Postprandial glucose-lowering effect of cagaita (Eugenia dysenterica DC) fruit juice in dysglycemic subjects with metabolic syndrome: An exploratory study.

Cagaita (Eugenia dysenterica DC) is an ellagitannin-containing Myrtaceae fruit from Cerrado biome. This fruit seems to be a promising candidate for an adjuvant in glucose regulation in healthy subjects. However, it is not known whether cagaita juice would have the same effect on dysglycemic subjects with metabolic syndrome (MetS). Therefore, the present work aimed to evaluate the effect of cagaita fruit juice on postprandial glycemia in dysglycemic subjects with MetS, and whether cagaita ellagitannins could be metabolized to urolithins. To evaluate glycemic effects, two different meals were consumed by volunteers (n = 12) with a 1-week interval among them. The first one consisted of white bread (50 g) plus water (300 mL) as a control; the second one, white bread (50 g) plus clarified cagaita juice (300 mL). Bioavailability was assessed in 24 h urine, after the consumption of a single amount of 300 mL of cagaita juice by healthy (n = 16) and MetS subjects (n = 7). The results showed that dysglycemic subjects with MetS presented a 53% reduction of incremental area under the curve (iAUC) of glucose, 38% reduction of insulin, 78% reduction of GIP (glucose-dependent insulinotropic polypeptide), and 58% reduction of C-peptide (p < 0.05), after the consumption of cagaita juice along with bread, in comparison to control water. However, both GLP-1 (glucagon-like peptide-1) and glucagon were not affected by cagaita juice ingestion. Concerning bioavailability, it was observed, for the first time, the metabolization of cagaita ellagitannins to urolithins by healthy and dysglycemic individuals with MetS, with a prevalence of metabotype B in both groups (44% and 42%, respectively), followed by metabotype A (37% and 29%, respectively), and metabotype 0 (19% and 29%, respectively).

Correction to: Ouabain Accelerates Collective Cell Migration Through a cSrc and ERK1/2 Sensitive Metalloproteinase Activity.

The original version of the article unfortunately contained an error in the author group. Dr. Isabel Larré was not submitted and published in the original version.

Ouabain Accelerates Collective Cell Migration Through a cSrc and ERK1/2 Sensitive Metalloproteinase Activity.

Studies made in the Madin-Darby canine kidney (MDCK) epithelial cell line showed that ouabain regulates cell adhesion and cell-adhesion-related biological processes, such as migration. Here, we demonstrated that 10 nM ouabain accelerates collective cell migration and heals wounds in cultured MDCK cell monolayers. Ouabain-induced acceleration of cell migration depends on activation of the cSrc-ERK1/2 signaling cascade, as it was inhibited by the kinase inhibitors PP2 and PD98059. Activation of the cSrc-ERK1/2 signaling cascade increased expression and activation of the extracellular matrix metalloproteinase-2 (MMP-2). Inhibition of MMP activity using the generic inhibitor GM6001 or the potent iMMP-2 inhibitor prevented the accelerative effect of ouabain. Likewise, Focal Adhesion Kinase (FAK) inhibition with the transfection of dominant negative peptide FRNK impaired the effect of ouabain. These results suggest that ouabain binding to the Na+,K+-ATPase accelerates collective migration of MDCK cells through activation of the cSrc-ERK1/2-FAK signaling cascade and promoting secretion and MMP activity.

Blood-brain barrier and foetal-onset hydrocephalus, with a view on potential novel treatments beyond managing CSF flow.

Despite decades of research, no compelling non-surgical therapies have been developed for foetal hydrocephalus. So far, most efforts have pointed to repairing disturbances in the cerebrospinal fluid (CSF) flow and to avoid further brain damage. There are no reports trying to prevent or diminish abnormalities in brain development which are inseparably associated with hydrocephalus. A key problem in the treatment of hydrocephalus is the blood-brain barrier that restricts the access to the brain for therapeutic compounds or systemically grafted cells. Recent investigations have started to open an avenue for the development of a cell therapy for foetal-onset hydrocephalus. Potential cells to be used for brain grafting include: (1) pluripotential neural stem cells; (2) mesenchymal stem cells; (3) genetically-engineered stem cells; (4) choroid plexus cells and (5) subcommissural organ cells. Expected outcomes are a proper microenvironment for the embryonic neurogenic niche and, consequent normal brain development.

Diagnosis and staging of pancreatic ductal adenocarcinoma.

