Modification of appetite by bread consumption: A systematic review of randomized controlled trials.

The inclusion of different ingredients or the use of different baking technologies may modify the satiety response to bread, and aid in the control of food intake. The aim of this study was to perform a systematic search of randomized clinical trials on the effect of bread consumption on appetite ratings in humans. The search equation was ("Bread"[MeSH]) AND ("Satiation"[MeSH] OR "Satiety response"[MeSH]), and the filter "clinical trials." As a result of this procedure, 37 publications were selected. The satiety response was considered as the primary outcome. The studies were classified as follows: breads differing in their flour composition, breads differing in ingredients other than flours, breads with added organic acids, or breads made using different baking technologies. In addition, we have revised the data related to the influence of bread on glycemic index, insulinemic index and postprandial gastrointestinal hormones responses. The inclusion of appropriate ingredients such as fiber, proteins, legumes, seaweeds and acids into breads and the use of specific technologies may result in the development of healthier breads that increase satiety and satiation, which may aid in the control of weight gain and benefit postprandial glycemia. However, more well-designed randomized control trials are required to reach final conclusions.

An enriched, cereal-based bread affects appetite ratings and glycemic, insulinemic, and gastrointestinal hormone responses in healthy adults in a randomized, controlled trial.

BACKGROUND: Bread can contribute to the regulation of appetite. OBJECTIVE: The objective of this study was to investigate the appetite ratings and postprandial glucose, insulin, and gastrointestinal hormone responses related to hunger and satiety after the intake of a cereal-based bread. METHODS: A randomized, controlled crossover trial was conducted in 30 healthy adults (17 men and 13 women) aged 19-32 y with body mass index of 19.2-28.5. Each volunteer consumed the cereal-based bread and the control bread 2 times, with a 1-wk wash-out period, over a total of 4 sessions. The cereal-based bread contained a variety of cereal flours (wheat, oat, and spelt) and consisted of 22% dried fruits (figs, apricots, raisins, and prunes). It was also enriched with both fiber (7% from wheat cross-linked maltodextrins and pea) and protein (10-11% from wheat gluten and hydrolyzed wheat proteins). The control bread consisted of white bread with margarine and jam to control for energy density, fat, and sugar content. We measured appetite ratings using standardized visual analogue scales and glucose, insulin, and gastrointestinal hormone responses over a postprandial time of 4 h after the ingestion of each bread. Linear mixed-effects models were used to compare the areas under the curve (AUCs) for different variables. RESULTS: Consuming the cereal-based bread decreased prospective consumption more than consumption of the control bread (-5.3 ± 0.6 m · min and -4.4 ± 0.6 m · min, respectively; P = 0.02) and increased satiety more (6.2 ± 0.7 m · min and 5.2 ± 0.6 m · min, respectively; P = 0.04), although subsequent ad libitum energy intake 4 h later did not differ. Postprandial blood glucose, insulin, ghrelin, glucagon-like peptide 1 and gastric inhibitory polypeptide AUCs were lower after the ingestion of the cereal-based bread, whereas the pancreatic polypeptide AUC was higher than with the control bread (P < 0.05). CONCLUSIONS: Consumption of the cereal-based bread contributed to appetite control by reducing hunger and enhancing satiety. In addition, consumption of this bread improved glycemic, insulinemic, and gastrointestinal hormone responses in healthy adults. This trial was registered at clinicaltrials.gov as NCT02090049.

Ancient DNA sheds light on the ancestry of pre-hispanic Canarian pigs.

BACKGROUND: Canarian Black (CB) pigs belong to an autochthonous and endangered breed, which is spread throughout the Canarian archipelago. It is commonly accepted that they represent a relic of the pig populations that were bred by the Berbers in North Africa over millennia. It is important to note that the geographic isolation of the Canary Islands has preserved this genetic legacy intact from foreign introgressions until the Spanish conquest of the archipelago in the 15(th) century. Ten years ago, it was demonstrated that, in CB pigs, the frequency of the Asian A2 cytochrome-b haplogroup reached 73%. The current work aimed at investigating whether this observation is explained by either a recent or an ancient introgression of CB pigs with Far Eastern pigs. RESULTS: Genetic analyses of 23 ancient samples from pre-hispanic Canarian pigs (420 to 2500 years before present) showed that Near Eastern and Far Eastern genetic signatures were totally absent in the primitive Canarian pre-hispanic pigs. Indeed, the haplotypes detected in these pigs were closely related to those of North African and European wild boars. CONCLUSIONS: Our results demonstrate that the high frequency of the Far Eastern mitochondrial cytochrome B A2 haplotype in modern Canarian Black pigs probably corresponds to a relatively recent introgression with British breeds.

