Pediatric Swine Model of Methicillin-Resistant Staphylococcus aureus Sepsis-Induced Coagulopathy, Disseminated Microvascular Thrombosis, and Organ Injuries.

Sepsis-induced coagulopathy leading to disseminated microvascular thrombosis is associated with high mortality and has no existing therapy. Despite the high prevalence of Gram-positive bacterial sepsis, especially methicillin-resistant Staphylococcus aureus (MRSA), there is a paucity of published Gram-positive pediatric sepsis models. Large animal models replicating sepsis-induced coagulopathy are needed to test new therapeutics before human clinical trials. HYPOTHESIS: Our objective is to develop a pediatric sepsis-induced coagulopathy swine model that last 70 hours. METHODS AND MODELS: Ten 3 weeks old piglets, implanted with telemetry devices for continuous hemodynamic monitoring, were IV injected with MRSA (n = 6) (USA300, Texas Children's Hospital 1516 strain) at 1 × 109 colony forming units/kg or saline (n = 4). Fluid resuscitation was given for heart rate greater than 50% or mean arterial blood pressure less than 30% from baseline. Acetaminophen and dextrose were provided as indicated. Point-of-care complete blood count, prothrombin time (PT), activated thromboplastin time, d-dimer, fibrinogen, and specialized coagulation assays were performed at pre- and post-injection, at 0, 24, 48, 60, and 70 hours. Piglets were euthanized and necropsies performed. RESULTS: Compared with the saline treated piglets (control), the septic piglets within 24 hours had significantly lower neurologic and respiratory scores. Over time, PT, d-dimer, and fibrinogen increased, while platelet counts and activities of factors V, VII, protein C, antithrombin, and a disintegrin and metalloproteinase with thrombospondin-1 motifs (13th member of the family) (ADAMTS-13) decreased significantly in septic piglets compared with control. Histopathologic examination showed minor focal organ injuries including microvascular thrombi and necrosis in the kidney and liver of septic piglets. INTERPRETATIONS AND CONCLUSIONS: We established a 70-hour swine model of MRSA sepsis-induced coagulopathy with signs of consumptive coagulopathy, disseminated microvascular thrombosis, and early organ injuries with histological minor focal organ injuries. This model is clinically relevant to pediatric sepsis and can be used to study dysregulated host immune response and coagulopathy to infection, identify potential early biomarkers, and to test new therapeutics.

A novel interaction between extracellular vimentin and fibrinogen in fibrin formation.

INTRODUCTION: Thrombosis is frequently manifested in critically ill patients with systemic inflammation, including sepsis and COVID-19. The coagulopathy in systemic inflammation is often associated with increased levels of fibrinogen and D-dimer. Because elevated levels of vimentin have been detected in sepsis, we sought to investigate the relationship between vimentin and the increased fibrin formation potential observed in these patients. MATERIALS AND METHODS: This hypothesis was examined by using recombinant human vimentin, anti-vimentin antibodies, plasma derived from healthy and critically ill patients, confocal microscopy, co-immunoprecipitation assays, and size exclusion chromatography. RESULTS: The level of vimentin in plasma derived from critically ill subjects with systemic inflammation was on average two-fold higher than that of healthy volunteers. We determined that vimentin directly interacts with fibrinogen and enhances fibrin formation. Anti-vimentin antibody effectively blocked fibrin formation ex vivo and caused changes in the fibrin structure in plasma. Additionally, confocal imaging demonstrated plasma vimentin enmeshed in the fibrin fibrils. Size exclusion chromatography column and co-immunoprecipitation assays demonstrated a direct interaction between extracellular vimentin and fibrinogen in plasma from critically ill patients but not in healthy plasma. CONCLUSIONS: The results describe that extracellular vimentin engages fibrinogen in fibrin formation. In addition, the data suggest that elevated levels of an apparent aberrant extracellular vimentin potentiate fibrin clot formation in critically ill patients with systemic inflammation; consistent with the notion that plasma vimentin contributes to the pathogenesis of thrombosis.

Sucrose Consumption during Late Adolescence Impairs Adult Neurogenesis of the Ventral Dentate Gyrus without Inducing an Anxiety-like Behavior.