The management of pancreatic ductal adenocarcinoma (PDAC) is a major public health concern worldwide. Currently, most PDAC patients are diagnosed in advanced stages. The signs and symptoms of the disease, except for jaundice, are non-specific. Thus, the current challenge is to identify earlier those individuals for whom specific screening tools and specific treatments would be beneficial. On the basis of the recommendations of the group of experts of multiple medical specialties of the GALLgo Project, the patients with PDAC should be managed by a multidisciplinary team to assess the personal and family history, the best diagnostic and staging procedures and consider all important aspects for treatment decisions. In this article, the group of experts proposes strategies to shorten the diagnosis times in PDAC patients.

Consensus guidelines for diagnosis, treatment and follow-up of patients with pancreatic cancer in Spain.

The management of patients with pancreatic cancer has advanced over the last few years. We convey a multidisciplinary group of experts in an attempt to stablish practical guidelines for the diagnoses, staging and management of these patients. This paper summarizes the main conclusions of the working group. Patients with suspected pancreatic ductal adenocarcinoma should be rapidly evaluated and referred to high-volume centers. Multidisciplinary supervision is critical for proper diagnoses, staging and to frame a treatment plan. Surgical resection together with chemotherapy offers the highest chance for cure in early stage disease. Patients with advanced disease should be classified in treatment groups to guide systemic treatment. New chemotherapeutic regimens have resulted in improved survival. Symptomatic management is critical in this disease. Enrollment in a clinical trial is, in general, recommended.

[The value of isotopic ventriculography in the prognosis and follow-up of patients undergoing dynamic myocardioplasty]. / Valor de la ventriculografía isotópica en el pronóstico y seguimiento de los pacientes sometidos a miocardioplastia dinámica.

Dynamic cardiomyoplasty was performed in twenty patients with dilated cardiomyopathy. The electrical stimulation was produced by a double chambered pacemaker. Patients were studied by nuclear ventriculography one week before surgery, in the immediate postoperative phase and 8 or 12 months later. Five patients died (four of them were operative deaths). In this group the left ventricular ejection fraction (LVEF) was lower than in survivors (22 +/- 8% vs 28 +/- 4%; p less than 0.001). The end-diastolic volume and the mitral regurgitation index were greater (200 +/- 76 ml/m2 vs 153 +/- 34 ml/m2; p less than 0.001 and 2.12 +/- 0.75 vs 1.68 +/- 0.54; p less than 0.001, respectively). The immediate effect of cardiomyoplasty was the significative reduction in the contractility. However, at 8 or 12 months of follow-up, the LVEF increased in the 72% of the survivors. The end-diastolic volume and the regurgitation index decreased significantly. The clinical status improved in the 81% of the survivors. The best results were obtained in those patients in which a pulse train stimulation was employed in the training phase. Nevertheless, the changes in LVEF are not consistent with the improvement in the clinical status. The improve in the cardiac performance should be also due to the reduction in the left ventricular diameters and in the mitral functional regurgitation.

[Morphologic substrates of the ventricular route of secretion and transport of substances in the tubero-infundibular region of the hypothalamus. Ultrastructural study]. / Sustratos morfológicos de la vía ventricular de secreción y transporte de sustancias en la región tuberoinfundibular del hipotálamo. Estudio ultraestructural.

Ultrastructural studies of the ependyma of the tuberoinfundibular region of the rat hypothalamus have revealed the existence of intraventricular axonal endings and of cytoplasmic blebs and bulbs that project from the apical surface of the ependymal cells to the ventricular lumen. All these structures account for the processes of ependymal apocrine secretion and the neuroventriculocrinia, and hence the release of biologically active substances into the cerebrospinal fluid (CSF). These substances contained in the CSF must act on the nervous nuclei of the tuberoinfundibular region, such as the arcuate nucleus, which is very important in the neuroendocrine regulation of the anterior pituitary gland. Dilated intercellular spaces among neighbouring ependymocytes of this region, small intraependymal cisternae and, in particular, a lateral prolongation of the infundibular recess, which courses through the nervous tissue between the arcuate nucleus and the median eminence from the vertex of the lateral angle of the infundibular recess, may be the route followed by the CSF from the third ventricle to the tissue compartment of the tuberoinfundibular region. Also studied are the cisternae of the region and the relationships of these with the lateral prolongation of the infundibular recess. Some of these cisternae may be filled by the CSF through the prolongation. In this way, the tissue compartment of CSF would be enlarged, and hence the ventricular route for the secretion and transport of biologically active substances would be potentiated.

