Olanzapine-induced cardiomyopathy: A mimicker of obesity cardiomyopathy?

Olanzapine, an atypical antipsychotic medication, has gained prominence in the treatment of schizophrenia and related psychotic disorders due to its effectiveness and perceived safety profile. However, emerging evidence suggests a potential link between olanzapine use and adverse cardiovascular effects, including cardiomyopathy. This narrative review explores the mechanisms, clinical implications, and management strategies associated with olanzapine-induced cardiomyopathy. A comprehensive review of the literature was conducted to investigate the relationship between olanzapine and cardiomyopathy. The search included epidemiological studies, clinical case reports, and mechanistic research focusing on the pathophysiology of olanzapine-induced cardiomyopathy. The review also examined treatment strategies for managing this potential complication. Olanzapine-induced cardiomyopathy is hypothesized to be associated with metabolic disturbances and receptor antagonism. The metabolic effects of olanzapine, such as weight gain, insulin resistance, and dyslipidemia, share similarities with obesity-related cardiomyopathy. Additionally, olanzapine's antagonism of certain receptors may contribute to cardiovascular stress. The review highlighted that patients with new-onset heart failure and significant weight gain while on olanzapine should be closely monitored for signs of cardiomyopathy. Early detection and prompt withdrawal of olanzapine, along with initiation of goal-directed medical therapy, are crucial for mitigating this potentially life-threatening condition. The relationship between olanzapine and cardiomyopathy is complex and not yet fully understood. However, the potential for significant cardiovascular risk necessitates vigilance among healthcare providers. Early identification and management of olanzapine-induced cardiomyopathy can improve patient outcomes. Further research is needed to elucidate the precise mechanisms behind this adverse effect and to develop optimized treatment strategies for patients requiring antipsychotic therapy.

Reduced left atrial strain and risk of ischemic stroke in patients with normal sinus rhythm: a systematic review and meta-analysis

INTRODUCTION: Abnormalities in the left atrium have been linked to a higher risk of ischemic cerebrovascular events. Left atrial (LA) strain analysis can identify LA dysfunction, even in patients with normal LA volumes. However, the precise association between LA strain and the occurrence of ischemic stroke in individuals who are in normal sinus rhythm (NSR) is not well established. Hypothesis: This systematic review and meta-analysis aimed to assess the relationship between reduced LA strain and the risk of ischemic stroke in patients with NSR. METHODS: We searched PubMed, Embase, and Cochrane Central for studies that examined our clinical question. Two reviewers independently performed study selection, data extraction, and assessment of bias. Statistical analysis was performed using Review Manager 5.4.1. Heterogeneity was assessed with I2 statistics. We calculated pooled multivariable-adjusted hazard ratios (HR) with 95% confidence intervals (CI) under a random effects model. RESULTS: We included 8,632 patients from 4 cohort studies, of which 3 were prospective. The mean follow-up ranged from 2.5 years to 10.9 years. The mean age ranged from 68.8 to 75.2 years. All results were obtained through multivariable-adjusted analysis, which includes adjusting for LA size and occurrence of new-onset atrial fibrillation during follow-up. The incidence of ischemic stroke was significantly increased in patients with reduced reservoir strain (HR 1.53; 95% CI 1.09-2.15; p=0.01; Figure 1) and conduit strain (HR 1.39; 95% CI 1.16-1.59; p < 0.001). Reduced contractile strain was not predictive of stroke incidence (HR 1.94; 95% CI 0.96-3.93; p=0.07). CONCLUSIONS: Our findings indicate an independent association of reduced LA strain with an increased incidence of ischemic stroke in patients without a previous history of atrial fibrillation. Future studies are warranted to evaluate the role of LA strain as part of a comprehensive risk stratification for stroke.

A Case of Valve-in-Valve-in-Valve for Severe Aortic Regurgitation: Is Lifetime Management Upon Us?

BACKGROUND: The incremental use of transcatheter aortic valve replacement will inexorably lead to structural valve deterioration and the need for both a second and third valvular interventions, raising the question of feasibility. CASE SUMMARY: We present the case of a 76-year-old man that presented with cardiogenic shock refractory to inotropic support. His workup revealed severe bioprosthetic aortic regurgitation 5 years after undergoing transcatheter aortic valve-in-valve implantation. After confirming anatomical suitability with multimodality imaging, he underwent uncomplicated valve-in-valve-in-valve (ViViV) implantation of a 23 mm Edwards S3 Ultra valve with rapid clinical improvement. CONCLUSIONS: Whether in the form of stenosis or severe regurgitation as in our patient, ViViV is feasible. Careful preprocedural planning and confirmation of anatomical suitability with multimodality imaging are key for success and safety.

