Vestibular migraine: an update.

PURPOSE OF REVIEW: We performed a narrative review of the recent findings in epidemiology, clinical presentation, mechanisms and treatment of vestibular migraine. RECENT FINDINGS: Vestibular migraine is an underdiagnosed condition that has a high prevalence among general, headache and neuro-otology clinics. Vestibular migraine has a bimodal presentation probably associated with a hormonal component in women. These patients could have a complex clinical phenotype including concomitant autonomic, inflammatory or connective tissue conditions that have a higher prevalence of psychological symptoms, which may mistakenly lead to a diagnosis of a functional neurological disorder. A high proportion of patients with postural perceptual persistent dizziness have a migraine phenotype. Independently of the clinical presentation and past medical history, patients with the vestibular migraine phenotype can respond to regular migraine preventive treatments, including those targeting the calcitonin gene-related peptide pathways. SUMMARY: Vestibular migraine is an underdiagnosed migraine phenotype that shares the pathophysiological mechanisms of migraine, with growing interest in recent years. A thorough anamnesis is essential to increase sensitivity in patients with unknown cause of dizziness and migraine treatment should be considered (see supplemental video-abstract).

Comparative Effects of Neuromuscular- and Strength-Training Protocols on Pathomechanical, Sensory-Perceptual, and Motor-Behavioral Impairments in Patients with Chronic Ankle Instability: Randomized Controlled Trial.

(1) Background: Chronic ankle instability (CAI) is a complex condition that includes limited mobility, perceived instability, and recurrent ankle sprains are common characteristics that reduce the quality of life in subjects who suffer from CAI. Neuromuscular training and strength training have been recommended in CAI management interventions. However, there are contradictory findings on results when comparing neuromuscular training, strength training, and the control group. The objective of this study was to compare the effectiveness of 8 weeks of neuromuscular intervention training, strength training, and no intervention in a sporting population with reported CAI. (2) Methods: Sixty-seven athletes with CAI were randomly assigned to a neuromuscular training group (NG), strength training group (SG), or control group (CG). Participants completed 8 weeks of neuromuscular training (a combination of static and dynamic exercises), strength training (resistance band exercises), or no training. Outcome measures were assessed at baseline and after 8 weeks and included selfs-reported instability feeling (CAIT), dynamic balance (SEBT), ankle dorsiflexion range of motion (WBLT), and functional status (FAAM and FAAM-SPORT). (3) Results: There were significant differences between strength and control groups in the posteromedial direction of SEBT, FAAM, and FAAM-SPORT after 8 weeks of intervention. (4) Conclusions: Neuromuscular training and strength training based on resistance bands exercises showed significant improvements in ankle dorsiflexion, subjective feeling of instability, functional status, and dynamic balance in patients with CAI.

Transcriptomic Profile and Probiotic Properties of Lactiplantibacillus pentosus Pre-adapted to Edible Oils.

In this study, we determined whether pre-adapting Lactiplantibacillus pentosus strains, isolated from Aloreña green table olives, to vegetable-based edible oils improved their robustness and functionality; this may have great importance on their stress response during fermentation, storage, and digestion. Pre-adapting the strains to the corresponding oils significantly increased their probiotic functionality (e.g., auto-aggregation, co-aggregation with pathogens, and mucin adhesion), although results depended on the strain and the oil used for pre-adaptation. As such, we selected olive-adapted (TO) L. pentosus AP2-16, which exhibited improved functionality, and subjected it to transcriptomic profiling with the aim to understand the molecular mechanisms involved in the adaptation and the increased functionality. Global transcriptomic analysis of oil-adapted (olive or almond) and non-adapted (control) L. pentosus AP2-16 realized that 3,259 genes were expressed, with 2,779 mapped to the reference database. Comparative transcriptomic analysis showed that 125 genes (olive vs. control) and 108 genes (olive vs. almond) became significantly differentially expressed. TO L. pentosus AP2-16 responded by rerouting its metabolic pathways to balance energy production and storage, cell growth and survivability, host interactions (glycoconjugates), and other physiological features. As such, the pre-adaptation of lactobacilli with olive oil switches their transcriptional network to regulate robustness and functionality, possibly representing a novel approach toward the design and manufacture of probiotic products with improved stability and functionality.

Combined Manufacturing Process of Copper Electrodes for Micro Texturing Applications (AMSME).

