New molecular approaches in adipogenesis regulation: The connexin 43 role

Indexación: Scopus; Redalyc.La prevalencia de la obesidad a nivel mundial se ha incrementado rápidamente durante los últimos años debido principalmente a los cambios en el estilo de vida de la población con un aumento significativo en el consumo de energía y disminución de los niveles de actividad física. Es por esto que la comunidad científica está interesada en comprender de forma más profunda los mecanismos que regulan la fisiopatología de la obesidad. Dentro de los diferentes blancos de estudio se encuentra la adipogénesis, cuyo entendimiento es fundamental para comprender el desarrollo de la obesidad y las patologías asociadas a esta. Recientemente ha surgido importantes evidencias que involucran a la proteína de canales de “Gap Junction” conexina 43 (Cx43) en la regulación de los procesos relacionados con adipogénesis, cuyo papel es básicamente anti-adipogénico, sin embargo, nuevas funciones de Cx43 en la regulación de la formación del tejido adiposo siguen descubriéndose.The global prevalence of obesity has been increased rapidly over the past few years mainly due to changes in the lifestyle of the population with a significant increase in energy consumption and decreased levels of physical activity. As a result, the scientific community is interested in a deeper understanding of the mechanisms that regulate the pathophysiology of obesity. In this context, adipogenesis process is an important target of study to understand the obesity and associated pathologies. Recently has been emerged important evidence that involve gap junction channel protein connexin 43 (Cx43) in the regulation of processes related to adipogenesis, whose role is fundamentally anti-adipogenic. However, new functions of Cx43 in the regulation of adipose tissue function also continued to emerge.http://www.redalyc.org/articulo.oa?id=5594990800

Medical imaging: Foundations and scope

Indexación: Scopus; Radalyc.En la actualidad es innegable la utilidad de las diversas modalidades de imagenología médica como apoyo clínico tanto en la generación de diagnósticos de un buen número de enfermedades como en la planeación de tratamientos tendientes a proporcionar una alternativa de solución a las personas que, por una u otra razón, manifiestan algún desequilibrio en su salud. Entre las modalidades imagenológicas que, frecuentemente, se utilizan en el ámbito médico se pueden mencionar: Ultrasonido (US), Resonancia Magnética (MRI), Tomografía Computarizada sencilla (CT) y multicapa (MSCT), Tomografía Computarizada por Emisión de Positrones (PET) y Tomografía Computarizada por Emisión de Fotones simples (SPECT). En este sentido, este artículo tiene como finalidad presentar una descripción ordenada, coherente y sistemática de cada una de las mencionadas modalidades y establecer la vinculación de la MSCT con situaciones clínicas íntimamente relacionadas con la anatomía cardiaca y procesos de hipertensión. La razón por la cual se hace énfasis en la MSCT es debido a que, por una parte, se cuenta con un número importante de bases de datos tanto de sujetos fisiológicos como de sujetos patológicos y, por la otra, que se tiene previsto presentar un conjunto de técnicas computacionales que serán exploradas en el desarrollo de futuras investigaciones en el contexto de aspectos anatómico-cardiológicos que influyen directa o indirectamente en la aparición, desarrollo y prevalencia de procesos hipertensivos.Nowdays, several forms of medical imaging are usefulness in clinical support for both diagnostics diseases generation and treatment planning designed to provide an alternative solution to people who, for one or another reason, manifest an imbalance in your health. Among the imaging modalities that frequently are used in the medical field may include: Ultrasound (US), magnetic resonance imaging (MRI), simple computed tomography (CT) and multilayer computed tomography (MSCT), CT positron emission tomography (PET) Computed tomography and single photon emission (SPECT). In this sense, this article presents an orderly, coherent and systematic description of these modalities and it establishes relationship with the MSCT modality and clinical situations closely related to cardiac anatomy and hypertension processes. The reason emphasis on MSCT is done is because, on the one hand, we have a large number of databases both physiological subjects and pathological subjects and, on the other, we plan to present a set of computational techniques that will be explored in future research, in the context of cardiologic anatomical aspects, with directly or indirectly influence in the emergence, development and prevalence of hypertensive processes.http://www.redalyc.org/articulo.oa?id=5594990700