Intravital Microscopy to Study the Effect of Matrix Metalloproteinase Inhibition on Acute Myeloid Leukemia Cell Migration in the Bone Marrow.

Hematopoiesis is the process through which all mature blood cells are formed and takes place in the bone marrow (BM). Acute myeloid leukemia (AML) is a blood cancer of the myeloid lineage. AML progression causes drastic remodeling of the BM microenvironment, making it no longer supportive of healthy hematopoiesis and leading to clinical cytopenia in patients. Understanding the mechanisms by which AML cells shape the BM to their benefit would lead to the development of new therapeutic strategies. While the role of extracellular matrix (ECM) in solid cancer has been extensively studied during decades, its role in the BM and in leukemia progression has only begun to be acknowledged. In this context, intravital microscopy (IVM) gives the unique insight of direct in vivo observation of AML cell behavior in their environment during disease progression and/or upon drug treatments. Here we describe our protocol for visualizing and analyzing MLL-AF9 AML cell dynamics upon systemic inhibition of matrix metalloproteinases (MMP), combining confocal and two-photon microscopy and focusing on cell migration.

Extubation failure: Upper airway obstruction by chewing gum. A case report.

Extubation failure can result from different complications, mostly well described in the literature such as laryngeal edema. Airway obstruction by foreign bodies is a less frequent and unexpected complication and its detection remains a challenge to healthcare professionals. In this case-report, we describe a patient admitted in an intensive care unit following a motor vehicle accident and who underwent an extubation failure and tracheostomy placement due to a misdiagnosed obstruction of a foreign body in the upper airway. Thus, screening of foreign bodies should be considered with a careful interpretation of medical imagery and clinical evaluation in these patients. Finally, cuff leak test, ultrasonography and videolaryngoscopy can be important adjuvants to the identification of suspected foreign bodies.

Loss of the epithelial marker CDX1 predicts poor prognosis in early-stage CRC patients.

BACKGROUND: We have previously shown that non-curative chemotherapy imposes fetal conversion and high metastatic capacity to cancer cells. From the set of genes differentially expressed in Chemotherapy Resistant Cells, we obtained a characteristic fetal intestinal cell signature that is present in a group of untreated tumors and is sufficient to predict patient prognosis. A feature of this fetal signature is the loss of CDX1. METHODS: We have analyzed transcriptomic data in public datasets and performed immunohistochemistry analysis of paraffin embedded tumor samples from two cohorts of colorectal cancer patients. RESULTS: We demonstrated that low levels of CDX1 are sufficient to identify patients with poorest outcome at the early tumor stages II and III. Presence tumor areas that are negative for CDX1 staining in stage I cancers is associated with tumor relapse. CONCLUSIONS: Our results reveal the actual possibility of incorporating CDX1 immunostaining as a valuable biomarker for CRC patients.

Nanoparticle-encapsulated retinoic acid for the modulation of bone marrow hematopoietic stem cell niche.

More effective approaches are needed in the treatment of blood cancers, in particular acute myeloid leukemia (AML), that are able to eliminate resistant leukemia stem cells (LSCs) at the bone marrow (BM), after a chemotherapy session, and then enhance hematopoietic stem cell (HSC) engraftment for the re-establishment of the HSC compartment. Here, we investigate whether light-activatable nanoparticles (NPs) encapsulating all-trans-retinoic acid (RA+NPs) could solve both problems. Our in vitro results show that mouse AML cells transfected with RA+NPs differentiate towards antitumoral M1 macrophages through RIG.1 and OASL gene expression. Our in vivo results further show that mouse AML cells transfected with RA+NPs home at the BM after transplantation in an AML mouse model. The photo-disassembly of the NPs within the grafted cells by a blue laser enables their differentiation towards a macrophage lineage. This macrophage activation seems to have systemic anti-leukemic effect within the BM, with a significant reduction of leukemic cells in all BM compartments, of animals treated with RA+NPs, when compared with animals treated with empty NPs. In a separate group of experiments, we show for the first time that normal HSCs transfected with RA+NPs show superior engraftment at the BM niche than cells without treatment or treated with empty NPs. This is the first time that the activity of RA is tested in terms of long-term hematopoietic reconstitution after transplant using an in situ activation approach without any exogenous priming or genetic conditioning of the transplanted cells. Overall, the approach documented here has the potential to improve consolidation therapy in AML since it allows a dual intervention in the BM niche: to tackle resistant leukemia and improve HSC engraftment at the same time.

