Pharmacological properties of polyphenols : Bioavailability, mechanisms of action and biological effects in in vitro studies, animal models and humans

Funding Information: Funding: This work was supported by the following grants from the Instituto de Salud Carlos III CB16/10/00435 (CIBERFES), (PID2019‐110906RB‐I00/AEI/10.13039/501100011033) from the Spanish Ministry of Innovation and Science, PROMETEO/2019/097 de “Consellería, de Sanitat de la Gener‐ alitat Valenciana”, and the EU Funded H2020‐DIABFRAIL‐LATAM (Ref: 825546), European Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL), and of the ERA‐NET Co‐ fund ERA‐HDHL (GA No. 696295 of the EU Horizon 2020 Research and Innovation Program). Part of the equipment employed in this work has been funded by Generalitat Valenciana and co‐financed with ERDF funds (OP ERDF of Comunitat Valenciana 2014–2020). Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Drugs are bioactive compounds originally discovered from chemical structures present in both the plant and animal kingdoms. These have the ability to interact with molecules found in our body, blocking them, activating them, or increasing or decreasing their levels. Their actions have allowed us to cure diseases and improve our state of health, which has led us to increase the longevity of our species. Among the molecules with pharmacological activity produced by plants are the polyphenols. These, due to their molecular structure, as drugs, also have the ability to interact with molecules in our body, presenting various pharmacological properties. In addition, these compounds are found in multiple foods in our diet. In this review, we focused on discussing the bioavailability of these compounds when we ingested them through diet and the specific mechanisms of action of polyphenols, focusing on studies carried out in vitro, in animals and in humans over the last five years. Knowing which foods have these pharmacological activities could allow us to prevent and aid as concomitant treatment against various pathologies.Peer reviewe

Improvement of Telephone Communication in Elderly Cochlear Implant Patients

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Spotlight on MicroPulse laser trabeculoplasty in open-angle glaucoma: What's on? A eeview of the literature

Glaucoma is the most common cause of permanent blindness in the world, caused by a progressive optic neuropathy. Patients with glaucoma are often treated with topical medicines therapy in order to reduce intra-ocular pressure (IOP). On the other hand, laser therapies, with the introduction of Argon Laser Trabeculoplasty (ALT) and successively with Selective Laser Trabeculoplasty (SLT), were reported to be effective in IOP control, with low adverse effect rates. In recent years, the micropulse laser, a subthreshold laser technology, was introduced with the goal of reducing side effects while maintaining the effectiveness of the laser treatments. Several studies focused on Micropulse Diode Laser Trabeculoplasty (MDLT) in open-angle glaucoma, to evaluate its effectiveness and possible side effects. Promising results were reported, but irradiation circumstances have not been standardized yet and its role as a substitute for previous laser techniques has yet to be defined. As a result, the goal of this review was to analyze the physical principles at the basis of MDLT and to frame it in the open-angle glaucoma management setting, highlighting the advantages and shortfalls of this technique

Macular Impairment in Fabry Disease: A Morpho-functional Assessment by Swept-Source OCT Angiography and Focal Electroretinography.

Purpose Fabry disease (FD) is a multiorgan X-linked condition characterized by a deficiency of the lysosomal enzyme alpha-galactosidase A, resulting in a progressive intralysosomal deposit of globotriaosylceramide. The aim of this study was to evaluate the macular ultrastructure of the vascular network using optical coherence tomography angiography (OCTA) and to evaluate macular function using focal electroretinography (fERG) in Fabry patients (FPs). Methods A total of 20 FPs (38 eyes, mean age 57 ± 2.12 SD, range of 27-80 years) and 17 healthy controls (27 eyes, mean age 45 years ± 20.50 SD, range of 24-65 years) were enrolled in the study. Color fundus photography, swept-source optical coherence tomography (SS-OCT), OCTA and fERG were performed in all subjects. The OCTA foveal avascular zone (FAZ), vasculature structure, superficial and deep retinal plexus densities (images of 4.5 × 4.5 mm) and fERG amplitudes were measured. Group differences were statistically assessed by Student's t-test and ANOVA. Results In the FP group, the FAZ areas of the superficial and deep plexuses were enlarged (P = 0.036, t = 2.138; P < 0.001, t = -3.889, respectively), the vessel density was increased in the superficial plexus, and the fERG amplitude was reduced (P < 0.001, t = -10.647) compared with those in healthy controls. No significant correlations were found between the structural and functional data. Conclusions OCTA vascular abnormalities and reduced fERG amplitudes indicate subclinical signs of microangiopathy with early retinal dysfunction in FPs. This study highlights the relevance of OCTA imaging analysis in the identification of abnormal macular vasculature as an ocular hallmark of FD

PreserFlo® MicroShunt: an overview of this minimally invasive device for open-angle glaucoma

