Prevención cardiovascular y de la osteoporosis con terapia hormonal sustitutiva

Se recomienda actualmente que todo médico -sea cual sea su especialidad- aproveche la oportunidad que supone la atención clínica a cualquier mujer postmenopáusica o que se halle en torno a la menopausia para aconsejarle acerca de los beneficios y riesgos que supone la terapia hormonal sustitutiva (THS) con estrógenos y progesterona. Una vez que sea adecuadamente informada de estos beneficios y riesgos, debe ser la propia mujer quien decida si va a iniciar o no esta terapia, teniendo en cuenta no sólo su propio perfil de riesgo sino también sus preferencias. Los beneficios más claros se refieren a la reducción del riesgo de osteoporosis y de fracturas, así como al control y prevención de algunos síntomas frecuentes en la menopausia. Para prevenir la osteoporosis se requiere un uso continuado de IaTHS. También existen cada vez más argumentos que sugieren una reducción del riesgo de un primer episodio coronario. No obstante, no hay pruebas de que laTHS sea útil en la prevención secundaria de la cardiopatía isquémica o aporte alguna protección frente a los accidentes cerebrovasculares. Las desventajas más importantes de la THS se refieren a un mayor riesgo de hiperplasia de endometrio y de cáncer endometrial cuando se usan estrógenos solos, sin combinarlos con progestágenos. También existe un pequeño incremento del riesgo de cáncer de mama cuando se prolonga la THS, también cuando se asocian progestágenos

Empagliflozin reduces vascular damage and cognitive impairment in a mixed murine model of Alzheimer's disease and type 2 diabetes

Background Both Alzheimer's disease (AD) and type 2 diabetes (T2D) share common pathological features including inflammation, insulin signaling alterations, or vascular damage. AD has no successful treatment, and the close relationship between both diseases supports the study of antidiabetic drugs to limit or slow down brain pathology in AD. Empagliflozin (EMP) is a sodium-glucose co-transporter 2 inhibitor, the newest class of antidiabetic agents. EMP controls hyperglycemia and reduces cardiovascular comorbidities and deaths associated to T2D. Therefore, we have analyzed the role of EMP at the central level in a complex mouse model of AD-T2D. Methods We have treated AD-T2D mice (APP/PS1xdb/db mice) with EMP 10 mg/kg for 22 weeks. Glucose, insulin, and body weight were monthly assessed. We analyzed learning and memory in the Morris water maze and the new object discrimination test. Postmortem brain assessment was conducted to measure brain atrophy, senile plaques, and amyloid-beta levels. Tau phosphorylation, hemorrhage burden, and microglia were also measured in the brain after EMP treatment. Results EMP treatment helped to maintain insulin levels in diabetic mice. At the central level, EMP limited cortical thinning and reduced neuronal loss in treated mice. Hemorrhage and microglia burdens were also reduced in EMP-treated mice. Senile plaque burden was lower, and these effects were accompanied by an amelioration of cognitive deficits in APP/PS1xdb/db mice. Conclusions Altogether, our data support a feasible role for EMP to reduce brain complications associated to AD and T2D, including classical pathological features and vascular disease, and supporting further assessment of EMP at the central level

Dietary total antioxidant capacity is associated with leukocyte telomere length in a children and adolescent population

Background & Aims: Oxidative stress and inflammation seem to be potential underlying mechanisms for telomere attrition. A lack of specific antioxidants is believed to increase free radical damage and a greater risk for telomere shortening. Our aim was to evaluate the relationship between diet and leukocyte telomere length in a cross-sectional study of children and adolescents. We hypothesized that dietary total antioxidant capacity would be positively associated with telomere length. Methods: Telomere length was measured by quantitative real-time polymerase chain reaction in 287 participants (55% males, 6–18 years), who were randomly selected from the GENOI study. Results: A positive correlation between dietary total antioxidant capacity and telomere length (r=0.157, p=0.007) was found after adjustment for age and energy intake. However, higher white bread consumption was associated with shorter telomeres (β=-0.204, p=0.002) in fully-adjusted models. Interestingly, those individuals who had simultaneously higher dietary total antioxidant capacity and lower white bread consumption significantly presented the longest telomeres. Moreover, the multivariable-adjusted odds ratio for very short telomeres was 0.30 for dietary total antioxidant capacity (p=0.023) and 1.37 for white bread (p=0.025). Conclusion: It was concluded that longer telomeres were associated with higher dietary total antioxidant capacity and lower white bread consumption in S2panish children and adolescents. These findings might open a new line of investigation about the potential role of an antioxidant diet in maintaining telomere length