Evaluation of the prescription pattern of ferrous sulfate as a therapy for preventing iron deficiency anemia in infants.

BACKGROUND: Iron deficiency prevalence in infants is high. Therefore, iron supplementation has been recommended and specified as a program. This study aimed to determine the characteristics of the prescription of ferrous sulfate as a preventive therapy for iron deficiency anemia in young infants. METHODS: We conducted a descriptive cross-sectional study of clinical records of young infants with eight visits per year. We analyzed a total of 287 records. The prescription characteristics included five criteria prescription indication, age at prescription, dosage, periodicity, and time. These characteristics were scored as follows 1 point when it was considered adequate and 0 when it was considered inadequate; the minimum possible score was 0, and the maximum possible score was 5 points. Statistical analysis included percentages and 95% confidence intervals (CI). RESULTS: The prescription pattern of ferrous sulfate as preventive therapy in infants under one year of age was indicated in 100% of the records reviewed. All five criteria were met in 18.1% of the reviewed records (95%CI 13.6-22.6). The lowest compliance corresponded to adequate dosage (29.2%; 95%CI 23.9-34.5). Age at prescription was correct in 75.9% (95%CI 70.9-80.9); duration of prescription was correct in 44.2% (95%CI 38.4-50.0), and periodicity was proper in 31.1% (95%CI 25.9-36.7) of the files reviewed. CONCLUSIONS: Compliance with the prescription of ferrous sulfate as a preventive measure for anemia in infants was not as expected; interventions are needed to reverse this behavior.

INTRODUCCIÓN: Debido a que la prevalencia de deficiencia de hierro en el lactante es alta, el aporte de hierro se ha recomendado como suplemento y se ha concretado como programa. El objetivo del estudio fue determinar las características de la prescripción de sulfato ferroso como terapia de prevención de anemia ferropénica en el lactante menor. MÉTODOS: Se llevó a cabo un estudio descriptivo con diseño transversal de expedientes clínicos de lactantes menores con ocho consultas al año. Se analizaron 287 expedientes. Las características de prescripción incluyeron cinco criterios: indicación de prescripción, edad de indicación, dosificación, periodicidad y tiempo. Se calificó con 1 punto cuando la característica se consideró adecuada y con 0 cuando se consideró inadecuada; la puntuación mínima posible fue 0 y la puntuación máxima posible de 5 puntos. El análisis estadístico incluyó porcentajes e intervalos de confianza (IC) al 95%. RESULTADOS: El patrón de prescripción del sulfato ferroso como terapia preventiva en el menor de un año se encontró indicado en 100% de los expedientes revisados. Se cumplió exactamente con los cinco criterios en el 18.1% de los expedientes revisados (IC95% 13.6-22.6); el cumplimiento más bajo correspondió a la dosificación adecuada (29.2%; IC95% 23.9-34.5). La edad de inicio fue correcta en el 75.9% (IC95% 70.9-80.9); la duración de la prescripción fue correcta en el 44.2% (IC95% 38.4-50.0) y la periodicidad fue correcta en el 31.1% (IC95% 25.9-36.7) de los expedientes revisados. CONCLUSIONES: El cumplimiento de la prescripción de sulfato ferroso como medida preventiva de la anemia en lactantes no fue el esperado, por lo que se requiere adoptar intervenciones para revertir este comportamiento.

Twisting development, the birth of a potential new gene.

Evolution has long been considered to be a conservative process in which new genes arise from pre-existing genes through gene duplication, domain shuffling, horizontal transfer, overprinting, retrotransposition, etc. However, this view is changing as new genes originating from non-genic sequences are discovered in different organisms. Still, rather limited functional information is available. Here, we have identified TWISTED1 (TWT1), a possible de novo-originated protein-coding gene that modifies microtubule arrangement and causes helicoidal growth in Arabidopsis thaliana when its expression is increased. Interestingly, even though TWT1 is a likely recent gene, the lack of TWT1 function affects A. thaliana development. TWT1 seems to have originated from a non-genic sequence. If so, it would be one of the few examples to date of how during evolution de novo genes are integrated into developmental cellular and organismal processes.