Surface texturing has brought significant improvements in the functional properties of parts and components. Sinker electro discharge machining (SEDM) is one of the processes which generates great texturing results at different scale. An electrode is needed to reproduce the geometry to be textured. Some geometries are difficult or impossible to achieve on an electrode using conventional and even unconventional machining methods. This work sets out the advances made in the manufacturing of copper electrodes for electro erosion by additive manufacturing, and their subsequent application to the functional texturing of Al-Cu UNS A92024-T3 alloy. A combined procedure of digital light processing (DLP) additive manufacturing, sputtering and micro-electroforming (AMSME), has been used to produce electrodes. Also, a specific laboratory equipment has been developed to reproduce details on a microscopic scale. Shells with outgoing spherical geometries pattern have been manufactured. AMSME process has shown ability to copper electrodes manufacturing. A highly detailed surface on a micrometric scale have been achieved. Copper shells with minimum thickness close to 300 µm have been tested in sinker electro discharge machining (SEDM) and have been shown very good performance in surface finishing operations. The method has shown great potential for use in surfaces texturing.

Short-Term Effects of Balance Training with Stroboscopic Vision for Patients with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial.

Chronic Ankle Instability (CAI) is one of the most common musculoskeletal dysfunctions. Stroboscopic vision (SV) training has been deemed to enhance somatosensorial pathways in this population group; nevertheless, until recently no studies have addressed the additional effects of this treatment option to the traditional therapeutic approach. METHODS: To evaluate the effectiveness of a partial visual deprivation training protocol in patients with CAI, a randomized controlled trial was carried out. Patients with CAI (n = 73) were randomized into either a balance training, SV training, or a control (no training) group. For participants assigned into training groups, they received 18 training sessions over 6 weeks. The primary outcome was dynamic balance as measured by the Star Excursion Balance Test assessed at baseline and after 6 weeks of intervention. Secondary outcome measures included ankle dorsiflexion range of motion, self-reported instability feeling, and ankle functional status. RESULTS: Better scores in stroboscopic training and balance training groups in all outcome measures were observed in comparison with the control group with moderate to large effect sizes. Stroboscopic training was more effective than neuromuscular training in self-reported instability feeling (cohen's d = 0.71; p = 0.042) and anterior reach distance of the star excursion balance test (cohen's d = 1.23; p = 0.001). CONCLUSIONS: Preliminary findings from the effects of SV Stroboscopic training in patients with CAI, suggest that SV may be beneficial in CAI rehabilitation.

Variation for Composition and Quality in a Collection of the Resilient Mediterranean 'de penjar' Long Shelf-Life Tomato Under High and Low N Fertilization Levels.

The 'de penjar' tomato (Solanum lycopersicum L.) is a group of local varieties from the Spanish Mediterranean region carrying the alc mutation, which provides long shelf-life. Their evolution under low-input management practices has led to the selection of resilient genotypes to adverse conditions. Here we present the first evaluation on nutritional fruit composition of a collection of 44 varieties of 'de penjar' tomato under two N fertilization levels, provided by doses of manure equivalent to 162 kg N ha-1 in the high N treatment and 49 kg N ha-1 in the low N treatment. Twenty-seven fruit composition and quality traits, as well as plant yield and SPAD value, were evaluated. A large variation was observed, with lycopene being the composition trait with the highest relative range of variation (over 4-fold) under both N treatments, and significant differences among varieties were detected for all traits. While yield and most quality traits were not affected by the reduction in N fertilization, fruits from the low N treatment had, on average, higher values for hue (5.9%) and lower for fructose (-11.5%), glucose (-15.8%), and total sweetness index (-12.9%). In addition, lycopene and ß-carotene presented a strongly significant genotype × N input interaction. Local varieties had higher values than commercial varieties for traits related to the ratio of sweetness to acidity and for vitamin C, which reinforces the appreciation for their organoleptic and nutritional quality. Highest-yielding varieties under both conditions displayed wide variation in the composition and quality profiles, which may allow the selection of specific ideotypes with high quality under low N conditions. These results revealed the potential of 'de penjar' varieties as a genetic resource in breeding for low N inputs and improving the organoleptic and nutritional tomato fruit quality.

Nutritional Characterization of a Traditional Cultivar of Tomato Grown Under Organic Conditions-cv. "Malacara".