Comparison of fiber effect on glycemic index and glycemic load in differents types of bread

Indexación: Scopus; Redalyc.Existen diversos alimentos que contienen como nutriente principal hidratos de carbono, destacando entre ellos el pan por su masivo consumo a nivel mundial. Numerosos estudios se han llevado a cabo con el fin de reducir su índice glicémico, sin embargo, aún existe controversia sobre la acción de la fibra dietética en la disminución del IG en este alimento. Este estudio determinó el efecto de la fibra dietética sobre el índice glicémico y carga glicémica en dos tipos de panes comerciales en 23 individuos sanos quienes consumieron aleatoriamente 3 diferentes productos, de 50 g de carbohidratos cada uno, durante 6 días: pan blanco (PH), pan integral (PF), y solución glucosada como producto de referencia (SG). Se midió glicemia en ayunas y post-prandial a los tiempos 15, 30, 45, 60, 90 y 120 min. La insulina fue medida en el minuto 0 y 120 min. El área bajo la curva de glicemia resultó más baja para ambos tipos de pan PH 13589 ±1557, PF 12005 ±1254 que para el producto de referencia SG 14089 ±1245. Los valores del índice glicémico PH 68,55 ±1,2 y PF 62,10 ±1,3 y carga glicémica PH 16,45 ±1,4 resultaron más bajos para el pan con mayor aporte de fibra 9,93 ± 1,1, sin diferencias en la concentración de insulina, sugiriendo que la cantidad de carbohidratos y tipo de fibra contenidos en el pan integral, pueden considerarse factores intrínsecos en su composición nutricional, capaces de afectar la respuesta glicémica post- ingesta de estos productos en individuos sanos.There are several foods that contain carbohydrates as the main nutrient, being one of the most important the bread for its massive worldwide consumption. Numerous studies have been done in order to reduce its glycemic index, however there is still controversy about the action of dietary fiber in the decrease of GI in this product. In this study, it was determined the effect of dietetic fiber on glycemic index and glycemic load in two types of commercial breads in 23 healthy individuals who randomly consumed 3 different products during 6 days of 50g of carbohydrates each: white bread (PH), whole wheat bread (PE) and glucose solution as reference product (SG). Fasting and postprandial glycemia was measured at times 15, 30, 45, 60, 90 and 120 minutes. Insuline was measured at 0 min and 120 min. The area under de glycemia curve was lower for both bread types PH 13589 ±1557, PF 12005 ±1254 than for the reference product SG 14089 ±1245. The values of the glycemic index PH 68,55 ±1,2 and PF 62,01 ±1,3 and glycemic load PH 16.45 ±1,4 were lower for bread with more amount fiber 9,93 ± 1,1, with no difference in insulin concentration, suggesting that the amount of carbohydrates and fiber type contained in whole wheat bread can be considered intrinsic factors in bread composition, affecting the post-intake glycemic response of this type of products in healthy individuals.http://www.redalyc.org/articulo.oa?id=5594990800

Effect of oat β-glucan on glycemic index and glycemic load of a nutritional supplement sweetened with sucralose in healthy adults: A randomized clinical trial

