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OBJECTIVE: Time-restricted eating (TRE), a dietary approach that confines food intake to specific time windows, has shown metabolic benefits. However, its impact on body weight loss remains inconclusive. The objective of this study was to investigate the influence of early TRE (eTRE) and delayed TRE (dTRE) on fat mobilization using human adipose tissue (AT) cultures. METHODS: Subcutaneous AT was collected from 21 participants with severe obesity. We assessed fat mobilization by measuring glycerol release in AT culture across four treatment conditions: control, eTRE, dTRE, and 24-h fasting. RESULTS: TRE had a significant impact on lipolysis (glycerol release [mean (SD)] in micromoles per hour per gram: control, 0.05 [0.003]; eTRE, 0.10 [0.006]; dTRE, 0.08 [0.005]; and fasting, 0.17 [0.008]; p < 0.0001). Both eTRE and dTRE increased lipolysis compared with the control group, with eTRE showing higher glycerol mobilization than dTRE during the overall 24-h time window, especially at the nighttime/habitual sleep episode (p < 0.0001). Further analysis of TRE based on fasting duration revealed that, independently of the time window, glycerol release increased with fasting duration (in micromoles per hour per gram: 8 h = 0.08 [0.001]; 12 h = 0.09 [0.008]; and 16 h of fasting = 0.12 [0.011]; p < 0.0001). CONCLUSIONS: This study provides insights into the potential benefits of TRE on fat mobilization and may guide the design of future dietary strategies for weight management and metabolic health.
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STUDY OBJECTIVES: Napping is a common habit in many countries. Nevertheless, studies about the chronic effects of napping on obesity are contradictory, and the molecular link between napping and metabolic alterations has yet to be studied. We aim to identify molecular mechanisms in adipose tissue (AT) that may connect napping and abdominal obesity. METHODS: In this cross-sectional study, we extracted the RNA repeatedly across 24h from cultured AT explants and performed RNA sequencing. Circadian rhythms were analyzed using 6 consecutive time points across 24 hours. We also assessed global gene expression in each group (nappers vs. non-nappers). RESULTS: With napping, there was a loss of rhythmicity in 88% of genes that showed circadian rhythmicity among non-nappers, a reduction in rhythm amplitudes of 29%, and significant phase changes from a coherent unimodal acrophase in non-nappers, towards a scattered and bimodal acrophase in nappers. Those genes that lost rhythmicity with napping were mainly involved in pathways of glucose and lipid metabolism, and of the circadian clock. Additionally, we found differential global gene expression between nappers and non-nappers with 34 genes down- and 32 genes up-regulated in nappers. The top up-regulated gene (IER3) and top down-regulated pseudogene (VDAC2P2) in nappers have been previously shown to be involved in inflammation. CONCLUSION: These new findings may have implications for our understanding of napping's effects on obesity and metabolic disorders.
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BACKGROUND: The study has two main aims: (1) to analyze and validate the factor structure of the Fear of COVID-19, Workplace health and safety training, and Behavioral Safety Compliance scales (Study 1) in frontline Spanish COVID-19 workers from different sectors (food sector, hospitals, and death care services); and (2) to analyze and validate the factor structure of a reduced version of these scales (Study 2) in Spanish workers in the healthcare sector. METHOD: Analyses carried out using R 1.4.2. allowed us to validate the factor structure of the scales in the two studies. The sample consisted of 361 participants in study 1; and 708 participants in study 2. RESULTS: The results indicate that the instruments offer adequate evidence of reliability and validity. CONCLUSIONS: The questionnaire (especially the short version) can be used by employees who were in frontline of COVID-19 in a reliable and valid way in the post-COVID-19 period, and even to prevent potential similar events that might threaten professionals' physical and mental health in the future.