Evaluation of the prescription pattern of ferrous sulfate as a therapy for preventing iron deficiency anemia in infants / Evaluación del patrón de prescripción de sulfato ferroso como terapia de prevención de anemia ferropénica en el lactante

Abstract Background: Iron deficiency prevalence in infants is high. Therefore, iron supplementation has been recommended and specified as a program. This study aimed to determine the characteristics of the prescription of ferrous sulfate as a preventive therapy for iron deficiency anemia in young infants. Methods: We conducted a descriptive cross-sectional study of clinical records of young infants with eight visits per year. We analyzed a total of 287 records. The prescription characteristics included five criteria prescription indication, age at prescription, dosage, periodicity, and time. These characteristics were scored as follows 1 point when it was considered adequate and 0 when it was considered inadequate; the minimum possible score was 0, and the maximum possible score was 5 points. Statistical analysis included percentages and 95% confidence intervals (CI). Results: The prescription pattern of ferrous sulfate as preventive therapy in infants under one year of age was indicated in 100% of the records reviewed. All five criteria were met in 18.1% of the reviewed records (95%CI 13.6-22.6). The lowest compliance corresponded to adequate dosage (29.2%; 95%CI 23.9-34.5). Age at prescription was correct in 75.9% (95%CI 70.9-80.9); duration of prescription was correct in 44.2% (95%CI 38.4-50.0), and periodicity was proper in 31.1% (95%CI 25.9-36.7) of the files reviewed. Conclusions: Compliance with the prescription of ferrous sulfate as a preventive measure for anemia in infants was not as expected; interventions are needed to reverse this behavior.

Resumen Introducción: Debido a que la prevalencia de deficiencia de hierro en el lactante es alta, el aporte de hierro se ha recomendado como suplemento y se ha concretado como programa. El objetivo del estudio fue determinar las características de la prescripción de sulfato ferroso como terapia de prevención de anemia ferropénica en el lactante menor. Métodos: Se llevó a cabo un estudio descriptivo con diseño transversal de expedientes clínicos de lactantes menores con ocho consultas al año. Se analizaron 287 expedientes. Las características de prescripción incluyeron cinco criterios: indicación de prescripción, edad de indicación, dosificación, periodicidad y tiempo. Se calificó con 1 punto cuando la característica se consideró adecuada y con 0 cuando se consideró inadecuada; la puntuación mínima posible fue 0 y la puntuación máxima posible de 5 puntos. El análisis estadístico incluyó porcentajes e intervalos de confianza (IC) al 95%. Resultados: El patrón de prescripción del sulfato ferroso como terapia preventiva en el menor de un año se encontró indicado en 100% de los expedientes revisados. Se cumplió exactamente con los cinco criterios en el 18.1% de los expedientes revisados (IC95% 13.6-22.6); el cumplimiento más bajo correspondió a la dosificación adecuada (29.2%; IC95% 23.9-34.5). La edad de inicio fue correcta en el 75.9% (IC95% 70.9-80.9); la duración de la prescripción fue correcta en el 44.2% (IC95% 38.4-50.0) y la periodicidad fue correcta en el 31.1% (IC95% 25.9-36.7) de los expedientes revisados. Conclusiones: El cumplimiento de la prescripción de sulfato ferroso como medida preventiva de la anemia en lactantes no fue el esperado, por lo que se requiere adoptar intervenciones para revertir este comportamiento.

Anther Culture of the Gametophytic Self-Incompatible Species Physalis ixocarpa Brot.

Here we present an optimized protocol for in vitro embryo formation and plant regeneration through anther culture of the Mexican husk tomato (Physalis ixocarpa Brot.). This protocol relies on the application of an anther thermal shock at a specific developmental stage prior to the in vitro culture, ensures embryo formation from anthers without callus formation, and allows spending less time to regenerate doubled haploid complete plants. This protocol has been used for different cultivars of Physalis ixocarpa (Chapingo, Rendidora, Puebla, Arandaz, Manzano, Tamazula, Salamanca, and Milpero), and also for two wild-type accessions, all of them cultivated in Mexico. Chapingo cultivar responded with the highest percentage of androgenesis on the embryo induction medium (EIM).

