 55.3%). The most affected stomach area was antrum (69/155, 44.5%), union esophagus and stomach (24/155, 15.5%) and body (19/155, 12.3%). With regard to gender a male predominance was observed being 76 (56.7%) for the intestinal type and 47 (55.3%) for diffuse, allowing to establish a relationship of 1.31 and 1.26, respectively. The hazard rate ratio is 1.97 (IC = 0.8251 - 4.7290, p = 0.20), indicating that Guatemalans patients with H. pylori infection have twice the risk of intestinal cancer type one of the diffuse type, while the joint probability that an H. pylori positive patient develop cancer is 0.0058 (CI 0.0052 to 0008), greater than the global probability reported by WHO.

Identificación de las pruebas más sensibles y específicas para el diagnóstico de Helicobacter pylori pre y post-tratamiento en pacientes dispépticos / Identification of the most sensitive and specific tests for the diagnosis of Helicobacter pylori pre and post-treatment dyspeptic patients

Con el fin de determinar la prueba no invasiva más sensible y específica para el diagnóstico de la infección por Helicobacter pylori y confirmar su erradicación post-tratamiento, se estudiaron prospectivamente 178 pacientes con dispepsia que acudieron a la clínica de endoscopía del Instituto Nacional de Cancerología (INCAN). A todos se les realizó la detección de antígeno fecal a través de una prueba inmunocromatográfìca comercial (Anarapid®) y un panel de pruebas serológicas que incluyó anticuerpos IgM, IgA, IgG CagA anti-H. pylori por medio de método inmunoenzimático (ELISA). Dichas pruebas se evaluaron estadísticamente para determinar su sensibilidad, especificidad y concordancia (índice kappa) comparando con el resultado de la biopsia, el cual fue considerado el estándar de oro. Así mismo se realizaron pruebas enzimáticas (Pepsinógeno I y II) para evaluar la integridad de la mucosa gástrica y se determinó su asociación con la sintomatología, según la prueba de Ji cuadrado. La detección de anticuerpos IgA anti-H. pylori presentó la mayor sensibilidad (74.2%) y la prueba de antígeno fecal la mayor especificidad (69.9%), respecto a las demás pruebas. Sesenta y tres pacientes diagnosticados con infección por H. pylori en la etapa inicial recibieron tratamiento específico y se les dio seguimiento por 5 meses para evaluar los cambios en la sintomatología. Al finalizar los cinco meses se les realizó el mismo panel de pruebas, observándose que en la mayoría de los pacientes los valores de pepsinógeno I y II se encontraron dentro del rango normal. En la evaluación post-tratamiento el índice de pepsinógeno I/II se normalizó en 24.86% de los pacientes y se incrementó el número de pacientes asintomáticos de 1.6% a 34.9%, lo cual demostró la eficacia del tratamiento. El antígeno fecal y anticuerpos IgA contra H. pylori en conjunto son las pruebas recomendadas para hacer el diagnóstico de la infección pre-tratamiento, mientras que en la fase post- tratamiento la prueba que demostró el éxito terapéutico es el antígeno fecal. Para la mayoría de la población de este estudio los valores de pepsinógeno I y II se encontraron en el rango normal, lo cual es indicativo de que sufren de una dispepsia funcional u otra enfermedad que no afecta la mucosa gástrica. Se hace además necesario continuar con los estudios de la utilidad de la determinación de pepsinógeno I /II y su asociación con el riesgo a desarrollar cáncer gástrico.

With the objective to determine a non-invasive most sensible and specific test for the diagnosis of H. pylori infection and confirming eradication after treatment, 178 patients with dyspepsia were prospectively studied during treatment at the Endoscopy clinic of the National Cancer Institute (INCAN). They underwent fecal antigen detection using a commercial immunoassay (Anarapid ®) technique and a panel of serological tests that included IgM, IgA, IgG (CagA) anti-H. pylori by immunosorbent assay (ELISA). These tests were statistically evaluated through 2x2 contingency tables (Kappa index) comparing with the biopsy results, which is considered the gold standard. Likewise enzyme assays were performed (Pepsinogen I and II) to assess the integrity of the gastric mucosa and determined its correlation with symptoms according to chi-square test. Findings indicate that the detection of IgA anti-H. pylori had the highest sensitivity (74.2%) and the fecal antigen test had the highest specificity (69.9%) compared to the other tests. Sixty three patients diagnosed with initial stage H. pylori infection received specific treatment and were followed for 5 months to evaluate changes. At the end of five months of specific treatment, the same test panel was gathered. Results showed that in most patients values pepsinogen I and II were within normal range. In post-treatment evaluation the rate of pepsinogen I / II was normalized in 24.86% of patients and the number of asymptomatic patients increased from 1.1% to 30.99%, which demonstrated the efficacy of treatment. Results show that fecal antigen and IgA antibody against H. pylori tests are together the recommended tests for diagnosis of pre-treatment infection, whereas in the post-treatment phase, the fecal antigen test demonstrated therapeutic success. Values of pepsinogen I and II were in the normal range for the majority of the study population, which is indicative of suffering from functional dyspepsia or another disease that affects the gastric mucosa. It is further necessary to continue studies of the usefulness of the determination of pepsinogen I / II and its association with the risk of developing gastric cancer

