Healthy effects of prebiotics and their metabolites against intestinal diseases and colorectal cancer

A specific group of plant and animal oligosaccharides does not suffer enzymatic digestion in the human upper intestinal tract, achieving the colon microbial ecosystem in intact form. The reason for that is their diverse glycosidic bond structure, in comparison with common energetic polysaccharides as starch or glycogen. In this complex ecosystem, these molecules serve as energy sources, via fermentation, of distinctive beneficial bacterial groups, mainly belonging to the Anaerostipes, Bifidobacterium, Coprococcus, Faecalibacterium, Lactobacillus, Roseburia and other genera. The main catabolic products of these fermentations are short-chain fatty acids (SCFA) as acetate, propionate and butyrate, which appear in high concentrations in the lumen around the colon mucosa. Acetate and propionate are associated to energetic purposes for enterocytes, hepatocytes and other cells. Butyrate is the preferred energy source for colonocytes where it controls their cell cycle; butyrate is able to induce cell cycle arrest and apoptosis in tumor colonocytes. These oligosaccharides that increase beneficial colon bacterial populations and induce SCFA production in this ecosystem are called prebiotics. Here, different sources and chemical structures for prebiotics are described, as well as their modulatory effect on the growth of specific probiotic bacterial groups in the colon, and how their fermentation renders diverse SCFA, with beneficial effects in gut healt

Immunomodulation of mesenchymal stem cells in discogenic pain

13 p.BACKGROUND CONTEXT: Back pain is a highly prevalent health problem in the world today and has a great economic impact on health-care budgets. Intervertebral disc (IVD) degeneration has been identified as a main cause of back pain. Inflammatory cytokines produced by macrophages or disc cells in an inflammatory environment play an important role in painful progressive degeneration of IVD. Mesenchymal stem cells (MSCs) have shown to have immunosuppressive and antiinflammatory properties. Mesenchymal stem cells express a variety of chemokines and cytokines receptors having tropism to inflammation sites. PURPOSE: This study aimed to develop an in vitro controlled and standardized model of inflammation and degeneration of IVD with rat cells and to evaluate the protective and immunomodulatory effect of conditioned medium (CM) from the culture of MSCs to improve the conditions presented in herniated disc and discogenic pain processes. STUDY DESIGN: This is an experimental study. METHODS: In this study, an in vitro model of inflammation and degeneration of IVD has been developed, as well as the effectiveness of CM from the culture of MSCs. RESULTS: Conditioned medium from MSCs downregulated the expression of various proinflammatory cytokines produced in the pathogenesis of discogenic pain such as interleukin (IL)-1β, IL-6, IL-17, and tumor necrosis factor (TNF). CONCLUSION: Mesenchymal stem cells represent a promising alternative strategy in the treatment of IVD degeneration inasmuch as there is currently no treatment which leads to a complete remission of long-term pain in the absence of drug

Utilidad diagnóstica de la ecografía tiroidea clínica a pie de cama en el paciente hospitalizado con sospecha de tirotoxicosis. Hospital General Universitario Gregorio Marañón

Objective: To analyze the diagnostic utility of thyroid ultrasound in hospitalized patients with suspected thyrotoxicosis. Materials and methods: An observational, cross-sectional and descriptive study was carried out in patients with suspected thyrotoxicosis whose consultation was sent to the Endocrinology and Nutrition Service of the aforementioned hospital during a period of 12 months (May 2018 to May 2019) evaluating a total of 14 patients. A member of the department's team of endocrinologists (who was unaware of the clinical data) performed the bedside ultrasound evaluation during hospitalization. Results: Of the 14 patients evaluated, 71.4% (n = 10) were women, overall age was 59.5 years (p25-p75: 50 - 70), with the most frequent admission service being cardiology with 50 % (n=7), presence of arrhythmia the most common reason for admission (39.9%; n=6) and the use of beta-blockers as the predominant drugs (50%; n=7). Only 28.6% n=4) of the evaluated patients had a history of hyperthyroidism. The level of concordance between the presumptive diagnosis prior to thyroid ultrasound and the final diagnosis during follow-up was k=0.424 (p<0.001), while between the diagnosis after thyroid ultrasound and the final diagnosis during follow-up was k=0.832 (p<0.001). Conclusion: Thyroid ultrasound is a useful tool in the management of patients with thyrotoxicosis in a hospitalization ward. Keywords: ultrasound, thyroid, thyrotoxicosis, diagnosis, thyroiditis.Objetivo: Valorar la utilidad diagnóstica de la ecografía tiroidea clínica en pacientes hospitalizados con sospecha de tirotoxicosis. Materiales y métodos: Se realizó un estudio observacional, transversal y descriptivo en pacientes con sospecha de tirotoxicosis cuya interconsulta fue enviada al Servicio de Endocrinología y Nutrición del mencionado hospital durante un periodo de 12 meses (mayo de 2018 a mayo de 2019) evaluándose un total de 14 pacientes. Un miembro del equipo de endocrinólogos del servicio (que desconocía los datos clínicos) efectuó la valoración ecográfica a pie de cama Resultados: De los 14 pacientes evaluados, el 71,4% (n=10) fueron mujeres, el promedio de edad fue 59,5 años (p25-p75: 50 – 70), siendo el servicio de ingreso más frecuente cardiología con 50% (n=7), la presencia de arritmia el motivo de ingreso más común (39,9%; n=6) y el uso de betabloqueantes como fármacos predominantes (50%; n=7). Solo 28,6% (n=4) de los pacientes evaluados presentaban antecedente de hipertiroidismo. El nivel de concordancia entre el diagnostico de presunción previo a la ecografía tiroidea y el diagnostico final durante el seguimiento fue k=0,424 (p<0,001), mientras que la concordancia entre el diagnostico posterior a la ecografía tiroidea y el diagnostico final durante el seguimiento fue k=0,832 (p<0,001). Conclusión: La ecografía tiroidea es una herramienta útil en el manejo de pacientes con tirotoxicosis en una planta de hospitalización Palabras clave: ecografía, tiroides, tirotoxicosis, diagnostico, tiroiditis