Sucrose consumption impairs behavioral and cognitive functions that correlate with decreased neurogenesis in animal models. When consumed during early adolescence, this disaccharide promotes anxious and depressive behaviors, along with a reduction in the generation of new neurons in the dentate gyrus of the hippocampus. Data concerning sucrose consumption during late adolescence are lacking, and the effect of sucrose intake on the ventral dentate gyrus of the hippocampus (which modulates anxiety and depression) remains elusive. Here, we tested whether sucrose intake during late adolescence causes anxiety or impaired neurogenesis in the ventral dentate gyrus. Rats did not display anxiety-like behaviors neither at the light−dark box test nor at the open field exploration. However, there was a significant increase in proliferative cells in the subgranular zone of the ventral dentate gyrus in rats exposed to sucrose (p < 0.05). This increased proliferation corresponded to neural stem cells (Radial Type 1 cells) in the group exposed to sucrose until adulthood but was not present in rats exposed to sucrose only during late adolescence. Remarkably, the phosphorylation of ERK1/2 kinases was increased in the hippocampi of rats exposed to sucrose only during late adolescence, suggesting that the increased proliferation in this group could be mediated by the MAPK pathway. On the other hand, although no differences were found in the number of immature granular neurons, we observed more immature granular neurons with impaired dendritic orientation in both groups exposed to sucrose. Finally, GAD65/67 and BCL2 levels did not change between groups, suggesting an unaltered hippocampal GABAergic system and similar apoptosis, respectively. This information provides the first piece of evidence of how sucrose intake, starting in late adolescence, impacts ventral dentate gyrus neurogenesis and contributes to a better understanding of the effects of this carbohydrate on the brain at postnatal stages.

Aberrant Fibrin Clot Structure Visualized Ex Vivo in Critically Ill Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection.

OBJECTIVES: Disseminated fibrin-rich microthrombi have been reported in patients who died from COVID-19. Our objective is to determine whether the fibrin clot structure and function differ between critically ill patients with or without COVID-19 and to correlate the structure with clinical coagulation biomarkers. DESIGN: A cross-sectional observational study. Platelet poor plasma was used to analyze fibrin clot structure; the functional implications were determined by quantifying clot turbidity and porosity. SETTING: ICU at an academic medical center and an academic laboratory. PATIENTS: Patients admitted from July 1 to August 1, 2020, to the ICU with severe acute respiratory syndrome coronavirus 2 infection confirmed by reverse transcription-polymerase chain reaction or patients admitted to the ICU with sepsis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Blood was collected from 36 patients including 26 ICU patients with COVID-19 and 10 ICU patients with sepsis but without COVID-19 at a median of 11 days after ICU admission (interquartile range, 3-16). The cohorts were similar in age, gender, body mass index, comorbidities, Sequential Organ Failure Assessment (SOFA) score, and mortality. More patients with COVID-19 (100% vs 70%; p = 0.003) required anticoagulation. Ex vivo fibrin clots formed from patients with COVID-19 appeared to be denser and to have smaller pores than those from patients with sepsis but without COVID-19 (percent area of fluorescent fibrin 48.1% [SD, 16%] vs 24.9% [SD, 18.8%]; p = 0.049). The turbidity and flow-through assays corroborated these data; fibrin clots had a higher maximum turbidity in patients with COVID-19 compared with patients without COVID-19 (0.168 vs 0.089 OD units; p = 0.003), and it took longer for buffer to flow through these clots (216 vs 103 min; p = 0.003). In patients with COVID-19, d-dimer levels were positively correlated with percent area of fluorescent fibrin (ρ = 0.714, p = 0.047). Denser clots (assessed by turbidity and thromboelastography) and higher SOFA scores were independently associated with delayed clot lysis. CONCLUSIONS: We found aberrant fibrin clot structure and function in critically ill patients with COVID-19. These findings may contribute to the poor outcomes observed in COVID-19 patients with widespread fibrin deposition.

Cannabinoid receptors are differentially regulated in the pancreatic islets during the early development of metabolic syndrome.

