Evaluation of the potential of total proanthocyanidin content in feces as an intake biomarker.

Due to the health benefits associated with proanthocyanidins (PAs), it is useful to identify dietary PA biomarkers that can be determined by simple methods. Since increased levels of circulating PA metabolites are associated with increased fecal PA content, this study explores the spectrophotometric measurement of fecal PA content and its use as a biomarker of PA intake. To this end, fecal PA content was measured using an adaptation of Porter's spectrophotometric method in samples from a preclinical study and an observational study. In the former, excretion of 250-400 mg PA polymer equivalents/100 g feces was observed during supplementation and the day after, together with a significant association (p < 0.05) between PA intake and the excretion of both intact PAs and some PA metabolites, i.e., (+)-catechin, (-)-epicatechin and syringic acid. No relationship between intake and excretion was found in the observational study, either for the entire group (mean excretion of 240 ± 226 mg PA polymer equivalents/100 g feces) or after stratification into tertiles of consumption. In conclusion, the spectrophotometric determination of total PA content in feces proved to be a valid compliance marker in a preclinical study, but it was not associated with PA intake in free-living subjects. The potential of total PA excretion in observational studies, determined in fecal samples collected the day before dietary recall or in several fecal samples from the same subject, remains to be elucidated, as does a complete validation of the method proposed here.

Índice HOMA-IR como predictor de reducción de exceso de peso en pacientes con índice de masa corporal (IMC)≥ 35kg/m2 sometidos a gastrectomía vertical / Higher HOMA-IR index is associated with increased excess weight loss in patients with BMI ≥ 35 kg/m2 after vertical gastrectomy

INTRODUCCIÓN: La cirugía bariátrica es considerada la herramienta más efectiva para el tratamiento de la obesidad severa. No está claro si los pacientes con resistencia a la insulina responden igual que otras personas. Nuestro objetivo es evaluar la asociación entre el índice HOMA-IR prequirúrgico con el porcentaje de sobrepeso perdido (%PSP) un año poscirugía bariátrica usando la técnica gastrectomía vertical (GV). MÉTODOS: Cohorte retrospectiva incluyendo pacientes ≥ 18 años con IMC ≥ 35 kg/m2 intervenidos por primera vez con GV entre 2014-2017 en la Clínica Avendaño, Perú. Se incluyó solo aquellos con diabetes mellitus tipo 2, hipertensión arterial o dislipidemia. Un %PSP al año ≥ 60% fue considerado satisfactorio. Se usó regresión Lineal y de Poisson con varianza robusta en forma cruda y ajustada para evaluar asociaciones con %PSP. RESULTADOS: La muestra de 91 pacientes tuvo una mediana de 34 años y un 57,1% fueron mujeres. Un 85,7% presentó resistencia a la insulina según HOMA-IR. Al año poscirugía el 76,9% tuvo un %PSP satisfactorio. En el modelo lineal ajustado por cada año de edad adicional hubo un 0,29% menos %PSP (p = 0,019), y por cada punto extra del HOMA-IR hubo 0,93% más %PSP (p = 0,004). La regresión de Poisson ajustada mostró un 2% menos de éxito por cada año de edad adicional (p = 0,050) y un 2% más de éxito por cada punto adicional de HOMA-IR (p = 0,038). CONCLUSIONES: Se encontró asociación entre mayor valor prequirúrgico de HOMA-IR con un mayor %PSP al año poscirugía. Es posible que la resistencia a insulina no afecte de forma adversa los resultados de la cirugía bariátrica GV

INTRODUCTION: Bariatric surgery is considered the most effective treatment for severe obesity. However, it is not clear if patients with diabetes mellitus or insulin resistance have the same response than patients without those conditions. Our objective was to evaluate association between pre-surgical HOMA-IR index and percentage of excess weight loss (EWL%) one year after bariatric surgery using sleeve gastrectomy. METHODS: Retrospective cohort including patients ≥ 18 years old with BMI ≥ 35 kg/m2, who underwent primary sleeve gastrectomy between 2014-2017 at the Avendaño Medical Center, Peru. Only patients with Type 2 Diabetes, Hypertension, or Dyslipidemia were included. EWL% ≥ 60% one year after surgery was considered satisfactory. Crude and adjusted Lineal and Poisson regression with robustness was used to assess statistical associations with EWL%. RESULTS: Ninety-one patients were included with a median of 34 years, and 57.1% were women. 85.7% had insulin resistance as per HOMA-IR. One year after surgery, 76.9% had a satisfactory EWL%. The lineal model showed .29% less EWL% per each extra year of life (P = .019), and .93% more EWL% per each extra HOMA-IR point (P = .004). The adjusted Poisson model showed 2% lower risk of having a satisfactory EWL% per each additional year of life (P = .050), and 2% more chance of success per each additional HOMA-IR point (P = .038). CONCLUSIONS: There was association between a higher pre-surgical HOMA-IR index and increased EWL% one year after surgery. It is possible that insulin resistance does not affect negatively sleeve gastrectomy outcomes