Whole-Mount Immunolocalization Procedure for Plant Female Meiocytes.

Here we present an optimized protocol for immunolocalization of meiotic proteins during female meiosis in whole mount tissues. It ensures ovule morphology integrity and homogeneous reagent penetration. The method relies on paraformaldehyde tissue fixation, polyacrylamide embedding, tissue permeabilization, antibody incubation, counterstaining, and confocal microscopy analysis. This protocol has been used in diverse Arabidopsis ecotypes and in the legume Vigna unguiculata.

Cytoskeletal transgelin 2 contributes to gender-dependent adipose tissue expandability and immune function.

During adipogenesis, preadipocytes' cytoskeleton reorganizes in parallel with lipid accumulation. Failure to do so may impact the ability of adipose tissue (AT) to shift between lipid storage and mobilization. Here, we identify cytoskeletal transgelin 2 (TAGLN2) as a protein expressed in AT and associated with obesity and inflammation, being normalized upon weight loss. TAGLN2 was primarily found in the adipose stromovascular cell fraction, but inflammation, TGF-ß, and estradiol also prompted increased expression in human adipocytes. Tagln2 knockdown revealed a key functional role, being required for proliferation and differentiation of fat cells, whereas transgenic mice overexpressing Tagln2 using the adipocyte protein 2 promoter disclosed remarkable sex-dependent variations, in which females displayed "healthy" obesity and hypertrophied adipocytes but preserved insulin sensitivity, and males exhibited physiologic changes suggestive of defective AT expandability, including increased number of small adipocytes, activation of immune cells, mitochondrial dysfunction, and impaired metabolism together with decreased insulin sensitivity. The metabolic relevance and sexual dimorphism of TAGLN2 was also outlined by genetic variants that may modulate its expression and are associated with obesity and the risk of ischemic heart disease in men. Collectively, current findings highlight the contribution of cytoskeletal TAGLN2 to the obese phenotype in a gender-dependent manner.-Ortega, F. J., Moreno-Navarrete, J. M., Mercader, J. M., Gómez-Serrano, M., García-Santos, E., Latorre, J., Lluch, A., Sabater, M., Caballano-Infantes, E., Guzmán, R., Macías-González, M., Buxo, M., Gironés, J., Vilallonga, R., Naon, D., Botas, P., Delgado, E., Corella, D., Burcelin, R., Frühbeck, G., Ricart, W., Simó, R., Castrillon-Rodríguez, I., Tinahones, F. J., Bosch, F., Vidal-Puig, A., Malagón, M. M., Peral, B., Zorzano, A., Fernández-Real, J. M. Cytoskeletal transgelin 2 contributes to gender-dependent adipose tissue expandability and immune function.

The Saccharomyces cerevisiae mitochondrial unselective channel behaves as a physiological uncoupling system regulated by Ca2+, Mg2+, phosphate and ATP.

It is proposed that the Saccharomyces cerevisiae the Mitochondrial Unselective Channel ((Sc)MUC) is tightly regulated constituting a physiological uncoupling system that prevents overproduction of reactive oxygen species (ROS). Mg(2+), Ca(2+) or phosphate (Pi) close (Sc)MUC, while ATP or a high rate of oxygen consumption open it. We assessed (Sc)MUC activity by measuring in isolated mitochondria the respiratory control, transmembrane potential (ΔΨ), swelling and production of ROS. At increasing [Pi], less [Ca(2+)] and/or [Mg(2+)] were needed to close (Sc)MUC or increase ATP synthesis. The Ca(2+)-mediated closure of (Sc)MUC was prevented by high [ATP] while the Mg(2+) or Pi effect was not. When Ca(2+) and Mg(2+) were alternatively added or chelated, (Sc)MUC opened and closed reversibly. Different effects of Ca(2+) vs Mg(2+) effects were probably due to mitochondrial Mg(2+) uptake. Our results suggest that (Sc)MUC activity is dynamically controlled by both the ATP/Pi ratio and divalent cation fluctuations. It is proposed that the reversible opening/closing of (Sc)MUC leads to physiological uncoupling and a consequent decrease in ROS production.

Whole-mount immunolocalization to study female meiosis in Arabidopsis.

