Resistina: una nueva hormona expresada en el tejido adiposo

La resistina es una proteína de 12,5 kDa rica en residuos de cisteína que se secreta principalmente en los adipocitos. El descubrimiento de la resistina pareció ser un principio prometedor para el tratamiento de la resistencia a la insulina inducida por la obesidad. Sin embargo, aunque en roedores su función parece estar relacionada con el empeoramiento de la sensibilidad a la insulina, en humanos todavía no se puede afirmar con claridad su papel. En los roedores, la resistina actúa de forma perjudicial en la ruta de señalización de la insulina en los principales tejidos diana, como son el tejido adiposo, el hígado y el músculo. Esta hormona también estimula la producción hepática de glucosa y sus niveles circulantes son elevados en animales obesos, mientras que estos niveles disminuyen de manera muy significativa después de la restricción alimenticia. Todos estos datos sugieren que además de la resistencia a la insulina, la resistina también ejerce una acción importante en la regulación de la homeostasis metabólica. Además, en humanos, dada su expresión en células mononucleares, es de suponer que esta proteína juega un papel importante en los procesos inflamatorios y/o inmunitarios. Aunque los trabajos que han estudiado sus acciones en relación a la resistencia a insulina inducida por la obesidad son bastante contradictorios, es de esperar que pueda ejercer múltiples funciones biológicas, teniendo en cuenta la variedad de tejidos en que es expresada

Trichosporon asahii an emerging etiologic agent of fungal infection and colonization in heart failure patients in intensive care unit: case report and literature review

JUSTIFICATIVA E OBJETIVOS: As infecções fúngicas por Trichosporon Asahii têm sido cada vez mais freqüentes nas últimas duas décadas. Quadros graves com alta mortalidade são tradicionalmente descritos em pacientes neutropênicos com câncer. Recentemente, a infecção tem ocorrido também em outros grupos de pacientes. O objetivo deste estudo foi descrever a crescente prevalência de Trichosporon asahii em unidade de terapia intensiva cardiológica (UTIC), com perfil de pacientes habitualmente não susceptíveis a tal infecção fúngica, relatar um caso clínico e revisão da literatura. RELATO DO CASO: Paciente do sexo feminino, 85 anos, com antecedentes de hipertensão arterial sistêmica, insuficiência cardíaca (fração de ejeção = 30%) e embolia pulmonar, admitida na UTI depois de parada cardiorrespiratória em fibrilação ventricular durante consulta de rotina. Evoluiu sem seqüela neurológica. O ecocardiograma não revelou alterações em relação ao exame anterior. Não houve alteração dos indicadores de necrose miocárdica. A paciente apresentou falha na extubação traqueal e desmame difícil, necessitando ventilação mecânica prolongada mesmo após traqueostomia. Houve complicações por insuficiência renal aguda e infecções recorrentes (respiratória, urinária e sistêmica), com boa resposta ao tratamento com antibióticos de amplo espectro. Após sete meses de internação na UTI, evoluiu com choque séptico, associado à infecção urinária por Trichosporon asahii, com hemoculturas identificadas pelo mesmo fungo. Iniciado tratamento com anfotericina B lipossomal (5 mg/kg/dia). Apesar do uso associado de vancomicina e imipenem, houve piora clínica progressiva. Hemoculturas colhidas no sétimo dia de uso de antifúngico revelaram-se negativas, porém a urocultura ainda revelou o crescimento de T. asahii. Evoluiu com óbito após 18 dias de tratamento, por falência de múltiplos órgãos. CONCLUSÕES: O aumento da gravidade dos pacientes internados nas UTI e o uso disseminado de antibióticos de amplo espectro têm possibilitado o surgimento de infecções por fungos incomuns. As infecções graves por Trichosporon asahii, descritas como restritas a pacientes imunossuprimidos, oncológicos e hematológicos, têm sido freqüentemente encontradas em pacientes idosos, com insuficiência cardíaca grave e com alta mortalidade intra-hospitalar, internados em UTI. Deve-se estar atento à possibilidade da emergência de infecções por fungos não usuais em pacientes com este perfil clínico.BACKGROUND AND OBJECTIVES: Infection with the non-Candida yeast species Trichosporon have been recognized with increasing frequency over the last two decades. Invasive disease due to trichosporonosis has been reported from neutropenic patients with cancer and the mortality is high. Recently, others groups of patients have become susceptible to this rare fungi. We report the emerging of infection with pathogenic Trichosporon asahii in severely ill heart failure patients in a tertiary cardiological intensive care unit (CICU). We describe our data, and report a fatal case of disseminated trichosporonosis in a patient with heart failure. We also review literature pertaining to T. asahii infections. CASE REPORT: An 85 year-old woman with a history of hypertension, heart failure (ejection fraction (EJ): 30%) and pulmonary embolism was admitted to a medical cardiological ICU after cardiac arrest (ventricular fibrillation) resuscitated during a routine consultation. There were no neurological sequelae and the echocardiogram revels no changes, neither the cardiac biomarkers. Ventricular fibrillation was considered secondary to heart failure. The patient had extubation failure and difficult weaning needing long term mechanical ventilation even after tracheostomy. Her hospital course was complicated by acute renal failure and recurrent respiratory, urinary and systemic bacterial infections, which responded to broad-spectrum antibiotics. After a temporary improvement she developed urinary infection and subsequent septic shock. Cultures of urine and blood specimens grew T. asahii. Treatment with liposome amphotericin B (5 mg/kg/day) was started. Despite receiving vancomycin and imipenem, the clinical condition of the patient deteriorates. Blood taken for culture on the seventh day of amphotericin B therapy were negative but urine specimen still grew T. asahii. On the eighteenth day of antifungal therapy, the patient died with multiorgan failure. CONCLUSIONS: The increasing of severely ill patients, and the use of broad spectrum antibiotics, has predisposed the emerging of invasive infections by rare and new opportunistic fungal pathogens. Severe infection related to T. asahii, until recently restricted to neutropenic patients with cancer, has been frequently identified in heart failure patients with advanced age. The mortality is high. These data highlights the importance of considering this group of patients as a risk group for T. asahii infection