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COVID-19 , Miedo , Personal de Salud , Salud Laboral , Pandemias , Humanos , COVID-19/psicología , COVID-19/prevención & control , Miedo/psicología , Masculino , Femenino , Adulto , Personal de Salud/psicología , Persona de Mediana Edad , Encuestas y Cuestionarios , España , Reproducibilidad de los ResultadosRESUMEN
Melatonin is a pineal hormone that modulates the circadian system and exerts soporific and phase-shifting effects. It is also involved in many other physiological processes, such as those implicated in cardiovascular, endocrine, immune, and metabolic functions. However, the role of melatonin in glucose metabolism remains contradictory, and its action on human adipose tissue (AT) explants has not been demonstrated. We aimed to assess whether melatonin (a pharmacological dose) influences insulin sensitivity in human AT. This will help better understand melatonin administration's effect on glucose metabolism. Abdominal AT (subcutaneous and visceral) biopsies were obtained from 19 participants with severe obesity (age: 42.84 ± 12.48 years; body mass index: 43.14 ± 8.26 kg/m2) who underwent a laparoscopic gastric bypass. AT biopsies were exposed to four different treatments: control (C), insulin alone (I) (10 nM), melatonin alone (M) (5000 pg/mL), and insulin plus melatonin combined (I + M). All four conditions were repeated in both subcutaneous and visceral AT, and all were performed in the morning at 8 a.m. (n = 19) and the evening at 8 p.m. (in a subsample of n = 12). We used western blot analysis to determine insulin signaling (using the pAKT/tAKT ratio). Furthermore, RNAseq analyses were performed to better understand the metabolic pathways involved in the effect of melatonin on insulin signaling. As expected, insulin treatment (I) increased the pAKT/tAKT ratio compared with control (p < .0001). Furthermore, the addition of melatonin (I + M) resulted in a decrease in insulin signaling as compared with insulin alone (I); this effect was significant only during the evening time (not in the morning time). Further, RNAseq analyses in visceral AT during the evening condition (at 8 p.m.) showed that melatonin resulted in a prompt transcriptome response (around 1 h after melatonin addition), particularly by downregulating the insulin signaling pathway. Our results show that melatonin reduces insulin sensitivity in human AT during the evening. These results may partly explain the previous studies showing a decrease in glucose tolerance after oral melatonin administration in the evening or when eating late when endogenous melatonin is present.
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Resistencia a la Insulina , Melatonina , Humanos , Melatonina/farmacología , Resistencia a la Insulina/fisiología , Adulto , Masculino , Femenino , Persona de Mediana Edad , Insulina/metabolismo , Tejido Adiposo/metabolismo , Tejido Adiposo/efectos de los fármacosRESUMEN
BACKGROUND: Artificial intelligence (AI) is becoming more useful as a decision-making and outcomes predictor tool. We have developed AI models to predict surgical complexity and the postoperative course in laparoscopic liver surgery for segments 7 and 8. METHODS: We included patients with lesions located in segments 7 and 8 operated by minimally invasive liver surgery from an international multi-institutional database. We have employed AI models to predict surgical complexity and postoperative outcomes. Furthermore, we have applied SHapley Additive exPlanations (SHAP) to make the AI models interpretable. Finally, we analyzed the surgeries not converted to open versus those converted to open. RESULTS: Overall, 585 patients and 22 variables were included. Multi-layer Perceptron (MLP) showed the highest performance for predicting surgery complexity and Random Forest (RF) for predicting postoperative outcomes. SHAP detected that MLP and RF gave the highest relevance to the variables "resection type" and "largest tumor size" for predicting surgery complexity and postoperative outcomes. In addition, we explored between surgeries converted to open and non-converted, finding statistically significant differences in the variables "tumor location," "blood loss," "complications," and "operation time." CONCLUSION: We have observed how the application of SHAP allows us to understand the predictions of AI models in surgical complexity and the postoperative outcomes of laparoscopic liver surgery in segments 7 and 8.
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Inteligencia Artificial , Hepatectomía , Laparoscopía , Neoplasias Hepáticas , Humanos , Laparoscopía/métodos , Hepatectomía/métodos , Femenino , Masculino , Persona de Mediana Edad , Neoplasias Hepáticas/cirugía , Neoplasias Hepáticas/patología , Anciano , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Tempo Operativo , AdultoRESUMEN
Background and purpose: Napping is a widespread practice worldwide and has in recent years been linked to increased abdominal adiposity. Lipase E or LIPE encodes the protein hormone-sensitive lipase (HSL), an enzyme that plays an important role in lipid mobilization and exhibits a circadian expression rhythm in human adipose tissue. We hypothesized that habitual napping may impact the circadian expression pattern of LIPE, which in turn may attenuate lipid mobilization and induce abdominal fat accumulation. Methods: Abdominal adipose tissue explants from participants with obesity (n = 17) were cultured for a 24-h duration and analyzed every 4 h. Habitual nappers (n = 8) were selected to match non-nappers (n = 9) in age, sex, BMI, adiposity, and metabolic syndrome traits. Circadian LIPE expression rhythmicity was analyzed using the cosinor method. Results: Adipose tissue explants exhibited robust circadian rhythms in LIPE expression in non-nappers. In contrast, nappers had a flattened rhythm. LIPE amplitude was decreased in nappers as compared with non-nappers (71% lower). The decrease in amplitude among nappers was related to the frequency of napping (times per week) where a lower rhythm amplitude was associated with a higher napping frequency (r = -0.80; P = 0.018). Confirmatory analyses in the activity of LIPE's protein (i.e., HSL) also showed a significant rhythm in non-nappers, whereas significance in the activity of HSL was lost among nappers. Conclusion: Our results suggest that nappers display dysregulated circadian LIPE expression as well as dysregulated circadian HSL activity, which may alter lipid mobilization and contribute to increased abdominal obesity in habitual nappers.
