Nanoarchitectonics of an acetogenin-enriched nanosystem mediated by an aqueous extract ofAnnona cherimolaMill with anti-inflammatory and proapoptotic activity against HepG2 cell line.

For the first time, this study shows the nanoarchitectonic process to obtain an acetogenin-enriched nanosystem (AuNPs-Ac) using an aqueous extract fromAnnona cherimolaMill (ACM) composed of gold nanoparticles embedded in an organic matrix that acts as stabilizing agent and presents anti-inflammatory activity and cytotoxical effect against HepG2 cell line, promoting apoptosis. The synthesis of AuNPs-Ac was confirmed by x-ray diffraction analysis, showing metallic gold as the only phase, and the scanning transmission microscope showed an organic cap covering the AuNPs-Ac. Fourier-transformed infrared suggests that the organic cap comprises a combination of different annonaceous acetogenins, alkaloids, and phenols by the presence of bands corresponding to aromatic rings and hydroxyl groups. High-Performance Liquid Chromatography has demonstrated the presence of annonacin, a potent acetogenin, in the extract of ACM. Anin vitroanti-inflammatory activity of the extract of ACM and the AuNPs-Ac was performed using the albumin denaturation method, showing a nonlinear response, which is better than sodium diclofenac salt in a wide range of concentrations that goes from 200 to 400µg ml-1with both samples. The viability assay was studied using trypan blue, treating IMR90 and HepG2 at different concentrations of AuNPs-Ac. The results defined a median lethal dose of 800µg ml-1against HepG2 through apoptosis according to the ratio of caspase-cleaved 9/alpha-tubulin evaluated. It was also demonstrated that the nanosystem presents a higher cytotoxic effect on the HepG2 cell line than in IMR90, suggesting a targeted mechanism. In addition, the nanosystem performs better than using only the extract of ACM in the anti-inflammatory or antiproliferative test, attributed to their higher surface area.

Awareness and Self-Reported Knowledge and Training on Nutrition in Older People among Primary Care Practitioners.

OBJECTIVES: To assess the awareness and training of primary care physicians on nutrition in older patients. DESIGN: Observational, real-world data survey. SETTING: Primary Care. PARTICIPANTS: One hundred sixty-two physicians, generalists and specialists, working in primary care. MEASUREMENTS: Participants received an online questionnaire with 18 questions concerning the importance of nutrition, degree of knowledge, needs, and training in nutrition. The results were evaluated using univariate descriptive analysis, with a percentage for each chosen answer. Logistic regression models were used to evaluate if answers were related to training in nutrition and professional experience. RESULTS: 43.2% of participants reported that nutrition is very important in individuals over 65 years old, and 90% were aware of the importance of nutrition in healthy aging. Nutritional problems affect 30 to 50% of patients, according to 44.7% of participants. 89.2% agree about the need for nutritional assessment in older patients; however, the professionals believe they should be better prepared. Two out of three respondents consider the training received in nutrition during their undergraduate course or continuing medical education as deficient. Time of professional practice was mainly associated with conceptual facts, while continuing medical education did with practical issues, mainly the use of screening and diagnostic tools [FRAIL (OR: 3.16; 95%IC: 1.55-6.46), MNA-SF (OR: 6.455; 95%IC: 2.980-13.981) and SARC-F (OR: 3.063; 95%IC: 1.284-7.309)]. CONCLUSION: Although primary care professionals are aware of the importance of nutrition in older patients, there are still gaps in daily practice that could be improved by developing educational strategies.

Impact of mediterranean diet promotion on environmental sustainability: a longitudinal analysis.

