1
|
Elola Pastor AI, Prieto García B, Díaz Martín JJ. Evaluation of the first 5 years of a glutaric aciduria type I neonatal screening programme in Asturias. An Pediatr (Barc) 2024:S2341-2879(24)00137-6. [PMID: 38714461 DOI: 10.1016/j.anpede.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/29/2024] [Indexed: 05/10/2024] Open
Abstract
INTRODUCTION . Neonatal screening of glutaric aciduria type 1 (GA-1) has brought radical changes in the course and outcomes of this disease. This study analyses the outcomes of the first 5 years (2015-2019) of the AGA1 neonatal screening programme in our autonomous community. MATERIAL . We conducted an observational, descriptive and retrospective study. All neonates born between January 1, 2015 and December 31, 2019 that participated in the neonatal screening programme were included in the study. The glutarylcarnitine (C5DC) concentration in dry blood spot samples was measured by means of tandem mass spectrometry applying a cut-off point of 0.25 µmol/L. RESULTS . A total of 30 120 newborns underwent screening. We found differences in the C5DC concentration based on gestational age, type of feeding and hours of life at sample collection. These differences were not relevant for screening purposes. There were no differences between neonates with weights smaller and greater than 1500 g. Screening identified 2 affected patients and there were 3 false positives. There were no false negatives. The diagnosis was confirmed by genetic testing. Patients have been in treatment since diagnosis and have not developed encephalopathic crises in the first 4 years of life. CONCLUSIONS . Screening allowed early diagnosis of two cases of GA-1 in the first 5 years since its introduction in our autonomous community. Although there were differences in C5DC levels based on gestational age, type of feeding and hours of life at blood extraction, they were not relevant for screening.
Collapse
Affiliation(s)
| | - Belén Prieto García
- Unidad de Bioquímica Clínica, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Juan José Díaz Martín
- Sección de Gastroenterología y Nutrición Pediátrica, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Asturias, Spain
| |
Collapse
|
2
|
Zhang C, Zhang Y, Liu D, Mei M, Song N, Zhuang Q, Jiang Y, Guo Y, Liu G, Li X, Ren L. Dexmedetomidine mitigates acute kidney injury after coronary artery bypass grafting: a prospective clinical trial. Rev Esp Cardiol (Engl Ed) 2024:S1885-5857(24)00067-7. [PMID: 38423177 DOI: 10.1016/j.rec.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION AND OBJECTIVES To evaluate the impact of dexmedetomidine impact on cardiac surgery-associated acute kidney injury (CSA-AKI), kidney function, and metabolic and oxidative stress in patients undergoing coronary artery bypass grafting with heart-lung machine support. METHODS A randomized double-masked trial with 238 participants (50-75 years) undergoing coronary artery bypass grafting was conducted from January 2021 to December 2022. The participants were divided into Dex (n=119) and NS (n = 119) groups. Dex was administered at 0.5 mcg/kg over 10minutes, then 0.4 mcg/kg/h until the end of surgery; the NS group received equivalent saline. Blood and urine were sampled at various time points pre- and postsurgery. The primary outcome measure was the incidence of CSA-AKI, defined as the occurrence of AKI within 96hours after surgery. RESULTS The incidence of CSA-AKI was significantly lower in the Dex group than in the NS group (18.26% vs 32.46%; P=.014). Substantial increases were found in estimated glomerular filtration rate value at T4-T6 (P<.05) and urine volume 24hours after surgery (P<.01). Marked decreases were found in serum creatinine level, blood glucose level at T1-T2 (P<.01), blood urea nitrogen level at T3-T6 (P<.01), free fatty acid level at T2-T3 (P<.01), and lactate level at T3-T4 (P<.01). CONCLUSIONS Dex reduces CSA-AKI, potentially by regulating metabolic disorders and reducing oxidative stress.
Collapse
Affiliation(s)
- Congli Zhang
- Department of Anesthesiology, First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China
| | - Yang Zhang
- Department of Anesthesiology, First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China
| | - Di Liu
- Department of Anesthesiology, First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China
| | - Mei Mei
- Department of Anesthesiology, First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China
| | - Nannan Song
- Department of Anesthesiology, First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China
| | - Qin Zhuang
- Department of Anesthesiology, First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China
| | - Yiyao Jiang
- Department of Cardiac Surgery, First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China
| | - Yuanyuan Guo
- Department of Urology, First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China
| | - Gang Liu
- Department of Anesthesiology, First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China
| | - Xiaohong Li
- Department of Anesthesiology, First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China.
| | - Li Ren
- School of Laboratory Medicine, Bengbu Medical University, Bengbu, Anhui, China.