The endocannabinoid system is found in tissues that regulate the glycemia, including adipose tissue, muscle, and pancreatic islets. Diet-induced metabolic syndrome changes the expression of the CB receptors in muscle, adipose tissue, and liver. However, it is poorly understood whether metabolic syndrome (MetS) affects the expression of CB receptors in pancreatic ß cells. We analyzed the expression of CB receptors in pancreatic ß cells under chronic high-sucrose diet (HSD)-induced MetS. Wistar rats fed an HSD as a model of MetS were used to investigate changes in cannabinoid receptors. After 8 weeks of treatment, we evaluated the appearance of the following MetS biomarkers: glucose intolerance, hyperinsulinemia, insulin resistance, hypertriglyceridemia, and an increase in visceral adiposity. To determine the presence of CB1 and CB2 receptors in pancreatic ß cells, immunofluorescence of primary cell cultures and pancreatic sections was performed. For whole-islet quantification of membrane-bound CB1 and CB2 receptors, western-blotting following differential centrifugation was conducted. Our results revealed that an HSD treatment closely mimics the alterations seen in MetS. We observed that in primary cell culture, CB1 and CB2 receptors were expressed at a higher level in pancreatic ß cells compared with non-ß cells. MetS resulted in a reduction of CB1 in the islet, whereas abundant CB2 was observed after the treatment. CB1 and CB2 receptors are differentially expressed in pancreatic ß cells during MetS development.

Resistencia a la colistina en cepas de Klebsiella pneumoniae multidrogorresistente del período 2015-2018 en un instituto materno perinatal de Lima, Perú / Colistin resistance in multidrug-resistant Klebsiella pneumoniae strains at a perinatal maternal institute in Lima, Peru, 2015-2018

RESUMEN El objetivo del estudio fue evaluar los niveles y mecanismos de resistencia a la colistina y a los carbapenémicos en cepas de Klebsiella pneumoniae multidrogorresistente aisladas durante el periodo 2015-2018 en el Instituto Materno Perinatal de Lima. Se analizó la sensibilidad mediante difusión en disco y microdilución. La presencia de genes de resistencia a los carbapenémicos y a la colistina se determinó por reacción en cadena de la polimerasa (PCR, por sus siglas en inglés) y se la relacionó con la clonalidad. Se analizaron 36 cepas de K. pneumoniae, cinco (13,8%) fueron resistentes a la colistina, pertenecían a diferentes grupos clonales. Se encontraron dos cepas con carbapenemasas (bla KPC y bla NDM) y no se detectaron genes plasmídicos para la colistina. Los niveles de resistencia al resto de antimicrobianos testados fueron elevados, a excepción de amikacina (13,9%). Los resultados destacan la presencia de cepas resistentes a la colistina (33,3% en 2018), situación preocupante por ser esta parte de las últimas alternativas de tratamiento para las infecciones causadas por patógenos multirresistentes.

ABSTRACT The objective of this study was to evaluate the presence of colistin- and carbapenemic-resistant genes in multidrug-resistant Klebsiella pneumoniae strains isolated at the Instituto Materno Perinatal de Lima (2015-2018). Susceptibility levels were analyzed by disk diffusion and microdilution. The presence of colistin- and carbapenemic-resistant genes was determined by polymerase chain reaction (PCR) and was related to clonality. A total of 36 K. pneumoniae strains were analyzed, 5 (13.8%) were resistant to colistin and belonged to different clonal groups. Only 2 strains were found with carbapenemases (bla KPC and bla NDM), and no colistin plasmid genes were detected. High resistance levels to the other tested antimicrobials were observed, except for amikacin (13.9%). The results highlight the presence of colistin-resistant strains (33.3% in 2018), a worrying situation as they are part of the latest treatment alternatives for infections caused by multiresistant pathogens.

Modulating the rate of fibrin formation and clot structure attenuates microvascular thrombosis in systemic inflammation.