OBJECTIVE: This article aims to estimate the differences in environmental impact (greenhouse gas [GHG] emissions, land use, energy used, acidification and potential eutrophication) after one year of promoting a Mediterranean diet (MD). METHODS: Baseline and 1-year follow-up data from 5800 participants in the PREDIMED-Plus study were used. Each participant's food intake was estimated using validated semi-quantitative food frequency questionnaires, and the adherence to MD using the Dietary Score. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The association between MD adherence and its environmental impact was calculated using adjusted multivariate linear regression models. RESULTS: After one year of intervention, the kcal/day consumed was significantly reduced (-125,1 kcal/day), adherence to a MD pattern was improved (+0,9) and the environmental impact due to the diet was significantly reduced (GHG: -361 g/CO2-eq; Acidification:-11,5 g SO2-eq; Eutrophication:-4,7 g PO4-eq; Energy use:-842,7 kJ; and Land use:-2,2 m2). Higher adherence to MD (high vs. low) was significantly associated with lower environmental impact both at baseline and one year follow-up. Meat products had the greatest environmental impact in all the factors analysed, both at baseline and at one-year follow-up, in spite of the reduction observed in their consumption. CONCLUSIONS: A program promoting a MD, after one year of intervention, significantly reduced the environmental impact in all the factors analysed. Meat products had the greatest environmental impact in all the dimensions analysed.

Association between type 2 diabetes and depressive symptoms after a 1-year follow-up in an older adult Mediterranean population.

OBJECTIVES: To examine the cross-sectional association between baseline depressive symptoms and the presence of type 2 diabetes (T2D), and its association with glycated hemoglobin (HbA1c) and other metabolic variables, and the prospective association of depressive symptoms and HbA1c after 1 year of follow-up. METHODS: n = 6224 Mediterranean older adults with overweight/obesity and metabolic syndrome (48% females, mean age 64.9 ± 4.9 years) were evaluated in the framework of the PREDIMED-Plus study cohort. Depressive symptoms were assessed using the Beck Depression Inventory-II and HbA1c was used to measure metabolic control. RESULTS: The presence of T2D increased the likelihood of higher levels of depressive symptoms (χ2 = 15.84, p = 0.001). Polynomial contrast revealed a positive linear relationship (χ2 = 13.49, p = 0.001), the higher the depressive symptoms levels, the higher the prevalence of T2D. Longitudinal analyses showed that the higher baseline depressive symptoms levels, the higher the likelihood of being within the HbA1c ≥ 7% at 1-year level (Wald-χ2 = 24.06, df = 3, p < .001, for the full adjusted model). Additionally, depressive levels at baseline and duration of T2D predicted higher HbA1c and body mass index, and lower physical activity and adherence to Mediterranean Diet at 1 year of follow-up. CONCLUSIONS: This study supports an association between T2D and the severity of depressive symptoms, suggesting a worse metabolic control from mild severity levels in the short-medium term, influenced by lifestyle habits related to diabetes care. Screening for depressive symptoms and a multidisciplinary integrative therapeutic approach should be ensured in patients with T2D.

Comprehensive profiling of ceramides in human serum by liquid chromatography coupled to tandem mass spectrometry combining data independent/dependent acquisition modes.

Ceramides are sphingolipids with a structural function in the cell membrane and are involved in cell differentiation, proliferation and apoptosis. Recently, these chemical species have been pointed out as potential biomarkers in different diseases, due to their abnormal levels in blood. In this research, we present an overall strategy combining data-independent and dependent acquisitions (DIA and DDA, respectively) for identification, confirmation, and quantitative determination of ceramides in human serum. By application of liquid chromatography-tandem mass spectrometry (LC-MS/MS) method in DIA mode we identified 49 ceramides including d18:1, d18:0, d18:2, d16:1, d17:1 and t18:0 species. Complementary, quantitative determination of ceramides was based on a high-throughput and fully automated method consisting of solid-phase extraction on-line coupled to LC-MS/MS in DDA to improve analytical features avoiding the errors associated to sample processing. Quantitation limits were at pg mL-1 level, the intra-day and between-days variability were below 20 and 25 %, respectively; and the accuracy, expressed as bias, was always within ±25 %. The proposed method was tested with the CORDIOPREV cohort in order to obtain a qualitative and quantitative profiling of ceramides in human serum. This characterization allowed identifying d18:1 ceramides as the most concentrated with 70.8% of total concentration followed by d18:2 and d18:0 with 13.0 % and 8.8 %, respectively. Less concentrated ceramides, d16:1, d17:1 and t18:0, reported a 7.1 % of the total content. Combination of DIA and DDA LC-MS/MS analysis enabled to profile qualitative and quantitatively ceramides in human serum.

