Tadalafil improves lean mass and endothelial function in nonobese men with mild ED/LUTS: in vivo and in vitro characterization

PURPOSE: Phosphodiesterase type-5 inhibitor administration in diabetic men with erectile dysfunction (ED) is associated with reduced waist circumference. We evaluated potential effects of daily tadalafil administration on body composition and investigated its possible mechanism(s) of action in C2C12 skeletal muscle cells in vitro. METHODS: Forty-three men on stable caloric intake (mean age 48.5 ± 7; BMI 25.5 ± 0.9 kg/m2) complaining mild ED and/or low urinary tract symptoms (LUTS) were randomly assigned to receive tadalafil (TAD) 5 mg/daily (once-a-day=OAD-TAD; n = 23) or 20 mg on-demand (on-demand=OD-TAD; n = 20) for 2 months. Primary outcomes were variations of body composition measured by Dual-energy X-ray absorptiometry; secondary outcomes were ED/LUTS questionnaire scores along with hormone (testosterone, estradiol, insulin) and endothelial function (Endopat2000) variations. RESULTS: OAD-TAD increased abdominal lean mass (p < 0.01) that returned to baseline after 2 months withdrawal. LUTS scores improved (p<0.01) in OD-TAD while ED scores improved (p < 0.01) in both groups. We found significant improvements in endothelial function (p < 0.05) that directly correlated with serum insulin (p < 0.01; r = 0.3641) and inversely correlated with estradiol levels (p < 0.01; r = 0.3655) even when corrected for potential confounders. Exposure of C2C12 cells upon increasing tadalafil concentrations (10-7 to 10-6 M) increased total androgen receptor mRNA and protein expression as well as myogenin protein expression after 24 and 72 h (2.8 ± 0.4-fold and 1.4 ± 0.02-fold vs. control, respectively, p < 0.05). CONCLUSIONS: Daily tadalafil improved lean mass content in non-obese men probably via enhanced insulin secretion, estradiol reduction, and improvement of endothelial function in vivo. The in vitro increased myogenin and androgen receptor protein expression in skeletal muscle cells suggests a translational action of phosphodiesterase type-5 on this receptor

La educación como estrategia de inserción en espacios con alto porcentaje de población migrante. Estudio de caso Hilario Ascasubi

In an attempt to understand the variable migration process in the context of globalization, we turn to one of its components as a trigger: the educational system of migrant populations in situations of exclusion, social vulnerability or inclusion. These categories are useful both for the interpretation of the phenomenon and for undertaking strategies leading to the resolution of different unsettling situations. The incorporation of immigrant students is a generalized issue in the education systems of most countries, and it is the responsibility of the institutions to achieve socio-cultural integration and reach intercultural coexistence.This paper aims to analyze the mechanisms of social and cultural integration of the Bolivian people in schools of Hilario Ascasubi, a town in the South West of the Province of Buenos Aires, as part of their strategies for insertion into the host space, trying to understand, from the case study, the role that education plays in the social dynamics of the group.This work used data from interviews and surveys carried out with different actors in school settings: principals, teachers, students and parents. Results were achieved from the application of quantitative and qualitative techniques.The results of this work gave rise to a series of research topics about the role of education with regard to the transmission of values for the construction of more equitable and less vulnerable societies for immigrants.En un intento por comprender el variable proceso migratorio en el marco de la globalización, recurrimos a uno de sus componentes como disparador: el sistema educativo de las poblaciones migrantes ante situaciones de exclusión, vulnerabilidad social o de inclusión. Estas categorías son útiles tanto para la interpretación del fenómeno, como para emprender estrategias que conduzcan a resolver diferentes situaciones conflictivas. La incorporación de alumnos inmigrantes está trascendiendo significativamente en los sistemas educativos de los países, y reside en la responsabilidad de las instituciones lograr la integración socioeducativa y alcanzar una coexistencia intercultural. El presente trabajo apunta a analizar los mecanismos de integración social y cultural de la población boliviana en ámbitos escolares de Hilario Ascasubi, localidad situada en el S.O. de la Provincia de  Buenos Aires, como parte de sus estrategias de inserción al espacio receptor, tratando de entender, a partir del caso de estudio, el rol que cumple la educación en la dinámica social del grupo. Para ello, se ha recurrido a datos extraídos de entrevistas y encuestas realizadas a diferentes    actores del medio escolar: directivos, docentes, alumnos y padres, obteniendo resultados a partir de la aplicación de técnicas cuanti- cualitativas. Esto da apertura a una sucesión de temas de investigación sobre el protagonismo de la educación, en lo que hace a la transmisión de valores para la construcción de sociedades más equitativas y menos vulnerables para los inmigrantes