| |
Collapse
|
3
|
Chen K, Lin T, Yao W, Chen X, Xiong X, Huang Z. Adipocytes-derived exosomal miR-122 promotes non-alcoholic fat liver disease progression via targeting Sirt1. Gastroenterol Hepatol 2022:S0210-5705(22)00312-0. [PMID: 36584755 DOI: 10.1016/j.gastrohep.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 11/28/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022]
Abstract
AIMS Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease that affects adipose function. This study aimed to explore the function of adipocytes-derived exosomal (ADEs) miR-122 in NAFLD. METHODS A high-fat and high-fructose diet-induced rat model and a palmitic acid (PA)-induced in vitro model were established. The RNA level of miR-122 and Sirt1 was measured using qRT-PCR. The protein levels of exosome biomarkers, and lipogenesis, inflammation and fibrosis biomarkers were determined by western blotting. Cell viability and apoptosis were assessed using cell counting kit-8 and flow cytometry, respectively. Serum alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglyceride levels were measured. Liver tissue damage was assessed using haematoxylin and eosin staining. The interaction between miR-122 and Sirt1 3'UTR was assessed using a luciferase reporter gene assay. RESULTS ADEs exhibited abundant level of miR-122 and promoted lipogenesis, impaired hepatocyte survival, enhanced liver damage and increased serum lipid levels in vivo and in vitro. Inhibition of miR-122 in ADEs alleviated NAFLD progression, lipid and glucose metabolism, liver inflammation and fibrosis both in vivo and in vitro. miR-122 binds directly to the 3'UTR of Sirt1 to suppress its expression. Moreover, Sirt1 overexpression reversed the increase in cell apoptosis, glucose and lipid metabolism, liver inflammation and fibrosis induced by ADEs in vivo and in vitro. CONCLUSIONS The ADEs miR-122 promotes the progression of NAFLD via modulating Sirt1 signalling in vivo and in vitro. The ADEs miR-122 may be a promising diagnostic biomarker and therapeutic target for NAFLD.
Collapse
Affiliation(s)
- Kai Chen
- Digestive Department, Longhai First Hospital Affiliated to Xiamen Medical College, Zhangzhou, Fujian, PR China
| | - Tingting Lin
- Department of Endocrinology, Longhai First Hospital Affiliated to Xiamen Medical College, Zhangzhou, Fujian, PR China
| | - Weirong Yao
- Inspection Department, Longhai First Hospital Affiliated to Xiamen Medical College, Zhangzhou, Fujian, PR China
| | - Xinqiao Chen
- Neurology Department, Longhai First Hospital Affiliated to Xiamen Medical College, Zhangzhou, Fujian, PR China
| | - Xiaoming Xiong
- Department of Endocrinology, Longhai First Hospital Affiliated to Xiamen Medical College, Zhangzhou, Fujian, PR China
| | - Zhufeng Huang
- Department of Endocrinology, Longhai First Hospital Affiliated to Xiamen Medical College, Zhangzhou, Fujian, PR China.
| |
Collapse
|
4
|
Sánchez-Cruz JF, Aguilar-Alonso P, Rubio-Zapata HA, Flores-Flores EM. Hypozincemia in Mexican patients with diabetic foot ulcer treated out of hospital. CIR CIR 2022; 90:34-40. [PMID: 35120107 DOI: 10.24875/ciru.20001065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To know the frequency of people with hypozincemia in a group of Mexican patients with Diabetic Foot Ulcers (DFU)m and its relationship with metabolic and clinical profile. MATERIAL AND METHODS Cross-sectional, analytical, and observational study in patients with and without DFU, treated in Family Medicine Units from Instituto Mexicano del Seguro Social (IMSS) in Mérida, Yucatán, México. Frequency of hypozincemia (Zn serum < 70 g/ml) and its relationship with the levels of Glycosylated Hemoglobin (HbA1c), cholesterol and triglycerides was analyzed. RESULTS 70% of patients with DFU and 25% without DFU had hypozincemia (OR = 5.2, 95% CI 2.139-12.65, p = 0.0004). Patients with hypozincemia were older and the highest prevalence was between 50 and 60 years. The average area of the DFU showed no differences in patients with and without hypozincemia. Patients with DFU reported higher levels of HbA1c, cholesterol, triglycerides, BMI, and blood pressure compared to patients without DFU. Hypozincemia was associated with higher BMI values. CONCLUSION The frequency of hypozincemia in diabetic patients with UPD is high and is behaving as a risk factor for presenting UPD, so its identification should be routine.