Intensive Weight-Loss Lifestyle Intervention Using Mediterranean Diet and COVID-19 Risk in Older Adults: Secondary Analysis of PREDIMED-Plus Trial.

OBJECTIVES: We tested the effects of a weight-loss intervention encouraging energy-reduced MedDiet and physical activity (PA) in comparison to ad libitum MedDiet on COVID-19 incidence in older adults. DESIGN: Secondary analysis of PREDIMED-Plus, a prospective, ongoing, multicentre randomized controlled trial. SETTING: Community-dwelling, free-living participants in PREDIMED-Plus trial. PARTICIPANTS: 6,874 Spanish older adults (55-75 years, 49% women) with overweight/obesity and metabolic syndrome. INTERVENTION: Participants were randomised to Intervention (IG) or Control (CG) Group. IG received intensive behavioural intervention for weight loss with an energy-reduced MedDiet intervention and PA promotion. CG was encouraged to consume ad libitum MedDiet without PA recommendations. MEASUREMENTS: COVID-19 was ascertained by an independent Event Committee until December 31, 2021. COX regression models compared the effect of PREDIMED-Plus interventions on COVID-19 risk. RESULTS: Overall, 653 COVID-19 incident cases were documented (IG:317; CG:336) over a median (IQR) follow-up of 5.8 (1.3) years (inclusive of 4.0 (1.2) years before community transmission of COVID-19) in both groups. A significantly lowered risk of COVID-19 incidence was not evident in IG, compared to CG (fully-adjusted HR (95% CI): 0.96 (0.81,1.12)). CONCLUSIONS: There was no evidence to show that an intensive weight-loss intervention encouraging energy-reduced MedDiet and PA significantly lowered COVID-19 risk in older adults with overweight/obesity and metabolic syndrome in comparison to ad libitum MedDiet. Recommendations to improve adherence to MedDiet provided with or without lifestyle modification suggestions for weight loss may have similar effects in protecting against COVID-19 risk in older adults with high cardiovascular risks.

Health-related quality of life in individuals with metabolic syndrome: a cross-sectional study / Calidad de vida relacionada con la salud en individuos con síndrome metabólico: un estudio descriptivo

INTRODUCTION AND OBJECTIVES: Metabolic syndrome (MetS) is a combination of various cardiovascular risk factors with a major impact on morbidity and premature mortality. However, the impact of MetS on self-reported health-related quality of life (HRQoL) is unknown. This study evaluated the HRQoL in a Spanish adult population aged 55 years and older with MetS. METHOD: A cross-sectional analysis was performed with baseline data from the PREDIMED-Plus multicentre randomized trial. The participants were 6430 men and women aged 55-75 years with overweight/obesity (body mass index ≥27 and ≤40kg/m2) and MetS. The SF-36 questionnaire was used as a tool to measure HRQoL. Scores were calculated on each scale of the SF-36 by gender and age. RESULTS: Participants showed higher scores in the social function (mean 85.9, 95% CI; 85.4-86.4) and emotional role scales (mean 86.8, 95% CI; 86.0-87.5). By contrast, the worst scores were obtained in the aggregated physical dimensions. In addition, men obtained higher scores than women on all scales. Among men, the worst score was obtained in general health (mean 65.6, 95% CI; 65.0-66.2), and among women, in body pain (mean 54.3, 95%CI; 53.4-55.2). A significant decrease was found in the aggregated physical dimensions score among participants 70-75 years old, but an increased one in the aggregated mental dimensions, compared to younger participants. CONCLUSIONS: Our results reflect that the MetS may negatively affect HRQoL in the aggregated physical dimensions, body pain in women, and general health in men. However, this adverse association was absent for the psychological dimensions of HRQoL, which were less affected