Here we describe a whole-mount immunolocalization protocol to follow the subcellular localization of proteins during female meiosis in Arabidopsis thaliana, a model species that is used to study sexual reproduction in flowering plants. By using confocal microscopy, the procedure allows one to follow megasporogenesis at all stages before differentiation of the functional megaspore. This in particular includes stages that occur during prophase I, such as the installation of the axial and central elements of the synaptonemal complex along the meiotic chromosomes. In contrast to procedures that require microtome sectioning or enzymatic isolation and smearing to separate female meiocytes from neighboring cells, this 3-day protocol preserves the constitution of the developing primordium and incorporates the architecture of the ovule to provide a temporal and spatial context to meiotic divisions. This opens up the possibility to systematically compare the dynamics of protein localization during female and male meiosis. Steps describe tissue collection and fixation, preparation of slides and polyacrylamide embedding, tissue permeabilization, antibody incubation, propidium iodide staining, and finally image acquisition by confocal microscopy. The procedure adds an essential technique to the toolkit of plant meiotic analysis, and it represents a framework for technical adaptations that could soon allow the analysis of plant reproductive alternatives to sexual reproduction.

An efficient method for miRNA detection and localization in crop plants.

microRNAs are a class of non-coding small RNAs (sRNAs) that are important regulators of gene expression at the post-transcriptional level by mRNA cleavage or translation inhibition. Another class of sRNAs are siRNAs, which also regulate gene expression but by causing DNA methylation. This epigenetic regulatory role has been observed for some miRNAs as well. The use of sRNAs allows the development of biotechnological applications in plants. To develop these types of applications, and to better understand the natural roles they play, it is important to be able to detect and to localize these sRNAs at the plant tissue level. Sometimes, in crop plants this can be challenging. Therefore, we developed a tissue printing hybridization protocol for easy and efficient detection of sRNAs and demonstrate this by the analysis of the spatio-temporal expression patterns of the miRNAs miR159 and miR164 in fruits of various crop plants. Moreover, we show the possibility to also detect the expression of miRNAs in fruit juice using a dot blot hybridization approach.

Polymorphism and methylation patterns in Agave tequilana Weber var. 'Azul' plants propagated asexually by three different methods.

Genetic variation in three forms of asexually propagated Agave tequilana Weber var. 'Azul' plants namely offsets, bulbils and in vitro cultured individuals was studied by AFLP analysis. Low levels of variation were observed between mother plants and offsets and a higher level between mother plant and bulbils. Families obtained from commercial plantations showed lower levels of variation in comparison to families grown as ornamentals. No variation was observed between the original explant and four generations of in vitro cultured plants. Epigenetic variation was also studied by analyzing changes in methylation patterns between mother plants and offspring in each form of asexual reproduction. Offsets and bulbils showed an overall decrease in methylation whereas in vitro cultured plants showed patterns specific to each generation: Generations 1 and 4 showed overall demethylation whereas Generations 2 and 3 showed increased methylation. Analysis of ESTs associated with transposable elements revealed higher proportions of ESTs from Ty1-copia-like, Gypsy and CACTA transposable elements in cDNA libraries obtained from pluripotent tissue suggesting a possible correlation between methylation patterns, expression of transposable element associated genes and somaclonal variation.

The L-α-lysophosphatidylinositol/GPR55 system and its potential role in human obesity.

GPR55 is a putative cannabinoid receptor, and l-α-lysophosphatidylinositol (LPI) is its only known endogenous ligand. We investigated 1) whether GPR55 is expressed in fat and liver; 2) the correlation of both GPR55 and LPI with several metabolic parameters; and 3) the actions of LPI on human adipocytes. We analyzed CB1, CB2, and GPR55 gene expression and circulating LPI levels in two independent cohorts of obese and lean subjects, with both normal or impaired glucose tolerance and type 2 diabetes. Ex vivo experiments were used to measure intracellular calcium and lipid accumulation. GPR55 levels were augmented in the adipose tissue of obese subjects and further so in obese patients with type 2 diabetes when compared with nonobese subjects. Visceral adipose tissue GPR55 correlated positively with weight, BMI, and percent fat mass, particularly in women. Hepatic GPR55 gene expression was similar in obese and type 2 diabetic subjects. Circulating LPI levels were increased in obese patients and correlated with fat percentage and BMI in women. LPI increased the expression of lipogenic genes in visceral adipose tissue explants and intracellular calcium in differentiated visceral adipocytes. These findings indicate that the LPI/GPR55 system is positively associated with obesity in humans.