Systemic inflammation can lead to coagulopathy and disseminated intravascular coagulation (DIC). In prior studies, the recombinant A2 domain of human von Willebrand factor (VWF; A2 protein) attenuated DIC and decreased mortality in lipopolysaccharide (LPS)-treated mice. Here, we performed studies to dissect the mechanism by which the A2 protein moderates DIC. We used confocal microscopy to analyze the fibrin clot structure in plasma from healthy humans and endotoxemic mice, turbidity assays to examine fibrin polymerization, and a murine model for LPS-induced DIC and introduced a loss-of-function mutation into the A2 protein for fibrin. The mutation of the residue E1567 located in the α2 helix of the folded A2 domain of VWF inhibited binding activity for fibrin, possibly mapping a novel region containing a putative binding site for fibrin. The A2 protein increased the initial rate of change of fibrin polymerization, intercalated into the fibrin network, and modified the resultant clot structure in vitro. Furthermore, ex vivo experiments using plasma from mice with endotoxemia treated with the A2 protein revealed an increased rate of fibrin formation and an altered clot structure as compared with plasma from nontreated sick animals. Moreover, and in contrast to the A2 mutant, the A2 protein improved survival and reduced fibrin deposition and microvascular thrombosis in mice with endotoxemia-induced DIC. Importantly, in vivo and in vitro studies indicated that the A2 protein did not affect experimental thrombosis. Thus, we provide evidence for a novel treatment to attenuate systemic inflammation-induced coagulopathy/DIC via targeting fibrin formation, without an increased risk for bleeding.

Colistin resistance in multidrug-resistant Klebsiella pneumoniae strains at a perinatal maternal institute in Lima, Peru, 2015-2018. / Resistencia a la colistina en cepas de Klebsiella pneumoniae multidrogorresistente del período 2015-2018 en un instituto materno perinatal de Lima, Perú.

The objective of this study was to evaluate the presence of colistin- and carbapenemic-resistant genes in multidrug-resistant Klebsiella pneumoniae strains isolated at the Instituto Materno Perinatal de Lima (2015-2018). Susceptibility levels were analyzed by disk diffusion and microdilution. The presence of colistin- and carbapenemic-resistant genes was determined by polymerase chain reaction (PCR) and was related to clonality. A total of 36 K. pneumoniae strains were analyzed, 5 (13.8%) were resistant to colistin and belonged to different clonal groups. Only 2 strains were found with carbapenemases (bla KPC and bla NDM), and no colistin plasmid genes were detected. High resistance levels to the other tested antimicrobials were observed, except for amikacin (13.9%). The results highlight the presence of colistin-resistant strains (33.3% in 2018), a worrying situation as they are part of the latest treatment alternatives for infections caused by multiresistant pathogens.

El objetivo del estudio fue evaluar los niveles y mecanismos de resistencia a la colistina y a los carbapenémicos en cepas de Klebsiella pneumoniae multidrogorresistente aisladas durante el periodo 2015-2018 en el Instituto Materno Perinatal de Lima. Se analizó la sensibilidad mediante difusión en disco y microdilución. La presencia de genes de resistencia a los carbapenémicos y a la colistina se determinó por reacción en cadena de la polimerasa (PCR, por sus siglas en inglés) y se la relacionó con la clonalidad. Se analizaron 36 cepas de K. pneumoniae, cinco (13,8%) fueron resistentes a la colistina, pertenecían a diferentes grupos clonales. Se encontraron dos cepas con carbapenemasas (bla KPC y bla NDM) y no se detectaron genes plasmídicos para la colistina. Los niveles de resistencia al resto de antimicrobianos testados fueron elevados, a excepción de amikacina (13,9%). Los resultados destacan la presencia de cepas resistentes a la colistina (33,3% en 2018), situación preocupante por ser esta parte de las últimas alternativas de tratamiento para las infecciones causadas por patógenos multirresistentes.

Evidence for the Misfolding of the A1 Domain within Multimeric von Willebrand Factor in Type 2 von Willebrand Disease.

Von Willebrand factor (VWF), an exceptionally large multimeric plasma glycoprotein, functions to initiate coagulation by agglutinating platelets in the blood stream to sites of vascular injury. This primary hemostatic function is perturbed in type 2 dysfunctional subtypes of von Willebrand disease (VWD) by mutations that alter the structure and function of the platelet GPIbα adhesive VWF A1 domains. The resulting amino acid substitutions cause local disorder and misfold the native structure of the isolated platelet GPIbα-adhesive A1 domain of VWF in both gain-of-function (type 2B) and loss-of-function (type 2M) phenotypes. These structural effects have not been explicitly observed in A1 domains of VWF multimers native to blood plasma. New mass spectrometry strategies are applied to resolve the structural effects of 2B and 2M mutations in VWF to verify the presence of A1 domain structural disorder in multimeric VWF harboring type 2 VWD mutations. Limited trypsinolysis mass spectrometry (LTMS) and hydrogen-deuterium exchange mass spectrometry (HXMS) are applied to wild-type and VWD variants of the single A1, A2, and A3 domains, an A1A2A3 tridomain fragment of VWF, plasmin-cleaved dimers of VWF, multimeric recombinant VWF, and normal VWF plasma concentrates. Comparatively, these methods show that mutations known to misfold the isolated A1 domain increase the rate of trypsinolysis and the extent of hydrogen-deuterium exchange in local secondary structures of A1 within multimeric VWF. VWD mutation effects are localized to the A1 domain without appreciably affecting the structure and dynamics of other VWF domains. The intrinsic dynamics of A1 observed in recombinant fragments of VWF are conserved in plasma-derived VWF. These studies reveal that structural disorder does occur in VWD variants of the A1 domain within multimeric VWF and provides strong support for VWF misfolding as a result of some, but not all, type 2 VWD variants.