Collapse
Affiliation(s)
- Juan F Sánchez-Cruz
- Instituto Mexicano del Seguro Social, Delegación Estatal en Yucatán, Mérida, Yucatán
| | | | | | | |
Collapse
|
5
|
Cerón-Solano G, Zepeda RC, Romero Lozano JG, Roldán-Roldán G, Morin JP. Bariatric surgery and alcohol and substance abuse disorder: A systematic review. Cir Esp 2021; 99:635-647. [PMID: 34690075 DOI: 10.1016/j.cireng.2021.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/13/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Bariatric surgery is a relatively safe surgical procedure with a high success rate. However, recent reports indicate a higher prevalence of alcohol or substance abuse disorder in this patient group. The purpose of this study was to review the related evidence to serve as a reference for multidisciplinary teams who treat these patients. METHODS We searched the PubMed and CENTRAL databases. The odds ratios were extracted from the different articles, comparing the prevalence of the abuse of alcohol or other substances in the postoperative period versus preoperative levels. We also compared the prevalence of alcohol use disorder after different types of bariatric surgery. RESULTS A total of 49 121 bariatric patients (80.8% female) were evaluated for alcohol use disorder. In general, bariatric surgery was found to be associated with an increase in the prevalence of alcohol abuse (4.58 ± 5.3 vs. 1.58 ± 10.7% in the preoperative period). We also found that the population of patients who underwent RYGB procedures had a higher prevalence of alcohol use disorder than patients who underwent another type of surgery (OR: 1.83; 95% CI: 1.51-2.21). The prevalence of substance abuse disorder (other than alcohol) after this procedure is less studied, although there appears to be an increased risk of abuse of certain substances. CONCLUSIONS Bariatric surgery is the best treatment for obesity and its complications. The evidence reviewed suggests that it correlates with a modest but consistent increase in the prevalence of abuse of alcohol and other substances. Medical teams who treat bariatric patients must be informed about this eventuality for its timely prevention, diagnosis and treatment.
Collapse
Affiliation(s)
- Giovanni Cerón-Solano
- Departamento Cirugía General, Hospital General de Cuautitlán, ISEM, Universidad Autónoma de México, Estado de México, Mexico; Hospital General Dr. Rubén Leñero, Secretaría de Salud de la Ciudad de México, Mexico City, Mexico
| | - Rossana C Zepeda
- Centro de Investigaciones Biomédicas, Universidad Veracruzana, Xalapa, Veracruz, Mexico
| | | | - Gabriel Roldán-Roldán
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Jean-Pascal Morin
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
| |
Collapse
|
6
|
Martínez Cuevas E, Muñoz Peláez C, Ordax Carbajo E, Navazo Eguia AI, Martín Viñe L, Prieto Jimeno A, Alonso-Álvarez ML. Sleep apnoea-hypopnoea syndrome in the obese and non-obese: Clinical, polysomnographical and clinical characteristics. An Pediatr (Barc) 2021; 95:147-58. [PMID: 34446401 DOI: 10.1016/j.anpede.2020.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 07/29/2020] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Sleep apnoea-hypopnoea syndrome (SAHS) and childhood obesity are two high prevalence conditions that represent a public health challenge. OBJECTIVE To analyse the association between both and comparing child groups that had or did not have both conditions. PATIENTS AND METHODS A prospective study in children (3-14 years), referred to the "Multidisciplinary Sleep Unit" due to suspected SAHS, between 1 November 2015 and 1 August 2017. The following parameters were evaluated: anthropometry, symptoms, blood pressure, ear, nose, and throat examination, polysomnography (nocturnal PSG) and laboratory tests. RESULTS A total of 67 children were evaluated (64% non-obese (NOb) and 36% obese (Ob). It was observed that the Ob were older (P < .001), slept less hours (P = .028), did less physical exercise (P = .029), ate less in the school dining room (P = .009), had la lower sleep efficiency, and had abnormal values in carbohydrate and lipid metabolism. The children with SAHS were younger (P = .010), a high percentage of daytime sleepiness (P = .001), and breathing through the mouth (P = .006), greater percentile of diastolic blood pressure (P = .019) and a lower IGF-1 (P = .003) than those that did not have SAHS. The comparison of the SAHS NOb and SAHS Ob groups, showed that the first group were younger (P = .010), snored more (P = .012), had a more severe SAHS (IAH 13.1 vs 5.4, P = .041), and a higher GOT (P < .001). In the second group, they slept less hours P = .038) and showed lower values of glucose (P = .039), insulin (P < .001), and HOMA (P < .001). CONCLUSION The behaviour of SAHS is different in obese children and non-obese children, with differences in age, clinical characteristics, severity of SAHS, and metabolic changes. The children diagnosed with SAHS were in the higher percentile of diastolic blood pressure. Obesity was associated with worse sleep quality, and changes in carbohydrate and lipid metabolism.