Effects of mechanical in-exsufflation in preventing postextubation acute respiratory failure in intensive care acquired weakness patients: a randomized controlled trial.

OBJECTIVE: We hypothesized that the use of mechanical insufflation-exsufflation can reduce the incidence of acute respiratory failure within the 48-hour post-extubation period in intensive care unit-acquired weakness patients. METHODS: This was a prospective randomized controlled open-label trial. Patients diagnosed with intensive care unit-acquired weakness were consecutively enrolled based on a Medical Research Council score ≤ 48/60. The patients randomly received two daily sessions; in the control group, conventional chest physiotherapy was performed, while in the intervention group, chest physiotherapy was associated with mechanical insufflation-exsufflation. The incidence of acute respiratory failure within 48 hours of extubation was evaluated. Similarly, the reintubation rate, intensive care unit length of stay, mortality at 28 days, and survival probability at 90 days were assessed. The study was stopped after futility results in the interim analysis. RESULTS: We included 122 consecutive patients (n = 61 per group). There was no significant difference in the incidence of acute respiratory failure between treatments (11.5% control group versus 16.4%, intervention group; p = 0.60), the need for reintubation (3.6% versus 10.7%; p = 0.27), mean length of stay (3 versus 4 days; p = 0.33), mortality at Day 28 (9.8% versus 15.0%; p = 0.42), or survival probability at Day 90 (21.3% versus 28.3%; p = 0.41). CONCLUSION: Mechanical insufflation-exsufflation combined with chest physiotherapy seems to have no impact in preventing postextubation acute respiratory failure in intensive care unit-acquired weakness patients. Similarly, mortality and survival probability were similar in both groups. Nevertheless, given the early termination of the trial, further clinical investigation is strongly recommended. CLINICAL TRIALS REGISTER: NCT01931228.

Different niches for stem cells carrying the same oncogenic driver affect pathogenesis and therapy response in myeloproliferative neoplasms.

Aging facilitates the expansion of hematopoietic stem cells (HSCs) carrying clonal hematopoiesis-related somatic mutations and the development of myeloid malignancies, such as myeloproliferative neoplasms (MPNs). While cooperating mutations can cause transformation, it is unclear whether distinct bone marrow (BM) HSC-niches can influence the growth and therapy response of HSCs carrying the same oncogenic driver. Here we found different BM niches for HSCs in MPN subtypes. JAK-STAT signaling differentially regulates CDC42-dependent HSC polarity, niche interaction and mutant cell expansion. Asymmetric HSC distribution causes differential BM niche remodeling: sinusoidal dilation in polycythemia vera and endosteal niche expansion in essential thrombocythemia. MPN development accelerates in a prematurely aged BM microenvironment, suggesting that the specialized niche can modulate mutant cell expansion. Finally, dissimilar HSC-niche interactions underpin variable clinical response to JAK inhibitor. Therefore, HSC-niche interactions influence the expansion rate and therapy response of cells carrying the same clonal hematopoiesis oncogenic driver.

The Regular Consumption of Nuts Is Associated with a Lower Prevalence of Abdominal Obesity and Metabolic Syndrome in Older People from the North of Spain.

BACKGROUND: The aim of this study was to relate the adherence to nut consumption (30 g) three or more days per week to the prevalence of abdominal obesity and metabolic syndrome (MetS) in an elderly population from the north of Spain. METHODS: The study consists of an observational, descriptive, cross-sectional, and correlational study conducted in 556 non-institutionalised individuals between 65 and 79 years of age. To define the consumption recommendation of nuts the indication of the questionnaire MEDAS-14 was followed. The diagnosis of MetS was conducted using the International Diabetes Federation (IDF) criteria. RESULTS: In 264 subjects aged 71.9 (SD: ±4.2) years old, 39% of whom were men, the adherence to nut consumption recommendations was 40.2%. Of these individuals, 79.5% had abdominal obesity. The prevalence of MetS was 40.2%, being 47.6% in men and 35.4% in women (p < 0.05). A nut consumption lower than recommended was associated with a 19% higher prevalence of abdominal obesity (Prevalence Ratio: 1.19; 95% CI: 1.03-1.37; p < 0.05) and a 61% higher prevalence of MetS (Prevalence Ratio: 1.61; 95% CI: 1.16-2.25; p = 0.005) compared to a consumption of ≥3 servings per week. CONCLUSION: An inverse relationship was established between nut consumption and the prevalence of abdominal obesity and metabolic syndrome.