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Tejido Adiposo , Lipasa , Esterol Esterasa , Humanos , Grasa Abdominal/metabolismo , Tejido Adiposo/metabolismo , Ritmo Circadiano , Obesidad/metabolismo , Esterol Esterasa/metabolismoAsunto(s)
Carcinoma Hepatocelular , Hipertensión Portal , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/complicaciones , Carcinoma Hepatocelular/cirugía , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/cirugía , Neoplasias Hepáticas/patología , Hipertensión Portal/complicaciones , Hipertensión Portal/cirugía , Hipertensión Portal/patologíaRESUMEN
La mala calidad de sueño afecta la salud física y mental, por lo que dormir lo suficiente ayuda a activar la mente y prevenir problemas de salud. Objetivo. El propósito de este estudio fue identificar la salud mental y la calidad de sueño durante la pandemia por la COVID-19. Materiales y método. Se aplicaron tres encuestas en línea (HARS (Hamilton Anxiety Rating Scale), HDRS (Hamilton Depression Rating Scale) y PSQI (Pittsburgh Sleep Quality Index) a 203 profesores de la región de Puno entre damas y varones (102 varones y 101 mujeres) con edades de 25 años hasta 58 años (Edad promedio = 39,19 ±5,47 años), los mismos que cumplieron el aislamiento social obligatorio. Resultados. Los niveles de ansiedad identificados en el estudio fueron altos, el 55,88 % de los varones y el 60,40 % de las mujeres presentan trastornos de depresión; el 77,45 % de los varones y el 70,30 % de las mujeres presentan trastornos de ansiedad y el 47, 06 % de los varones y el 44,55 % de las mujeres presentan una pobre calidad de sueño. Conclusiones. Estos factores afectan a la salud mental de la población por lo que es necesario abordar los problemas de salud mental de las personas durante esta pandemia de COVID-19.
Poor sleep quality affects physical and mental health, so getting enough sleep helps to activate the mind and prevent health problems. Objective. The purpose of this study was to identify mental health and sleep quality during the COVID-19 pandemic. Materials and Method. Three online surveys (HARS (Hamilton Anxiety Rating Scale), HDRS (Hamilton Depression Rating Scale) and PSQI (Pittsburgh Sleep Quality Index) were applied to 203 teachers in the Puno region between women and men (102 men and 101 women) aged 25 years to 58 years (mean age = 39.19 ±5.47 years), the same who met the mandatory social isolation. Results. The levels of anxiety identified in the study were high, 55.88 % of the males and 60.40 % of the females presented depressive disorders; 77.45 % of the males and 70.30 % of the females presented anxiety disorders and 47.06 % of the males and 44.55 % of the females presented poor sleep quality. Conclusions. These factors affect the mental health of the population so it is necessary to address the mental health problems of people during this pandemic of COVID-19.
A má qualidade do sono afeta a saúde física e mental, portanto, dormir o suficiente ajuda a ativar a mente e a prevenir problemas de saúde. Objetivo. O objetivo deste estudo foi identificar a saúde mental e a qualidade do sono durante a pandemia da COVID-19. Materiais e método. Três pesquisas on-line (HARS (Hamilton Anxiety Rating Scale), HDRS (Hamilton Depression Rating Scale) e PSQI (Pittsburgh Sleep Quality Index) foram aplicadas a 203 professores e professoras da região de Puno (102 homens e 101 mulheres) com idades entre 25 e 58 anos (idade média = 39,19 ±5,47 anos), que completaram o isolamento social obrigatório. Resultados. Os níveis de ansiedade identificados no estudo eram altos, 55,88% dos homens e 60,40% das mulheres tinham distúrbios depressivos; 77,45% dos homens e 70,30% das mulheres tinham distúrbios de ansiedade e 47,06% dos homens e 44,55% das mulheres tinham má qualidade de sono. Conclusões. Estes fatores afetam a saúde mental da população e é necessário abordar os problemas de saúde mental das pessoas durante esta pandemia da COVID-19.