The loss of genetic diversity due to the replacement of local tomato (Solanum lycopersicum L.) varieties by improved cultivars has been mitigated in many cases by the good work of organic farmers in maintaining local agricultural biodiversity. In parallel to these initiatives, in recent years, consumers have developed an increasing awareness of both food-related health, environmental issues, and food demand to recover the flavors of the past. In the case of tomatoes, these attributes (nutritional, organoleptic, social, and environmental) are closely related to organic production using local varieties. "Malacara" tomato is an example of a local variety. Coming from Sierra de Cádiz, it is a varietal type called "Cuelga" ("for hanging," because the tomato trusses are hung from beams in the farmhouses). Cultivated and harvested in the open air during the summer months, these tomatoes are commercialized and consumed in the winter. Historically, this variety has enabled the fresh consumption of tomatoes during the winter, without the need to force cultivation. It is highly appreciated in the local cuisine and is the basis for sauces figuring in typical dishes. Its characteristic traits are small, pallid fruits, and long shelf life. The main objective of this work has been to typify two Malacara tomato cultivars (red and yellow color) grown under organic farming conditions, through the characterization of morphological, nutritional, and volatile parameters. The main differences are due to morphological parameters (fruit weight and color of the exocarp and endocarp). Other characteristics such as the content of ash, fiber, moisture, the concentration of iron, magnesium, and calcium, and content of lycopene are different between both cultivars. This study provides information on the nutritional and aromatic composition of two Malacara tomato cultivars, differentiated by their color and grown under organic farming conditions. The results add value to the native horticultural heritage and can aid in the selection of tomato varieties suitable for a sustainable production system and to produce tomatoes with high nutritional value and rich in aroma.

Negative pressure ventilation as a bridge to lung transplant.

Recent years have witnessed evolution of lung allocation strategies to prioritize sicker recipients. In the pre-transplant period, this has translated into increased utilization of invasive extracorporeal or mechanical ventilatory support as a bridge to lung transplantation. The morbidity associated with these strategies warrants consideration to less invasive respiratory support modalities. Herein, we present a case highlighting successful bridge to lung transplantation with a relatively non-invasive negative pressure ventilator.

Insights Into the Adaptation to Greenhouse Cultivation of the Traditional Mediterranean Long Shelf-Life Tomato Carrying the alc Mutation: A Multi-Trait Comparison of Landraces, Selections, and Hybrids in Open Field and Greenhouse.

Long shelf-life tomato (Solanum lycopersicum) landraces, characterized by carrying the alc allele in the NOR.NAC locus, have been traditionally cultivated in the Mediterranean region. These materials are adapted to open field conditions under low input conditions. However, cultivation under greenhouse is expanding fueled by increasing demand of these traditional tomatoes. We hypothesize that the large diversity in the long shelf-life landraces and derived materials can be exploited for adaptation to these new cultivation conditions. We have evaluated 12 varieties (seven landraces, three selections and two hybrids) carrying the alc mutation under open field (OF) and greenhouse (GH) cultivation, and evaluated them for 52 morphological, agronomic, chemical properties, and chemical composition descriptors. All descriptors, except six morphological ones, were variable. The variety effect was the greatest contributor to variation for most morphological traits, as well as for fruit weight, fruit shape, dry matter, and soluble solids content. However, significant environmental and genotype × environment interaction were found for 36 and 42 descriptors, respectively. Fruits from GH plants had lower weight and firmness and were less red than those from OF. On average, in GH yield was 35% lower and daily fruit weight loss in post-harvest 41% higher than in OF. However, fruits from GH had on average higher dry matter and soluble solids contents, antioxidant activity, glucose, fructose, and ascorbic acid concentrations, but lower contents in lycopene and ß-carotene than those from OF. A principal components analysis clearly separated varieties according to the cultivation environment. However, the distribution pattern of varieties within each of the two clusters (GH and OF) was similar, despite the strong G × E interaction for many descriptors. Landraces from the same origin plotted in the same area of each cluster, and selections and hybrids plotted together with the landraces. The results reveal a high impact of the cultivation environment on morphological, agronomic, chemical properties, and chemical composition of Mediterranean long shelf-life traditional tomato varieties. This suggests that breeding programs specifically focused to adaptation to greenhouse conditions should be developed.