Heterogeneous run-and-tumble motion accounts for transient non-Gaussian super-diffusion in haematopoietic multi-potent progenitor cells.

Multi-potent progenitor (MPP) cells act as a key intermediary step between haematopoietic stem cells and the entirety of the mature blood cell system. Their eventual fate determination is thought to be achieved through migration in and out of spatially distinct niches. Here we first analyze statistically MPP cell trajectory data obtained from a series of long time-course 3D in vivo imaging experiments on irradiated mouse calvaria, and report that MPPs display transient super-diffusion with apparent non-Gaussian displacement distributions. Second, we explain these experimental findings using a run-and-tumble model of cell motion which incorporates the observed dynamical heterogeneity of the MPPs. Third, we use our model to extrapolate the dynamics to time-periods currently inaccessible experimentally, which enables us to quantitatively estimate the time and length scales at which super-diffusion transitions to Fickian diffusion. Our work sheds light on the potential importance of motility in early haematopoietic progenitor function.

General anaesthetics reduce acute lymphoblastic leukaemia malignancies in vitro and in vivovia CXCR4 and osteopontin mediated mechanisms.

Background: Acute lymphoblastic leukaemia (ALL) is a common type of cancer in children. General anaesthetics are often used on patients undergoing painful procedures during ALL treatments but their effects on ALL malignancy remain unknown. Herein, we aim to study the effect of propofol and sevoflurane on the migration, homing and chemoresistance of ALL cells. Methods: NALM-6 and Reh cells were treated with propofol (5 and 10 µg/ml) or sevoflurane (3.6%) in vitro for six hours. Then, cells were harvested for adhesion assay and migration assay in vitro. In in vivo experiments, GFP-NALM-6 cells were pre-treated with propofol (10 µg/ml) or sevoflurane (3.6%) for six hours. Then, cells were injected intravenously to C57BL/6 female mice followed by intravital microscopy. For chemoresistance study, cells were treated with rising concentrations of Ara-c (0.05-50 nM) plus 10µg/ml of propofol or Ara-C plus 3.6% of sevoflurane for 4 hours, followed by the assessment of cell viability via CCK-8 assay and detection of autophagy via flow cytometry. Results: Both anaesthetics reduced in vivo migration and in vivo homing as exemplified by 1) the reduction in the number of cells entering the bone marrow and 2) the disturbance in homing location in relation to endosteal surface. Our results indicated that general anaesthetics reduced the surface CXCR4 expression and the adhesion of leukaemia cells to thrombin cleaved osteopontin (OPN) was reduced. Those changes might result in the alterations in migration and homing. In addition, both anaesthetics sensitised ALL cells to Ara-c possibly through CXCR4 mediated mechanisms. Propofol but not sevoflurane enhanced chemo-related cell death via inducing cytotoxic autophagy. Conclusion: Together, our data suggest that both propofol and sevoflurane could reduce ALL migration, and homing in vivo and in vitro via CXCR4 and OPN mediated mechanisms. Both anaesthetics could sensitise ALL cells to chemotherapy possibly via CXCR4 mediated mechanisms.

Effects of Mechanical Insufflation-Exsufflation on Sputum Volume in Mechanically Ventilated Critically Ill Subjects.