INTRODUCCIÓN Y OBJETIVOS: El síndrome metabólico (SM) es la combinación de diversos factores de riesgo cardiovascular que pueden derivar en un mayor impacto en la morbimortalidad prematura. Sin embargo, el impacto del SM en la calidad de vida relacionada con la salud (CVRS) es desconocido. El objetivo de este estudio es evaluar la CVRS en la población adulta española de 55 años o más con SM. MÉTODOS: Se realizó un análisis transversal con los datos del ensayo PREDIMED-Plus. Seis mil cuatrocientos treinta varones y mujeres entre 55-75 años con sobrepeso/obesidad y SM. El instrumento de medida de la CVRS fue el cuestionario SF-36. Cada escala del SF-36 fue descrita y estratificada por sexo. RESULTADOS: Los participantes mostraron valores más altos en las escalas función social (media: 85,9; IC 95%: 85,4-86,4) y rol emocional (media: 86,8; IC 95%: 86,0-87,5). En los varones, la peor puntuación fue en la dimensión salud general (media: 65,6; IC 95%: 65,0-66,2) y en las mujeres el dolor corporal (media: 54,3; IC 95%: 53,4-55,2). Además, los varones obtuvieron puntuaciones más altas en todas las escalas. En la escala función física en varones se encontró una disminución significativa de la CVRS en los participantes entre 70 y 75 años en comparación con los más jóvenes. Las peores puntuaciones se obtuvieron en las dimensiones físicas agregadas. CONCLUSIONES: El SM afecta de manera negativa a la CVRS en las dimensiones agregadas físicas, haciendo especial hincapié en la esfera dolor corporal en mujeres y salud general en varones. Sin embargo, las esferas psicológicas se encuentran menos afectadas por el SM

Clinical decisions in patients with diabetes and other cardiovascular risk factors. A statement of the Spanish Society of Internal Medicine / Decisiones clínicas en pacientes con diabetes y otros factores de riesgo cardiovascular. Una declaración de la sociedad española de medicina interna

Although the mortality associated to cardiovascular diseases (CVD) has been reduced in the last decades, CVD remains the main cause of mortality in Spain and they are associated with an important morbidity and a huge economic burden. The increasing prevalence of obesity and diabetes could be slowing down the mortality reduction in Spain. Clinicians have often difficulty making clinical decisions due to the multiple clinical guidelines available. Moreover, in the current context of economic crisis it is critical to promote an efficient use of diagnostic and therapeutic proceedings to ensure the viability of public health care systems. The Spanish Society of Internal Medicine (SEMI) has coordinated a consensus document to answer questions of daily practice with the aim of facilitating physicians’ decision-making in the management of diabetes and cardiovascular risk factors from a cost-efficiency point of view (AU)

Aunque la mortalidad asociada a enfermedades cardiovasculares (ECV) se ha reducido en las últimas décadas, las ECV siguen siendo la causa principal de mortalidad en España y están asociadas a una morbilidad importante y una enorme carga económica. La creciente prevalencia de obesidad y de diabetes podría estar frenando la reducción en la mortalidad en España. Los médicos suelen tener mucha dificultad en la toma de decisiones clínicas debido a las múltiples guías clínicas disponibles. Por otro lado, en el contexto actual de la crisis económica es imprescindible promover un uso eficaz de los procedimientos diagnósticos y terapéuticos para garantizar la viabilidad de los sistemas de salud pública. La Sociedad Española de Medicina Interna (SEMI) ha desarrollado un documento de consenso para responder a las dudas que surgen en la práctica rutinaria con el objetivo de facilitar a los médicos la toma de decisiones en el control de la diabetes y en los factores de riesgo cardiovascular desde el punto de vista de la rentabilidad (AU)

La enseñanza virtual de imágenes clínicas, tutorizadas mediante correo electrónico, es más eficiente que la enseñanza tradicional / On-line learning with e-mail tutoring for clinical images is more efficient than traditional teaching methods