Diurnal variation of NMDA receptor expression in the rat cerebral cortex is associated with traumatic brain injury damage.

OBJECTIVE: Data from our laboratory suggest that recovery from a traumatic brain injury depends on the time of day at which it occurred. In this study, we examined whether traumatic brain injury -induced damage is related to circadian variation in N-methyl-D-aspartate receptor expression in rat cortex. RESULTS: We confirmed that traumatic brain injury recovery depended on the time of day at which the damage occurred. We also found that motor cortex N-methyl-D-aspartate receptor subunit NR1 expression exhibited diurnal variation in both control and traumatic brain injury-subjected rats. However, this rhythm is more pronounced in traumatic brain injury-subjected rats, with minimum expression in those injured during nighttime hours. These findings suggest that traumatic brain injury occurrence times should be considered in future clinical studies and when designing neuroprotective strategies for patients.

Models used in the study of traumatic brain injury.

Traumatic brain injury (TBI) is a contemporary health problem and a leading cause of mortality and morbidity worldwide. Survivors of TBI frequently experience disabling long-term changes in cognition, sensorimotor function, and personality. A crucial step in understanding TBI and providing better treatment has been the use of models to mimic the event under controlled conditions. Here, we describe the known head injury models, which can be classified as whole animal (in vivo), in vitro, and mathematical models. We will also review the ways in which these models have advanced the knowledge of TBI.

Does Exercise During Pregnancy Affect Placental Weight?: A Randomized Clinical Trial.

Placental weight (PW) is a measure commonly used to summarize growth and aspects of placental function. In a normal pregnancy, it is reasonable to assume that PW is related to aspects of the functional capacity of the placenta. The placenta, as the site for all maternal-fetal oxygen and nutrient exchange, influences birth weight and is thus central to a successful pregnancy outcome. PW is the most common way to characterize placental growth, which relates to placental function. With physical exercise becoming an integral part of life for many women, the question of whether exercise during pregnancy has an adverse effect on the growing fetus is very important. The aim was to examine the influence of an aerobic exercise program throughout pregnancy on PW among healthy pregnant women. A randomized control trial was used (registration trial number: NCT02420288). Women were randomized into an exercise group (EG; n = 33) or a control group (CG; n = 32) that received standard care. The EG trained 3 days/week (55-60 min/session) from gestational Weeks 9-11 until Weeks 38-39. The 85 training sessions involved aerobic, muscular and pelvic floor strength, and flexibility exercises. PW and other pregnancy outcomes were measured. There was high attendance to the exercise program, and no differences in the PW at delivery were observed between study groups (CG = 493.2 ± 119.6 g vs. EG = 495.4 ± 150 g, p = .95). A regular, supervised exercise program throughout pregnancy does not affect the PW in healthy pregnant women.

Effect of Intermediate-Frequency Repetitive Transcranial Magnetic Stimulation on Recovery following Traumatic Brain Injury in Rats.