Collapse
|
7
|
Cerón-Solano G, Zepeda RC, Romero Lozano JG, Roldán-Roldán G, Morin JP. Bariatric surgery and alcohol and substance abuse disorder: A systematic review. Cir Esp 2021; 99:S0009-739X(21)00109-3. [PMID: 33933262 DOI: 10.1016/j.ciresp.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 11/21/2020] [Accepted: 03/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Bariatric surgery is a relatively safe surgical procedure with a high success rate. However, recent reports indicate a higher prevalence of alcohol or substance abuse disorder in this patient group. The purpose of this study was to review the related evidence to serve as a reference for multidisciplinary teams who treat these patients. METHODS We searched the PubMed and CENTRAL databases. The odds ratios were extracted from the different articles, comparing the prevalence of the abuse of alcohol or other substances in the postoperative period versus preoperative levels. We also compared the prevalence of alcohol use disorder after different types of bariatric surgery. RESULTS A total of 49 121 bariatric patients (80.8% female) were evaluated for alcohol use disorder. In general, bariatric surgery was found to be associated with an increase in the prevalence of alcohol abuse (4.58±5.3 vs. 1.58±10.7% in the preoperative period). We also found that the population of patients who underwent RYGB procedures had a higher prevalence of alcohol use disorder than patients who underwent another type of surgery (OR: 1.83; 95% CI: 1.51-2.21). The prevalence of substance abuse disorder (other than alcohol) after this procedure is less studied, although there appears to be an increased risk of abuse of certain substances. CONCLUSIONS Bariatric surgery is the best treatment for obesity and its complications. The evidence reviewed suggests that it correlates with a modest but consistent increase in the prevalence of abuse of alcohol and other substances. Medical teams who treat bariatric patients must be informed about this eventuality for its timely prevention, diagnosis and treatment.
Collapse
Affiliation(s)
- Giovanni Cerón-Solano
- Departamento Cirugía General, Hospital General de Cuautitlán, ISEM, Universidad Autónoma de México, Estado de México, México; Hospital General Dr. Rubén Leñero, Secretaría de Salud de la Ciudad de México, Ciudad de México, México
| | - Rossana C Zepeda
- Centro de Investigaciones Biomédicas, Universidad Veracruzana, Xalapa, Veracruz, México
| | | | - Gabriel Roldán-Roldán
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Jean-Pascal Morin
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México.
| |
Collapse
|
8
|
Martínez Cuevas E, Muñoz Peláez C, Ordax Carbajo E, Navazo Eguia AI, Martín Viñe L, Prieto Jimeno A, Alonso-Álvarez ML. [Sleep apnoea-hypopnoea syndrome in the obese and non-obese: clinical, polysomnographical and clinical characteristics]. An Pediatr (Barc) 2020. [PMID: 33008792 DOI: 10.1016/j.anpedi.2020.07.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Sleep apnoea-hypopnoea syndrome (SAHS) and childhood obesity are la high prevalence conditions that represent a public health challenge. OBJECTIVE To analyse the association between both and comparing child groups that had or did not have both conditions. PATIENTS AND METHODS A prospective study in children (3-14 years), referred to the "Multidisciplinary Sleep Unit" due to suspected SAHS, between 1 November 2015 and 1 August 2017. The following parameters were evaluated: anthropometry, symptoms, blood pressure, ear, nose, and throat examination, polysomnography (nocturnal PSG) and laboratory tests. RESULTS A total of 67 children were evaluated (64% non-obese and 36% obese. It was observed that the obese were older (P<.001), slept less hours (P=.028), did less physical exercise (P=.029), ate less in the school dining room (P=.009), had la lower sleep efficiency, and had abnormal values in carbohydrate and lipid metabolism. The children with SAHS were younger (P=.010), a high percentage of daytime sleepiness (P=.001), and breathing through the mouth (P=.006), greater percentile of diastolic blood pressure (P=.019) and a lower IGF-1 (P=.003) than those that did not have SAHS. The comparison of the SAHS non-obese and SAHS obese groups, showed that the first group were younger (P=.010), snored more (P=.012), had a more severe SAHS (IAH 13.1 vs. 5.4, P=.041), and a higher GOT (P<.001). In the second group, they slept less hours P=.038) and showed lower values of glucose (P=.039), insulin (P<.001), and HOMA (P<.001). CONCLUSION The behaviour of SAHS is different in obese children and non-obese children, with differences in age, clinical characteristics, severity of SAHS, and metabolic changes. The children diagnosed with SAHS were in the higher percentile of diastolic blood pressure. Obesity was associated with worse sleep quality, and changes in carbohydrate and lipid metabolism.