Sustratos morfológicos de la vía ventricular de secreción y transporte de sustancias en la región tuberoinfundibular del hipotálamo: estudio ultraestructural / Morphologic substrates of the ventricular route of secretion and transport of substances in the tubero-infundibular region of the hypothalamus: ultrastructural study

Ultrastructural studies of the ependyma of the tuberoinfundibular region of the rat hypothalamus have revealed the existence of intraventricular axonal endings and of cytoplasmic blebs and bulbs that project from the apical surface of the ependymal cells to the ventricular lumen. All these structures account for the processes of ependymal apocrine secretion and the neuroventriculocrinia, and hence the release of biologically active substances into the cerebrospinal fluid (CSF). These substances contained in the CSF must act on the nervous nuclei of the tuberoinfundibular region, such as the arcuate nucleus, which is very important in the neuroendocrine regulation of the anterior pituitary gland. Dilated intercellular spaces among neighbouring ependymocytes of this region, small intraependymal cisternae and, in particular, a lateral prolongation of the infundibular recess, which courses through the nervous tissue between the arcuate nucleus and the median eminence from the vertex of the lateral angle of the infundibular recess, may be the route followed by the CSF from the third ventricle to the tissue compartment of the tuberoinfundibular region. Also studied are the cisternae of the region and the relationships of these with the lateral prolongation of the infundibular recess. Some of these cisternae may be filled by the CSF through the prolongation. In this way, the tissue compartment of CSF would be enlarged, and hence the ventricular route for the secretion and transport of biologically active substances would be potentiated

Are all recurrences of "pure" Sydenham chorea true recurrences of acute rheumatic fever?

We are conducting prospective studies of patients in Santiago, Chile, who have had an attack of rheumatic fever and are receiving continuous secondary prophylaxis with monthly injections of benzathine penicillin G. Throat cultures are obtained just prior to injection each month, and serum antistreptococcal antibody titers (antistreptolysin O and antideoxyribonuclease B) are performed at least every 3 months. During the course of these studies we have observed 17 recurrences of "pure" chorea in 10 patients (six girls). In four recurrences the timing of serologic studies and onset of chorea appeared to exclude the occurrence of an immunologically significant group A streptococcal infection within the preceding 6 to 9 months. In one case the period of serologic follow-up was too brief to allow a definite determination. In the remaining 12 recurrences serologic evidence was suggestive or confirmatory of recent streptococcal infection; however, in several instances the titer elevations were quite modest. Our data suggest that in certain chorea-prone patients, Sydenham chorea may recur after streptococcal infections too weak and transient to be readily detectable or, alternatively, after stimuli other than streptococcal infection.

Comunicación interauricular ostium secumdum con hendidura de la válvula mitral. Informe de tres casos operados y revisión de la literatura / Interauricular ostium secumdum communication with mitral valve cleavage. Report on three cases surgical treated and literature review

Se estudian 3 pacientes operados que presentaron comunicación interauricular (CIA) tipo ostium secumdum (OS) asociada con hendidura de la valva septal de la mitral (HVM). Se indican las distintas causas de la regurgitación mitral (RM) que se pueden presentar en el OS. Se comenta sobre la embriología de esta malformación. Se hace énfasis en los datos clínicos y de los exámenes complementarios para el diagnóstico de dicha entidad. La profilaxis antibiótica adecuada es una indicación en esta combinación de anomalías, para evitar la endocarditis bacteriana (AU)

[Isolated mitral valve substitution with Beall prosthesis. Long term results]. / Sustitución valvular mitral aislada con la prótesis de Beall. Resultados a largo plazo.

During a three-year period (1970 to 1973) the Beall mitral prosthesis (103, 104 & 105 series) was used in 97 patients for isolated mitral valve replacement. The early surgical mortality rate within the first 30 days of operation was 11.34%. Among the 86 survivors, 7 developed thromboembolic complications (8.14 per cent), and there were 20 late deaths. Incidence of other complications such as prosthetic malfunction and significant intravascular hemolysis are commented. The 92.42 per cent of the late survivors are in Class I or II of the N.Y.H.A. functional classification.

Sustitución valvular aórtica en asociación con by-pass aortocoronario por aneurisma de la arteria coronaria derecha. Reporte de un caso, con correción quirúrgica exitosa / Valvular aortic substitution associated with aortic coronary by-pass by right coronary artery aneurysm. Report of one case with successful surgical repair

Se reporta el caso de una joven de 20 años de edad portadora de una lesión combinada de la válvula aórtica de origen congénito a quien con motivo de sustitución valvular se le hace el diagnóstico intraoperatorio de aneurisma de la arteria coronaria derecha: se le practicó sustitución valvular aórtica con prótesis lenticular de Wada Cutter y se le realiza by-pass de teflón aortocoronario. Debido a la rareza de la entidad, a los pocos casos diagnosticados y a no encontrar reporte alguno de la corrección quirúrgica de éstos, creemos posible que sea el primer caso reportado de esta corrección quirúrgica exitosa. Se considera que por el mal pronóstico de los casos, debido a la índole de las complicaciones, y al adelanto de las modernas técnicas quirúrgicas, se justifique la intervención quirúrgica correctora de estos pacientes (AU)

