The corticotrophin-releasing factor/urocortin system regulates white fat browning in mice through paracrine mechanisms

Objectives: The corticotrophin-releasing factor (CRF)/urocortin system is expressed in the adipose tissue of mammals, but its functional role in this tissue remains unknown. Methods: Pharmacological manipulation of the activity of CRF receptors, CRF1 and CRF2, was performed in 3T3L1 white pre-adipocytes and T37i brown pre-adipocytes during in vitro differentiation. The expression of genes of the CRF/urocortin system and of markers of white and brown adipocytes was evaluated along with mitochondrial biogenesis and cellular oxygen consumption. Metabolic evaluation of corticosterone-deficient or supplemented Crhr1-null (Crhr1−/−) mice and their wild-type controls was performed along with gene expression analysis carried out in white (WAT) and brown (BAT) adipose tissues. Results: Peptides of the CRF/urocortin system and their cognate receptors were expressed in both pre-adipocyte cell lines. In vitro pharmacological studies showed an inhibition of the expression of the CRF2 pathway by the constitutive activity of the CRF1 pathway. Pharmacological activation of CRF2 and, to a lesser extent, inhibition of CRF1 signaling induced molecular and functional changes indicating transdifferentiation of white pre-adipocytes and differentiation of brown pre-adipocytes. Crhr1−/− mice showed increased expression of CRF2 and its agonist Urocortin 2 in adipocytes that was associated to brown conversion of WAT and activation of BAT. Crhr1−/− mice were resistant to diet-induced obesity and glucose intolerance. Restoring physiological circulating corticosterone levels abrogated molecular changes in adipocytes and the favorable phenotype of Crhr1−/− mice. Conclusions: Our findings suggest the importance of the CRF2 pathway in the control of adipocyte plasticity. Increased CRF2 activity in adipocytes induces browning of WAT, differentiation of BAT and is associated with a favorable metabolic phenotype in mice lacking CRF1. Circulating corticosterone represses CRF2 activity in adipocytes and may thus regulate adipocyte physiology through the modulation of the local CRF/urocortin system. Targeting CRF receptor signaling specifically in the adipose tissue may represent a novel approach to tackle obesity

Maxillary Incisors of the Horse before and at the Beginning of the Teeth Shedding: Radiographic and CT Study

To gain insight into the radiographic appearance of maxillary deciduous incisors and dental germs of maxillary permanent incisors in the period prior to teeth shedding, radiographs and computed tomography (CT) of 25 horse skulls, with an estimated age of between 12 and 42 months, were studied. Data regarding morphology and development were obtained. Dental germs of first maxillary permanent incisors were identified radiographically as rounded radiolucent areas at the level of the apical parts of the first deciduous incisors, in skulls with an estimated age of twelve months. The first sign of crown mineralization of these dental germs appeared in skulls supposedly a few months older. Before teeth shedding, the unerupted, mineralized crowns of the first permanent incisor could be identified radiographically relatively caudal to the corresponding first deciduous incisors. The results of the present study indicate that radiographic intraoral images are suitable to identify the grade of development of the dental germs of maxillary permanent incisors. A detailed description of the radiographic appearance of deciduous incisors and dental germs of permanent incisors will help clinicians to expand their knowledge for diagnostic or treatment purposes

Complications and treatment errors in periodontal therapy in medically compromised patients

Patients who are medically compromised may be at an increased risk of complications and treatment errors following periodontal therapy. A review of the evidence on the topic is presented, in relation to the type of complication reported, of periodontal treatment, and of patients' medical status. Further, a framework for risk assessment and appropriate treatment modifications is introduced, with the aim of facilitating the management of patients with existing comorbidities and reducing the incidence of treatment complications

Relación de la calidad de vida profesional y el burnout en médicos de atención primaria