Traumatic brain injury (TBI) represents a significant public health concern and has been associated with high rates of morbidity and mortality. Although several research groups have proposed the use of repetitive transcranial magnetic stimulation (rTMS) to enhance neuroprotection and recovery in patients with TBI, few studies have obtained sufficient evidence regarding its effects in this population. Therefore, we aimed to analyze the effect of intermediate-frequency rTMS (2 Hz) on behavioral and histological recovery following TBI in rats. Male Wistar rats were divided into six groups: three groups without TBI (no manipulation, movement restriction plus sham rTMS, and movement restriction plus rTMS) and three groups subjected to TBI (TBI only, TBI plus movement restriction and sham rTMS, and TBI plus movement restriction and rTMS). The movement restriction groups were included so that rTMS could be applied without anesthesia. Our results indicate that the restriction of movement and sham rTMS per se promotes recovery, as measured using a neurobehavioral scale, although rTMS was associated with faster and superior recovery. We also observed that TBI caused alterations in the CA1 and CA3 subregions of the hippocampus, which are partly restored by movement restriction and rTMS. Our findings indicated that movement restriction prevents damage caused by TBI and that intermediate-frequency rTMS promotes behavioral and histologic recovery after TBI.

Baclofen in the Therapeutic of Sequele of Traumatic Brain Injury: Spasticity.

Traumatic brain injury (TBI) is an alteration in brain function, caused by an external force, which may be a hit on the skull, rapid acceleration or deceleration, penetration of an object, or shock waves from an explosion. Traumatic brain injury is a major cause of morbidity and mortality worldwide, with a high prevalence rate in pediatric patients, in which treatment options are still limited, not available at present neuroprotective drugs. Although the therapeutic management of these patients is varied and dependent on the severity of the injury, general techniques of drug types are handled, as well as physical and surgical. Baclofen is a muscle relaxant used to treat spasticity and improve mobility in patients with spinal cord injuries, relieving pain and muscle stiffness. Pharmacological support with baclofen is contradictory, because disruption of its oral administration may cause increased muscle tone syndrome and muscle spasm, prolonged seizures, hyperthermia, dysesthesia, hallucinations, or even multisystem organ failure. Combined treatments must consider the pathophysiology of broader alterations than only excitation/inhibition context, allowing the patient's reintegration with the greatest functionality.

Fetal and maternal heart rate responses to exercise in pregnant women. A randomized Controlled Trial / Respuesta de la frecuencia cardiaca fetal y materna al ejercicio en gestantes. Ensayo clínico aleatorio

Objective: To examine whether regular physical exercise during pregnancy improves the fetal and maternal heart rate response to different intensities of acute exercise. Material/methods: A randomized controlled trial was conducted. Sixty-three women with healthy singleton pregnancies were analyzed (n=38 in the exercise group (EG); n = 25 in the control group CG). Women from EG participated in a supervised exercise program from 9-12 until 38-40 weeks of gestation. Maternal and fetal response were evaluated in late pregnancy (week 34.08±2.27) walking for 3 minutes at different intensities: light exercise (LE: 40% maternal heart rate reserve) and moderate exercise (ME: 60% maternal heart rate). The primary outcome was the fetal heart rate response after maternal exertion at both intensities. Results: After maternal effort, the fetuses from the EG showed lower increases in heart rate than the fetuses from the CG at both intensities (LE: EG 139.1±14.2 vs. CG: 149.0±10.5; p = 0.004) and (ME: EG: 139.9±13.5 vs. 150.9±17.9; p = 0.008). The fetuses from the EG presented a lower time to recovery than those from the CG after LE (86±104.7 sec. vs. 405.2±384.7 sec.; p = 0.000) and ME (160.4±234.3 sec. vs. 596.9±461.4 sec; p = 0.000). The program was effective for improving maternal recovery after LE (341.2±281.6 sec. vs. 577.4±277.0 sec.; p = 0.002) and ME (525.8±309.0 sec. vs. 876.1±362.6 sec.; p = 0.000). Conclusion: Regular exercise during pregnancy may be associated with faster maternal and fetal recovery after maternal exertion, and with a lower increase in fetus heart rate (AU)