Anastomosis aortopulmonar intrapericárdica como tratamiento paliativo en la tetralogía de Fallot / Intrapericardial Aortopulmonary Anastomosis as a Palliative Treatment in Fallot's Tetralogy

Se describe la técnica de la anastomosis aortopulmonar interpericárdiaca derecha; se expresan sus indicaciones y las ventajas de estos procederes paliativos. Se dan los resultados de 64 casos, observándose el aumento de la saturación posoperatoria y como mayor complicación la infección. Se destaca el tamaño correcto de la fístula que no debe exceder de 5 mm de diámetro y de swu realización en cara posterior para evitar la acodadura de la anastomosis. Se preconiza el uso de esta técnica por ser la mejor para el tratamiento de los niños pequeños y lactantes cianóticos (AU)

Metodología de la cateterización de los vasos pulmonares a través de la toracotomía izquierda, en perros / Methodology of the pulmonar vassel catheterization by of left thoracotomy in dogs

Para la canulización de venas y arterias pulmonares con el objeto de investigar los parámetros fisiológicos de hemodilución de los pulmones en perros, los autores proponen el acceso a través de la toracotomía por el lado izquierdo. La pérdida mínima de sangre al introducir el catéter y la colocación cómoda del tronco de la arteria pulmonar, facilitan la técnica de cateterización y contribuyen a su rápida realización (AU)

Tratamiento quirúrgico de la estenosis pulmonar

Se presenta una clasificación de la estenosis pulmonar. Se revisan las indicaciones y el tratamiento quirúrgico de la estenosis pulmonar, con raíz aórtica normal, como malformación única y acompañada de otras malformaciones. Se exponen los dos métodos auxiliares del tratamiento: hipotermia superficial y circulación extracorpórea que se emplean en el Servicio de Cirugía Cardiovascular del Hospital Docente "Comandante Manuel Fajardo", de La Habana. Se describen las técnicas operatorias y los resultados de 21 casos de estenosis pulmonar operados en dichos servicios y que comprenden: Catorce casos de estenosis pulmonar valvular pura; cuatro casos de estenosis infundibular pulmonar pura; un caso de estenosis pulmonar valvular con comunicación interauricular y cortocircuito de derecha a izquierda(AU)

Tratamiento del bloqueo aurículoventricular con el marcapaso implantable

Hemos relatado nuestra experiencia con la implantación del marcapaso electrónico. Creemos que constituye el método de elección en aquellos casos en que el tratamiento médico resulta inefectivo para controlar las crisis de Stokes-Adams. Hay que tener en cuenta el mal estado general que tienen estos pacientes, en particular desde el punto de vista circulatorio. De los 18 pacientes operados once están vivos en la actualidad, llevando una existencia normal, habiéndose reintegrado algunos al trabajo activo. El mayor tiempo alcanzado por uno de estos pacientes es de 1 año y 3 días entre los fallecidos, y de 10 meses entre los que están vivos (AU)

TRatamiento quirúrgico de la comunicación interauricular

Se presentan treinta tres casos de comunicación interauricular operados en el Servicio de Cirugía Cardiovascular del Hospital "Cmdte. Manuel Fajardo". Presentamos una clasificación desde el punto de vista quirúrgico y señalamos el número de casos encontrados por nosotros. Exponemos nuestro criterio de operabilidad en este tipo de defecto. Presentamos el material de nuestros casos en cuanto a la edad, sexo, raza y tipos de defectos encontrados. Exponemos el método seguido por nosotros a cielo abierto que consiste en utilizar siempre la hipotermia superficial teniendo preparada la máquina de circulación extracorpórea con oxigenador plástico. Damos nuestro resultado postoperatorio y la mortalidad (AU)

Tratamiento quirúrgico de la coartación de aorta torácica; nuestros resultados

Presentamos 10 casos operados de coartación de aorta torácica en el Servicio de Cirugía Cardiovascular del Hospital "Comandante Manuel Fajardo". Exponemos una clasificación anatomotopográfica y relacionamos el número de casos encontrados por nosotros. Se expone el criterio de operabilidad en nuestro servicio. Exponemos los medios en que nos basamos para llegar al diagnóstico de coartación de aorta torácica. Se describe la técnica quirúrgica. Mencionamos nuestras complicaciones y hacemos referencia en el síndrome doloroso abdominal pot coartectomía de Sealy. Damos nuestros resultados (AU)