Collapse
Affiliation(s)
| | - Carmen Muñoz Peláez
- Unidad Multidisciplinar de Sueño y Ventilación Dr. J. Terán-Santos, Hospital Universitario de Burgos, Burgos, España
| | - Estrella Ordax Carbajo
- Unidad Multidisciplinar de Sueño y Ventilación Dr. J. Terán-Santos, Hospital Universitario de Burgos, Burgos, España
| | - Ana Isabel Navazo Eguia
- Unidad Multidisciplinar de Sueño y Ventilación Dr. J. Terán-Santos, Hospital Universitario de Burgos, Burgos, España
| | - Lourdes Martín Viñe
- Unidad Multidisciplinar de Sueño y Ventilación Dr. J. Terán-Santos, Hospital Universitario de Burgos, Burgos, España
| | | | - María Luz Alonso-Álvarez
- Unidad Multidisciplinar de Sueño y Ventilación Dr. J. Terán-Santos, Hospital Universitario de Burgos, Burgos, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España
| |
Collapse
|
9
|
Sangineto M, Luglio CV, Mastrofilippo T, Zingaro MT, Berardi E, Antonica G, Sabbà C, Napoli N. Analysis of hepatic stiffness after viral eradication in a population with chronic hepatitis C treated with DAAs. Med Clin (Barc) 2021; 156:317-23. [PMID: 32788043 DOI: 10.1016/j.medcli.2020.04.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/07/2020] [Accepted: 04/15/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES Despite chronic hepatitis C (CHC) is still a global burden as the high morbidity and mortality, the recently approved direct-acting antivirals (DAAs) permit a very high rate of sustained virologic response (SVR) in these patients. The clinical improvement due to viral eradication is being documented, however it is not clear why a subset of patients does not benefit in terms of fibrosis regression or hepatocellular carcinoma (HCC) development. Aim of the study was to assess the hepatic stiffness regression at SVR24 and detect factors impacting stiffness course. PATIENTS AND METHODS Hepatic stiffness assessed by acoustic radiation force impulse (ARFI) and anthropometric- and biochemical parameters were retrospectively collected by 166 CHC patients treated with DAAs, form baseline and SVR24. RESULTS Viral eradication significantly improved overall hepatic stiffness and other related hepatitis hallmarks such as ALT, AST, γGT, platelets count, AST to Platelets ratio Index (APRI), total- and LDL cholesterol. The multiple regression analysis showed that patients with baseline glucose > 110mg/dl presented a stiffness regression significantly lower when compared to low glucose patients (<110mg/dl), moreover baseline HbA1c strongly correlated with DeltaStiffness. 7 patients (4.2%) developed HCC and importantly, presented hyperglycaemia and no stiffness regression nor platelets count recover. CONCLUSIONS Although viral eradication with DAAs entails overall benefits, glycaemic decompensation negatively affects fibrosis regression and probably facilitates HCC development.
Collapse
|
10
|
Abstract
Adipose tissue is an endocrine organ with high metabolic activity. Countless adipose tissue-secreted adipokines and lipokines, as well as peptides and lipids with biological activity have thus far been discovered. Both white and brown and beige adipose tissue are known to contribute to energy homeostasis and metabolic regulation. The purpose of this review is to report on the most recent findings related to adipose tissue according to its color and its relationship with metabolic alterations associated with obesity. After a review of the specialized literature, white, brown and beige adipocyte populations were identified to be able to coexist within the same structure, and to modify global metabolic state in physiological or pathological situations.