Indexación: Scopus; RedalycLas propiedades hipoglicemiantes del β-glucano de avena son de interés para la industria alimentaria y el área clínica, por sus potenciales beneficios sobre la salud al disminuir la respuesta glicémica, el nivel sérico de lipoproteínas de baja densidad y el índice glicémico de los alimentos. Existen suplementos nutricionales específicos para diabéticos edulcorados con sucralosa cuyo índice glicémico y carga glicémica aún no han sido establecidos. El efecto del β-glucano de avena sobre el índice glicémico y carga glicémica de un suplemento nutricional edulcorado con sucralosa, fue determinado en 13 adultos sanos (6 hombres y 7 mujeres), quienes consumieron aleatoriamente 4 alimentos en días distintos, de 50 g de carbohidratos cada uno: suplemento nutricional para diabéticos (FN), suplemento nutricional con β-glucano (FN- β), y como productos de referencia: solución glucosada (SG) y pan blanco (PB). Se midió glicemia en ayunas y post- prandial a los tiempos 15, 30, 45, 60, 90 y 120 min. El área bajo la curva de glicemia resultó más baja para ambas fórmulas (FN) 12697±993, (FN-β) 11584 ±1171, que para los productos de referencia:(SG) 13900±1245, y (PB) 13267 ± 1557. Los valores de índice glicémico (FN) 67,02 ± 5,69, así como la carga glicémica resultaron intermedios y más bajos para el suplemento con β-glucano incorporado (FN –β) 59,8 ± 6,2; sin diferencias en la concentración de insulina, sugiriendo que la adición del β-glucano derivado de la avena reduce la velocidad de absorción intestinal de la glucosa, efecto que podría estudiarse en diabéticos.The hypoglycemic properties of oat β-glucan is of interest for the food industry and clinical area, for potencial health benefits by reducing glycemic response, serum low-density lipoprotein cholesterol, and glycemic index of meals. There are specific nutritional supplements for diabetics sweetened with sucralose whose glycemic index and glycemic load has not been established. Effect of oat β-glucan on glycemic index and glycemic load of a nutritional supplement sweetened with sucralose in healthy adults was determined in 13 healthy subjects (6 men and 7 women) old that consumed randomly 4 meals of 50 g of carbohydrates each in different days: a nutritional supplement for diabetics (FN), the nutritional supplement with β-glucan incorporated (FN-β) and two reference food, glucose solution (SG) and white bread (PB). Fasting and postprandial glycemia was measured at times 15, 30, 45, 60, 90 and 120 min. The area under the glycemia curve was lower for both formulas (FN) 12697±993, (FN-β) 11584 ±1171 than for reference products (SG) 13900±1245, y (PB) 13267 ± 1557. The values of glycemic index (GI) (FN) 67, 02 ± 5,69 and glycemic load were intermediate and more lower for the supplement with β-glucan incorporated (FN –β) 59, 8 ± 6,2, with no difference of insulin concentration . Suggesting that the addition of oat-derived β-glucan reduces the rate of intestinal absorption of glucose. This effect should be studied in diabetic.http://www.redalyc.org/articulo.oa?id=5594990800

Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) with Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial

Importance: An intraoperative higher level of positive end-expiratory positive pressure (PEEP) with alveolar recruitment maneuvers improves respiratory function in obese patients undergoing surgery, but the effect on clinical outcomes is uncertain. Objective: To determine whether a higher level of PEEP with alveolar recruitment maneuvers decreases postoperative pulmonary complications in obese patients undergoing surgery compared with a lower level of PEEP. Design, Setting, and Participants: Randomized clinical trial of 2013 adults with body mass indices of 35 or greater and substantial risk for postoperative pulmonary complications who were undergoing noncardiac, nonneurological surgery under general anesthesia. The trial was conducted at 77 sites in 23 countries from July 2014-February 2018; final follow-up: May 2018. Interventions: Patients were randomized to the high level of PEEP group (n = 989), consisting of a PEEP level of 12 cm H2O with alveolar recruitment maneuvers (a stepwise increase of tidal volume and eventually PEEP) or to the low level of PEEP group (n = 987), consisting of a PEEP level of 4 cm H2O. All patients received volume-controlled ventilation with a tidal volume of 7 mL/kg of predicted body weight. Main Outcomes and Measures: The primary outcome was a composite of pulmonary complications within the first 5 postoperative days, including respiratory failure, acute respiratory distress syndrome, bronchospasm, new pulmonary infiltrates, pulmonary infection, aspiration pneumonitis, pleural effusion, atelectasis, cardiopulmonary edema, and pneumothorax. Among the 9 prespecified secondary outcomes, 3 were intraoperative complications, including hypoxemia (oxygen desaturation with Spo2 ≤92% for >1 minute). Results: Among 2013 adults who were randomized, 1976 (98.2%) completed the trial (mean age, 48.8 years; 1381 [69.9%] women; 1778 [90.1%] underwent abdominal operations). In the intention-to-treat analysis, the primary outcome occurred in 211 of 989 patients (21.3%) in the high level of PEEP group compared with 233 of 987 patients (23.6%) in the low level of PEEP group (difference, -2.3% [95% CI, -5.9% to 1.4%]; risk ratio, 0.93 [95% CI, 0.83 to 1.04]; P =.23). Among the 9 prespecified secondary outcomes, 6 were not significantly different between the high and low level of PEEP groups, and 3 were significantly different, including fewer patients with hypoxemia (5.0% in the high level of PEEP group vs 13.6% in the low level of PEEP group; difference, -8.6% [95% CI, -11.1% to 6.1%]; P <.001). Conclusions and Relevance: Among obese patients undergoing surgery under general anesthesia, an intraoperative mechanical ventilation strategy with a higher level of PEEP and alveolar recruitment maneuvers, compared with a strategy with a lower level of PEEP, did not reduce postoperative pulmonary complications. Trial Registration: ClinicalTrials.gov Identifier: NCT02148692

Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial.

IMPORTANCE An intraoperative higher level of positive end-expiratory positive pressure (PEEP) with alveolar recruitment maneuvers improves respiratory function in obese patients undergoing surgery, but the effect on clinical outcomes is uncertain

Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial (vol 321, pg 2292, 2019)

status: publishe

Effect of intraoperative high Positive End-Expiratory Pressure (PEEP) with recruitment maneuvers vs low PEEP on postoperative pulmonary complications in obese patients : a randomized clinical trial

IMPORTANCE An intraoperative higher level of positive end-expiratory positive pressure (PEEP) with alveolar recruitment maneuvers improves respiratory function in obese patients undergoing surgery, but the effect on clinical outcomes is uncertain. OBJECTIVE To determine whether a higher level of PEEP with alveolar recruitment maneuvers decreases postoperative pulmonary complications in obese patients undergoing surgery compared with a lower level of PEEP. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 2013 adults with body mass indices of 35 or greater and substantial risk for postoperative pulmonary complications who were undergoing noncardiac, nonneurological surgery under general anesthesia. The trial was conducted at 77 sites in 23 countries from July 2014-February 2018; final follow-up: May 2018. INTERVENTIONS Patients were randomized to the high level of PEEP group (n = 989), consisting of a PEEP level of 12 cm H2O with alveolar recruitment maneuvers (a stepwise increase of tidal volume and eventually PEEP) or to the low level of PEEP group (n = 987), consisting of a PEEP level of 4 cm H2O. All patients received volume-controlled ventilation with a tidal volume of 7 mL/kg of predicted body weight. MAIN OUTCOMES AND MEASURES The primary outcomewas a composite of pulmonary complications within the first 5 postoperative days, including respiratory failure, acute respiratory distress syndrome, bronchospasm, new pulmonary infiltrates, pulmonary infection, aspiration pneumonitis, pleural effusion, atelectasis, cardiopulmonary edema, and pneumothorax. Among the 9 prespecified secondary outcomes, 3 were intraoperative complications, including hypoxemia (oxygen desaturation with SpO(2) 1 minute). RESULTS Among 2013 adults who were randomized, 1976 (98.2%) completed the trial (mean age, 48.8 years; 1381 [69.9%] women; 1778 [90.1%] underwent abdominal operations). In the intention-to-treat analysis, the primary outcome occurred in 211 of 989 patients (21.3%) in the high level of PEEP group compared with 233 of 987 patients (23.6%) in the low level of PEEP group (difference, -2.3%[95% CI, -5.9% to 1.4%]; risk ratio, 0.93 [95% CI, 0.83 to 1.04]; P =.23). Among the 9 prespecified secondary outcomes, 6 were not significantly different between the high and low level of PEEP groups, and 3 were significantly different, including fewer patients with hypoxemia (5.0% in the high level of PEEP group vs 13.6% in the low level of PEEP group; difference, -8.6%[95% CI, -11.1% to 6.1%]; P <.001). CONCLUSIONS AND RELEVANCE Among obese patients undergoing surgery under general anesthesia, an intraoperative mechanical ventilation strategy with a higher level of PEEP and alveolar recruitment maneuvers, compared with a strategy with a lower level of PEEP, did not reduce postoperative pulmonary complications