Parathyroid hormone has an important role in blood pressure regulation in vitamin D-insufficient individuals.

OBJECTIVE: The aim of the present study was to evaluate whether vitamin D status is related to blood pressure (BP) in adults. METHODS: We evaluated the relationship between vitamin D status, intact parathyroid hormone (iPTH) and BP in 332 adults. Anthropometric measurements, BP, and a fasting blood sample was obtained. Participants were stratified into the following BP categories: 1) normal BP; 2) high BP; 3) normal BP through medication. Vitamin D insufficiency was defined as 25-hydroxvitamin D ≤ 75 nmol/L; high iPTH as > 65 pg/mL. The relationships between vitamin D status, iPTH and BP were adjusted for body mass index, waist circumference, blood lipids, physical activity, and sunscreen use. RESULTS: No differences in prevalences of vitamin D insufficiency and high iPTH were observed among BP groups. No significant association was observed between BP and vitamin D status. Positive correlations were observed between iPTH and systolic BP (r = 0.168; P = 0.002) and between iPTH and diastolic BP (r = 0.168; P = 0.002). iPTH remained correlated with BP even with adjustments. CONCLUSIONS: The present study contributes to the understanding of calcemic hormones and BP regulation.

Relationship between Vitamin D Receptor gene polymorphisms and the components of metabolic syndrome.

BACKGROUND: The Vitamin D Receptor gene (VDR) is expressed in many tissues and modulates the expression of several other genes. The purpose of this study was to investigate the association between metabolic syndrome (MetSyn) with the presence of VDR 2228570 C > T and VDR 1544410 A > G polymorphisms in Brazilian adults. METHODS: Two hundred forty three (243) individuals were included in a cross-sectional study. MetSyn was classified using the criteria proposed by National Cholesterol Educational Program--Adult Treatment Panel III. Insulin resistance and ß cell secretion were estimated by the mathematical models of HOMA IR and ß, respectively. The VDR 2228570 C > T and VDR 1544410 A > G polymorphisms were detected by enzymatic digestion and confirmed by allele specific PCR or amplification of refractory mutation. RESULTS: Individuals with MetSyn and heterozygosis for VDR 2228570 C > T have higher concentrations of iPTH and HOMA ß than those without this polymorphism, and subjects with recessive homozygosis for the same polymorphisms presented higher insulin resistance than those with the heterozygous genotype. There is no association among VDR 1544410 A > G and components of MetSyn, HOMA IR and ß, serum vitamin D (25(OH)D3) and intact parathormone (iPTH) levels in patients with MetSyn. A significant lower concentration of 25(OH)D3 was observed only in individuals without MetSyn in the VDR 1544410 A > G genotype. Additionally, individuals without MetSyn and heterozygosis for VDR 2228570 C > T presented higher concentration of triglycerides and lower HDL than those without this polymorphism. CONCLUSIONS: Using two common VDR polymorphism data suggests they may influence insulin secretion, insulin resistance an serum HDL-cholesterol in our highly heterogeneous population. Whether VDR polymorphism may influence the severity of MetSyn component disorder, warrants examination in larger cohorts used for genome-wide association studies.

Eficacia del la terapia neural en el tratamiento de pacientes con epicondilitis humeral / Efficacy of the neural therapy in the treatment of patients with humeral epicondylitis