Collapse
Affiliation(s)
- María E Frigolet
- Hospital Infantil de México "Federico Gómez", Laboratory of Metabolic Diseases, Obesity and Diabetes, Mexico City, Mexico
| | - Ruth Gutiérrez-Aguilar
- Hospital Infantil de México "Federico Gómez", Laboratory of Metabolic Diseases, Obesity and Diabetes, Mexico City, Mexico
| |
Collapse
|
11
|
Cruthirds CL, van der Meij BS, Wierzchowska-McNew A, Deutz NEP, Engelen MPKJ. Presence or Absence of Skeletal Muscle Dysfunction in Chronic Obstructive Pulmonary Disease is Associated With Distinct Phenotypes. Arch Bronconeumol 2021; 57:264-72. [PMID: 32115277 DOI: 10.1016/j.arbres.2019.12.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/19/2019] [Accepted: 12/31/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Reduced skeletal muscle function and cognitive performance are common extrapulmonary features in Chronic Obstructive Pulmonary Disease (COPD) but their connection remains unclear. Whether presence or absence of skeletal muscle dysfunction in COPD patients is linked to a specific phenotype consisting of reduced cognitive performance, comorbidities and nutritional and metabolic disturbances needs further investigation. METHODS Thirty-seven patients with COPD (grade II-IV) were divided into two phenotypic cohorts based on the presence (COPD dysfunctional, n=25) or absence (COPD functional, n=12) of muscle dysfunction. These cohorts were compared to 28 healthy, age matched controls. Muscle strength (dynamometry), cognitive performance (Trail Making Test and STROOP Test), body composition (Dual-energy X-Ray Absorptiometry), habitual physical activity, comorbidities and mood status (questionnaires) were measured. Pulse administration of stable amino acid tracers was performed to measure whole body production rates. RESULTS Presence of muscle dysfunction in COPD was independent of muscle mass or severity of airflow obstruction but associated with impaired STROOP Test performance (p=0.04), reduced resting O2 saturation (p=0.003) and physical inactivity (p=0.01), and specific amino acid metabolic disturbances (enhanced leucine (p=0.02) and arginine (p=0.06) production). In contrast, COPD patients with normal muscle function presented with anxiety, increased fat mass, plasma glucose concentration, and metabolic syndrome related comorbidities (hypertension and dyslipidemia). CONCLUSION COPD patients with muscle dysfunction show characteristics of a cognitive - metabolic impairment phenotype, influenced by the presence of hypoxia, whereas those with normal muscle function present a phenotype of metabolic syndrome and mood disturbances.
Collapse
|
12
|
Noguera R, Burgos-Panadero R, Lucantoni F, de la Cruz-Merino L, Álvaro Naranjo T. [An integral view of cancer (III). Evaluation of new biomarkers and treatment strategies]. Rev Esp Patol 2020; 53:88-99. [PMID: 32199599 DOI: 10.1016/j.patol.2019.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 08/27/2019] [Indexed: 11/20/2022]
Abstract
We propose a comprehensive approach to oncological disease, based on a systemic consideration of biology, health and disease. Our two previous review articles focused on tumour microenvironment and the discovery of new biomarkers; here we discuss the practical application of these principles to pathology, through the identification, evaluation and quantitative analysis of new prognostic and predictive factors (Immunoscore, TIME). We also consider the clinical use of promising, better tolerated treatments, such as immunotherapy. The integrative pathologist now has access to the latest improved oncology stratification tools designed to identify effective treatment strategies, based on the natural evolution of clinical and scientific knowledge that transcend the gene-centric theory of cancer.
Collapse
|
13
|
Noguera R, Burgos-Panadero R, Gamero-Sandemetrio E, de la Cruz-Merino L, Álvaro Naranjo T. [An integral view of cancer (II). Fields of investigation and emerging biomarkers]. Rev Esp Patol 2019; 52:222-233. [PMID: 31530405 DOI: 10.1016/j.patol.2019.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/26/2019] [Accepted: 04/14/2019] [Indexed: 01/09/2023]
Abstract
Pathology and clinical oncology work hand in hand so that techniques and treatments, biomarkers and antibodies share the common goal of identifying integral new treatment regimens that are more effective and less aggressive. Evidence shows how tissue mechanics affect carcinogenesis and that tumor heterogeneity depends on metabolic stromal alteration and the Warburg effect of malignant cells, regulated directly by PD-1, becoming a target for immunotherapy. Proliferation and apoptosis depend on mitochondrial dysfunction in tumor cells, determining the grade of chemo/radio-resistance. The status of intestinal microbiota regulates immune response, tumor microenvironment structure and oncologic treatment response, whilst the Vitamin D receptor allows reprogramming of tumor stroma. Current collaboration between basic and clinical research paves the way for future investigation into areas such as tumor microenvironment and molecular mechanotherapy, metabolism and immunotherapy, mitochondria and oncogenesis, microbiota and chemotherapy, psychoneuroendocrine axis and homeostatic imbalance, epigenetics and reprogramming possibilities of the tumor phenotype. We review new prognostic and predictive biomarkers emerging from these fields of knowledge, opening up new therapeutic possibilities.