ObjetivoConocer la relación, si es que la hay, entre la calidad de vida profesional (CVP) y burnout de facultativos de atención primaria.DiseñoEstudio transversal mediante cuestionario CVP-35 y MBI (Maslach Burnout Inventory), por correo postal.ÁmbitoTres centros urbanos y 3 zonas de atención rural. Participó un total de 131 profesionalesMedicionesDel CVP-35 se obtienen puntuaciones que van de 0 (mínimo) a 10 (máximo). El cuestionario Maslach clasifica en nivel alto, medio y bajo de cada dimensión.ResultadosContestó a la encuesta el 71,7%. La edad media era de 44 años y la media de tarjetas sanitarias, 1.339. El número de consultas/día fue de 37; en cuanto las visitas domiciliarias, realizaban una diaria. El valor medio de la CVP fue de 4,48 (intervalo de confianza [IC] del 95%, 4,08-4,88). La percepción de la demanda tuvo una puntuación de 5,9 (IC del 95%, 5,6-6,1); la motivación intrínseca del profesional se situó en 6,5 (IC del 95%, 6,2-6,7) y el apoyo de los directivos en 3,8 (IC del 95%, 3,6-4,1). En cuanto al cuestionario MBI, se observó una despersonalización alta en el 54,3%, cansancio emocional alto en un 56,2% y realización personal alta en el 9,3%. La correlación mayor fue entre las demandas en el puesto y el cansancio emocional (r=0,6; p<0,0001), la motivación intrínseca y la realización personal (r=0,46; p<0,0001) y la calidad de vida profesional frente al cansancio emocional (r=−0,4; p<0,0005).ConclusionesLa CVP y el burnout miden dimensiones diferentes pero relacionadas. Por tanto, su utilidad es diferente en función de los objetivos. Con estos instrumentos se pueden identificar elementos clave de la gestión de personas que pueden mejorar la calidad de vida profesional.ObjectiveTo know the relationship, if this exists, between the quality of professional life (CPL) and the burnout of primary health care staff.DesignTransversal study employing CVP-35 test and MBI (Maslach Burnout Inventory), both sent by postmail.Setting3 urban centers and 3 rural centers. Total: 131 professionals.MeasuresIn the CVP-35 test, scores from 0 (minimum) to 100 (maximum) are obtained. Maslach categorised each dimension into high, medium and low level.Results71.7% answered. Medium age 44 years, average of 1339 sanitary cards. The number of visits/day was 37, home visits 1 per day. The CVP average was 4.48 (95% CI, 4.08-4.88). The damage perception in the post 5.9 (95% CI, 5.6-6.1); the professional intrinsic motivation 6.5 (95% CI, 6.2-6.7), and the manager support 3.8 (95% CI, 3.6-4.1). MBI: high depersonalization 54.3%, emotional exhaustion (r=0.6; P<.0001), intrinsic motivation, and personal accomplishment (r=0.46; P<.0001) and profesional quality of life front emotional fatigue (r= −0.4; P<.0005).ConclusionsCPL and burnout measure different but related dimensions. Therefore, its utility is dependent on the objectives. Target elements, which can improve the quality of professional life, can be identified from these tools

Antibiotic Prophylactic Regimens for Infective Endocarditis in Patients Undergoing Dental Procedures

Up to date causal relationship has been demonstrated between dental manipulations and the onset of infective endocarditis (IE). However, since 1955, numerous expert committees have proposed antibiotic prophylaxis (AP) to prevent bacteraemia of oral origin. Controversy regarding the efficacy of AP prior to the dental procedures has intensified in recent years because of the lack of conclusive evidence on its efficacy for the prevention of IE and on its cost-effectiveness, as well as the possibility of allergic reactions and the emergence of antibiotic resistance. Accordingly, AP is now maintained exclusively for patients at highest risk and who require the manipulation of the gingival or periapical regions of the teeth or perforation of the oral mucosa. In the context of a restrictive policy, the National Institute for Health and Clinical Excellence (NICE) of the United Kingdom published a new guideline in 2008 stating that “AP against IE is not recommended for persons undergoing dental procedures”, regardless of risk status and of the nature of the procedure to be performed. The NICE guideline has generated further controversy, and expert committees in other countries continue to publish prophylactic regimens for the prevention of IE secondary to dental procedures. In this chapter, we discuss the principal guidelines currently applicable in Europe, the USA and Australia, and we draw particular attention to the need for randomised clinical trials

Assessment of morbidity in gynaecologic oncology laparoscopy and identification of possible risk factors