Higher HOMA-IR index is associated with increased excess weight loss in patients with BMI≥35kg/m2 after vertical gastrectomy. / Índice HOMA-IR como predictor de reducción de exceso de peso en pacientes con índice de masa corporal (IMC)≥35kg/m2 sometidos a gastrectomía vertical.

INTRODUCTION: Bariatric surgery is considered the most effective treatment for severe obesity. However, it is not clear if patients with diabetes mellitus or insulin resistance have the same response than patients without those conditions. Our objective was to evaluate association between pre-surgical HOMA-IR index and percentage of excess weight loss (EWL%) one year after bariatric surgery using sleeve gastrectomy. METHODS: Retrospective cohort including patients ≥18 years old with BMI≥35kg/m2, who underwent primary sleeve gastrectomy between 2014-2017 at the Avendaño Medical Center, Peru. Only patients with Type 2 Diabetes, Hypertension, or Dyslipidemia were included. EWL% ≥60% one year after surgery was considered satisfactory. Crude and adjusted Lineal and Poisson regression with robustness was used to assess statistical associations with EWL%. RESULTS: Ninety-one patients were included with a median of 34 years, and 57.1% were women. 85.7% had insulin resistance as per HOMA-IR. One year after surgery, 76.9% had a satisfactory EWL%. The lineal model showed .29% less EWL% per each extra year of life (P=.019), and .93% more EWL% per each extra HOMA-IR point (P=.004). The adjusted Poisson model showed 2% lower risk of having a satisfactory EWL% per each additional year of life (P=.050), and 2% more chance of success per each additional HOMA-IR point (P=.038). CONCLUSIONS: There was association between a higher pre-surgical HOMA-IR index and increased EWL% one year after surgery. It is possible that insulin resistance does not affect negatively sleeve gastrectomy outcomes.

The direct role of selenocysteine in [NiFeSe] hydrogenase maturation and catalysis.

Hydrogenases are highly active enzymes for hydrogen production and oxidation. [NiFeSe] hydrogenases, in which selenocysteine is a ligand to the active site Ni, have high catalytic activity and a bias for H2 production. In contrast to [NiFe] hydrogenases, they display reduced H2 inhibition and are rapidly reactivated after contact with oxygen. Here we report an expression system for production of recombinant [NiFeSe] hydrogenase from Desulfovibrio vulgaris Hildenborough and study of a selenocysteine-to-cysteine variant (Sec489Cys) in which, for the first time, a [NiFeSe] hydrogenase was converted to a [NiFe] type. This modification led to severely reduced Ni incorporation, revealing the direct involvement of this residue in the maturation process. The Ni-depleted protein could be partly reconstituted to generate an enzyme showing much lower activity and inactive states characteristic of [NiFe] hydrogenases. The Ni-Sec489Cys variant shows that selenium has a crucial role in protection against oxidative damage and the high catalytic activities of the [NiFeSe] hydrogenases.

Tuberculosis peritoneal simulando carcinoma de ovario / Peritoneal tuberculosis mimicking ovarian carcinoma

La tuberculosis peritoneal es una ubicación extrapulmonar común en mujeres, con características similares a neoplasias malignas ováricas avanzadas. Es difícil de diagnosticar debido a que produce ascitis masiva y crecimiento peritoneal marcado, similar a la carcinomatosis. Se necesitan estudios patológicos y cultivos bacterianos para confirmarlo, ya que no existen hallazgos clínicos, de laboratorio o radiológicos patognomónicos para la patología. El tratamiento temprano generalmente tiene un buen pronóstico. Se presenta un caso de tuberculosis peritoneal con la triada clásica (ascitis similar a carcinoma ovárico en etapas avanzadas, tumores abdominopélvicos y aumento de las concentraciones séricas de CA-125). La laparotomía mostró nódulos abdominales-peritoneales con inflamación granulomatosa. La paciente inició tratamiento y, durante el seguimiento, los síntomas al igual que las concentraciones de CA-125 normalizaron.