Introducción. La enseñanza de la patología médica a través de imágenes es la clave para conseguir habilidad clínica en el diagnóstico. Objetivos. Comparar la eficacia docente de un método de enseñanza basado en imágenes en un entorno no presencial frente a la enseñanza tradicional en un entorno presencial, y evaluar el grado de satisfacción del alumno sobre este método de innovación docente en la enseñanza de la patología médica. Materiales y métodos. El estudio se realizó durante el curso 2005-2006 entre 62 alumnos de Patología médica, de la Facultad de Medicina de Córdoba. Se compararon los dos métodos de enseñanza: el presencial (en cada seminario se expusieron verbalmente 15 imágenes) y en el no presencial (imágenes clínicas expuestas en la página web de la Facultad de Medicina con tutorización a través del correo electrónico). La evaluación consistió en la valoración clínica de 16 imágenes (ocho imágenes de cada modelo de enseñanza). Se comparó la puntuación del examen teórico con la de las imágenes clínicas. Tras el examen final, el alumno realizó un cuestionario de evaluación. Resultados. La calificación media final de las imágenes (sobre 10 puntos) fue de: 6.8+/-1.5 y la del test (sobre 10 puntos) fue de 7.3+/-0.9. La calificación media de las imágenes expuestas en la web (7.4+/-1.6) fue superior a la del modelo presencial (6.3+/-1.7) p<0.0001. Existía una correlación entre la puntuación total de la imagen y la del test (r:0.584, p<0.0001). Asimismo, se correlacionaba la calificación de la imagen del modelo presencial y la e la imagen expuesta en al web (r:0.697, p<0.0001. Conclusiones. Las calificaciones de los casos expuestos en la web fueron superiores a las de los casos expuestos en los seminarios presenciales. La enseñanza de la patología médica a través de imágenes clínicas fue un método muy bien considerado por los alumnos (AU)

Introduction. The teaching of Internal Medicine through images is the key for the achievement of clinical skills in the diagnosis. Aims. To compare the efficiency of a teaching method based on images in a face-to-face learning situation with the traditional teaching methods, and to evaluate the degree of satisfaction amongst the alumni regarding the new teaching method within the Internal Medicine. Materials and methods. The study was carried out throughout the academic year 2005/06 amongst 62 Internal Medicine students in the School of Medicine in Córdoba. Two teaching methods were compared: (i) face-to-face- 15 images were exposed in workshop, and (ii)distance-clinical images were exposed at the School of Medicine web site through a tutorial system based on e-mail. The evaluation consisted in a clinical evaluation of 16 images-8 images for each teaching method. The results from the multiple choice exam and the clinical images exam were also compared. Finally, students answered an assessment questionnaire. Results. The final average qualification – out of 10- for the images was: 6.8+/-1.5 and fot the multiple choice exam – out of 10- was 7.3+/-0.9. The average qualification was higher for the images exposed at the web site than for the face-to-face model: (7.4+/-1.6) vs (6.3+/-1.7) p<0.0001. There was a correlation between the total punctuation for the images and the examination (r:0.584, p<0.0001). Moreover, there was also a correlation between the qualification obtained for the images in the face-to-face method and the images exposed on-line (r:0.697, p<0.0001). Conclusions: Qulaifications for the cases displayed on the website were higher than those for the cases exposed on the face-to-face workshops. In addition to this, students had a very positive opinion regarding the new teaching method for Internal Medicine based on clinical images (AU)

Coronas implantosoportadas: ¿individualizar o ferulizar? / Implant-supported crowns: Individualized or splinting?

Existen diferentes formas de rehabilitación de coronas sobre implantes adyacentes en un tramo edéntulo. Las opciones que pueden encontrarse son la de restaurar con varias coronas unitarias, o bien unir esas coronas en una sola prótesis. Material y Método: Se llevó a cabo una búsqueda bibliográfica a través de bases de datos en revistas especializadas de Odontología. Resultados: En la bibliografía revisada se observa que existen defensores y detractores de cada una de las técnicas, basándose cada autor en distintos estudios y argumentos. Discusión: Se encontraron ventajas e inconvenientes en ambas opciones prostodóncicas, valorando en base a éstos cuándo utilizar cada una de las técnicas propuestas. Conclusiones: Cuando las condiciones son idóneas, se considera adecuada la restauración con coronas individuales; por otro lado cuando existan condiciones adversas (implantes cortos, hueso de mala calidad, carga inmediata o factores oclusales no adecuados), en las que el reparto de fuerzas pueda comprometer el pronóstico de la restauración, la ferulización será el tratamiento de elección (AU)