Prospective evaluation of automated follicle monitoring in 58 in vitro fertilization cycles: follicular volume as a new indicator of oocyte maturity.

OBJECTIVES: To assess the practical use of SonoAVC in an IVF program, and to establish new criteria for hCG administration based on follicular volume. DESIGN: Prospective clinical study. SETTING: Private IVF Center. PATIENT(S): Fifty-eight women with infertility undergoing IVF. INTERVENTION(S): Two dimensional (2D) and three dimensional (3D) scanning on the day of hCG administration. MAIN OUTCOME MEASURE(S): Image quality, mean follicular diameter obtained by 2D and 3D sonography, follicular volume, number of oocytes retrieved, number of mature oocytes, time needed for each examination. RESULT(S): Approximately 60% of the patients included in this study had good image quality and could be monitored by 3D scans with subsequent application of the SonoAVC software. When image quality is good, measurements obtained by the automated mode are comparable to those obtained manually in 62% of cases. Automated monitoring is significantly quicker than conventional manual monitoring. Follicles with a measured volume >/=0.6 cc on the day of hCG administration are associated with the finding of mature oocytes at the time of egg retrieval. CONCLUSION(S): SonoAVC allows reliable evaluation of stimulated ovaries, and may help us establish new criteria for timing hCG administration based on follicular volume estimation rather than follicular size. Software improvements are needed to improve universal patient use.

Prevalencia de portadores asintomáticos de streptococcus pyogenes y streptococcus pneumoniae en estudiantes del primer año de la Facultad de Odontología USMP, agosto 2009 / Prevalence of asymptomatic carriers of Streptococcus pyogenes and Streptococcus pneumoniae in San Martín de Porres University Dentistry Students

Objetivo: Determinar la prevalencia de portadores asintomáticos de Streptococcus pyogenes y Streptococcus pneumoniae en estudiantes de Odontología de la Universidad San Martin de Porres. Material y Método: Se tomaron 64 muestras mediante hisopado faríngeo las que fueron sembradas en Agar sangre de carnero con gentamicina para aislamiento de la flora alfa hemolítica y con sulfametoxazol para los beta hemolíticos, las que fueron incubadas a 35 grados C por 48 horas. Posteriomente se realizaron pruebas de sensibilidad con optoquina y bacitracina para detectar Streptococcus pneumoniae y Streptococcus pyogenes, respectivamente. Adicionalmente se realizó la prueba de solubilidad en bilis con las cepas alfa hemolíticas para verificar la presencia de neumococos. Resultados: De la muestra estudiada, el 48,43% correspondió a portadores de Streptococcus pneumoniae, alcanzando el sexo femenino un mayor porcentaje (64,51%) mientras que el 6,25% de la muestra fue portador de Streptococcus pyogenes, en el cual también predominó el sexo femenino con un 75%.Conclusiones: La prevalencia de portación asintomática de Streptococcus pneumoniae fue de 48,43% y de Streptococcus pyogenes de 6,25% en los estudiantes, valor significativo que indica el riesgo de presentar las infecciones asociadas a estas especies o de transmitirlas a personas inmunocomprometidas.

Objective: To determine the prevalence of asymptomatic carriers of Streptococcus pyogenes and Streptococcus pneumoniae in San Martin de Porres Universitys dentistry students. Materials and Methods: Sixty four samples were taken using a pharyngeal swab; they were cultured in sheep blood agar with gentamicine in order to isolate alpha hemolytic bacteria and with sulfamethoxazole in order to isolate beta hemolytic bacteria. These were incubated at 35 grados C for 48hrs. Subsequently, optoquin and bacitracine tests were used to detect Streptococcus pneumoniae and Streptococcus pyogenes respectively. Additionally, the bile solubility test was performed for alpha hemolytic strains to verify the presence of pneumococcus. Results: Of the studied sample, 48.43% corresponded to carriers of Streptococcus pneumoniae, reaching the female sex a major percentage (64.51 %) than the masculine sex. Another 6.25% of the sample was a carrier of Streptococcus pyogenes in which also the female sex predominated with 75 % of the positive results. Conclusions: The prevalence of Streptococcus pneumoniae carrier state was 48.43 % and of Streptococcus pyogenes 6.25 % in the students. This significant value indicates a risk of presenting infections associated with these species or of infecting immunocompromised individuals.