Correlation of the Homeostasis Model Assessment Index and Adiponectin, Leptin and Insulin Levels to Body Mass Index-Associated Gene Polymorphisms in Adolescents.

OBJECTIVES: This study aimed to describe correlations between glucose, insulin and adipokine levels and the homeostasis model assessment (HOMA) index with regards to the presence/absence of fat mass and obesity-associated (FTO) rs9939609 and peroxisome proliferator-activated receptor (PPAR)-y rs1801282 single nucleotide polymorphisms (SNPs) as indicators of body mass index in adolescents. METHODS: This cross-sectional study was conducted between September and December 2016 in Toluca, Mexico. A total of 71 students between 14-18 years old were included. Various anthropometric and laboratory measurements were collected, including lipid profile, glucose, insulin and adipokine levels and HOMA index. The degree of association between variables was evaluated with regards to the presence/absence of the SNPs. RESULTS: Leptin levels were significantly higher among female students (P = 0.001), although adiponectin levels did not differ significantly (P = 0.060). There were significant positive correlations between insulin levels and HOMA index with FTO (r = 0.391; P = 0.007 and r = 0.413; P = 0.005, respectively) and PPARγ (r = 0.529; P = 0.007 and r = 0.537; P = 0.007, respectively) SNPs. Leptin showed a significant positive correlation in the presence of PPARγ (r = 0.483; P = 0.007) or in the absence of both SNPs (r = 0.627; P = 0.039). However, adiponectin was significantly negatively correlated in the presence of FTO, either alone (r = -0.333; P = 0.024) or in combination with PPARγ (r = -0.616; P = 0.043). CONCLUSION: The presence of FTO and/or PPARγ SNPs might be related to a genetic predisposition to metabolic syndrome.

Insight into Potential Probiotic Markers Predicted in Lactobacillus pentosus MP-10 Genome Sequence.

Lactobacillus pentosus MP-10 is a potential probiotic lactic acid bacterium originally isolated from naturally fermented Aloreña green table olives. The entire genome sequence was annotated to in silico analyze the molecular mechanisms involved in the adaptation of L. pentosus MP-10 to the human gastrointestinal tract (GIT), such as carbohydrate metabolism (related with prebiotic utilization) and the proteins involved in bacteria-host interactions. We predicted an arsenal of genes coding for carbohydrate-modifying enzymes to modify oligo- and polysaccharides, such as glycoside hydrolases, glycoside transferases, and isomerases, and other enzymes involved in complex carbohydrate metabolism especially starch, raffinose, and levan. These enzymes represent key indicators of the bacteria's adaptation to the GIT environment, since they involve the metabolism and assimilation of complex carbohydrates not digested by human enzymes. We also detected key probiotic ligands (surface proteins, excreted or secreted proteins) involved in the adhesion to host cells such as adhesion to mucus, epithelial cells or extracellular matrix, and plasma components; also, moonlighting proteins or multifunctional proteins were found that could be involved in adhesion to epithelial cells and/or extracellular matrix proteins and also affect host immunomodulation. In silico analysis of the genome sequence of L. pentosus MP-10 is an important initial step to screen for genes encoding for proteins that may provide probiotic features, and thus provides one new routes for screening and studying this potentially probiotic bacterium.

Decisions in complex clinical situations: Prevalence and factors associated in general public.

Many studies have focused on advanced directives. However, the type of treatment that citizens would choose in critical health situations and whether their decision varies with their sociodemographic characteristics and their experiences of life both within and outside the family context, are unknown. This study analyzes the factors associated with choosing or refusing life support treatment in hypothetical situations of differing clinical complexity. This transversal descriptive study was carried out by questionnaires given to 1051 participants from primary care centres. The Life Support Preferences Questionnaire (LSPQ) used to assess preferences of life-sustaining treatment, describes six scenarios with different prognoses. Analysis of the sociodemographic characteristics and life experiences of the subjects led to the following findings. In situations of very severe prognosis, treatment is mostly rejected. When there is chance of recovery, treatment is mostly accepted, especially in the least aggressive cases and when deciding for another person. A greater propensity to reject treatment was observed among subjects over 55 years, those in poor health and those who had observed a terminal illness in a family member. Practising Catholics are more likely to accept treatment in all medical situations described. Preferences for life support treatment are linked to sociodemographic characteristics and life experiences of patients. Physicians should bear in mind these characteristics when confronted with critical clinical situations, involving difficult decisions.