Peritoneal tuberculosis is a common extrapulmonary site in females, mimicking an advanced ovarian malignancy. It is difficult to diagnose because it may produce massive ascites, and a gross peritoneal appearance similar to carcinomatosis. It requires confirmation by pathological studies and bacterial cultures, as there are not pathognomonic clinical, laboratory or radiologic findings. Early treatment usually is associated to good prognosis. A case of peritoneal tuberculosis with the classic triad (advanced-stage ovarian carcinoma-like ascites, abdominopelvic tumors and elevated serum CA-125 levels) is presented. Laparotomy showed abdominal and peritoneal nodules reported as granulomatous inflammation on biopsy. Patient started treatment and, on follow-up, symptoms and CA-125 levels normalized.

Teratoma quístico de ovario con múltiples glóbulos flotantes intraquísticos / Ovarian cystic teratoma with multiple intracystic floating globules

Los teratomas quísticos ováricos están compuestos principalmente de un quiste cubierto total o parcialmente por epitelio que simula epidermis queratinizada con glándulas sebáceas y sudoríparas. La presencia de bolas o glóbulos flotantes dentro de un teratoma quístico de ovario es un hallazgo inusual. Se presenta el caso de una paciente de 40 años con antecedente de dolor pélvico de 6 meses de evolución. La evaluación ecográfica demostró un quiste de ovario de 26 x 16 centímetros con múltiples estructuras móviles, esféricas, ecogénicas y flotantes dentro de la tumoración quística. Se realizó salpingooforectomía derecha durante la laparotomía. El diagnóstico histopatológico fue teratoma quístico maduro. La presencia de glóbulos flotantes intraquisticos es raras veces observado, pero es patognomónico del teratoma quístico maduro.

Ovarian cystic teratomas are mainly composed of a cyst enterily or partly lined by epithelium resembling keratinized epidermis with sebaceous and sweat glands. The presence of floating balls or globules inside an ovarian cystic teratoma is an unusual finding. We report a 40-year old with a history of pelvic pain for 6 months. The ultrasonographic evaluation showed an ovarian cyst of 26 x 16 centimeters with multiple mobile, spherical echogenic structures floating in the cystic mass. Right oophorosalpingectomy was performed by laparotomy. Histopathology diagnosis was mature cystic teratoma. The appearance of intracystic floating globules is rarely seen but it is pathognomonic for mature cystic teratoma.

Induction of a proton gradient across a gold-supported biomimetic membrane by electroenzymatic H2 oxidation.

Energy-transduction mechanisms in living organisms, such as photosynthesis and respiration, store light and chemical energy in the form of an electrochemical gradient created across a lipid bilayer. Herein we show that the proton concentration at an electrode/phospholipid-bilayer interface can be controlled and monitored electrochemically by immobilizing a membrane-bound hydrogenase. Thus, the energy derived from the electroenzymatic oxidation of H2 can be used to generate a proton gradient across the supported biomimetic membrane.

Inter- and intra-observer variability in the echocardiographic evaluation of right ventricular function.

INTRODUCTION AND OBJECTIVES: Echocardiographic evaluation of right ventricular systolic function remains subject to debate because of the anatomic peculiarities of the right ventricle. Several methods have been developed for quantifying right ventricular systolic function. The aim of this study was to determine the reliability and reproducibility of a number of echocardiographic parameters by evaluating their inter-observer and intra-observer variability. METHODS: The study included 30 patients with isolated mitral valvulopathy scheduled for heart surgery. All underwent echocardiography, which was performed independently by two echocardiographers within 24 hours. The intra-observer analysis was carried out using the recorded images at least 1 month after they had been obtained. The parameters studied were the tricuspid annular plane systolic excursion (TAPSE), the tricuspid annular peak systolic velocity on tissue Doppler imaging, right ventricular outflow tract fractional shortening, fractional shortening of right ventricular diameters, and fractional shortening of right ventricular areas. Variability was analyzed using the intraclass correlation coefficient. RESULTS: The degree of concordance on TAPSE and tricuspid annular peak systolic velocity measurement was good in the inter-observer analysis and excellent in the intra-observer analysis. However, concordance was poor on measurements of the fractional shortening of the right ventricular outflow tract, areas and diameters on both inter-observer and intra-observer analyses. CONCLUSIONS: The most reliable and reproducible echocardiographic parameters for evaluating right ventricular systolic function in patients with isolated mitral valvulopathy were the TAPSE and the tricuspid annular peak systolic velocity.