There are different methods of crown rehabilitation refering to implants adjacent in edentulous sites. The options can be: rehabilitation with several single crowns or the splinting of the crowns in the prostheses. Material and method: A bibliographical research through the data base of the U.C.M. library and a review of clinical files of patients treated under the title implant-prostheses has been carried out. Results: There are supporters and non-supporters of each technique, based on different arguments and studies. Discussion: Advantages and inconvenients have been found in each method, taking these into consideration when it comes to using the appropriate restoration. Conclusions: When conditions are suitable, the implants can be restored by using single crowns. On the other hand, when there are no ideal factors (short implants, low bone quality, early loading, adverse oclussal factors) the use of splinting crowns will be more appropriate (AU)

Efecto de la alimentación mediterránea en la respuesta lipémica posprandial / Effect of the Mediterranean diet on postprandial lipemic response

Introducción. La variabilidad individual de la respuesta lipémica posprandial excede a la que se produce en la lipemia del ayuno, debido a la influencia de factores ambientales y genéticos. Uno de los factores ambientales más relevantes es el tipo de alimentación habitual de las personas. El consumo de dietas ricas en grasa saturada favorece un mayor aumento de partículas ricas en triglicéridos posprandiales que con el consumo de dietas muy pobres en grasa y de dietas ricas en grasa poliinsaturada n-3. Sin embargo, son pocos los estudios que investiguen el efecto de la grasa monoinsaturada sobre los valores de lípidos plasmáticos en estado posprandial. Por consiguiente, nuestro objetivo fue analizar el efecto agudo de la ingesta de distintos tipos de grasa sobre la lipemia posprandial. Sujetos y métodos. La población a estudiar consistió en 21 voluntarios varones jóvenes sanos y con una edad media de 23 años a los que se sometieron a 3 sobrecargas grasas con vitamina A. La composición de la sobrecarga grasa fue de 1 g de grasa/kg de peso (el 65% grasa) con diferente composición grasa y siguiendo un protocolo aleatorizado y cruzado. La composición de las 3 sobrecargas grasas fue la siguiente: comida rica en ácidos grasos monoinsaturados procedente del aceite de oliva (un 22% de grasas saturadas, un 38% de ácidos grasos monoinsaturados, un 4% de ácidos grasos poliinsaturados y un 0,7% de ácido alfa-linolénico); comida rica en grasa saturada (un 38% de grasas saturadas, un 22% de ácidos grasos monoinsaturados, un 4% de ácidos grasos poliinsaturados y un 0,7% de ácido alfa-linolénico), y por último, una comida rica en ácidos grasos poliinsaturados n-3 de origen vegetal (un 20% de grasas saturadas, un 24% de ácidos grasos monoinsaturados, un 16% de ácidos grasos poliinsaturados y un 4% de ácido alfa-linolénico). Se extrajo sangre venosa en el tiempo 0 y a las 2, 4, 6 y 8,5 h. Se determinaron los valores plasmáticos de triglicéridos, colesterol total, lipoproteínas de alta densidad, lipoproteínas de baja densidad y apolipoproteínas A-I y B. Resultados. Se observó una mayor concentración de triglicéridos en el tiempo 2, con la comida rica en aceite de oliva que con las grasas saturada y poliinsaturada, rica en nueces. En el tiempo 8 se encontró una menor concentración de triglicéridos tras la sobrecarga rica en aceite de oliva comparada con la rica en nueces. No hubo cambios para el resto de partículas lipídicas estudiadas. Conclusión. Las personas mostraron una cinética de aclaramiento distinta en los valores de triglicéridos posprandiales tras la comida rica en aceite de oliva en comparación con la comida rica en grasa saturada y poliinsaturada n-3 (AU)