BACKGROUND: Mechanical insufflation-exsufflation (MI-E) is a noninvasive technique performed to simulate cough and remove sputum from proximal airways. To date, the effects of MI-E on critically ill patients on invasive mechanical ventilation are not fully elucidated. In this randomized crossover trial, we evaluated the efficacy and safety of MI-E combined to expiratory rib cage compressions (ERCC). METHODS: Twenty-six consecutive subjects who were sedated, intubated, and on mechanical ventilation > 48 h were randomized to perform 2 sessions of ERCC with or without additional MI-E before tracheal suctioning in a 24-h period. The primary outcome was sputum volume following each procedure. Secondary end points included effects on respiratory mechanics, hemodynamics, and safety. RESULTS: In comparison to ERCC alone, median (interquartile range) sputum volume cleared was significantly higher during ERCC+MI-E (0.42 [0-1.39] mL vs 2.29 [1-4.67] mL, P < .001). The mean ± SD respiratory compliance improved in both groups immediately after the treatment, with the greater improvement in the ERCC+MI-E group (54.7 ± 24.1 mL/cm H2O vs 73.7 ± 35.8 mL/cm H2O, P < .001). Differences between the groups were not significant (P = .057). Heart rate increased significantly in both groups immediately after each intervention (P < .05). Additionally, a significant increase in oxygenation was observed from baseline to 1 h post-intervention in the ERCC+MI-E group (P < .05). Finally, several transitory hemodynamic variations occurred during both interventions, but these were nonsignificant and were considered clinically irrelevant. CONCLUSIONS: In mechanically ventilated subjects, MI-E combined with ERCC increased the sputum volume cleared without causing clinically important hemodynamic changes or adverse events. (ClinicalTrials.gov registration: NCT03316079.).

[Adherence to the healthy eating guide issued by the Sociedad Española de Nutrición Comunitaria (SENC) (2018) among non-institutionalized elderly in Santander, Spain]. / Adherencia a la guía de alimentación saludable de la Sociedad Española de Nutrición Comunitaria (SENC) (2018) en personas mayores no institucionalizadas de Santander, España.

INTRODUCTION: Introduction: the aging of S panish population has increased in the last decades; in Santander, 24,73 % of the population are elderly people. Adherence to the recommendations for a healthy diet in this group has been associated with improved health status and quality of life. Objectives: to assess the degree of adherence to the recommendations issued by the Healthy Eating Guide for Primary Care and Citizen Groups of the SENC (2018) in a non-institutionalized population sample between 65 and 79 years of age in the municipality of Santander (Spain). Methods: this was a cross-sectional, observational and descriptive study. A total of 317 individuals aged 71.8 (± 4.1) years, attending three Primary Care Centers (CAP) of the Cantabrian Health Service (SCS), participated. A self-developed questionnaire was extracted from the 2018 SENC Guide recommendations. The relationship between two independent qualitative variables was analyzed using the chi-squared test, considering significant a p-value < 0.05. Results: adherence to the recommendations in foods for daily consumption was: water (23 %), cereals and potatoes (12,9 %), fruits (50,2 %), vegetables (16,7 %), olive oil (61,8 %) and dairy products (39,1 %). For weekly-consumption foods it was: fish (12 %), white meats (17 %), eggs (19,9 %), legumes (75,1 %) and nuts (36,9 %). Conclusions: the results obtained show a low adherence to SENC recommendations except for legumes. For this reason, it is necessary to influence this population group in order to improve their dietary habits.

INTRODUCCIÓN: Introducción: el envejecimiento de la población española se ha incrementado en las últimas décadas; en Santander, el 24,73 % de la población son personas mayores. La adherencia a las recomendaciones de una alimentación saludable en este colectivo se ha relacionado con un mejor estado de salud y calidad de vida. Objetivos: evaluar el grado de adherencia a las recomendaciones de la Guía de Alimentación Saludable para Atención Primaria y Colectivos Ciudadanos de la SENC (2018) en un grupo de población de entre 65 y 79 años de edad, no institucionalizada, del municipio de Santander (España). Métodos: este fue un estudio transversal, observacional y descriptivo. Participaron 317 individuos de 71,8 ( 4,1) años, correspondientes a tres Centros de Atención Primaria (CAP) del Servicio Cántabro de Salud (SCS). Se cumplimentó un cuestionario de elaboración propia, extraído de las recomendaciones de la Guía de la SENC (2018). Se analizó la relación entre dos variables cualitativas independientes mediante la prueba del chi cuadrado, considerando significativo un valor p < 0,05. Resultados: la adherencia a las recomendaciones de alimentos de consumo diario fue: agua (23 %), cereales y patatas (12,9 %), frutas (50,2 %), verduras y hortalizas (16,7 %), aceite de oliva (61,8 %) y lácteos (39,1 %). En los alimentos de consumo semanal fue: pescado (12 %), carnes blancas (17 %), huevos (19,9 %), legumbres (75,1 %) y frutos secos (36,9 %). Conclusiones: los resultados obtenidos muestran una baja adherencia a las recomendaciones de la SENC, excepto en las legumbres. Por este motivo se precisa incidir en este grupo de población para mejorar sus hábitos dietéticos.