BACKGROUND: The aim of this study was to ascertain the incidence of and the risk factors associated with morbidity in laparoscopy performed on patients with cervical cancer and endometrial cancer. METHODS: This was an observational study of a cohort of 128 women, 89 with endometrial cancer and 39 with cervical cancer from January 2000 to December 2011. We used the Student's t-test or the Mann-Whitney U test for continuous variables, and the Chi-square or Fisher's exact test for categorical variables. RESULTS: Complications were found in 44 patients (34.4%). After a multivariate analysis, among the risk factors associated with the presence of complications as the only type of surgery was found to be statistically significant (p = 0.043), more frequent in the most complex procedures such as Wertheim operation, trachelectomy, and para-aortic lymphadenectomy. Type of surgery (p = 0.003) and tumour type (p = 0.003) were risk factors associated with conversion to laparotomy. It was more frequent among the most complex procedures and cervical cancer cases. Regarding the need for transfusion, significant differences were observed in terms of surgery duration (p < 0.001), more frequent in longer surgery. CONCLUSION: Morbidity in laparoscopic surgical oncology is related to the surgery complexity, where the basal characteristics of the patient are not a factor of influence in the development of complications

Communication abilities in the clinical interview

[Resumen] Las habilidades comunicacionales constituyen una parte importante de la entrevista clínica. Para una mejor comprensión pueden dividirse en los siguientes apartados: contexto, escucha, comprensión, estrategia y resumen general. Se detallan en cada uno de ellos (a excepción del contexto por haber sido bordado en otro artículo) una serie de técnicas o consideraciones de interés que facilitan una mejora en la interacción del profesional de la salud (fisioterapeuta) con el consultante. Esta mejora repercute tanto en una mayor calidad de los resultados como a nivel afectivo y emocional en ambos protagonistas de la relación.[Abstract] The communication skills are an important part of the clinical interview. To get a better comprehension they can be divided into the following steps: context, listening, acknowledgement, strategy and summary. Some techniques or interesting considerations which can improve health care provider (physiotherapist) patient relationship are explained in each one (but the context because it has been considered in another article). This improvement is involved with not only better clinical outcomes, but also affective and emotional level for both relationship's main character

Identifying the components of school physical environment with participatory learning approach (Case study: Boys’ middle schools of Tabriz)

Background and Objectives: One of the important and influential issues of research is recognizing the components of the physical environment of schools as learning process can be influenced by the physical environment of the school. Paying attention to the architectural features of school buildings, among other features, can be achieved by creating schools with successful students. What is commonly known today as the physical model of the school are the classrooms that are continuously connected through the corridor, and this pattern of building schools as a pattern continues. If the learning environment, whether classroom or school, is designed in such a way that students are the center of activity, it provides a very good ground for increasing students' interest in the school environment. In the collaborative learning method that is the goal of the research, students are placed in such an environment and engage in collaborative activity. The purpose of this study was to identify the physical environment components of schools with a participatory learning approach. Methods: This applied research is of descriptive-analytical type. The statistical population of the study was male middle school students in Tabriz. 356 male middle school students were randomly selected from four schools in different parts of the city. The data were analyzed by one-sample t-test and chi-square test. Findings: The results showed that the satisfaction of the physical environment in all four studied schools was low and the tendency for the environments in which the students could participate was very high. It can be deduced that the more the physical environment of the school has favorable conditions for participatory learning, the higher the level of satisfaction and interest in learning in students are, and also education and training take place properly. Conclusion: The results showed that the elements of physical environment such as furniture, green space, color, and space geometry are among the most important factors in learning, especially learning and cooperative activity in schools, which can have a significant effect on students’ satisfaction and their presence with enthusiasm at school. One of the suggestions of the present study is to design suitable and efficient spaces according to the aesthetic and psychological principles as well as the use of collaborative learning method for lecture-based teaching.   ===================================================================================== COPYRIGHTS  ©2020 The author(s). This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, as long as the original authors and source are cited. No permission is required from the authors or the publishers.  ====================================================================================

Morphometric study of the nerve fibers of the oculomotor nerve in dog

The intracranial portion of the right oculomotor nerves was extracted from six adult German Shepherd dogs. The nerves were studied using light and electron microscopy. Nerve area was calculated, and myelinated and unmyelinated fibers were analized to determine number, diameter and area. Also in the myelinated fibers the area and diameter of the correspondent axon, and thickness of the myeline sheath were measured. The mean number of fibers was 8543.50±1231.85 for myelinated and 1402.00±241.58 for unmyelinated. The mean fiber diameter was 10.23±0.68 μm for myelinated and 0.43±0.21 μm for unmyelinated. This study demonstrated that the oculomotor nerves in dogs have structural and ultrastructural characteristics that are similar to those from other specie