Introduction. Because of environmental and genetic factors, individual variability in postprandial lipemic response is greater than that produced in fasting lipemia. One of the most important environmental factors is the individual's normal diet. Diets rich in saturated fatty acids (SAFA) favor a greater increase in postprandial triglyceride (TG)-rich particles than low-fat diets and those rich in polyunsaturated N-3 fatty acids (PUFA). However, few studies have investigated the effect of monounsaturated fatty acids (MUFA) on plasma lipid levels in the postprandial state. Consequently, the aim of this study was to analyze the acute effect of intake of distinct types of fat on postprandial lipemia. Subjects and methods. Twenty-one healthy male volunteers with a mean age of 23 years underwent three vitamin A-fat load tests consisting of 1 g of fat/kg body weight (65% fat) with distinct fat compositions, following a randomized, crossover protocol. The composition of the diets was: high-MUFA diet from olive oil (22% SAFA, 38%; MUFA, 4%; PUFA, 0.7%; alpha-linolenic acid); high-SAFA diet (38% SAFA; 22% MUFA, 4% PUFA, 0.7% alpha-linolenic acid); PUFA-rich diet from vegetable fats (20% SAFA, 24% MUFA, 16% PUFA, 4% alpha-linolenic acid). Blood samples were taken at 0, 2, 4, 6, and 8.5 hours.. Plasma TG, total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, apolipoprotein (Apo) A-I and Apo B were determined. Results. TG concentration was greater at 2 hours the after intake of food rich in olive oil than after the intake of saturated and polyunsaturated fats, rich in nuts. At 8 hours, TG concentration was lower after the intake of food rich in olive oil than after the intake of polyunsaturated fat, rich in nuts. No changes in total cholesterol, HDL, LDL, Apo A-I or Apo B were observed. Conclusion. The kinetics of TG clearance differed after the monounsaturated fat load test compared with polyunsaturated N-3 and saturated fat loads (AU)

Efecto protector de la alimentación mediterránea sobre la citotoxicidad inducida por la grasa saturada en células endoteliales humanas / Protective effect of a mediterranean-type diet on the saturated fat-induced human endothelial cultured cells cytotoxicity

Introducción. En la actualidad hay evidencias claras de que las lipoproteínas posprandiales ricas en triglicéridos son un factor independiente para el desarrollo de la enfermedad arteriosclerótica. Por ello, resulta interesante estudiar el efecto agudo de la ingesta de distintos tipos de grasa sobre el endotelio vascular. Objetivo. Estudiar si las lipoproteínas posprandiales grandes, ricas en triglicéridos obtenidas tras la ingesta aguda de 3 comidas ricas en grasa de diferente origen (mantequilla, aceite de oliva o nueces) inducen una citotoxicidad in vitro diferente sobre las células endoteliales humanas. Pacientes y métodos. Se seleccionó a 8 voluntarios normolipémicos y homocigóticos para el alelo E3 de la Apo E que recibieron una comida rica en grasa (1 g/kg de peso corporal, 60.000 U de vitamina A y 7 mg de colesterol/kg de peso), que contenía un 60% de calorías como grasa, un 15% como proteínas y un 25% como hidratos de carbono. Se llevaron a cabo extracciones en el tiempo 0 y cada hora hasta las 11 h. Las partículas grandes (Sf > 400) ricas en triglicéridos fueron aisladas inmediatamente tras la obtención de plasma. Se establecieron cultivos de células endoteliales humanas de vena de cordón umbilical y se determinó el grado de citotoxicidad mediante el ensayo colorimétrico de cuantificación de células muertas, basado en la medida de actividad de la lactato dehidrogenasa. Resultados. La citotoxicidad, medida como actividad de LDH, inducida por las lipoproteínas grandes, ricas en triglicéridos obtenidas tras la ingesta de la comida rica en mantequilla (30,35 ± 3,07 U/l) fue superior a la producida por la comida rica en aceite de oliva virgen (23,08 ± 3,81 U/l; p < 0,049) y la dieta rica en nueces (21,63 ± 3,18 U/l; p < 0,012). No se observaron diferencias significativas en la citotoxicidad producida entre la comida rica en aceite y la rica en nueces (p < 0,763). Conclusiones. Nuestros datos sugieren que la ingesta de una comida grasa rica en aceite de oliva o en nueces induce una menor citotoxicidad en células endoteliales en cultivo. Este mecanismo es protector frente a la enfermedad arteriosclerótica (AU)

