¿Pensamos en la enfermedad arterial periférica de los miembros inferiores en nuestros pacientes mayores con diabetes antes de que aparezcan las complicaciones? / Do we think of peripheral arterial disease of the lower limbs in our elderly patients with diabetes when complications appear?

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Shall We Dance? Dancing Modulates Executive Functions and Spatial Memory.

BACKGROUND: Aging is generally considered to be related to physical and cognitive decline. This is especially prominent in the frontal and parietal lobes, underlying executive functions and spatial memory, respectively. This process could be successfully mitigated in certain ways, such as through the practice of aerobic sports. With regard to this, dancing integrates physical exercise with music and involves retrieval of complex sequences of steps and movements creating choreographies. METHODS: In this study, we compared 26 non-professional salsa dancers (mean age 55.3 years, age-range 49-70 years) with 20 non-dancers (mean age 57.6 years, age-range 49-70 years) by assessing two variables: their executive functions and spatial memory performance. RESULTS: results showed that dancers scored better that non-dancers in our tests, outperforming controls in executive functions-related tasks. Groups did not differ in spatial memory performance. CONCLUSIONS: This work suggests that dancing can be a valid way of slowing down the natural age-related cognitive decline. A major limitation of this study is the lack of fitness assessment in both groups. In addition, since dancing combines multiple factors like social contact, aerobic exercise, cognitive work with rhythms, and music, it is difficult to determine the weight of each variable.

Modulation of human monocyte CD36 by type 2 diabetes mellitus and other atherosclerotic risk factors.

BACKGROUND: The pathophysiological role of CD36 in atherosclerosis seems to be largely dependent on its pro-inflammatory function and ability to take up oxidized low-density lipoprotein. Controversy exists concerning the potential beneficial/harmful effects of vascular CD36 inhibition in atherosclerosis. However, as atherosclerosis in murine models does not result in clinical end points such as plaque rupture and thrombotic ischaemia, typical of human disease, clinical studies are required to understand the functional role of CD36 in human atherosclerosis. MATERIALS AND METHODS: Our aim was to investigate whether CD36 expression in monocytes is modulated by the presence of an increasing number of atherosclerotic risk factors, and specifically by hyperglycaemia because of diabetes mellitus. The study included 33 patients with advanced atherosclerosis and eight healthy blood donors, as controls. The patients were classified according to the presence of atherosclerotic risk factors. Diabetes mellitus was classified as either well-controlled or poorly controlled. Monocytes were exposed in vitro to low (5·5mM) or high glucose (26mM) concentrations for increasing times. RESULTS: Our results demonstrated that protein levels of glycated CD36 were significantly higher in patients with 3-4 atherosclerotic risk factors than in those with 0-2 atherosclerotic risk factors or in subjects with no atherosclerotic symptoms (P=0·04, in both cases). However, when we analysed just the poorly controlled diabetic patients, their glycated CD36 levels were lower. These data were corroborated by in vitro studies demonstrating that increasing glucose concentrations reduced glycated protein levels (P<0·05). CONCLUSIONS: Our results demonstrate that CD36 expression is altered by hyperglycaemia in atherosclerotic patients.

Recuperación funcional tras infusión intracoronaria de células mononucleadas de médula ósea autóloga en pacientes con infarto crónico anterior y depresión severa de la función ventricular / Functional Recovery Following Intracoronary Infusion of Autologous Mononuclear Bone Marrow Cells in Patients With Chronic Anterior Myocardial Infarction and Severely Depressed Ventricular Function