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Humanos , Adulto , Calidad del SueñoRESUMEN
BACKGROUND: Laparoscopic liver surgery has progressively evolved. Consequently, liver procedures are increasingly performed laparoscopically, particularly in experienced centers. However, vascular resection and reconstruction still are considered a limitation for laparoscopy1 due to the risk of bleeding and the technical difficulty. METHODS: A 72-year-old woman with a history of colorectal cancer had a 10 cm metastasis diagnosed in the right hemiliver with tumoral invasion of the right portal branch and tumor thrombus advancing to the portal confluence. After adjuvant chemotherapy and with stable disease, surgical resection was planned.2,3 Tips to avoid portal stenosis were carefully followed. RESULTS: The operation was performed with a fully laparoscopic procedure. To minimize manipulation, an in situ right hepatectomy was performed.4 The right hepatic artery was dissected and ligated. The liver transection was guided with a caudal approach of the middle hepatic vein.5 The right biliary duct was then divided, achieving an excellent exposure of the portal bifurcation. The main and left portal trunks were occluded with vascular clamps, and the right portal vein was sharply divided with scissors. The stump was sutured to minimize backflow bleeding and to cover the tumor thrombus. Then, the portal opening was transversally sutured with a 5/0 running suture. The clamps were released, and the authors observed no bleeding and an adequate caliber with no stenosis. The procedure was completed in the standard fashion. The postoperative course was uneventful, and the woman was discharged on postoperative day 3. No early or late complications were observed.6 CONCLUSIONS: In selected cases, patients who require vascular resection and reconstruction during hepatectomies can benefit from the advantages of a laparoscopic approach.
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Laparoscopía , Neoplasias Hepáticas , Anciano , Femenino , Hepatectomía/métodos , Venas Hepáticas/cirugía , Humanos , Laparoscopía/métodos , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/cirugía , Vena Porta/cirugíaRESUMEN
BACKGROUND: Radical re-resection has been demonstrated beneficial in incidental gallbladder cancer (iGBC) stages ≥ pT1b [1]. Anatomical resection (AR) of segments IVb-V is recommended, particularly for iGBC and liver-sided tumors [2]. Laparoscopically, this is a challenging procedure, as well as the regional lymphadenectomy, since inflammation from previous surgery can hinder identification of extrahepatic bile ducts. This difficult minimally invasive procedure, facilitated with indocyanine green (ICG) fluorescence enhancement [3] is herein didactically demonstrated. METHODS: A 73 y. o. female patient underwent laparoscopic cholecystectomy for cholelithiasis. An iGBC -pT2b with positive cystic node-was found. Completion radical surgery was decided. Before surgery, 1.5mg of ICG was intravenously administered. A regional lymphadenectomy (stations 5-8-9-12-13) was safely performed: ICG allowed for bile duct visualization despite scarring from previous procedure. AR (IVb-V) was performed based on a glissonian-pedicle approach. After completing the procedure, a new dose of ICG was administered to discard ischemic areas in the remnant. RESULTS: Total operative time was 359 min. Intermittent Pringle maneuver resulted in <50 ml bleeding. Hospital stay was 3 days. Pathological examination revealed no residual tumor in the liver bed. Ten lymph nodes were resected; 3 of them (2 retroportal and 1 common hepatic artery) showing tumoral invasion. After surgery, 6 cycles of adjuvant chemotherapy (Gemcitabine-Oxaliplatin) was administered. CONCLUSIONS: Laparoscopic radical surgery (AR of segments IVb-V plus regional lymphadenectomy) for iGBC is feasible and safe [4]. ICG fluorescence can be of help to identify hilar structures and rule out areas of ischemia.
