Efecto del extracto etanólico de semilla de Salvia hispánica l. sobre la hipertensión: modulación de la expresión de genes en un modelo murino.

La hipertensión arterial (HTA) es una de las patologías de mayor prevalencia (30-35 %) a nivel mundial. Este es uno de los principales factores de riesgo para enfermedades cardiovasculares y está directamente relacionada con patologías como la obesidad y dislipidemias, entre otras. Su regulación está dada principalmente por la enzima convertidora de angiotensina (ECA). Los inhibidores de la enzima convertidora de angiotensina (usados como tratamiento de primera línea) producen reacciones adversas en el paciente, por lo que se ha incrementado el interés en la búsqueda de alternativas en el tratamiento de la HTA a partir de fuentes naturales. Diversas especies pertenecientes a la familia de las salvias han mostrado un efecto hipotensor asociado a la presencia de compuestos antioxidantes. En este estudio se analizó el efecto de un extracto etanólico de semilla de chía, en un modelo de ratas con hipertensión, sobre la expresión de los genes implicados en los mecanismos de regulación de la HTA: Ace, Agtr1a, Nos3 y Bdkrb2. Para el desarrollo de este trabajo se obtuvo un extracto etanólico de semilla de chía (EESH), se cuantificaron los polifenoles y flavonoides totales, y se determinó el IC50 sobre la enzima ECA I. Por otro lado, se generó un modelo de ratas con hipertensión inducida por la administración de L-NAME (inhibidor de la síntesis de óxido nítrico). A las ratas hipertensas se asignaron 3 tratamientos; un grupo recibió captopril, otro recibió EESH, y uno más permaneció con la administración de L-NAME (grupo hipertenso). A otro grupo se le administró agua destilada como tratamiento durante todo el estudio (grupo sano). Se diseñaron oligonucleótidos específicos para los genes Ace, Agtr1a, Nos3, Bdkrb2 y Gapdh. El análisis de expresión de genes se realizó por RT-PCR en muestras de tejido cardiaco, utilizando oligonucleótidos específicos para cada gen. La cantidad de polifenoles y flavonoides en el EESH fue de 1.55 g/100g de semilla y 23 % de quercetina, respectivamente; y se determinó un IC50 de 9.37 mg/ml. La inducción de la HTA incrementó los valores de PA a 310 - 328 mmHg, mientras que el grupo sano mostró valores de 100 mmHg. Después de la administración de los diferentes tratamientos, las ratas que recibieron L-NAME presentaron un incremento del 31.2 % en los valores de PA, mientras que la administración de captopril y EESH produjo una disminución del 0.2 % en los valores de PA. La administración crónica de L-NAME produjo una disminución en la ganancia de peso de las ratas hipertensas, mientras que las ratas sanas continuaron incrementando su peso hasta un 7.8 % con respecto al inicio de los tratamientos. El análisis de expresión de los genes demostró que la administración de L-NAME produjo una disminución significativa en la expresión del gen Ace, mientras que los niveles de los genes Agtr1a y Nos3 se incrementaron de forma significativa, con respecto a los valores basales (ratas sanas). Las ratas hipertensas tratadas con captopril mostraron niveles de expresión de los genes Ace, Agtr1a estadísticamente iguales a los mostrados por los niveles basales. La administración del EESH a las ratas hipertensas produjo un efecto similar al captopril en los valores de expresión de los genes Agtr1a y Nos3, los cuales mostraron igualdad estadística a los niveles basales; sin embargo, la expresión del gen Ace solo presentó igualdad estadística con las ratas tratadas con captopril, pero no con los niveles basales. La expresión del gen Bdkrb2 no mostró cambios significativos en su expresión en los diferentes grupos de ratas tratados. El EESH produce un efecto inhibitorio sobre la ECA, y mostró un efecto similar en la PA de las ratas hipertensas. Similar al obtenido por la administración de captopril. Además, se observa un efecto regulatorio en la expresión de genes involucrados en la modulación de la PA. El EESH podría ser utilizado como, y para el desarrollo de, agentes coadyuvantes en el tratamiento de la hipertensión

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Histamine and Tyramine in Chihuahua Cheeses during Shelf Life: Association with the Presence of tdc and hdc Genes

Cheese is a product of animal origin with a high nutritional value, and it is one of the most consumed dairy foods in Mexico. In addition, Chihuahua cheese is the most consumed matured cheese in Mexico. In the production process of Chihuahua cheese, maturation is carried out by adding acid lactic microorganisms, mainly of the Lactococcus genus and, in some cases, also the Streptococcus and Lactobacillus genus. As part of the metabolism of fermenting microorganisms, biogenic amines can develop in matured foods, which result from the activity of amino decarboxylase enzymes. In cheeses, histamine and tyramine are the main amines that are formed, and the consumption of these represents a great risk to the health of consumers. In this work, the presence of biogenic amines (histamine and tyramine) was determined by HPLC at different times of the shelf life of Chihuahua cheeses. In addition, the presence of genes hdc and tdc that code for the enzymes responsible for the synthesis of these compounds (histidine and tyrosine decarboxylase, or HDC and TDC) was determined by molecular techniques. A significant correlation was observed between the presence of both histamine and tyramine at the end of shelf life with the presence of genes that code for the enzymes responsible for their synthesis

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study (vol 46, pg 2021, 2022)

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Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2