Objetivo: Examinar si el ejercicio físico regular durante el embarazo mejora la respuesta de la frecuencia cardiaca fetal y materna a diferentes intensidades de ejercicio físico. Material/métodos: Se desarrolló un ensayo clínico aleatorio. Sesenta y tres mujeres sanas y con embarazo simple fueron analizadas (n=38 en el grupo de ejercicio (GE); n = 25 en el grupo de control CG). Las mujeres del GE participaron en un programa de ejercicio físico supervisado desde la semana 9-12 de gestación hasta la 38-40. La respuesta materna y fetal fue evaluada al _nal del embarazo (semana 34,08±2,27) caminando durante 3 minutos a diferentes intensidades: ejercicio ligero (EL: 40% frecuencia cardiaca de reserva) y ejercicio moderado (EM: 60% frecuencia cardiaca de reserva). La variable dependiente principal fue la respuesta de la frecuencia cardiaca fetal tras ambas intensidades de esfuerzo materno. Resultados: Tras el esfuerzo materno, los fetos del GE mostraron un menor incremento de la frecuencia cardiaca a ambas intensidades en comparación con los fetos del GC (EL: GE 139,1±14,2 vs. GC: 149,0±10,5; p = 0,004) y (EM: GE: 139,9±13,5 vs. GC: 150,9±17,9; p = 0,008). Los fetos del GE presentaron un menor tiempo de recuperación que los fetos del GC después de EL (86±104.7 seg. vs. 405,2±384,7 seg.; p = 0,000) y EM (160,4±234,3 seg. vs. 596,9±461,4 seg; p = 0,000). El programa de ejercicio físico fue efectivo en la mejora de la recuperación materna tras el EL (341,2±281,6 seg. vs. 577,4±277,0 seg.; p = 0,002) y EM (525,8±309,0 seg. vs. 876,1±362,6 seg.; p = 0,000). Conclusión: El ejercicio regular durante el embarazo puede estar asociado con una recuperación más rápida tanto materna como fetal tras el esfuerzo materno, y con un menor incremento de la frecuencia cardiaca fetal (AU)

Exercise and depression in overweight and obese pregnant women: a randomised controlled trial / Ejercicio y depresión en mujeres embarazadas con sobrepeso y obesidad: ensayo clínico aleatorio

Objective: To assess the effectiveness of a regular physical exercise program on the prevention of depression in overweight and obese pregnant women. Material and method: A randomised controlled trial was conducted at Hospital Universitario de Fuenlabrada in Madrid. A total of 106 overweight and obese healthy pregnant women (32.70±3.90 years), with uncomplicated and singleton gestation were analyzed (52 to the exercise group (EG) and 54 to the control group (CG)). Women from EG participated in a physical conditioning program throughout pregnancy, which included a total of 55- to 60-minute weekly sessions, 3 days per week. The main outcome measure was the patients’ depression level, assessed by the Center for Epidemiological Studies Depression scale (CES-D). Other pregnancy outcomes were measured. Results: A smaller percentage of depressed women were identified in the EG compared to the CG in the third trimester: entire group EG: 17.8% vs. CG: 47.2% p=0.002, overweight EG: 16.2% vs. CG: 47.7% p=0.003 and adequate weight gain EG: 8.7% vs. CG: 62.5% p=0.000. Comparations within EG showed a significantly reduce of the percentage of depressed women in the third trimester in comparison with the first one: entire group 25% vs. 15.9% p=0.000; overweight 24.32% vs. 16.2% p=0.003; excessive weight gain 31.57% vs. 26.31% p=0.007 and adequate weight gain: 21.73% vs. 8.7% p=0.005. Whereas this percentage tended to increase significantly within the CG. Conclusion: An adapted exercise program designed for overweight and obese pregnant women may reduce the prevalence of depression in late pregnancy, and turn out in a longer gestational age at labour among depressive active pregnant women (AU)

Objetivo: Evaluar la eficacia de un programa de ejercicio físico regular en la prevención de la depresión en mujeres gestantes con sobrepeso y obesidad. Material y método: Se llevó a cabo un ensayo clínico aleatorio en el Hospital Universitario de Fuenlabrada en Madrid. Un total de 106 mujeres gestantes sanas con sobrepeso y obesidad (32,70±3,90 años), sin complicaciones y con gestación simple fueron analizadas (52 en el grupo de ejercicio (GE) y 54 en el grupo de control (GC)). Las mujeres del GE participaron en un programa de acondicionamiento físico durante el embarazo, incluyendo sesiones semanales de 55 a 60 minutos, 3 días a la semana. La variable principal de estudio fue el nivel de depresión de las pacientes, evaluado a través de 'Center for Epidemiological Studies Depression scale (CES-D)'. Otros resultados del embarazo fueron medidos. Resultados: Se identificó un menor porcentaje de mujeres con depresión en el GE en comparación con el GC en el tercer trimestre de embarazo: grupo entero GE: 17,8% vs. GC: 47,2% p=0,002, sobrepeso GE: 16,2% vs. GC: 47,7% p=0,003 y ganancia de peso adecuada GE: 8,7% vs. GC: 62,5% p=0,000. Las comparaciones dentro del GE mostraron una reducción significativa del porcentaje de mujeres con depresión en el tercer trimestre de embarazo en comparación con el primer trimestre: grupo entero 25% vs. 15,9% p=0,000; sobrepeso 24,32% vs. 16,2% p=0,003; ganancia de peso excesiva 31,57% vs. 26,31% p=0,007 y ganancia de peso adecuada: 21,73% vs. 8,7% p=0,005. Mientras que este porcentaje tendió a incrementarse significativamente dentro del GC. Conclusión: Un programa adaptado de ejercicio físico diseñado para mujeres con sobrepeso y obesidad puede reducir la prevalencia de depresión al final del embarazo, y resultar en una edad gestacional más prolongada en el momento del parto entre las gestantes deprimidas físicamente activas (AU)