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Neoplasias de la Vesícula Biliar , Laparoscopía , Neoplasias Hepáticas , Femenino , Fluorescencia , Neoplasias de la Vesícula Biliar/diagnóstico por imagen , Neoplasias de la Vesícula Biliar/cirugía , Hepatectomía/métodos , Humanos , Verde de Indocianina , Laparoscopía/métodos , Neoplasias Hepáticas/cirugía , Escisión del Ganglio Linfático/métodosAsunto(s)
Cirugía Bariátrica , Anomalías del Sistema Digestivo , Hepatopatías , Fallo Hepático , Trasplante de Hígado , Obesidad Mórbida , Cirugía Bariátrica/efectos adversos , Humanos , Hígado , Hepatopatías/cirugía , Fallo Hepático/cirugía , Trasplante de Hígado/efectos adversos , Necrosis/etiología , Obesidad Mórbida/cirugíaAsunto(s)
Colectomía , Laparoscopía , Anastomosis Quirúrgica , Humanos , Íleon/cirugía , Intestino Delgado/cirugíaRESUMEN
Self-concept is one of the most relevant variables in the field of personality, and a negative self-perception can pose a risk to the adolescent's development. The present study aimed to analyze the psychometric properties proposed by Aguirre and collaborators for the dimensional self-concept questionnaire (AUDIM-M). The total sample was 560 adolescents from the city of Chihuahua, Chihuahua, with a mean age of 12.96 ± 0.88 years. The factor structure of the questionnaire was analyzed using confirmatory factor analysis. The analyses show that a four-factor structure is viable and adequate (GFI 0.964; RMSEA 0.057; CFI 0.950). The four-factor structure (personal self-concept, physical self-concept, social self-concept, and academic self-concept), according to statistical and substantive criteria, shows adequate indicators of reliability and validity adjustment. The model obtained coincides with that proposed by Aguirre et al. Improving adolescents' self-concept undoubtedly contributes to their quality of life, hence the need for valid and reliable instruments for its measurement; this study could be a first approach for future research.
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Anxiety about aging is an important mediating factor in attitudes and behavior toward elderly individuals as well as a mediating factor in the adjustment to one's own aging processes. The aim of this study was to analyze the factor structure, internal consistency and factorial invariance by sex of the Lasher and Faulkender Anxiety about Aging Scale. The sample consisted of 601 Mexican older adults, 394 women and 207 men, with a mean age of 70.69 ± 8.10 years. The factor structure of the questionnaire was analyzed using confirmatory factor analysis. Analyses show that a four-factor structure is feasible and adequate. The four-factor structure (fear of the elderly, psychological concerns, physical appearance and fear of loss), according to statistical and substantive criteria, showed adequate reliability and validity indicators. However, the obtained model does not fully coincide with that proposed by the questionnaire authors, although it continues to support the multi-factor component of anxiety about aging. On the other hand, the factor structure, the factor loadings and the intercepts are considered invariant in the two populations (men and women); however, there are differences between populations on the means of the physical appearance and fear of loss factors.
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The traditional teaching style in which the teacher is in control and there is a submissive attitude in students is predominant in Mexico. The development of identity in preadolescence is subjected to social groups, which could develop interpersonal difficulties through the controlling teaching style. Although the fear of negative evaluation in students and competitive sport has been studied in education, relatively little research has been done in the area of physical education in relation to the controlling style. The purpose of this study was to investigate the correlation and predictive relationship between controlling teaching and the fear of negative evaluation mediated by the frustration of the basic psychological needs (BPN), controlled motivation, and individualism/competitiveness through the theoretical framework of self-determination theory. Participants were 1132 students in the fifth and sixth grades in public elementary schools in the state of Chihuahua, Mexico, with ages between 10 and 13 (M = 10.51 years; SD = 0.66 years). Results indicate the perceived controlling teaching style positively predicted the fear of negative evaluation in students of this study through BPN frustration, that is positively related to low-quality motivation, which is related to a higher level of individualism/competitiveness. This, in turn, is proven to be a predictor of the fear of negative evaluation. The results also discuss the promotion of the autonomy support style, avoiding the controlling teaching style, for the minimization of negative results related to the perception of fear and the development of student well-being both within and beyond the school context.