Fruit composition diversity in land races and modern pepino (Solanum muricatum) varieties and wild related species.

Pepino (Solanum muricatum) fruits from 15 accessions of cultivated pepino as well as six accessions from wild relatives were evaluated for contents in dry matter, protein, ß-carotene, chlorophylls and seven minerals. Several-fold differences among accessions were found for most traits. Average values obtained were similar to those of melon and cucumber, but the phenolic contents were much higher. Wild species had significantly higher average contents for all traits vs. the cultivated pepino accessions. And, the comparisons among the cultivated pepino varieties showed that the modern varieties were more uniform in composition, and they possessed significantly lower concentrations of protein, P, K, and Zn than local land races. Most of the significant correlations among composition traits were positive. Our studies show that regular consumption of pepino fruits could make a significant contribution to the recommended daily intake of P, K, Fe and Cu as well as to the average daily intake of phenolics. Furthermore, the higher values for most nutrients measured in the wild species and in the local land races indicate that new pepino varieties with improved fruit contents in nutrient and bioactive compounds can be developed.

A comparison of discriminant logistic regression and Item Response Theory Likelihood-Ratio Tests for Differential Item Functioning (IRTLRDIF) in polytomous short tests.

BACKGROUND: Short scales are typically used in the social, behavioural and health sciences. This is relevant since test length can influence whether items showing DIF are correctly flagged. This paper compares the relative effectiveness of discriminant logistic regression (DLR) and IRTLRDIF for detecting DIF in polytomous short tests. METHOD: A simulation study was designed. Test length, sample size, DIF amount and item response categories number were manipulated. Type I error and power were evaluated. RESULTS: IRTLRDIF and DLR yielded Type I error rates close to nominal level in no-DIF conditions. Under DIF conditions, Type I error rates were affected by test length DIF amount, degree of test contamination, sample size and number of item response categories. DLR showed a higher Type I error rate than did IRTLRDIF. Power rates were affected by DIF amount and sample size, but not by test length. DLR achieved higher power rates than did IRTLRDIF in very short tests, although the high Type I error rate involved means that this result cannot be taken into account. CONCLUSIONS: Test length had an important impact on the Type I error rate. IRTLRDIF and DLR showed a low power rate in short tests and with small sample sizes.

Characterization of composition traits related to organoleptic and functional quality for the differentiation, selection and enhancement of local varieties of tomato from different cultivar groups.

Tomato (Solanum lycopersicum) local varieties are having an increasing demand. We characterized 69 local tomato accessions from eight cultivar groups for proximate composition traits, major sugars, acids and antioxidants. A large diversity was found, with differences among accessions of almost tenfold for lycopene. Significant differences were found among cultivar group means for most traits. The Cherry and Penjar groups generally presented higher dry matter, soluble solids content, titratable acidity, taste index, ß-carotene, ascorbic acid, total phenolics, and antioxidant activity that the other groups. Wide ranges of variation were found within each cultivar group. Positive correlations were found between proximate traits related to taste and antioxidants. The multivariate principal components analysis confirms the distinct profile of the Cherry and Penjar groups and the large variation within groups. The results will be useful for the differentiation, enhancement and selection of local tomato varieties with improved organoleptic properties and functional quality.

Diversity for chemical composition in a collection of different varietal types of tree tomato (Solanum betaceum Cav.), an Andean exotic fruit.

We evaluated 23 tree tomato (Solanum betaceum) accessions from five cultivar groups and one wild relative (Solanum cajanumense) for 26 composition traits. For all traits we found highly significant differences (P<0.001) among the materials studied. The high diversity found within S. betaceum for composition traits was matched by a high diversity within each of the cultivar groups. We found that sucrose and citric acid were the most important soluble sugar and organic acid, respectively, in tree tomato. Fruit in the anthocyanin pigmented (purple) group had a carotenoid content similar to that in the yellow-orange cultivar groups. Total phenolic content was significantly correlated (r=0.8607) with antioxidant activity. Analyses of mineral content showed that tree tomato is a good source of K, Mg, and Cu. Multivariate principal components analysis (PCA) confirmed that an important diversity exists within each cultivar group. The results we have obtained indicate that the high diversity found within the tree tomato could be exploited for selection and breeding for developing the tree tomato as a commercial crop.