For moderate-to-severe glaucoma, trabeculectomy remains the “gold standard” intraocular pressure (IOP)-lowering treatment; nonetheless, this method requires extensive post-operative maintenance. Microinvasive glaucoma surgery (MIGS) treatments are designed to lessen intra- and post-operative care burden while offering an acceptable IOP decrease for individuals with mild to moderate glaucoma. The PreserFlo® MicroShunt (previously InnFocus MicroShunt) is an 8.5 mm glaucoma drainage device manufactured from poly(styrene-block-isobutylene-block-styrene) (SIBS), an extremely biocompatible and bioinert material. The lumen is narrow enough to prevent hypotony, but big enough to avoid being obstructed by sloughed cells or pigment. The device is implanted ab externo, as a stand-alone procedure or in conjunction with cataract surgery, with intraoperative mitomycin C, and a bleb is produced under the conjunctiva and Tenon’s capsule. The MicroShunt was CE-marked in 2012 and designed for primary open-angle glaucoma, the IOP of which remains uncontrolled after maximally tolerated topical treatment. Several clinical trials evaluating the MicroShunt’s long-term safety and effectiveness have been conducted, highlighting the effectiveness of the device over time, along with a tolerable safety profile. The present review aims to gather evidence of PreserFlo’s effectiveness and safety results almost 10 years after its introduction, and furthermore, to compare it with other MIGS and with the gold-standard trabeculectomy for glaucoma management

Overview on defocus incorporated multiple segments lenses: a novel perspective in myopia progression management

Myopia is becoming more common across the world, affecting approximately two billion people and rising. Different kinds of therapies (optical, pharmaceutical, environmental, or behavioral) have been proposed to decrease myopia progression, but with variable results and a lack of standardization. The evidence that targeted myopic defocus inhibits eye length growth has paved the way for several contact and spectacle lense designs to induce a peripheral defocus, thus slowing myopia progression, but the perfect configuration has yet to be defined. One of the newest and more promising approaches in this field is the use of Defocus Incorporated Multiple Segments (DIMS) lenses. These lenses are built from the assumption that targeted myopic defocus, produced by 396 mid-peripheral lenslets with positive power, inhibits eye length growth. Recent studies have highlighted the effectiveness of these lenses compared to children who had worn single vision spectacle lenses, in terms of myopia control and tolerability. Despite the evidence that these lenses can help slow down the progression of myopia, the occasional mid-peripheral aberrations they can induce, as well as the overall eye strain that comes with wearing them, should not be overlooked. The aim of this review is to give attention to the advantages and the shortfalls of this new approach and to evaluate its effectiveness in clinical practice

Anterior Segment-Optical Coherence Tomography Bleb Morphology Comparison in Minimally Invasive Glaucoma Surgery: XEN Gel Stent vs. PreserFlo MicroShunt

Background: The purpose of this study is to compare the morphology of six-month follow-up blebs created by a subconjunctival glaucoma surgical device (XEN45) to those created by a PreserFlo MicroShunt with a sub-Tenon insertion, utilizing AS-OCT. Methods: A retrospective study of 29 eyes who underwent XEN45 implantation and 29 eyes who underwent PreserFlo MicroShunt implantation. The patients were analyzed at 24 h, 1 week, 1 month, 3 months and 6 months. At each visit, the maturation and morphological alterations of the blebs were observed, as well as connections with the IOP. Results: In both groups, IOP showed significant reduction at all follow ups (p &lt; 0.0001). In XEN group, the most common bleb morphology in the immediate postoperative was the subconjuntival separation type (42%) followed by the uniform type (34%), with a trend inversion at 6 month follow up (51% of uniform type). On the contrary, the most common morphology after PreserFlo was the multiple internal layer (55%), which showed a tendency to reduce over time and was substituted by the microcystic multiform, whose percentage increased over time (17% at day 1 vs. 44% at month 6). Uniform appearance was associated by the posterior episcleral fluid (PEF) lake presence. Both horizontal and vertical diameters significantly increased over time. Conclusion: XEN and PreserFlo implantation resulted in the production of diffuse blebs with different characteristics, which may influence IOP lowering capacity and bleb revisions necessity over time

Uso del debate como herramienta metodológica docente en estudios del Grado en Medicina: DEBATMITAL