Introduction. Evidence points to elevated levels of postprandial triglyceride-rich lipoproteins as a risk factor in the development of the atherosclerotic disease. Then, it would be interesting to study the acute effect of three different meals on the vascular endothelium. Objective. To analyze the different effects of the postprandial triglyceride-rich lipoproteins obtained during three meals on endothelial cells cytotoxicity. Patients and methods. Eight healthy apoE 3/3 male volunteers were given a vitamin A fat-loading test (1 g of fat/kg body weight, 60,000 IU of vitamin A and 7 mg of cholesterol/kg body weight) consisting of 60% fat, 15% protein and 25% carbohydrates. Blood samples were taken at time 0 and every hour until the 11th hour. The large triglyceride-rich proteins (Sf > 400) were isolated from 4 ml of plasma. Human umbilical vein endothelial cells were grown and the cytotoxic effect of the large triglyceride rich proteins were measured by the colorometric assay with the quantification of dead cells and cell lysis based on the measurement of lactate dehydrogenase (LDH). Results. The triglyceride rich lipoproteins from a butter-rich meal induced a higher cytotoxicity (30.35 ± 3.07 IU/L) than the particles from an olive oil-rich (23.08 ± 3.81 IU/L; p < 0.049) or a walnut-enrich meal (21.63 ± 3.18 IU/L; p < 0.012). No significant difference was found between olive oil and walnuts meals (p < 0.763). Conclusions. Our data suggest that the consumption of an olive oil-enriched or a walnuts-enriched meal induced a lower cytotoxicity on endothelial cells, as a protection from atherosclerotic disease (AU)

Actividad coagulante del factor VII (FVIIc) en ancianos con cardiopatía isquémica / Coagulant activity of factor VII (FVIIc) in old people with ischemic heart disease

Fundamento. La actividad coagulante del factor VII (FVIIc) aumenta con la edad y es un factor de riesgo en el sujeto de mediana edad, pero no se sabe su protagonismo en el anciano. El objetivo de este trabajo es evaluar si la FVIIc es un factor de riesgo en dicha población. Pacientes y método: Diseño: casos y controles. Formaron el grupo 'casos' 79 pacientes que cumplieron los siguientes criterios de inclusión: a) edad entre 65 y 85 años, y b) ingreso en el Hospital Valle de los Pedroches de Pozoblanco por infarto de miocardio y/o angina inestable en un período comprendido entre 2 años y 6 meses previos al inicio del estudio. El grupo 'control' lo formaron 81 sujetos, de similar edad, extraídos al azar de las listas del Padrón Municipal, excluyendo aquéllos con cardiopatía coronaria. La FVIIc se midió por métodos convencionales. El plasma problema se diluyó con plasma deficiente en FVIIc y se midieron los tiempos de coagulación tras añadir tromboplastina y calcio. La medición se calibró frente a un plasma 'control' y el resultado se presentó en forma de porcentaje sobre el control. Resultados: No hubo diferencias significativas entre la FVIIc entre casos (118,3 [22,2]) y controles (116,5 [24,4]; p = 0,630) en el grupo total. Al estratificar por edad se observó que, en el grupo de más de 75 años, los casos tenían una FVIIc superior a los controles (124,1 [18,2] frente a 113,3 [23,5]; p < 0,05). Al estratificar por sexos se observaron unos resultados en los varones similares al grupo global. En el análisis bivariable, en sujetos con enfermedad coronaria, la FVIIc se relacionó con el colesterol total, cLDL, apoproteína B, índice de masa corporal, HbA1c y edad. Los factores que se relacionaron con la FVIIc en el análisis multivariable fueron la glucosa basal, el índice de masa corporal y de forma negativa con el cHDL. Conclusiones: La FVIIc está elevada en la enfermedad coronaria del sujeto muy anciano, por lo que puede ser un factor de riesgo coronario significativo en este grupo de edad (AU)