Perinatal outcomes in preterm growth-restricted twins: effects of gestational age and fetal condition.

OBJECTIVE: To evaluate the perinatal outcome of intrauterine growth-restricted preterm twins and contribution of prematurity to morbidity and mortality. STUDY DESIGN: A case-control study of 211 preterm twins: 108 growth-restricted twins matched with 103 normal growth twins of the same gestational age. Mortality and morbidity rates were compared between groups. RESULT: Fetal and overall perinatal mortality rates of growth-restricted fetuses were higher than normal growth ones. Respiratory distress syndrome incidence was lower and neurologic sequelae incidence higher in growth-restricted twins. No differences were observed between groups with respect to neonatal mortality, low Apgar score, neonatal intensive care unit admission, periventricular hemorrhage, sepsis, jaundice, and hematologic or metabolic disorders. CONCLUSION: Adverse perinatal outcomes of preterm twins complicated with intrauterine growth restriction are represented by a higher antepartum mortality rate, but once born alive, neonatal outcomes seem to be associated only with gestational age at birth, excluding a protective effect on lung maturation and a higher risk of long-term neurologic sequelae.

Sex hormone-binding globulin: a new marker of disease severity and prognosis in men with chronic heart failure.

INTRODUCTION AND OBJECTIVES: Sex hormone-binding globulin (SHBG) is a key regulator of the actions of anabolic steroids. Chronic heart failure (HF) has been associated with anabolic steroid deficiency, but its relationship with SHBG is not known. METHODS: The study involved 104 men (53+/-11 years) with HF (i.e. left ventricular ejection fraction [LVEF] <40%) attending a specialist clinic on optimum treatment and in a stable condition. At enrolment, the median and interquartile range (IQR) SHBG level was determined, associated hormone levels were measured, and known risk factors were recorded. The study end-point was cardiac death within 3 years. RESULTS: At enrolment, the SHBG level (median 34.5 nmol/L, IQR 27-50 nmol/L) was correlated with the N-terminal probrain natriuretic peptide level (r=0.271, P=.005), LVEF (r=-0.263, P=.007), body mass index (r=-0.199, P=.020) and total testosterone level (r=0.332, P=.001). The median SHBG level was higher in the 16 patients (15.4%) who died, at 48.5 nmol/L (IQR 36-69.5 nmol/L) vs. 33 nmol/L (IQR 25.3-48.7 nmol/L; P=.001), and a high level was associated with an increased risk of death (hazard ratio [HR]=1.045, 95% confidence interval [CI] 1.021-1.069; P< .001). The association remained significant after adjustment in Cox multivariate regression modeling, at HR=1.049 (95% CI 1.020-1.079; P=.001). Analysis by SHBG tertiles showed mortality was 30% in the third tertile, 14% in the second, and 4% in the first (log rank 0.007; HR=3.25, 95% CI 1.43-7.34; P=.004). CONCLUSIONS: The SHBG level correlated with measures of HF severity and was associated with a higher risk of cardiac death. Further studies are needed to clarify whether SHBG plays a role in HF pathophysiology.

Globulina transportadora de hormonas sexuales: nuevo marcador de severidad y pronóstico en varones con insuficiencia cardiaca crónica / Sex hormone-binding globulin: a new marker of disease severity and prognosis in men with chronic heart failure