Cystatin C has a dual role in post-traumatic brain injury recovery.

Cathepsin B is one of the major lysosomal cysteine proteases involved in neuronal protein catabolism. This cathepsin is released after traumatic injury and increases neuronal death; however, release of cystatin C, a cathepsin inhibitor, appears to be a self-protective brain response. Here we describe the effect of cystatin C intracerebroventricular administration in rats prior to inducing a traumatic brain injury. We observed that cystatin C injection caused a dual response in post-traumatic brain injury recovery: higher doses (350 fmoles) increased bleeding and mortality, whereas lower doses (3.5 to 35 fmoles) decreased bleeding, neuronal damage and mortality. We also analyzed the expression of cathepsin B and cystatin C in the brains of control rats and of rats after a traumatic brain injury. Cathepsin B was detected in the brain stem, cerebellum, hippocampus and cerebral cortex of control rats. Cystatin C was localized to the choroid plexus, brain stem and cerebellum of control rats. Twenty-four hours after traumatic brain injury, we observed changes in both the expression and localization of both proteins in the cerebral cortex, hippocampus and brain stem. An early increase and intralysosomal expression of cystatin C after brain injury was associated with reduced neuronal damage.

Real-Time Detection of Telomerase Activity in Cancer Cells using a Label-Free Electrochemical Impedimetric Biosensing Microchip.

The enzyme telomerase is present in about 85% of human cancers which makes it not only a good target for cancer treatment but also an excellent marker for cancer detection. Using a single stranded DNA probe specific for telomerase binding and reverse transcription tethered to an interdigital gold electrode array surface, the chromosome protection provided by the telomerase was replicated and followed by Electrochemical Impedance Spectroscopy as an unlabeled biosensor. Using this system designed in-house, easy and affordable, impedance measurements were taken while incubating at 37 °C and promoting the probe elongation. This resulted in up to 14-fold increase in the charge transfer resistance when testing a telomerase-positive nuclear extract from Jurkat cells compared to the heat-inactivated telomerase-negative nuclear extract. The electron transfer process at the Au electrodes was studied before the elongation, at different times after the elongation, and after desorption of non-specific binding.

Does the neuroprotective role of anandamide display diurnal variations?

The endocannabinoid system is a component of the neuroprotective mechanisms that an organism displays after traumatic brain injury (TBI). A diurnal variation in several components of this system has been reported. This variation may influence the recovery and survival rate after TBI. We have previously reported that the recovery and survival rate of rats is higher if TBI occurs at 1:00 than at 13:00. This could be explained by a diurnal variation of the endocannabinoid system. Here, we describe the effects of anandamide administration in rats prior to the induction of TBI at two different times of the day: 1:00 and 13:00. We found that anandamide reduced the neurological damage at both times. Nevertheless, its effects on bleeding, survival, food intake, and body weight were dependent on the time of TBI. In addition, we analyzed the diurnal variation of the expression of the cannabinoid receptors CB1R and CB2R in the cerebral cortex of both control rats and rats subjected to TBI. We found that CB1R protein was expressed more during the day, whereas its mRNA level was higher during the night. We did not find a diurnal variation for the CB2R. In addition, we also found that TBI increased CB1R and CB2R in the contralateral hemisphere and disrupted the CB1R diurnal cycle.