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INTRODUCTION: rectoscopy and 18F-FDG PET/CT as a diagnostic algorithm for the assessment of tumor response in rectal cancer after neoadjuvant chemoradiation therapy (CRT) is very useful. MATERIAL AND METHODS: this was a prospective longitudinal study in patients with locally advanced rectal cancer treated with neoadjuvant CRT. Patients were assessed after CRT completion with a digital rectal examination, proctoscopy and 18F-FDG PET/CT. Patients were subdivided as clinical (cCR) or radiologic (rCR) responders and non-responders according to tumor response. Clinical and radiological re-assessment was compared with the surgical specimen. Pathological tumor regression (pCR) grade was determined according to Mandard's classification. Of the 68 patients included, 15 (22 %) presented pCR in the surgical specimen and tumor persistence (non-PCR) was detected in the remaining 53 (78 %). Clinical assessment (DRE+ rectoscopy) identified 15 patients as cCR and 53 as non-cCR, two were false positives and two were false negatives. The overall accuracy was 94 %. 18F-FDG PET/CT identified 18 patients as rCR and 50 as non-rCR, one was a false positive and four were false negatives. The overall accuracy was 92 %. A combination of clinical findings and 18F-FDG PET/CT resulted in an accuracy of 96 %. The combination of clinical findings + 18F-FDG PET/CT was able to correctly identify all cases of pCR, with the exception of one case that presented a tumor regression of 80 %. In this series, 18F-PET-CT and clinical assessment had excellent accuracies in differentiating PCR from non-PCR after CRT completion. PET-CT combined with clinical assessment had a better accuracy than both modalities independently. 18F-FDG PET/CT is a valid tool that complements the clinical assessment of tumor response.
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Tomografía Computarizada por Tomografía de Emisión de Positrones , Neoplasias del Recto , Fluorodesoxiglucosa F18 , Humanos , Estudios Longitudinales , Terapia Neoadyuvante , Tomografía de Emisión de Positrones , Estudios Prospectivos , Radiofármacos , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Recto/terapia , Resultado del TratamientoRESUMEN
COVID-19 is associated with severe coagulopathy. We present three cases of colonic ischemia that can be attributed to the hypercoagulable state related with SARS-CoV2 and disseminated intravascular coagulation. Three males aged 76, 68 and 56 with respiratory distress presented episodes of rectal bleeding, abdominal distension and signs of peritoneal irritation. Endoscopy (case 1) and computed tomography angiography revealed colonic ischemia. One patient (case 2) in which a computed tomography (CT) scan showed perforation of the gangrenous cecum underwent surgery. D-dimer levels were markedly increased (2,170, 2,100 and 7,360 ng/ml) in all three patients. All three patients died shortly after diagnosis
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Humanos , Masculino , Persona de Mediana Edad , Anciano , Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Pandemias , Colitis Isquémica/virología , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Colitis Isquémica/diagnóstico , Resultado Fatal , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: Fat mobilization in adipose tissue (AT) has a specific timing. However, circadian rhythms in the activity of the major enzyme responsible for fat mobilization, hormone-sensitive lipase (HSL), have not been demonstrated in humans. OBJECTIVE: To analyze in a cross-sectional study whether there is an endogenous circadian rhythm in HSL activity in human AT ex vivo and whether rhythm characteristics are related to food timing or fasting duration. METHODS: Abdominal AT biopsies were obtained from 18 severely obese participants (age: 46 ± 11 years; body mass index 42 ± 6 kg/m2) who underwent laparoscopic gastric bypass. Twenty-four-hour rhythms of HSL activity and LIPE (HSL transcript in humans) expression in subcutaneous AT were analyzed together with habitual food timing and night fasting duration. RESULTS: HSL activity exhibited a circadian rhythm (P = .023) and reached the maximum value at circadian time 16 (CT) that corresponded to around midnight (relative local clock time. Similarly, LIPE displayed a circadian rhythm with acrophase also at night (P = .0002). Participants with longer night fasting duration >11.20 hours displayed almost double the amplitude (1.91 times) in HSL activity rhythm than those with short duration (P = .013); while habitual early diners (before 21:52 hours) had 1.60 times higher amplitude than late diners (P = .035). CONCLUSIONS: Our results demonstrate circadian rhythms in HSL activity and may lead to a better understanding of the intricate relationships between food timing, fasting duration and body fat regulation.
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Tejido Adiposo/metabolismo , Ritmo Circadiano/fisiología , Ayuno/metabolismo , Obesidad/metabolismo , Esterol Esterasa/metabolismo , Adulto , Estudios Transversales , Femenino , Derivación Gástrica , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Obesidad/cirugíaRESUMEN
Central hepatectomy is one of the most difficult procedures to perform laparoscopically. Rotellar and colleagues described a standardized technique, tailored specifically to laparoscopy, which facilitates its safe performance based on three principles: no liver mobilization, initial Glissonean control (based on Laennec's capsule approach) and root approach of the major veins.