Estradiol regulates brown adipose tissue thermogenesis via hypothalamic AMPK

Copyright © 2014 Elsevier Inc. All rights reserved.Peer reviewedPublisher PD

Mobility patterns of scholar communities in Southwestern European countries

The present study aimed to provide an in-depth assessment of the commuting patterns of scholar communities of southwestern European countries and to identify measures to improve their sustainable performance regarding mobility. The adopted methodology characterized the mobility pattern of students as a sustainability indicator and the availability of related infrastructures and local public transport networks. Data were gathered by qualitative (behavioral questionnaires) and quantitative (technical audits) approaches, based on measurable indicators (key performance indicators and scores (ranging between 0–5)). Overall, French schools showed the best sustainable performance regarding mobility (2.0) and Gibraltar had the lowest (1.2). The existence of bike parking and electric car charging points were the main weaknesses founds (with their related mean scores being 0.6 and 0.2, respectively). The score associated with annual CO2 emissions due to students’ mobility had the best performance, where all countries managed to obtain an average of 3.1. The global score, which assessed the sustainable performance of scholar communities regarding mobility, had a mean value of 1.5 for all studied countries, which highlights the potential for improvement of the studied schools, mainly targeting the public transport network optimization and the enhancement of scholar infrastructures concerning bicycle parking and electric cars.This research was funded by the Interreg SUDOE funding program of the European Regional Development Fund, through ClimACT Project (SOE1/P3/P0429). J. Lage acknowledges the support of the FCT—Fundação para a Ciência e Tecnologia, I.P. (Portugal) for the contract CEEC-IND/02366/2020 and N. Canha also acknowledges the support of FCT, through the contract 2021.00088.CEECIND. The FCT support is also gratefully acknowledged by C2TN/IST authors (UIDB/04349/2020 + UIDP/04349/2020) and by CESAM author (UIDB/50017/2020+UIDP/50017/2020). The authors also acknowledge the support of H2020 Project ECF4CLIM (Grant agreement ID: 101036505).info:eu-repo/semantics/publishedVersio

Bsx, a novel hypothalamic factor linking feeding with locomotor activity, is regulated by energy availability