La epicondilitis se asocia a profesiones que conllevan a una actividad física mantenida, sobre todo en la que se refiere a movimientos o esfuerzos de repetición; constituyen un motivo habitual de baja laboral. Esta enfermedad es una de las que se presenta con mayor frecuencia en consulta de los Servicios Integrales de Rehabilitación. Objetivo: demostrar la eficacia de la terapia neural en el tratamiento de pacientes con diagnóstico de epicondilitis humeral en el servicio de medicina bioenergética del hospital universitario Manuel Ascunce Domenech desde enero a diciembre de 2008. Método: se realizó un estudio experimental, tipo ensayo clínico fase II abierto, en 47 pacientes diagnosticados con epicondilitis humeral, atendidos en la Clínica de Medicina Bioenergética. Se les aplicó un tratamiento con terapia neural. Los datos fueron obtenidos mediante el formulario clínico realizado al efecto, los mismos fueron procesados, mediante el programa informático SPSS 11.5 para Windows, se utilizaron las técnicas estadísticas descriptivas y las estadísticas inferencial. Resultados: con la aplicación de la escala visual analógica del dolor (EVA) y la de BARTHEL (evaluación de la capacidad funcional) se obtuvieron valores altos de mejoría entre la quinta y la décima sesión del tratamiento. Existió la peculiaridad de una recuperación funcional más tardía en aparición con respecto al alivio del dolor, se logró una mejoría funcional excelente. El por ciento de reacciones adversas fue bajo. Conclusiones: la terapia neural constituye una terapéutica efectiva para erradicar el dolor y la impotencia funcional secundaria a una epicondilitis.

Epicondylitis is associate to professions that leads to maintained physical activity, above all in which it refers to movements or efforts of repetition; it constitutes a habitual cause of work-related leave. This disease is showed with greater frequency in the Rehabilitation Integral Services consultation. Objective: to demonstrate the efficacy of neural therapy in the treatment of patients with humeral epicondylitis diagnosis in the bioenergetics medicine service at the Teaching Hospital Manuel Ascunce Domenech from January to December 2008. Method: an experimental study, type open phase II clinical trial was performed in 47 patients diagnosed with humeral epicondylitis, treated at the Bioenergetics Medicine Clinic, who a treatment with neural therapy were applied. Data were obtained by means of the clinical form carried out for this purpose; they were processed through the SPSS 11.5 computer program for Windows, descriptive and inferential statistical techniques were used. Results: with the application of the analogical visual scale of pain and the one of Barthel (evaluation of the functional capacity) high values of improvement between the fifth and the tenth session of treatment were obtained. The peculiarity of a functional recovery later in appearing regarding the relief of pain existed; an excellent functional improvement was achieved. It was a low percent of adverse reactions. Conclusions: neural therapy constitutes an effective therapeutics to eradicate pain and functional impotence secondary to an epicondylitis.

Relação entre estado nutricional da vitamina D e pressão arterial em adultos residentes na cidade de São Paulo / Relationship between vitamin D status and blood pressure in adults living at Sao Paulo city

Introdução A baixa concentração sérica de vitamina D tem sido associadas com a hipertensão no mundo todo. A hipovitaminose D tem sido observada mesmo na nossa população. Objetivo Investigar as concentrações séricas de vitamina D e sua associação com a pressão arterial (PA) em indivíduos adultos residentes na cidade de São Paulo. Métodos Para esta dissertação foram desenvolvidos dois artigos. Na revisão (artigo 1), foram selecionados artigos indexados nas bases de dados Pubmed, Lilacs e Medline, incluindo estudos realizados no Brasil. O artigo original (artigo 2) descreve o estudo transversal realizado com 332 adultos, 65 por cento mulheres, onde foi avaliada a associação entre vitamina D, paratormônio intacto (PTHi) e PA. Foram feitas: aferição da PA e coleta de medidas antropométricas e amostras sanguíneas. A concentração sérica de 25(OH)D3 foi mensurada pela técnica de cromatografia líquida de alta eficiência (HPLC). O valor médio de 2 medidas de PA foi considerado para as análises. Os participantes foram divididos em 3 grupos: (1) PA normal; (2) PA elevada; (3) PA normal pelo uso de medicação. A insuficiência de vitamina D foi considerada quando 25(OH)D3 75 nmol/L e o PTHi elevado quando > 65 pg/mL. A relação entre vitamina D, PTHi e PA foi ajustada pelo índice de massa corpórea (IMC), circunferência da cintura (CC) e perfil lipídico. Resultados Na revisão foi enfatizada a relação da vitamina D com doenças cardiovasculares, considerando, inclusive, os diferentes mecanismos fisiológicos propostos. No artigo original, observou-se idade média e desvio padrão de 50 (15) anos, IMC 29 (6) kg/m² e CC 97 (13) cm. Entre os indivíduos avaliados, 75 por cento tinham sobrepeso ou obesidade. PA média foi 129/80 (18/11) mmHg. A concentração média de cálcio sérico foi 9,3 (0,5) mg/dL, PTHi 40,8 (18,7) pg/mL e vitamina D 55,8 (17,1) nmol/L. O PTHi elevado e a insuficiência de vitamina D estiveram presentes em 12 por cento e 86 por cento da amostra, respectivamente. Não foram observadas diferenças nas prevalências de insuficiência de vitamina D e PTHi elevado entre os grupos de PA.