Variabilidad inter e intraobservador en la valoración ecocardiográfica de la función del ventrículo derecho / Inter- and intra-observer variability in the echocardiographic evaluation of right ventricular function

Introducción y objetivos. La valoración ecocardiográfica de la función sistólica ventricular derecha es actualmente una cuestión pendiente de resolver, dadas las peculiaridades anatómicas del ventrículo derecho. Se han desarrollado diversos métodos para su cálculo. El objetivo del presente estudio es determinar la fiabilidad y reproducibilidad de diferentes parámetros ecocardiográficos estudiando su variabilidad inter e intraobservador. Métodos. Se incluyeron 30 pacientes con valvulopatía mitral aislada candidatos a cirugía cardiaca. Se realizó un ecocardiograma a todos los pacientes por dos investigadores de forma independiente en un periodo de 24 h. El análisis intraobservador se obtuvo a partir del primer mes desde imágenes grabadas. Los parámetros utilizados fueron la TAPSE (elevación sistólica del plano del anillo tricuspídeo), la velocidad pico sistólica del anillo tricuspídeo por Doppler tisular, la fracción de acortamiento del tracto de salida ventricular derecho, la fracción de acortamiento de los diámetros del ventrículo derecho y la fracción de acortamiento de las áreas del ventrículo derecho. La variabilidad fue analizada mediante el coeficiente de correlación intraclase. Resultados. La fuerza de concordancia de la TAPSE y la velocidad pico del anillo tricuspídeo es buena en el análisis interobservador y excelente en el análisis intraobservador. Sin embargo, la fracción de acortamiento del tracto de salida, de las áreas y de los diámetros muestran una pobre concordancia en el análisis inter e intraobservador Conclusiones. Las medidas ecocardiográficas más fiables y reproducibles en la valoración de la función sistólica ventricular derecha en pacientes con valvulopatía mitral aislada son la TAPSE y la velocidad pico del anillo tricuspídeo (AU)

Introduction and objectives. Echocardiographic evaluation of right ventricular systolic function remains subject to debate because of the anatomic peculiarities of the right ventricle. Several methods have been developed for quantifying right ventricular systolic function. The aim of this study was to determine the reliability and reproducibility of a number of echocardiographic parameters by evaluating their inter-observer and intra-observer variability. Methods. The study included 30 patients with isolated mitral valvulopathy scheduled for heart surgery. All underwent echocardiography, which was performed independently by two echocardiographers within 24 hours. The intra-observer analysis was carried out using the recorded images at least 1 month after they had been obtained. The parameters studied were the tricuspid annular plane systolic excursion (TAPSE), the tricuspid annular peak systolic velocity on tissue Doppler imaging, right ventricular outflow tract fractional shortening, fractional shortening of right ventricular diameters, and fractional shortening of right ventricular areas. Variability was analyzed using the intraclass correlation coefficient. Results. The degree of concordance on TAPSE and tricuspid annular peak systolic velocity measurement was good in the inter-observer analysis and excellent in the intra-observer analysis. However, concordance was poor on measurements of the fractional shortening of the right ventricular outflow tract, areas and diameters on both inter-observer and intra-observer analyses. Conclusions. The most reliable and reproducible echocardiographic parameters for evaluating right ventricular systolic function in patients with isolated mitral valvulopathy were the TAPSE and the tricuspid annular peak systolic velocity (AU)

Neurotoxicidad por contraste después de revascularización percutánea / No disponible

No disponible

[Effect of persistent microvascular obstruction on post-infarction ventricular remodeling following intracoronary bone-marrow cell transplantation: a contrast-enhanced cardiac magnetic resonance study]. / Impacto de la obstrucción microvascular persistente en el remodelado ventricular postinfarto tras el implante intracoronario de células mononucleadas de médula ósea: un estudio de cardiorresonancia con contraste.

INTRODUCTION AND OBJECTIVES: Late contrast-enhanced cardiac magnetic resonance (CMR) enables areas of persistent microvascular obstruction (PMO) to be detected early after acute myocardial infarction. Our aim was to evaluate the impact of PMO on subsequent ventricular remodeling in a cohort of patients with acute ST-elevation myocardial infarction (STEMI) who underwent intracoronary autologous bone-marrow mononuclear cell (ABMMC) transplantation. METHODS: In total, 14 patients underwent intracoronary transplantation of 66+/-39 x 10(6) ABMMCs 8+/-2 days following successful revascularization of a STEMI (i.e., TIMI flow grade 3 in the affected artery). Serial CMR studies with gadolinium-DTPA enhancement were performed at baseline and 10 months after infarction. Left ventricular volume and ejection fraction, regional contractility and the infarct size were measured and the presence of PMO (defined as hypoenhanced areas within the infarcted zone) was investigated. RESULTS: Overall, PMO was detected in five of the 14 patients (36%). Those with PMO tended to have a larger infarct size, larger ventricular volumes, and poorer regional and global left ventricular systolic function in baseline studies than those without PMO. At follow-up, there were significant associations between PMO and an increase in end-diastolic volume (25+/-24 mL vs. -2+/-19 mL; P=.037), the absence of an increase in end-diastolic parietal thickness (P=.027), and a smaller reduction in the number of akinetic or dyskinetic segments. CONCLUSIONS: The detection of PMO by CMR early after successful revascularization of a STEMI in patients who underwent intracoronary ABMMC transplantation was associated with adverse left ventricular remodeling.