Collapse
Affiliation(s)
- Rosa Noguera
- Departamento de Patología, Facultad de Medicina, Universidad de Valencia/Instituto de Investigaciones Sanitarias INCLIVA, Valencia, España; CIBERONC, Madrid, España
| | - Rebeca Burgos-Panadero
- Departamento de Patología, Facultad de Medicina, Universidad de Valencia/Instituto de Investigaciones Sanitarias INCLIVA, Valencia, España; CIBERONC, Madrid, España
| | - Esther Gamero-Sandemetrio
- Departamento de Patología, Facultad de Medicina, Universidad de Valencia/Instituto de Investigaciones Sanitarias INCLIVA, Valencia, España; CIBERONC, Madrid, España
| | | | - Tomás Álvaro Naranjo
- CIBERONC, Madrid, España; Servicio de Anatomía Patólogica, Hospital Verge de la Cinta, Tortosa, Tarragona, España.
| |
Collapse
|
14
|
López A, Varela JJ, Cid MM, Couñago M, Gago N. Hydroelectrolytic and infectious complications in one year of parenteral nutrition in critical care. ACTA ACUST UNITED AC 2018; 65:373-379. [PMID: 29680333 DOI: 10.1016/j.redar.2018.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/13/2018] [Accepted: 03/04/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Parenteral nutrition consists of the intravenous administration of macronutrients, micronutrients and electrolytes. Our objectives were to evaluate the biochemical alterations during the first ten days of initiation and to quantify the bacteremia related to the central venous catheter during the administration of parenteral nutrition. MATERIAL AND METHODS Retrospective study of incidence and prevalence. We included 51 patients who started intravenous nutritional support therapy at Critical Care. We intend to know the infectious complications of the central line associated with parenteral nutrition, to evaluate the most frequent hydroelectrolytic complications of parenteral nutrition, and to identify minimum control points in the detection of hydroelectrolytic alterations. RESULTS Statistically significant daily variations were found for glucose, magnesium, potassium and creatinine, and bordering on the statistical significance for albumin and phosphate, the alterations occurring between the second and third days fundamentally. Hypoalbuminemia and hypocalcemia were very frequent. GGT was the liver enzyme that increased more frequently. The infection rate was 14.86 per 1,000 days of central venous catheter. CONCLUSIONS We found daily variations in glucose, potassium and magnesium, as well as a decrease in creatinine. We emphasize the frequency of hypoalbuminemia, hypocalcemia and elevation of GGT. The most important variations occurred between the second and third day, highlighting the precocity of potassium alteration and the peak of glycemia. The rate of infection related to the central venous catheter in patients with parenteral nutrition was high.
Collapse
Affiliation(s)
- A López
- Grupo de Investigación en Anestesia y Cuidados Críticos, Instituto de Investigación Sanitaria Galicia SUR (ISS Galicia Sur). SERGAS-UVigo, Vigo, España; Servicio de Anestesia y Reanimación, Complexo Hospitalario Universitario de Ourense (CHUO), Sergas, Ourense, España.
| | - J J Varela
- Servicio de Farmacia, Complexo Hospitalario Universitario de Ourense (CHUO), Sergas, Ourense, España
| | - M M Cid
- Grupo de Investigación en Anestesia y Cuidados Críticos, Instituto de Investigación Sanitaria Galicia SUR (ISS Galicia Sur). SERGAS-UVigo, Vigo, España; Servicio de Anestesia y Reanimación, Complexo Hospitalario Universitario de Ourense (CHUO), Sergas, Ourense, España
| | - M Couñago
- Grupo de Investigación en Anestesia y Cuidados Críticos, Instituto de Investigación Sanitaria Galicia SUR (ISS Galicia Sur). SERGAS-UVigo, Vigo, España; Servicio de Anestesia y Reanimación, Complexo Hospitalario Universitario de Ourense (CHUO), Sergas, Ourense, España
| | - N Gago
- Grupo de Investigación en Anestesia y Cuidados Críticos, Instituto de Investigación Sanitaria Galicia SUR (ISS Galicia Sur). SERGAS-UVigo, Vigo, España; Servicio de Anestesia y Reanimación, Complexo Hospitalario Universitario de Ourense (CHUO), Sergas, Ourense, España
| |
Collapse
|
15
|
Pérez-Neri I, Ramírez-Bermúdez J, Ojeda-López C, Montes S, Soto-Hernández JL, Ríos C. Glutamine and citrulline concentrations reflect nitric oxide synthesis in the human nervous system. Neurologia 2020; 35:96-104. [PMID: 28867511 DOI: 10.1016/j.nrl.2017.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 07/02/2017] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Although citrulline is produced by nitric oxide (NO) synthase upon activation of the NMDA glutamate receptor, nitrite and nitrate (NOx) concentration is considered the best marker of NO synthesis, as citrulline is also metabolised by other enzymes. This study analyses the correlation between human cerebrospinal fluid NOx and citrulline concentrations in order to determine the extent to which citrulline reflects NO synthesis and glutamatergic neurotransmission. METHODS Participants were patients with acute neurological diseases undergoing lumbar puncture (n=240). NOx and amino acid concentrations were determined by HPLC. RESULTS NOx concentrations did not vary significantly where infection (p=0,110) or inflammation (p=0,349) were present. Multiple regression analysis showed that NOx concentration was correlated with glutamine (r=-0,319, p<0,001) and citrulline concentrations (r=0,293, p=0,005) but not with the citrulline/arginine ratio (r=-0,160, p=0,173). ANCOVA confirmed that NOx concentration was correlated with citrulline concentration (F=7,6, p=0,007) but not with the citrulline/arginine ratio (F=2,2, p=0,136), or presence of infection (F=1,8, p=0,173) or inflammation (F=1,4, p=0,227). No association was found between NOx and arginine or glutamate concentrations. CONCLUSION The results suggest that CSF citrulline concentration reflects NOx synthesis to some extent, despite the contribution of other metabolic pathways. In addition, this study shows that glutamine is an important modulator of NO synthase activity, and that arginine and glutamate are not correlated with NOx.