Effects of mechanical in-exsufflation in preventing postextubation acute respiratory failure in intensive care acquired weakness patients: a randomized controlled trial / Efeitos da insuflação-exsuflação mecânica na prevenção da insuficiência respiratória aguda pós-extubação em pacientes com fraqueza adquirida em terapia intensiva: um estudo controlado e randomizado

ABSTRACT Objective: We hypothesized that the use of mechanical insufflation-exsufflation can reduce the incidence of acute respiratory failure within the 48-hour post-extubation period in intensive care unit-acquired weakness patients. Methods: This was a prospective randomized controlled open-label trial. Patients diagnosed with intensive care unit-acquired weakness were consecutively enrolled based on a Medical Research Council score ≤ 48/60. The patients randomly received two daily sessions; in the control group, conventional chest physiotherapy was performed, while in the intervention group, chest physiotherapy was associated with mechanical insufflation-exsufflation. The incidence of acute respiratory failure within 48 hours of extubation was evaluated. Similarly, the reintubation rate, intensive care unit length of stay, mortality at 28 days, and survival probability at 90 days were assessed. The study was stopped after futility results in the interim analysis. Results: We included 122 consecutive patients (n = 61 per group). There was no significant difference in the incidence of acute respiratory failure between treatments (11.5% control group versus 16.4%, intervention group; p = 0.60), the need for reintubation (3.6% versus 10.7%; p = 0.27), mean length of stay (3 versus 4 days; p = 0.33), mortality at Day 28 (9.8% versus 15.0%; p = 0.42), or survival probability at Day 90 (21.3% versus 28.3%; p = 0.41). Conclusion: Mechanical insufflation-exsufflation combined with chest physiotherapy seems to have no impact in preventing postextubation acute respiratory failure in intensive care unit-acquired weakness patients. Similarly, mortality and survival probability were similar in both groups. Nevertheless, given the early termination of the trial, further clinical investigation is strongly recommended. Clinical Trials Register: NCT 01931228

RESUMO Objetivo: Verificar se o uso de insuflação-exsuflação mecânica pode reduzir a incidência da insuficiência respiratória aguda no período de 48 horas pós-extubação em pacientes com fraqueza adquirida em unidades de terapia intensiva. Métodos: Estudo prospectivo, randomizado, controlado e aberto. Os pacientes diagnosticados com fraqueza adquirida em unidade de terapia intensiva foram incluídos consecutivamente, com base em uma pontuação do Medical Research Council ≤ 48/60. Os pacientes receberam aleatoriamente duas sessões diárias; no grupo controle, realizou-se fisioterapia torácica convencional, enquanto no grupo intervenção, combinou-se fisioterapia torácica com insuflação-exsuflação mecânica. Avaliou-se a incidência de insuficiência respiratória aguda dentro de 48 horas após a extubação. Da mesma forma, avaliaram-se a taxa de reintubação, o tempo de permanência na unidade de terapia intensiva, a mortalidade aos 28 dias e a probabilidade de sobrevida aos 90 dias. O estudo foi interrompido após resultados de futilidade na análise intermediária. Resultados: Incluímos 122 pacientes consecutivos (n = 61 por grupo). Não houve diferença significativa na incidência de insuficiência respiratória aguda entre os tratamentos (11,5% no grupo controle versus 16,4% no grupo intervenção; p = 0,60), na necessidade de reintubação (3,6% versus 10,7%; p = 0,27), no tempo médio de internação (3 versus 4 dias; p = 0,33), na mortalidade aos 28 dias (9,8% versus 15,0%; p = 0,42) ou na probabilidade de sobrevida aos 90 dias (21,3% versus 28,3%; p = 0,41). Conclusão: A insuflação-exsuflação mecânica associada à fisioterapia torácica parece não ter impacto na prevenção da insuficiência respiratória aguda pós-extubação em pacientes com fraqueza adquirida na unidade de terapia intensiva. Da mesma forma, a mortalidade e a probabilidade de sobrevida foram semelhantes em ambos os grupos. No entanto, devido ao término precoce do estudo, recomenda-se enfaticamente uma investigação clínica mais aprofundada. Registro Clinical Trials: NCT 01931228

Redirection to the bone marrow improves T cell persistence and antitumor functions.

