Ideen un mètode per evitar la regurgitació recurrent

La ruminació, la tornada del menjar cap a la boca després de ser ingerida, pot ser un problema menor o dur a complicacions nutricionals severes. L'equip del professor del Departament de Medicina de la UAB i investigador de l'Institut de Recerca Hospital Universitari Vall d'Hebron Fernando Azpiroz ha desenvolupat un mètode per ensenyar a qui la pateix a modular l'activitat muscular fins a suprimir aquest comportament.La rumiación, la vuelta de la comida hacia la boca después de ser ingerida, puede ser un problema menor o llevar a complicaciones nutricionales severas. El equipo del profesor del Departamento de Medicina de la UAB e investigador del Instituto de Investigación Hospital Universitario Vall d'Hebron Fernando Azpiroz ha desarrollado un método para enseñar a quienes la padecen a modular la actividad muscular hasta suprimir este comportamiento.Rumination, the regurgitation of recently ingested food into the mouth, can be a minor problem or lead to severe nutritional complications. Professor Fernando Azpiroz, from the UAB Department of Medicine and Vall d'Hebron Research Institute, and his team, have developed a new method to show people suffering from rumination how to modulate their muscular activity in order to suppress it

Sodium-glucose cotransporter inhibitors : beyond glycaemic control

Diabetes increases the risk of adverse cardiovascular and renal events. Recently, sodium-glucose co-transporter 2 (SGLT2) inhibitors have been demonstrated to reduce cardiovascular complications and slow diabetic kidney disease progression in patients with type 2 diabetes. The glycaemic control exerted by these drugs is not greater than the one achieved with other classical glucose-lowering medications such as sulphonylureas. For that reason, plausible renoprotective mechanisms independent from glycaemic control have been proposed such as blood pressure control, body weight loss, intraglomerular pressure reduction and a decrease in urinary proximal tubular injury biomarkers. Interestingly, the hypothesis that SGLT2 inhibitors have a direct renoprotective effect has been addressed in diabetic and non-diabetic models. In this editorial, we update the different postulated mechanisms involved in the cardiorenal protection afforded by SGLT2 inhibition in chronic kidney disease

BRCA1 mutations in high-grade serous ovarian cancer are associated with proteomic changes in DNA repair, splicing, transcription regulation and signaling

Despite recent advances in the management of BRCA1 mutated high-grade serous ovarian cancer (HGSC), the physiology of these tumors remains poorly understood. Here we provide a comprehensive molecular understanding of the signaling processes that drive HGSC pathogenesis with the addition of valuable ubiquitination profiling, and their dependency on BRCA1 mutation-state directly in patient-derived tissues. Using a multilayered proteomic approach, we show the tight coordination between the ubiquitination and phosphorylation regulatory layers and their role in key cellular processes related to BRCA1-dependent HGSC pathogenesis. In addition, we identify key bridging proteins, kinase activity, and post-translational modifications responsible for molding distinct cancer phenotypes, thus providing new opportunities for therapeutic intervention, and ultimately advance towards a more personalized patient care

Efectes del tractament de la hidrocefàlia crònica de l'adult

La hidrocefàlia crònica de l'adult (HCA) és una causa de demència potencialment reversible. Per això, és molt important diferenciar-la d'altres causes de demència, com l'Alzheimer o el Parkinson, que poden presentar símptomes semblants. Investigadors de l'Hospital Universitari Vall Hebron-UAB, han estudiat la cognició i comportament d'un grup de pacients per analitzar els canvis que es produeixen després del tractament i descriure les variables que infueixien en la millora dels pacients per així poder diferenciar els pacients que presenten aquest síndrome dels altres.La hidrocefalia crónica del adulto (HCA) es una causa de demencia potencialmente reversible. Por ello, es muy importante diferenciarla de otras causas de demencia, como el Alzheimer o el Parkinson, que pueden presentar síntomas similares. Investigadores del Hospital Universitario Vall Hebron-UAB, han estudiado la cognición y comportamiento de un grupo de pacientes para analizar los cambios que se producen después del tratamiento y describir las variables que influyen en la mejora de los pacientes para así poder diferenciar los pacientes que presentan este síndrome de los demás

HLA-DR expression in clinical-grade bone marrow-derived multipotent mesenchymal stromal cells : a two-site study

Altres ajuts: BST is a member of the Spanish Cell Therapy Network (Red de Terapia Celular, TerCel, expedient No. RD16/0011/0028), awarded by the Generalitat de Catalunya as Consolidated Research Group and developed in the context of AdvanceCat with the support of ACCIÓ (Catalonia Trade & Investment; Generalitat de Catalunya) under the Catalonian ERDF operational program (European Regional Development Fund) 2014-2020.Background: Contrary to the minimal criteria proposed by the International Society for Cell and Gene Therapy for defining multipotent mesenchymal stromal cells (MSC), human leukocyte antigen (HLA)-DR expression is largely unpredictable in ex vivo-expanded clinical-grade cultures. Although activation of MSC in culture does not appear to affect their functionality, a large study investigating the impact of HLA-DR expression on cell identity and potency is still missing in the literature. Methods: A retrospective analysis of HLA-DR expression in 130 clinical batches of bone marrow (BM)-MSC from two independent Good Manufacturing Practice-compliant production facilities was performed in order to identify the consequences on critical quality attributes as well as potential activation cues and dynamics of MSC activation in culture. Results: HLA-DR cells in culture were confirmed to maintain fibroblastic morphology, mesenchymal phenotype identity, multipotency in vitro, and immunomodulatory capacity. Interestingly, the use of either human sera or platelet lysate supplements resulted in similar results. Conclusions: HLA-DR expression should be considered informative rather than as a criterion to define MSC. Further work is still required to understand the impact of HLA-DR expression in the context of product specifications on BM-MSC qualities for clinical use in specific indications

Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament

Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. The aim of this study was to detail the clinical, radiological, arthroscopic, and pathological findings of mucoid degeneration of the anterior cruciate ligament and report the clinical outcomes following arthroscopic treatment. A historical cohort of patients who underwent arthroscopic total or partial excision of the anterior cruciate ligament due to mucoid degeneration between 2011 and 2014 were reviewed. The minimum follow-up was 3 years. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. The visual analogue scale score, the International Knee Documentation Committee score, and the Tegner Lysholm Knee Score were collected preoperatively, postoperatively, and during the follow-up period. Seventeen females (67%) and eight males (33%) were included in the final analysis. The mean age at the time of surgery was 57 years (range, 31 to 78 years). Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. No reconstruction was performed at the same time. A positive Lachman test and a negative pivot shift were noted after surgery in all cases. Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01). Our study provides further evidence that arthroscopic total or partial excision of anterior cruciate ligament is a safe and effective treatment for mucoid degeneration of the anterior cruciate ligament, improving patient satisfaction and function without causing clinical instability in daily activities. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary

Guideline on the use of onabotulinumtoxinA in chronic migraine. a consensus statement from the European Headache Federation

OnabotulinumtoxinA is being increasingly used in the management of chronic migraine (CM). Treatment with onabotulinumtoxinA poses challenges compared with traditional therapy with orally administered preventatives. The European Headache Federation identified an expert group that was asked to develop the present guideline to provide recommendations for the use of onabotulinumtoxinA in CM. The expert group recommend onabotulinumtoxinA as an effective and well-tolerated treatment of CM. Patients should preferably have tried two to three other migraine prophylactics before start of onabotulinumtoxinA. Patients with medication overuse should be withdrawn from the overused medication before initiation of onabotulinumtoxinA if feasible, if not onabotulinumtoxinA can be initiated from the start or before withdrawal. OnabotulinumtoxinA should be administered according to the PREEMPT injection protocol, i.e. injecting 155 U-195 U to 31-39 sites every 12-weeks. We recommend that patients are defined as non-responders, if they have less than 30% reduction in headache days per month during treatment with onabotulinumtoxinA. However other factors such as headache intensity, disability and patient preferences should also be considered when evaluating response. Treatment should be stopped, if the patient does not respond to the first two to three treatment cycles. Response to continued treatment with onabotulinumtoxinA should be evaluated by comparing the 4 weeks before with the 4 weeks after each treatment cycle. It is recommended that treatment is stopped in patients with a reduction to less than 10 headache days per month for 3 months and that patients are re-evaluated 4-5 months after stopping onabotulinumtoxinA to make sure that the patient has not returned to CM. Questions regarding efficacy and tolerability of onabotulinumtoxinA could be answered on the basis of scientific evidence. The other recommendations were mainly based on expert opinion. Future research on the treatment of CM with onabotulinumtoxinA may further improve the management of this highly disabling disorder

Use of an acellular collagen-elastin matrix to support bladder regeneration in a porcine model of peritoneocystoplasty

Bladder reconstruction without using the intestine remains a challenge to this day despite the development of new biomaterials and cell cultures. Human bladder engineering is merely anecdotic, and mostly in vitro and animal studies have been conducted. In our study using a porcine model, we performed a bladder augmentation using an autologous parietal peritoneum graft (peritoneocystoplasty) and determined whether the attachment of an acellular collagen-elastin matrix (Group 1) or lack of (Group 2) had better histologic and functional results. Thus far, peritoneocystoplasty has rarely been performed or combined with a biomaterial. After 6 weeks, we observed different degrees of retraction of the new bladder wall in both groups, although the retraction was lower and the histological analysis showed more signs of regeneration (neoangiogenesis and less fibrosis) in Group 1 than when compared with Group 2. No transitional cells were found in the new bladder wall in any of the groups, and no differences were observed in the functional test results. Performing a peritoneocystoplasty is an easy and safe procedure. The data supports the benefit of an acellular collagen-elastin matrix to reinforce bladder regeneration. However, in our study we observed too much retraction of the new wall and the histologic results were not acceptable to consider it an appropriate cystoplasty technique

Mecanismes de recuperació de la comprensió del llenguatge després d'una lesió massiva de l'hemisferi dominant

Els pacients que sobreviuen a un infart hemisfèric maligne presenten greus seqüeles motores, a les quals cal afegir una afàsia global (impossibilitat d'emetre i comprendre llenguatge oral i escrit) si l'hemisferi afectat és el dominant. El tractament més eficaç per a aquests pacients és l'extracció temporal d'una part de la volta cranial per tal de permetre l'expansió del cervell inflamat. Tanmateix, aquest tractament és controvertit quan l'hemisferi infartat és el dominant, per les seqüeles esperables. L'estudi d'una pacient de 20 anys amb un infart massiu esquerre a la qual se li va aplicar aquest tractament mostra resultats inesperadament favorables.Los pacientes que sobreviven a un infarto hemisférico maligno presentan graves secuelas motoras, a las que hay que añadir una afasia global (imposibilidad de emitir y comprender lenguaje oral y escrito) si el hemisferio afectado es el dominante. El tratamiento más eficaz para estos pacientes es la extracción temporal de una parte de la bóveda craneal para permitir la expansión del cerebro inflamado. Sin embargo, este tratamiento es controvertido cuando el hemisferio infartado es el dominante por las secuelas esperables. El estudio de una paciente de 20 años con un infarto masivo izquierdo a la que se le aplicó este tratamiento muestra resultados inesperadamente favorables