Es un estudio en modelos de rata acerca del papel de BSX, la actividad y la alimentación.We recently reported that the hypothalamic homeobox domain transcription factor Bsx plays an essential role in the central nervous system control of spontaneous physical activity and the generation of hyperphagic responses. Moreover, we found Bsx to be a master regulator for the hypothalamic expression of key orexigenic neuropeptide Y and agouti gene-related protein. We now hypothesized that Bsx, which is expressed in the dorsomedial and arcuate nucleus (ARC) of the hypothalamus, is regulated by afferent signals in response to peripheral energy balance. Bsx expression was analyzed using in situ hybridization in fed vs. fasted (24 h) and ghrelin vs. leptin-treated rats, as well as in mice deficient for leptin or the ghrelin signaling. Ghrelin administration increased, whereas ghrelin receptor antagonist decreased ARC Bsx expression. Leptin injection attenuated the fasting-induced increase in ARC Bsx levels but had no effect in fed rats. Dorsomedial hypothalamic nucleus Bsx expression was unaffected by pharmacological modifications of leptin or ghrelin signaling. Obese leptin-deficient (ob/ob) mice, but not obese melanocortin 4 receptor-knockout mice, showed higher expression of Bsx, consistent with dependency from afferent leptin rather than increased adiposity per se. Interestingly, exposure to a high-fat diet triggered Bsx expression, consistent with the concept that decreased leptin signaling due to a highfat diet induced leptin resistance. Our data indicate that ARC Bsx expression is specifically regulated by afferent energy balance signals, including input from leptin and ghrelin. Future studies will be necessary to test if Bsx may be involved in the pathogenesis of leptin resistance

A methodology to empower citizens towards a low-carbon economy. The potential of schools and sustainability indicators

Environmental empowering to control resource consumption and environmental impacts is critical to engage citizens to adopt more sustainable habits. This study demonstrates the potential benefits of innovative approaches based on sustainability indicators towards a low-carbon economy. A methodology to measure and promote sustainability in schools has been proposed and evaluated, aiming at showing the environmental performance and informing of potential environmental savings. The methodology, titled ClimACT, has two main purposes: measuring the environmental performance of schools through a school sustainability index based on measurable indicators in the areas of transport, procurement, green spaces, indoor air quality, energy, water and waste; and encouraging students, teachers and families towards an energy-efficient and low-carbon pathway through a structural procedure based on roles, activities and progress evaluation. The approach, applied to 39 pilot schools from Portugal, Spain, France and Gibraltar, achieved promising and encouraging results. All schools deployed the methodology successfully, achieving measurable environmental benefits in 95% of cases, with an average improvement of 10% in the global performance of schools after one year. Moreover, the 5112 surveys applied to school communities, before and after the methodology implementation, highlighted how the sustainable indicators had a significant influence on the daily lives of families, leading to improvements of their behaviour, with an average increase of 20% in indicators regarding good practices in transport, energy, water, waste and citizenship. The environmental empowering through measurable indicators is a step forward a low-carbon economy. This methodology is open and adaptable to all sectors and requirements

A methodology to empower citizens towards a low-carbon economy: the potential of schools and sustainability indicators

Environmental empowering to control resource consumption and environmental impacts is critical to engage citizens to adopt more sustainable habits. This study demonstrates the potential benefits of innovative approaches based on sustainability indicators towards a low-carbon economy. A methodology to measure and promote sustainability in schools has been proposed and evaluated, aiming at showing the environmental performance and informing of potential environmental savings. The methodology, titled ClimACT, has two main purposes: measuring the environmental performance of schools through a school sustainability index based on measurable indicators in the areas of transport, procurement, green spaces, indoor air quality, energy, water and waste; and encouraging students, teachers and families towards an energy-efficient and low-carbon pathway through a structural procedure based on roles, activities and progress evaluation. The approach, applied to 39 pilot schools from Portugal, Spain, France and Gibraltar, achieved promising and encouraging results. All schools deployed the methodology successfully, achieving measurable environmental benefits in 95% of cases, with an average improvement of 10% in the global performance of schools after one year. Moreover, the 5112 surveys applied to school communities, before and after the methodology implementation, highlighted how the sustainable indicators had a significant influence on the daily lives of families, leading to improvements of their behaviour, with an average increase of 20% in indicators regarding good practices in transport, energy, water, waste and citizenship. The environmental empowering through measurable indicators is a step forward a low-carbon economy. This methodology is open and adaptable to all sectors and requirements.info:eu-repo/semantics/publishedVersio

Managing Indoor Air Quality in ClimACT Schools

International audienc