Leptin-mediated hypothalamic pathway of cholecystokinin (CCK-8) to regulate body weight in free-feeding rats.

Regulation of body weight (BW) results from the interplay between different hormonal systems acting at central and peripheral level. This study aims at characterizing the involvement of cholecystokinin (CCK) in BW and energy balance regulation. We have characterized, in free-feeding rats, the effect of CCK-8 on 1) food intake, BW, and adiposity; 2) skeletal muscle metabolism; 3) leptin signaling pathway within the arcuate nucleus of the hypothalamus; and 4) the permeability of brain barriers to leptin. We demonstrate here that CCK-8 acutely decreases BW by a mechanism partially dependent on central leptin pathways, based on the following results: 1) the effect of CCK was less intense in rats lacking functional leptin receptors (Zucker fa/fa), 2) CCK-8 facilitated the uptake of leptin from peripheral circulation to cerebrospinal fluid (CSF), 3) the concentration of leptin in CSF of rats receiving CCK was more elevated in those animals showing higher loss of BW, and 4) CCK activated leptin signaling pathways within the hypothalamus as well as phosphorylation of AMP-activated protein kinase in skeletal muscle. We also suggest that gain of BW may be linked to individual susceptibility to the effect of CCK, because we observed that in animals treated with this hormone, the increase of BW negatively correlated with leptin concentration within the CSF. Our data show that CCK has a negative impact on energy balance and suggest that CCK facilitates the access of leptin to hypothalamic areas, thus allowing leptin to act on hypothalamic targets involved in BW control.

La responsabilidad del personal sanitario de quirófano: un principio básico de la seguridad del paciente / Responsibility of operating room staff: a basic principle in patient safety

Tras haber constituido una situación excepcional hace 50 años, la responsabilidad médica se ha convertido en un tema muy preocupante en función de la multiplicación del número de reclamaciones, pero también por las consecuencias psicológicas que causan y que acaban afectando a la relación médico-paciente. Esta relación que sólo puede ser concebida en un clima de recíproca confianza no puede existir cuando el diálogo entre ambas partes gira en torno de la duda, la sospecha o la desconfianza misma. En el presente trabajo se abordan los elementos básicos que integran la responsabilidad quirúrgica, su marco situacional, los criterios emanados de la jurisprudencia y el análisis de la técnica de gestión de riesgos como una metodología racional preventiva de responsabilidades, tanto civiles como penales, del personal sanitario involucrado en la actividad quirúrgica

Medical complaints were exceptional 50 years ago. Nowadays, medical responsibility has become a cause of concern due to the increase in the number of complaints and their psychological impact, especially their effect on the physician-patient relationship. This relationship should be based on mutual trust and cannot exist when the dialogue between both parties centers on doubts, suspicion and distrust. The present article discusses the basic elements of surgical responsibility, its situational context, the criteria emanating from jurisprudence, and analysis of the technique of risk management as a rational preventive methodology of responsibility, both civil and penal, in health professionals involved in surgical activity

Induction of cardiac uncoupling protein-2 expression and adenosine 5'-monophosphate-activated protein kinase phosphorylation during early states of diet-induced obesity in mice.

The objective of this work was to characterize the adaptation of cardiac metabolism to a lipid overload in a model of diet-induced obesity (DIO) in mice. After 8 wk dietary treatment, mice receiving a high-fat diet exhibited an increase in the amount of adipose tissue, accompanied by a surge in plasma leptin concentration (from 5.4-16.0 ng/ml). This was associated with: 1) an induction of uncoupling protein-2 (120%), 2) an increase in the phosphorylated form of AMP-activated protein kinase (120%), and 3) a reduction in lactate concentration and lactate dehydrogenase activity in myocardial tissue (40%). Because DIO induces leptin resistance, we analyzed leptin receptor functionality by measuring phospho-signal transducer and activator of transcription 3 in response to acute leptin (1 mg/kg). We observed that leptin receptor signaling remained unaltered within the heart but was fully impaired within the hypothalamus. Taken together, these data show that during DIO development, there is a metabolic shift in the heart aimed at increasing fatty acid oxidation to the detriment of carbohydrates. This effect seems to be leptin-dependent, suggesting that the increased adiposity observed during the onset of obesity might contribute to impairing ectopic lipidic deposition in the heart.