Severe Acute Respiratory Distress Syndrome

Acute respiratory distress syndrome is characterized by an increase of the permeability of the lungs’ alveolar-capillary membranes, leading to the extravasation of liquid rich in proteins inside the alveolar spaces that turns air-filled lungs into heavy high-osmotic pressure liquid-filled lungs. The consequence is the collapse of the lowermost lung regions, shunt, refractory hypoxemia, decrease in lungs’ compliance and increase in dead spaces that are more pronounced with the severity of the permeability changes of the pulmonary alveoli-capillary membrane. According to the recent Berlin definition, severe acute respiratory distress syndrome is defined by bilateral pulmonary infiltrates of recent onset (less than 1 week) in a patient with a risk factor for ARDS that has a PaO2/FIO2 equal or less than 100 with a positive end-expiratory pressure equal or more than 5 cm H2O with no evidence of cardiac failure or hypervolemia. Severe ARDS patients present a higher mortality ratio, a more difficult mechanical ventilatory support (higher airway pressures with low tidal ventilation and higher PaCO2 levels) and benefits for adjunctive ventilatory support therapy. The recommended mechanical ventilatory support in severe ARDS is with low tidal ventilation (less than 6 mL/Kg predicted body weight) with driving inspiratory pressures less than 15 cm H2O, respiratory rate sufficient to keep adequate minute ventilation and PaCO2 levels. PEEP higher than 15 cm H2O and prolonged prone position are recommended for more severe patients to improve their survival. Adjunctive recruitment maneuvers can be used to improve oxygenation and allow more homogeneous ventilation and PEEP titration. In refractory hypoxemia and especially in younger patients with prognosis, extra-corporeal veno-venous membrane oxygenation support can be used

Diffuse calcifications protect carotid plaques regardless of the amount of neoangiogenesis and related histological complications

Background. Neoangiogenesis is crucial in plaque progression and instability. Previous data from our group showed that Nestin-positive intraplaque neovessels correlated with histological complications. The aim of the present work is to evaluate the relationship between neoangiogenesis, plaque morphology, and clinical instability of the plaque. Materials and Methods. Seventy-three patients (53 males and 20 females, mean age 71 years) were consecutively enrolled. Clinical data and 14 histological variables, including intraplaque hemorrhage and calcifications, were collected. Immunohistochemistry for CD34 and Nestin was performed. RT-PCR was performed to evaluate Nestin mRNA (including 5 healthy arteries as controls). Results. Diffusely calcified plaques (13/73) were found predominantly in females (P=0.017), with a significantly lower incidence of symptoms (TIA/stroke (P=0.019) than noncalcified plaques but with the same incidence of histological complications (P=0.156)). Accordingly, calcified and noncalcified plaques showed similar mean densities of positivity for CD34 and Nestin. Nestin density, but not CD34, correlated with the occurrence of intraplaque hemorrhage. Conclusions. Plaques with massive calcifications show the same incidence of histological complications but without influencing symptomatology, especially in female patients, and regardless of the amount of neoangiogenesis. These results can be applied in a future presurgical identification of patients at major risk of developing symptoms

The study of calcified atherosclerotic arteries: an alternative to evaluate the composition of a problematic tissue reveals new insight including metakaryotic cells