Introducción y objetivos. Diferentes estudios han demostrado que la infusión intracoronaria de células mononucleadas de la médula ósea en pacientes con infarto agudo de miocardio mejora la función ventricular. Sin embargo, existe menos información sobre esta terapia en la fase crónica de un infarto. Este estudio analiza los cambios clínicos, ecocardiográficos y angiográficos observados en 19 pacientes con infarto anterior crónico revascularizado y función ventricular deprimida que fueron tratados con terapia celular. Métodos. Se estudió a los pacientes de forma seriada durante la fase del tratamiento, a los 6 meses y al año. La médula ósea autóloga fue extraída mediante punción aspirativa sobre cresta iliaca, y las células mononucleadas se aislaron por centrifugación en gradiente de densidad. Se efectuó un estudio biológico in vitro de una muestra de las células infundidas, para citofluorometría, marcación fenotípica y análisis de la capacidad quimiotáctica de las células infundidas. Resultados. A los 6 meses y al año de la terapia celular se observó una ligera mejoría clínica y de la función ventricular, más acusada en un grupo de pacientes respondedores. Éstos se caracterizaban por haberse sometido a revascularización de forma más cercana a la terapia celular. Se observó una relación inversa entre los parámetros funcionales y los biológicos que traducen un estado de actividad proclive a la migración. Conclusiones. La infusión intracoronaria de células mononucleares de la médula ósea en pacientes con infarto anterior crónico parece producir una ligera mejoría clínica y funcional a los 6 meses que se mantiene al año del tratamiento (AU)

Introduction and objectives. Studies have shown that intracoronary infusion of mononuclear bone marrow cells improves ventricular function in patients with acute myocardial infarction. However, less information is available about the use of this therapy during the chronic phase of a myocardial infarction. This study involved an analysis of the clinical, echocardiographic and angiographic changes observed in 19 patients with a revascularized chronic anterior myocardial infarction and depressed ventricular function who were treated by cell therapy. Methods. A series of patients were monitored during treatment and 6 months and 1 year after treatment. Autologous bone marrow was obtained by needle aspiration of the iliac crest and mononuclear cells were isolated by density-gradient centrifugation. An in vitro biological study of a sample of the infused cells was performed using fluorocytometry, phenotype marking and an analysis of the chemotactic properties of the cells. Results. Six months and 1 year after cell therapy, a modest improvement was observed in clinical status and ventricular function, which was most pronounced in the group of patients who responded. Characteristically, these patients were revascularized close to the time of cell therapy. There was an inverse relationship between functional recovery and biological parameters that reflected a state conducive to cell migration. Conclusions. The intracoronary infusion of mononuclear bone marrow cells into patients with chronic anterior myocardial infarction appeared to result in a modest clinical and functional improvement after 6 months which was sustained up to 1 year after treatment (AU)

Functional recovery following intracoronary infusion of autologous mononuclear bone marrow cells in patients with chronic anterior myocardial infarction and severely depressed ventricular function.

INTRODUCTION AND OBJECTIVES: Studies have shown that intracoronary infusion of mononuclear bone marrow cells improves ventricular function in patients with acute myocardial infarction. However, less information is available about the use of this therapy during the chronic phase of a myocardial infarction. This study involved an analysis of the clinical, echocardiographic and angiographic changes observed in 19 patients with a revascularized chronic anterior myocardial infarction and depressed ventricular function who were treated by cell therapy. METHODS: A series of patients were monitored during treatment and 6 months and 1 year after treatment. Autologous bone marrow was obtained by needle aspiration of the iliac crest and mononuclear cells were isolated by density-gradient centrifugation. An in vitro biological study of a sample of the infused cells was performed using fluorocytometry, phenotype marking and an analysis of the chemotactic properties of the cells. RESULTS: Six months and 1 year after cell therapy, a modest improvement was observed in clinical status and ventricular function, which was most pronounced in the group of patients who responded. Characteristically, these patients were revascularized close to the time of cell therapy. There was an inverse relationship between functional recovery and biological parameters that reflected a state conducive to cell migration. CONCLUSIONS: The intracoronary infusion of mononuclear bone marrow cells into patients with chronic anterior myocardial infarction appeared to result in a modest clinical and functional improvement after 6 months which was sustained up to 1 year after treatment.

Rituximab como tratamiento de la púrpura trombótica trombocitopénica asociada a lupus eritematoso sistémico / Rituximab as treatment for purpura associated to systemic lupus thrombocytopenic thrombotic erytematosus

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