Collapse
|
16
|
Fernández-Pérez L, de Mirecki-Garrido M, Guerra B, Díaz M, Díaz-Chico JC. Sex steroids and growth hormone interactions. ACTA ACUST UNITED AC 2016; 63:171-80. [PMID: 26775014 DOI: 10.1016/j.endonu.2015.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 11/09/2015] [Accepted: 11/10/2015] [Indexed: 01/17/2023]
Abstract
GH and sex hormones are critical regulators of body growth and composition, somatic development, intermediate metabolism, and sexual dimorphism. Deficiencies in GH- or sex hormone-dependent signaling and the influence of sex hormones on GH biology may have a dramatic impact on liver physiology during somatic development and in adulthood. Effects of sex hormones on the liver may be direct, through hepatic receptors, or indirect by modulating endocrine, metabolic, and gender-differentiated functions of GH. Sex hormones can modulate GH actions by acting centrally, regulating pituitary GH secretion, and peripherally, by modulating GH signaling pathways. The endocrine and/or metabolic consequences of long-term exposure to sex hormone-related compounds and their influence on the GH-liver axis are largely unknown. A better understanding of these interactions in physiological and pathological states will contribute to preserve health and to improve clinical management of patients with growth, developmental, and metabolic disorders.
Collapse
Affiliation(s)
- Leandro Fernández-Pérez
- Institute for Research in Biomedicine and Health (IUIBS), University of Las Palmas de Gran Canaria, Molecular and Translational Pharmacology - BioPharm Group, Las Palmas de G.C., Spain.
| | - Mercedes de Mirecki-Garrido
- Institute for Research in Biomedicine and Health (IUIBS), University of Las Palmas de Gran Canaria, Molecular and Translational Pharmacology - BioPharm Group, Las Palmas de G.C., Spain
| | - Borja Guerra
- Institute for Research in Biomedicine and Health (IUIBS), University of Las Palmas de Gran Canaria, Molecular and Translational Pharmacology - BioPharm Group, Las Palmas de G.C., Spain
| | - Mario Díaz
- Department of Animal Biology, University of La Laguna, Laboratory of Membrane Physiology and Biophysics, La Laguna, Spain
| | - Juan Carlos Díaz-Chico
- Institute for Research in Biomedicine and Health (IUIBS), University of Las Palmas de Gran Canaria, Molecular and Translational Pharmacology - BioPharm Group, Las Palmas de G.C., Spain
| |
Collapse
|
17
|
Paes ST, Marins JCB, Andreazzi AE. [Metabolic effects of exercise on childhood obesity: a current view]. Rev Paul Pediatr 2015; 33:122-9. [PMID: 25662015 PMCID: PMC4436964 DOI: 10.1016/j.rpped.2014.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 07/04/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE: To review the current literature concerning the effects of physical exercise on
several metabolic variables related to childhood obesity. DATA SOURCE: A search was performed in Pubmed/MEDLINE and Web of Science databases. The
keywords used were as follows: Obesity, Children Obesity, Childhood Obesity,
Exercise and Physical Activity. The online search was based on studies published
in English, from April 2010 to December 2013. DATA SYNTHESIS: Search queries returned 88,393 studies based on the aforementioned keywords;
4,561 studies were selected by crossing chosen keywords. After applying inclusion
criteria, four studies were selected from 182 eligible titles. Most studies found
that aerobic and resistance training improves body composition, lipid profile and
metabolic and inflammatory status of obese children and adolescents; however, the
magnitude of these effects is associated with the type, intensity and duration of
practice. CONCLUSIONS: Regardless of the type, physical exercise promotes positive adaptations to
childhood obesity, mainly acting to restore cellular and cardiovascular
homeostasis, to improve body composition, and to activate metabolism; therefore,
physical exercise acts as a co-factor in fighting obesity.
Collapse
|