Introducción y objetivos. La globulina transportadora de hormonas sexuales (SHBG) es una molécula clave en la regulación del efecto de los esteroides anabolizantes. En la insuficiencia cardiaca crónica se ha descrito un deterioro anabólico, pero se desconoce el valor de la SHBG. Métodos. Se incluyeron 104 varones (53 ± 11 años) con insuficiencia cardiaca (FEVI < 40%) atendidos en una consulta especializada, con tratamiento optimizado y situación clínica estable. A la inclusión, se midieron los niveles de SHBG (mediana [rango intercuartil]), otras hormonas relacionadas y factores de riesgo conocidos. Se estudió la aparición de muerte cardiaca a los 3 años. Resultados. A la inclusión, los niveles de SHBG (34,5 [27-50] nmol/l) se correlacionaron con los de NT-proBNP (r = 0,271; p = 0,005), la FEVI (r = -0,263; p = 0,007), el ín-dice de masa corporal (r = -0,199; p = 0,020) y la testosterona total (r = 0,332; p = 0,001). Los niveles de SHBG fueron mayores (48,5 [36-69,5] frente a 33 [25,3-48,7] nmol/l; p = 0,001) en pacientes que fallecieron (n = 16 [15,4%]) y se asociaron a un mayor riesgo de muerte (HR = 1,045; IC del 95%, 1,021-1,069; p < 0,001), que fue significativo tras el ajuste en un modelo multivariable de Cox (HR = 1,049; IC del 95%, 1,020-1,079; p = 0,001). El análisis por terciles mostró una mortalidad del 30% en el tercer tercil; el 14% en el segundo y el 4% en el primer tercil (log rank test, 0,007; HR = 3,25; IC del 95%, 1,43-7,34; p = 0,004). Conclusiones. Los niveles de SHBG se correlacionan con medidas de severidad de la insuficiencia cardiaca y se asocian a un mayor riesgo de muerte cardiaca. Nuevos estudios deben aclarar si la SHBG tiene un papel en la fisiopatología de la insuficiencia cardiaca (AU)

Introduction and objectives. Sex hormone-binding globulin (SHBG) is a key regulator of the actions of anabolic steroids. Chronic heart failure (HF) has been associated with anabolic steroid deficiency, but its relationship with SHBG is not known. Methods. The study involved 104 men (53±11 years) with HF (i.e. left ventricular ejection fraction [LVEF] <40 attending a specialist clinic on optimum treatment and in stable condition at enrolment the median interquartile range iqr shbg level was determined associated hormone levels were measured known risk factors recorded study end-point cardiac death within 3 years results 34 5 nmol l 27-50 correlated with n-terminal probrain natriuretic peptide r="0.332," p lvef body mass index total testosterone higher 16 patients 15 4 who died 48 36-69 vs 33 25 3-48 7 high an increased of hazard ratio hr 95 confidence interval ci 1 021-1 069 <.001). The association remained significant after adjustment in Cox multivariate regression modeling, at HR=1.049 (95% CI 1.020-1.079; P=.001). Analysis by SHBG tertiles showed mortality was 30% in the third tertile, 14% in the second, and 4% in the first (log rank 0.007; HR=3.25, 95% CI 1.43-7.34; P=.004). Conclusions. The SHBG level correlated with measures of HF severity and was associated with a higher risk of cardiac death. Further studies are needed to clarify whether SHBG plays a role in HF pathophysiology (AU)

Modified aquaporin 5 expression and distribution in submandibular glands from NOD mice displaying autoimmune exocrinopathy.

OBJECTIVE: To investigate the expression and localization of aquaporin 5 (AQP5) in salivary glands and salivary gland function in the NOD mouse. METHODS: All experiments were performed using NOD and BALB/c mice (ages 8 weeks and 24 weeks). Real-time reverse transcription-polymerase chain reaction, Western blotting, and immunohistochemical analysis were used to study the expression and distribution of AQP5 in salivary glands. In addition, salivary gland function was determined. RESULTS: Compared with the levels in BALB/c mice, relative AQP5 messenger RNA levels were not significantly modified in the parotid glands from NOD mice of both ages but were significantly increased in the submandibular glands from NOD mice of both ages. Western blot analyses of both salivary gland membranes revealed that the level of AQP5 protein was increased in 24-week-old NOD mice. Important inflammatory infiltrates were observed in the submandibular glands, but not in the parotid glands, from 24-week-old NOD mice. The 8-week-old and 24-week-old BALB/c mice and the 8-week-old NOD mice showed AQP5 primarily at the apical membrane of the salivary gland acinus. In contrast, in acini from the submandibular glands (but not the parotid glands) from 24-week-old NOD mice, AQP5 staining was reduced at the apical membrane but was increased at the basal membrane. A moderately statistically significant decrease in pilocarpine-stimulated salivary flow was observed in 24-week-old NOD mice compared with that in age-matched BALB/c mice. CONCLUSION: Submandibular glands from 24-week-old NOD mice displayed inflammatory infiltrates, increased AQP5 protein expression, and impaired AQP5 distribution. However, the moderately statistically significant decrease in the salivary flow rate in these mice did not match the extent of AQP5 misdistribution.