Background Calcifications of atherosclerotic plaques represent a controversial issue as they either lead to the stabilization or rupture of the lesion. However, the cellular key players involved in the progression of the calcified plaques have not yet been described. The primary reason for this lacuna is that decalcification procedures impair protein and nucleic acids contained in the calcified tissue. The aim of our study was to preserve the cellular content of heavily calcified plaques with a new rapid fixation in order to simplify the study of calcifications. Methods Here we applied a fixation method for fresh calcified tissue using the Carnoy’s solution followed by an enzymatic tissue digestion with type II collagenase. Immunohistochemistry was performed to verify the preservation of nuclear and cytoplasmic antigens. DNA content and RNA preservation was evaluated respectively with Feulgen staining and RT-PCR. A checklist of steps for successful image analysis was provided. To present the basic features of the F-DNA analysis we used descriptive statistics, skewness and kurtosis. Differences in DNA content were analysed with Kruskal-Wallis and Dunn’s post tests. The value of P < 0.05 was considered significant. Results Twenty-four vascular adult tissues, sorted as calcified (14) or uncalcified (10), were processed and 17 fetal tissues were used as controls (9 soft and 8 hard). Cells composing the calcified carotid plaques were positive to Desmin, Vimentin, Osteocalcin or Ki-67; the cellular population included smooth muscle cells, osteoblasts and osteoclasts-like cells and metakaryotic cells. The DNA content of each cell type found in the calcified carotid artery was successfully quantified in 7 selected samples. Notably the protocol revealed that DNA content in osteoblasts in fetal control tissues exhibits about half (3.0 ng) of the normal nuclear DNA content (6.0 ng). Conclusion Together with standard histology, this technique could give additional information on the cellular content of calcified plaques and help clarify the calcification process during atherosclerosis.United Therapeutics Corporatio

Continuing education: Biomedical Databases (I)

En las últimas décadas los adelantos en las Tecnologías de la Información y Comunicación permitieron que las Bases de Datos Biomédicas (BDB) se conviertan en la herramienta más importante para la búsqueda y recuperación de información. La formación permanente y continua de los profesionales de la salud requiere para mantenerse actualizado de un conocimiento teórico- práctico de las diferentes BDB. Una BD es una colección de información en uno o más archivos que permiten una búsqueda y posterior recuperación de la misma mediante el empleo de una computadora. Existen diversos tipos de BD, en el área biomédica las BD Documentales Bibliográficas o a Texto Completo, son las más ampliamente usadas. En esta quinta entrega de Educación Continua se analizarán las características generales, clasificación y estructura de las principales BD.In the past few decades advances in information and communication technology allowed biomedical databases to become the most important tool for information retrieval. Continuing education and training for medical and health professionals are required to stay updated on new technologies and scientific advancements. A database is a collection of data that is organized so that its contents can easily be accessed and managed to provide efficient information retrieval through the use of computers. There are many different types of databases, in the biomedical field the bibliographic and full text documentary databases are the most widely used. In this fifth part of Continuing Education we analyzed the general characteristics, classification and structure of the major databases.Facultad de Ciencias Médica

Continuing education: Biomedical Databases (II): MEDLINE/PubMed.

MEDLINE/PubMed es una de las bases de datos de bibliografía biomédica más grandes e importantes y el principal componente de PubMed que cubre las áreas de: Medicina, Enfermería, Odontología, Veterinaria, Sistemas de Salud y Ciencias Preclínicas. La interfaz de PubMed permite realizar búsquedas no solamente en MEDLINE sino también en otras 35 bases de datos del NCBI (Centro Nacional para la Información Biotecnológica). MEDLINE fue desarrollado por la Biblioteca Nacional de Medicina de los Estados Unidos (NLM) que forma parte del Instituto Nacional de Salud (NIH). En esta sexta entrega de Educación Continua se describen la estructura, el funcionamiento y las características de los principales componentes de MEDLINE/PubMed que permitirán al usuario realizar una búsqueda bibliográfica más eficiente.MEDLINE / PubMed is one of the largest and most important databases of biomedical literature and the main component of PubMed, covering the areas of medicine, nursing, dentistry, veterinary, health systems and preclinical sciences. The PubMed interface allows searching not only in MEDLINE but also in another 35 databases of NCBI (National Center for Biotechnology Information). MEDLINE was developed by the National Library of Medicine of the United States (NLM) which is part of the National Institute of Health (NIH). In this sixth part of Continuing Education we describe the structure, operation and features of the main components of MEDLINE/PubMed that will allow the user to perform a more efficient bibliographic search.Facultad de Ciencias Médica