Impacto de la obstrucción microvascular persistente en el remodelado ventricular postinfarto tras el implante intracoronario de células mononucleadas de médula ósea: un estudio de cardiorresonancia con contraste / Effect of Persistent Microvascular Obstruction on Post-Infarction Ventricular Remodeling Following Intracoronary Bone-Marrow Cell Transplantation: a Contrast-Enhanced Cardiac Magnetic Resonance Study

Introducción y objetivos. La cardiorresonancia magnéticacon realce tardío de contraste (RMc) permite la detecciónprecoz de obstrucción microvascular persistente(OMP) tras un infarto. Hemos analizado el impacto de laOMP en el remodelado ventricular de una cohorte de pacientes con infarto agudo de miocardio con ST elevado(IAMSTE) que recibieron implante intracoronario de células mononucleadas de médula ósea autóloga (CMMOA).Métodos. Catorce pacientes recibieron infusión intracoronaria de 66 ± 39 millones de CMMOA a los 8 ± 2 días de un IAMSTE revascularizado con éxito (flujo TIMI 3 epicárdico). Se realizaron estudios seriados de RMc con gadolinio- DTPA (basal y a los 10 meses del infarto), con análisis de volúmenes y fracción de eyección ventricular izquierda, motilidad regional, tamaño del infarto y presenciade OMP (definida como un área con ausencia de señalen el seno del infarto).Resultados. Se detectó OMP en 5 (36%) de los 14 pacientes,junto con una tendencia en el estudio basal a presentar un mayor tamaño del infarto, mayores volúmenes y peor función sistólica general y regional de ventrículo izquierdo respecto a aquellos sin OMP. En el seguimiento, la presencia de OMP se relacionó significativamente con un incremento en el volumen telediastólico (25 ± 24 frente a –2 ± 19 ml; p = 0,037), ausencia de incremento en el grosor telediastólico parietal (p = 0,027) y una menor reducciónen el número de segmentos acinéticos o discinéticos.Conclusiones. La OMP evaluada precozmente medianteRMc tras un IAMSTE revascularizado con éxito seasocia con un remodelado ventricular izquierdo adversoen pacientes sometidos a implante intracoronario de CMMOA

Introduction and objectives. Late contrast-enhancedcardiac magnetic resonance (CMR) enables areas ofpersistent microvascular obstruction (PMO) to bedetected early after acute myocardial infarction. Our aimwas to evaluate the impact of PMO on subsequentventricular remodeling in a cohort of patients with acuteST-elevation myocardial infarction (STEMI) whounderwent intracoronary autologous bone-marrowmononuclear cell (ABMMC) transplantation.Methods. In total, 14 patients underwent intracoronarytransplantation of 66±39 × 106 ABMMCs 8±2 daysfollowing successful revascularization of a STEMI (i.e.,TIMI flow grade 3 in the affected artery). Serial CMRstudies with gadolinium-DTPA enhancement wereperformed at baseline and 10 months after infarction. Left ventricular volume and ejection fraction, regionalcontractility and the infarct size were measured and thepresence of PMO (defined as hypoenhanced areas withinthe infarcted zone) was investigated.Results. Overall, PMO was detected in five of the 14patients (36%). Those with PMO tended to have a largerinfarct size, larger ventricular volumes, and poorer regional and global left ventricular systolic function in baseline studies than those without PMO. At follow-up, there were significant associations between PMO and an increase in end-diastolic volume (25±24 mL vs. –2±19 mL; P=.037), the absence of an increase in end-diastolic parietal thickness (P=.027), and a smaller reduction in the number of akinetic or dyskinetic segments.Conclusions. The detection of PMO by CMR earlyafter successful revascularization of a STEMI in patientswho underwent intracoronary ABMMC transplantationwas associated with adverse left ventricular remodeling