A key predictor for the success of gene-modified T cell therapies for cancer is the persistence of transferred cells in the patient. The propensity of less differentiated memory T cells to expand and survive efficiently has therefore made them attractive candidates for clinical application. We hypothesized that redirecting T cells to specialized niches in the BM that support memory differentiation would confer increased therapeutic efficacy. We show that overexpression of chemokine receptor CXCR4 in CD8+ T cells (TCXCR4) enhanced their migration toward vascular-associated CXCL12+ cells in the BM and increased their local engraftment. Increased access of TCXCR4 to the BM microenvironment induced IL-15-dependent homeostatic expansion and promoted the differentiation of memory precursor-like cells with low expression of programmed death-1, resistance to apoptosis, and a heightened capacity to generate polyfunctional cytokine-producing effector cells. Following transfer to lymphoma-bearing mice, TCXCR4 showed a greater capacity for effector expansion and better tumor protection, the latter being independent of changes in trafficking to the tumor bed or local out-competition of regulatory T cells. Thus, redirected homing of T cells to the BM confers increased memory differentiation and antitumor immunity, suggesting an innovative solution to increase the persistence and functions of therapeutic T cells.

Electronic Noses and Tongues in Wine Industry.

The quality of wines is usually evaluated by a sensory panel formed of trained experts or traditional chemical analysis. Over the last few decades, electronic noses (e-noses) and electronic tongues have been developed to determine the quality of foods and beverages. They consist of arrays of sensors with cross-sensitivity, combined with pattern recognition software, which provide a fingerprint of the samples that can be used to discriminate or classify the samples. This holistic approach is inspired by the method used in mammals to recognize food through their senses. They have been widely applied to the analysis of wines, including quality control, aging control, or the detection of fraudulence, among others. In this paper, the current status of research and development in the field of e-noses and tongues applied to the analysis of wines is reviewed. Their potential applications in the wine industry are described. The review ends with a final comment about expected future developments.

Changes in Oxidative Stress and Inflammatory Biomarkers in Fragile Adults over Fifty Years of Age and in Elderly People Exclusively Fed Enteral Nutrition.

We aim to evaluate whether exclusive feeding of an enteral formula enriched with n-3 long chain polyunsaturated fatty acids (n-3 LC-PUFA) affects oxidative stress and the antioxidant defence system and may improve the levels of some relevant inflammatory, and cardiovascular biomarkers in frail adults over fifty years of age and in elderly subjects. Fifty-five patients were divided into two groups and were exclusively fed a newly designed normoproteic and isocaloric enteral formula enriched with eicosapentaenoic (98 mg/d) and docosahexaenoic acids (46 mg/d) (n = 26) or a reference enteral diet (n = 29). Oxidative, inflammatory and cardiovascular risk biomarkers and red blood cell fatty acid profiles were determined at the beginning and after 90 and 180 days of feeding. The n-3 LC-PUFA percentage tended to be higher (P = 0.053) in the experimental group than in the reference group. Administration of the n-3 LC-PUFA diet did not increase oxidative stress or modify plasma antioxidant capacity but decreased antioxidant enzymatic activities. MMP-9 plasma concentration decreased with both formulae, whereas tPAI-1 tended to decrease (P = 0.116) with the administration of the experimental formula. In conclusion, administration of the new n-3 LC-PUFA-enriched product for 6 months did not negatively alter the oxidative status and improved some cardiovascular risk biomarkers.

Glycemic responses, appetite ratings and gastrointestinal hormone responses of most common breads consumed in Spain. A randomized control trial in healthy humans.