Xanthinuria: a rare cause of urolithiasis in the cat

Xanthinuria is a very rare disease in cats. Its etiology may have a genetic origin or may be due to an iatrogenic xan- thine-dehydrogenase inhibition that nally results in urolithiasis. The present work reports two cases of xanthine uro- lithiasis in European Shorthair unrelated male and female cats. Both uroliths were analyzed by stereoscopic microsco- py, infrared spectroscopy and scanning electron microscopy. Besides the report of these two clinical cases, a detailed pathophysiologic review and some updated recommendations for diagnosis and treatment for this condition were done.La xantinuria es una patología que se presenta raramente en los gatos. Su etiología puede tener origen genético o de- berse a una inhibición yatrogénica de la enzima xantina deshidrogenasa, que generalmente se mani esta con urolitiasis. En este trabajo se informa el hallazgo de dos urolitos de xantina en dos gatos, un macho y una hembra, de raza Euro- pea de pelo corto, no emparentados. Los urolitos fueron analizados mediante microscopía estereoscópica, espectrosco- pía infrarroja y microscopía electrónica de barrido. Además de informar sobre estos casos clínicos, se hace una revisión detallada de la siopatología y de las recomendaciones actuales para el diagnóstico y manejo médico de esta patología.Se agradece al Consejo Nacional de Ciencia y Tecnolo- gía de México (CONACyT) y al Programa de Mejora- miento del Profesorado de la Secretaria de Educación Pública de México 2011 (PROMEP-SEP), el apoyo complementario para la realización de este trabajo

Suplementación en estepas patagónicas: ¿oportunidad o riesgo ambiental?

El deterioro de los recursos forrajeros de la Patagonia se evidencia en la reducción de la cobertura vegetal, la producción primaria neta aérea (PPNA) y las existencias ovinas, esto último asociado con la caída de la señalada (porcentaje de corderos vivos a las ocho semanas posparto respecto al total de madres) y el aumento de pérdidas de corderos hasta su primera esquila. La suplementación invernal (aporte de parte de los requerimientos nutricionales diarios de los animales) puede ser de utilidad en las estepas patagónicas, ya que en invierno ocurre la mayor parte de la gestación ovina. Este trabajo sintetiza los resultados de tres experimentos realizados en estepas de las provincias de Río Negro, Chubut y Santa Cruz, dominadas por pastos poco preferidos del género Pappostipa (coirones). Los resultados muestran que la suplementación nitrogenada invernal aumenta la proporción de la superficie de los cuadros (potreros de gran tamaño) que es explorada por los animales y mejora la señalada, merced al incremento de la proporción de plantas de especies de baja calidad que son defoliadas. Sin embargo, una mayor presión de pastoreo podría desencadenar efectos erosivos graves, ya que son esas especies no preferidas las que impiden las pérdidas de suelo por erosión eólica. Se discute que la suplementación puede entrañar riesgos ambientales si no se adopta una estrategia global, referida a la carga animal, el momento del año, la categoría animal, la ubicación de los suplementos y su eventual traslado. En cambio, una estrategia que contemple estos aspectos mejoraría los índices productivos y el aprovechamiento de los recursos forrajeros.The deterioration of grasslands is evidenced by the reduction in forage cover, net aerial primary production and stocking rates, the latter resulting from a fall in numbers of sheep sheared (percentage of live lambs at eight weeks of age with respect to the total number of ewes) and an increase in lamb mortality in the first year. Winter supplementation (contribution of part of the daily nutritional requirements of animals) can be useful in the Patagonian steppes, since most of the sheep gestation occurs during winter time. This paper synthesizes the results of three experiments carried out in steppes located in the provinces of Río Negro, Chubut and Santa Cruz, dominated by poorly preferred grass species of the genus Pappostipa (coirones). The results suggest that winter nitrogen supplementation increases the proportion of paddock area that is explored by the animals and also improves the marking rate due to the increase in the proportion of plants of low-quality species that are defoliated. However, an increase in grazing pressure can trigger serious erosive effects, since it is precisely these no-preferred species that prevent soil losses due to wind erosion. It is discussed that the use of supplementation may entail environmental risks if a global strategy is not adopted, regarding stocking rate, the time of year, the animal species/age category, the location of supplements and their eventual relocation. On the other hand, a strategy that contemplates all these aspects could improve the productive indexes and the use of forage resources.EEA EsquelFil: Golluscio, Rodolfo Ángel. Universidad de Buenos Aires. Facultad de Agronomía. Cátedra de Forrajicultura; ArgentinaFil: Golluscio, Rodolfo Ángel. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura (IFEVA); ArgentinaFil: García Martínez, Guillermo Carlos. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agroforestal Esquel; ArgentinaFil: Ormaechea, Sebastián Gabriel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santa Cruz; ArgentinaFil: Valenta, Magalí Débora. Universidad de Buenos Aires. Facultad de Agronomía. Cátedra de Ovinotecnia; Argentin