[EN] The main purpose of the DEBATMITAL project is to increase the participation of students in the practical session on "Myths of Food" that is part of the optional subject “Nutrition and Dietetics" of the degree in Medicine of the University of Valencia. In front of the master class, which was basically the tool used in previous courses, students are organized into discussion groups to debate some food-related statements commonly heard. The assessment that students make of this initiative is very positive. They indicate that they have learned, they have had fun while participating in the debates, and that they prefer this tool to the master class. Therefore, the debate is a teaching tool that can not only be used in Social Sciences area, but can also be very useful for certain topics in Health Sciences, as in the case of the degree in Medicine.[ES] El proyecto DEBATMITAL tiene como objetivo principal aumentar la participación de los alumnos en la sesión práctica sobre “Mitos de la Alimentación” que forma parte de la asignatura optativa “Alimentación y Dietética” del grado en Medicina de la Universidad de Valencia. Frente a la clase magistral, que era básicamente la herramienta utilizada en cursos anteriores, se organiza la clase en grupos de debate para tratar diversas afirmaciones relacionadas con la alimentación que se pueden escuchar comúnmente. La valoración que los estudiantes hacen de esta iniciativa es muy positiva. Indican que han aprendido, que se han divertido mientras participaban en los debates, y que prefieren esta herramienta a la clase magistral. Por tanto, el debate es una herramienta docente que no solo se puede utilizar en el área de las Ciencias Sociales, sino que también puede ser muy útil para determinados temas en grados del área de Ciencias de la Salud, como es el caso del grado en Medicina.Olaso-González, G.; Romá-Mateo, C.; Serna García, E.; Gambini, J.; Correas, ÁG.; Gimeno, L.; Escrivá, C.... (2019). Uso del debate como herramienta metodológica docente en estudios del Grado en Medicina: DEBATMITAL. En IN-RED 2019. V Congreso de Innovación Educativa y Docencia en Red. Editorial Universitat Politècnica de València. 1022-1033. https://doi.org/10.4995/INRED2019.2019.10471OCS1022103

Uso de la infografía en la optativa “Alimentación y Dietética” del Grado de Medicina

[ES] Como sustitución de la clase magistral, en la sesión dedicada a tratar las características de “dietas occidentales de moda” de la asignatura optativa 34493-Alimentación y Dietética del Grado en Medicina de la Universitat de Valencia, se utilizaron infografías previamente diseñadas por los estudiantes. Con esta iniciativa se pretendía mejorar la participación del alumnado en la asignatura, además de profundizar en la materia, mejorar sus habilidades digitales y de búsqueda y síntesis de información. Esta propuesta fue bien valorada por el estudiantado, que mostró su preferencia por esta forma de trabajar frente a la clase magistral. Además, opinó que la actividad mejoraba su capacidad de transmitir información, de trabajar en equipo, su capacidad crítica y autocrítica y que resultaba muy entretenida. A partir de esta experiencia se podría concluir que la infografía es una herramienta útil para el abordaje de varios temas dentro del grado de Medicina.[EN] As a substitute for the master class, infographics previously designed by the students were used in the session dedicated to treating the characteristics of "fashionable western diets" of the optional subject 34493-Food and Dietetics of the Bachelor Degree in Medicine at the Universitat de Valencia. This initiative was intended to improve student participation in the subject, in addition to deepening the subject, improving their digital skills and the search and synthesis of information. This proposal was well appreciated by the students, who showed their preference for this way of working compared to the master class. In addition, they said that the activity improved their ability to transmit information, to work as a team, their critical and self-critical capacity and that it was very entertaining. From this experience, it could be concluded that infographics are a useful tool for addressing various topics within the Medicine degree.Olaso González, G.; Borras, C.; Piqueras, M.; Romá Mateo, C.; Gambini, J.; Gomez-Cabrera, MC.; G. Correas, Á.... (2020). Uso de la infografía en la optativa “Alimentación y Dietética” del Grado de Medicina. En IN-RED 2020: VI Congreso de Innovación Educativa y Docencia en Red. Editorial Universitat Politècnica de València. 193-207. https://doi.org/10.4995/INRED2020.2020.11954OCS19320

Retinal Pigment Epithelial and Outer Retinal Atrophy in Age-Related Macular Degeneration: Correlation with Macular Function

The purpose of this study was to investigate the relationship between the retinal pigment epithelium (RPE) and outer retina changes, expressed in terms of sub-RPE illumination (SRI) on optical-coherence tomography (OCT), and central retinal function, measured by visual acuity and focal electroretinogram (fERG), in patients with non-exudative age-related macular degeneration (neAMD). In this retrospective study, 29 eyes of 29 patients affected by early (24.14%), intermediate (41.38%), and advanced (34.48%) neAMD were evaluated. All enrolled eyes were studied with OCT to measure the total area of SRI, by using an automated standardized algorithm. Visual acuity and fERG were assessed. The area of SRI was negatively correlated with fERG amplitude (r &lt;= -0.4, p &lt;= 0.02) and best-corrected visual acuity (BCVA) (r &lt;= 0.4, p &lt;= 0.04). Our results indicate that the severity of retinal pigment epithelium and outer retina atrophy (RORA), indirectly quantified through the detection of SRI areas by commercial OCT algorithms, is correlated with central retinal dysfunction, as determined by visual acuity and fERG, supporting the combined use of structural exams and functional tests as valid tools to detect the extent of RPE and photoreceptors' disruption