The present study was carried out to determine the glycemic index (GI), glycemic load (GL), insulinemic index (InI), appetite ratings and postprandial plasma concentrations of gastrointestinal hormones related to the control of food intake after the ingestion of the five most common breads consumed in Spain with different compositions and manufacturing processes. Twenty-two healthy adults participated in a randomized crossover study. The breads tested were Ordinary, Precooked-Frozen, Candeal-flour, Alfacar whites and Wholemeal. All breads portions were calculated to supply 50 g of available carbohydrates. In addition, 50 g of glucose was used as a reference. A linear mixed-effects model was used to compare data calculated for all breads with glucose load. The GI value varied from 61 for the Wholemeal, to Alfacar 68, Ordinary 76, and 78 and 86 for the Precooked-Frozen and Candeal-flour breads, respectively. Wholemeal and Alfacar had lower GI than glucose. All tested breads had a lower GL (ranged 9 to 18) compared with glucose. Wholemeal GL was similar to Alfacar, but lower than the other white breads. InI were significantly lower for all breads (ranged 68 to 73) compared with glucose, and similar among them. The intake of the Wholemeal bread led to a higher release of gastric inhibitory polypeptide compared with the Ordinary and Precooked breads and to a higher release of pancreatic polypeptide compared with the Precooked-Frozen bread. All breads affected appetite ratings similarly. In conclusion, based on GL, the Wholemeal bread would be expected to exert a favorable glycemic response.

Adherencia a la guía de alimentación saludable de la Sociedad Española de Nutrición Comunitaria (SENC) (2018) en personas mayores no institucionalizadas de Santander, España / Adherence to the healthy eating guide issued by the Sociedad Española de Nutrición Comunitaria (SENC) (2018) among non-institutionalized elderly in Santander, Spain

INTRODUCCIÓN: el envejecimiento de la población española se ha incrementado en las últimas décadas; en Santander, el 24,73 % de la población son personas mayores. La adherencia a las recomendaciones de una alimentación saludable en este colectivo se ha relacionado con un mejor estado de salud y calidad de vida. OBJETIVOS: evaluar el grado de adherencia a las recomendaciones de la Guía de Alimentación Saludable para Atención Primaria y Colectivos Ciudadanos de la SENC (2018) en un grupo de población de entre 65 y 79 años de edad, no institucionalizada, del municipio de Santander (España). MÉTODOS: este fue un estudio transversal, observacional y descriptivo. Participaron 317 individuos de 71,8 (±4,1) años, correspondientes a tres Centros de Atención Primaria (CAP) del Servicio Cántabro de Salud (SCS). Se cumplimentó un cuestionario de elaboración propia, extraído de las recomendaciones de la Guía de la SENC (2018). Se analizó la relación entre dos variables cualitativas independientes mediante la prueba del chi cuadrado, considerando significativo un valor p < 0,05. RESULTADOS: la adherencia a las recomendaciones de alimentos de consumo diario fue: agua (23 %), cereales y patatas (12,9 %), frutas (50,2 %), verduras y hortalizas (16,7 %), aceite de oliva (61,8 %) y lácteos (39,1 %). En los alimentos de consumo semanal fue: pescado (12 %), carnes blancas (17 %), huevos (19,9 %), legumbres (75,1 %) y frutos secos (36,9 %). CONCLUSIONES: los resultados obtenidos muestran una baja adherencia a las recomendaciones de la SENC, excepto en las legumbres. Por este motivo se precisa incidir en este grupo de población para mejorar sus hábitos dietéticos

INTRODUCTION: the aging of the Spanish population has increased in the last decades; in Santander, 24,73 % of the population are elderly people. Adherence to the recommendations for a healthy diet in this group has been associated with improved health status and quality of life. OBJECTIVES: to assess the degree of adherence to the recommendations issued by the Healthy Eating Guide for Primary Care and Citizen Groups of the SENC (2018) in a non-institutionalized population sample between 65 and 79 years of age in the municipality of Santander (Spain). METHODS: this was a cross-sectional, observational and descriptive study. A total of 317 individuals aged 71.8 (± 4.1) years, attending three Primary Care Centers (CAP) of the Cantabrian Health Service (SCS), participated. A self-developed questionnaire was extracted from the 2018 SENC Guide recommendations. The relationship between two independent qualitative variables was analyzed using the chi-squared test, considering significant a p-value < 0.05. RESULTS: adherence to the recommendations in foods for daily consumption was: water (23 %), cereals and potatoes (12,9 %), fruits (50,2 %), vegetables (16,7 %), olive oil (61,8 %) and dairy products (39,1 %). For weekly-consumption foods it was: fish (12 %), white meats (17 %), eggs (19,9 %), legumes (75,1 %) and nuts (36,9 %). CONCLUSIONS: the results obtained show a low adherence to SENC recommendations except for legumes. For this reason, it is necessary to influence this population group in order to improve their dietary habits