Continuing education: Biomedical Databases (II): MEDLINE/PubMed

MEDLINE/PubMed es una de las bases de datos de bibliografía biomédica más grandes e importantes y el principal componente de PubMed que cubre las áreas de: Medicina, Enfermería, Odontología, Veterinaria, Sistemas de Salud y Ciencias Preclínicas. La interfaz de PubMed permite realizar búsquedas no solamente en MEDLINE sino también en otras 35 bases de datos del NCBI (Centro Nacional para la Información Biotecnológica). MEDLINE fue desarrollado por la Biblioteca Nacional de Medicina de los Estados Unidos (NLM) que forma parte del Instituto Nacional de Salud (NIH). En esta sexta entrega de Educación Continua se describen la estructura, el funcionamiento y las características de los principales componentes de MEDLINE/PubMed que permitirán al usuario realizar una búsqueda bibliográfica más eficiente.MEDLINE/PubMed is one of the largest and most important databases of biomedical literature and the main component of PubMed, covering the areas of medicine, nursing, dentistry, veterinary, health systems and preclinical sciences. The PubMed interface allows searching not only in MEDLINE but also in another 35 databases of NCBI (National Center for Biotechnology Information). MEDLINE was developed by the National Library of Medicine of the United States (NLM) which is part of the National Institute of Health (NIH). In this sixth part of Continuing Education we describe the structure, operation and features of the main components of MEDLINE/PubMed that will allow the user to perform a more efficient bibliographic search.Facultad de Ciencias Médica

Continuing education: Biomedical Databases (II): MEDLINE/PubMed.

MEDLINE/PubMed es una de las bases de datos de bibliografía biomédica más grandes e importantes y el principal componente de PubMed que cubre las áreas de: Medicina, Enfermería, Odontología, Veterinaria, Sistemas de Salud y Ciencias Preclínicas. La interfaz de PubMed permite realizar búsquedas no solamente en MEDLINE sino también en otras 35 bases de datos del NCBI (Centro Nacional para la Información Biotecnológica). MEDLINE fue desarrollado por la Biblioteca Nacional de Medicina de los Estados Unidos (NLM) que forma parte del Instituto Nacional de Salud (NIH). En esta sexta entrega de Educación Continua se describen la estructura, el funcionamiento y las características de los principales componentes de MEDLINE/PubMed que permitirán al usuario realizar una búsqueda bibliográfica más eficiente.MEDLINE / PubMed is one of the largest and most important databases of biomedical literature and the main component of PubMed, covering the areas of medicine, nursing, dentistry, veterinary, health systems and preclinical sciences. The PubMed interface allows searching not only in MEDLINE but also in another 35 databases of NCBI (National Center for Biotechnology Information). MEDLINE was developed by the National Library of Medicine of the United States (NLM) which is part of the National Institute of Health (NIH). In this sixth part of Continuing Education we describe the structure, operation and features of the main components of MEDLINE/PubMed that will allow the user to perform a more efficient bibliographic search.Facultad de Ciencias Médica

Continuing education: Biomedical Databases (II): MEDLINE/PubMed.

MEDLINE/PubMed es una de las bases de datos de bibliografía biomédica más grandes e importantes y el principal componente de PubMed que cubre las áreas de: Medicina, Enfermería, Odontología, Veterinaria, Sistemas de Salud y Ciencias Preclínicas. La interfaz de PubMed permite realizar búsquedas no solamente en MEDLINE sino también en otras 35 bases de datos del NCBI (Centro Nacional para la Información Biotecnológica). MEDLINE fue desarrollado por la Biblioteca Nacional de Medicina de los Estados Unidos (NLM) que forma parte del Instituto Nacional de Salud (NIH). En esta sexta entrega de Educación Continua se describen la estructura, el funcionamiento y las características de los principales componentes de MEDLINE/PubMed que permitirán al usuario realizar una búsqueda bibliográfica más eficiente.MEDLINE / PubMed is one of the largest and most important databases of biomedical literature and the main component of PubMed, covering the areas of medicine, nursing, dentistry, veterinary, health systems and preclinical sciences. The PubMed interface allows searching not only in MEDLINE but also in another 35 databases of NCBI (National Center for Biotechnology Information). MEDLINE was developed by the National Library of Medicine of the United States (NLM) which is part of the National Institute of Health (NIH). In this sixth part of Continuing Education we describe the structure, operation and features of the main components of MEDLINE/PubMed that will allow the user to perform a more efficient bibliographic search.Facultad de Ciencias Médica