Increasing trend in the prevalence of morbid obesity in Spain: from 1.8 to 6.1 per thousand in 14 years

Obesity, and especiallymorbid obesity, increases the risk of cardiovascular as well as non-cardiovascular diseases. Our objective was to ascertain the trends in morbid obesity in Spain from 1993 to 2006 using representative data from 106,048 participants in the National Health Surveys. An age-adjusted Poisson regression model stratified by sex was fitted using morbid obesity as the dependent variable. An increasing trend in prevalent morbid obesity from 1.8 to 6.1 per thousand participants was found (increase > 200%). Morbid obesity prevalence was higher in women. After adjusting for age, a monotonically increasing prevalence of morbid obesity was apparent for both men and women: the relative increase was 4% per year in women and 12% per year in men. These trends highlight the importance of preventive actions

Tomografía de emisión de fotones cerebral. Valor del índice corticocerebeloso y patrones gammagráficos en la enfermedad de Alzheimer y otras afecciones

Brain single photon emission computed tomography (SPECT) with 99mTc-HMPAO is a diagnostic tool for evaluating regional cerebral blood flow. Recently, the diagnostic possibilities of the method are being investigated in some neurologic disorders, such as cerebrovascular accidents, seizures and dementia. This work has been carried out with 54 subjects, 9 healthy volunteers and 45 patients (31 dementia and 14 epileptics), in order to evaluate gammagraphic patterns and the utility of cortico/cerebellar activity indexes. An interesting diagnostic finding is a significant decrease (p less than 0.001) in perfusion of temporoparietal regions in the patients with Alzheimer's disease in relation with the healthy volunteers' group. We have not found significant changes in perfusion in the group of epileptic patients during the interictal phase. We conclude emphasizing the interest of the SPECT in the differential diagnosis of dementia

Validation of metabolic syndrome using medical records in the SUN cohort

The objective of this study was to evaluate the validity of self reported criteria of Metabolic Syndrome (MS) in the SUN (Seguimiento Universidad de Navarra) cohort using their medical records as the gold standard. METHODS: We selected 336 participants and we obtained MS related data according to Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF). Then we compared information on the self reported diagnosis of MS and MS diagnosed in their medical records. We calculated the proportion of confirmed MS, the proportion of confirmed non-MS and the intraclass correlation coefficients for each component of the MS. RESULTS: From those 336 selected participants, we obtained sufficient data in 172 participants to confirm or reject MS using ATP III criteria. The proportion of confirmed MS was 91.2% (95% CI: 80.7- 97.1) and the proportion of confirmed non-MS was 92.2% (95% CI: 85.7-96.4) using ATP III criteria. The proportion of confirmed MS using IDF criteria was 100% (95% CI: 87.2-100) and the proportion of confirmed non-MS was 97.1% (95% CI: 85.1-99.9). Kappa Index was 0.82 in the group diagnosed by ATP III criteria and 0.97 in the group diagnosed by IDF criteria. Intraclass correlation coefficients for the different component of MS were: 0.93 (IC 95%:0.91- 0.95) for BMI; 0.96 (IC 95%: 0.93-0.98) for waist circumference; 0.75 (IC 95%: 0.66-0.82) for fasting glucose; 0.50 (IC 95%:0.35-0.639) for HDL cholesterol; 0.78 (IC 95%: 0.70-0.84) for triglycerides; 0.49 (IC 95%:0.34-0.61) for systolic blood pressure and 0.55 (IC 95%: 0.41-0.65) for diastolic blood pressure. CONCLUSIONS: Self-reported MS based on self reported components of the SM in a Spanish cohort of university graduates was sufficiently valid as to be used in epidemiological studies

Bottom-up construction of highly photoactive dye-sensitized titania using Ru(II) and Ir(III) complexes as building blocks

The one-pot co-condensation of tetrabutyl orthotitanate (TBOT) and the neutral Ru(II) N3 dye or the new cationic Ir(III) complex [Ir(ppy)2(3,3′-H2dcbpy)]PF6 have yielded novel hybrid in-situ titanias, which present an exceptional stability against leaching or photodegradation of the coordination dye. The main advantages of this strategy are: i) high dye incorporation level, ii) narrowing band gap and iii) high stability. These materials exhibit much higher photocatalytic activity, under both UV and visible light, not only than the dye-free titania but also than the related dye-sensitized titania prepared by post-synthetic grafting. This in-situ synthetic approach is a promising alternative route to prepare highly stable dye-sensitized materials with great applicability potential.We thank the Spanish MINECO (Projects CTQ2013-45518-P and CTQ2014-60017-R) for financial support