Effects of omega-3 fatty acids on arterial stiffness in patients with hypertension: a randomized pilot study.

BackgroundOmega-3 fatty acids prevent cardiovascular disease (CVD) events in patients with myocardial infarction or heart failure. Benefits in patients without overt CVD have not been demonstrated, though most studies did not use treatment doses (3.36 g) of omega-3 fatty acids. Arterial stiffness measured by pulse wave velocity (PWV) predicts CVD events independent of standard risk factors. However, no therapy has been shown to reduce PWV in a blood pressure-independent manner. We assessed the effects of esterified omega-3 fatty acids on PWV and serum markers of inflammation among patients with hypertension.Design and methodsWe performed a prospective, randomized; double-blinded pilot study of omega-3 fatty acids among 62 patients in an urban, safety net hospital. Patients received 3.36 g of omega-3 fatty acids vs. matched placebo daily for 3-months. The principal outcome measure was change in brachial-ankle PWV. Serum inflammatory markers associated with CVD risk were also assessed.ResultsThe majority (71 %) were of Latino ethnicity. After 3-months, mean change in arterial PWV among omega-3 and placebo groups was -97 cm/s vs. -33 cm/s respectively (p = 0.36 for difference, after multivariate adjustment for baseline age, systolic blood pressure, and serum adiponectin). Non-significant reductions in lipoprotein-associated phospholipase A2 (LpPLA2) mass and high sensitivity C-reactive protein (hsCRP) relative to placebo were also observed (p = 0.08, and 0.21, respectively).ConclusionHigh-dose omega-3 fatty acids did not reduce arterial PWV or markers of inflammation among patients within a Latino-predominant population with hypertension.Clinical trial registrationNCT00935766 , registered July 8 2009

Associations of Adiponectin with Adiposity, Insulin Sensitivity, and Diet in Young, Healthy, Mexican Americans and Non-Latino White Adults.

Low circulating adiponectin levels may contribute to higher diabetes risk among Mexican Americans (MA) compared to non-Latino whites (NLW). Our objective was to determine if among young healthy adult MAs have lower adiponectin than NLWs, independent of differences in adiposity. In addition, we explored associations between adiponectin and diet. This was an observational, cross-sectional study of healthy MA and NLW adults living in Colorado (U.S.A.). We measured plasma total adiponectin, adiposity (BMI, and visceral adipose tissue), insulin sensitivity (IVGTT), and self-reported dietary intake in 43 MA and NLW adults. Mean adiponectin levels were 40% lower among MA than NLW (5.8 ± 3.3 vs. 10.7 ± 4.2 µg/mL, p = 0.0003), and this difference persisted after controlling for age, sex, BMI, and visceral adiposity. Lower adiponectin in MA was associated with lower insulin sensitivity (R² = 0.42, p < 0.01). Lower adiponectin was also associated with higher dietary glycemic index, lower intake of vegetables, higher intake of trans fat, and higher intake of grains. Our findings confirm that ethnic differences in adiponectin reflect differences in insulin sensitivity, but suggest that these are not due to differences in adiposity. Observed associations between adiponectin and diet support the need for future studies exploring the regulation of adiponectin by diet and other environmental factors

The placebo response in trials of drug treatments for cancer-related fatigue: A systematic review, meta-analysis and meta-regression

Background: Cancer-related fatigue (CRF) is one of the most distressing symptoms experienced by patients. There is no gold standard treatment, although multiple drugs have been tested with little evidence of efficacy. Randomised controlled trials (RCTs) of these drugs have commented on the existence or size of the placebo response (PR). The objective of this systematic review was to establish the magnitude of the PR in RCTs of drugs to relieve CRF and to identify contributing factors. Method: RCTs were included in which the objective was to treat CRF. A meta-analysis was conducted using the standardised mean change (SMC) between baseline and final measurement in the placebo group. To explore factors that may be associated with the PR (eg, population or drug), a meta-regression was undertaken. Risk of bias was assessed using the revised Cochrane tool. Results: From 3916 citations, 30 relevant RCTs were identified. All had limitations that increased their risk of bias. The pooled SMC in reduction in fatigue status in placebo groups was −0.23 (95% confidence intervals −0.42 to −0.04). None of the variables analysed in the meta-regression were statistically significant related to PR. Conclusion: There is some evidence, based on trials with small samples, that the PR in trials testing drugs for CRF is non-trivial in size and statistically significant. We recommend that researchers planning drug studies in CRF should consider implementing alternative trial designs to better account for PR and decrease impact on the study results

Immune drug discovery from venoms

This review catalogues recent advances in knowledge on venoms as standalone therapeutic agents or as blueprints for drug design, with an emphasis on venom-derived compounds that affects the immune system. We discuss venoms and venom-derived compounds that affect total immune cell numbers, immune cell proliferation, immune cell migration, immune cell phenotype and cytokine secretion. Identifying novel compounds that 'tune' the system, up-regulating the immune response during infectious disease and cancer and down-regulating the immune response during autoimmunity, will greatly expand the tool kit of human immunotherapeutics. Targeting these pathways may also open therapeutic options that alleviate symptoms of envenomation. Finally, combining recent advances in venomics with progress in low cost, high-throughput screening platforms will no doubt yield hundreds of prototype immune modulating compounds in the coming years

Concepciones sobre el aprendizaje y su relación con las prácticas pedagógicas

The pedagogical practices have become the subject of multiple studies, and have received strong pressure and criticism due to the relationship of the knowledge achieved by the students, the professional development process of the teachers,and even, for its role in the implementation of new curricular policies, among other incidents. This article, as a contribution to the study the pedagogical practices, exposes some arguments about the theoretical perspective used to explain learning,with strong or weak relation with the school and the classroom in particular. To achieve it, four perspectives must be outlaid: As transmission of knowledge, as a way to process information and as a situated historical, social and cultural set up and from a sociopolitics perspective. But, what’s the importance about recognizing the different perspectives to explain learning in the study of the pedagogical practices? It could be two reasons. In first place, don’t think that learning is a transparent factor, as in, can you study pedagogical practices without considering learning as a source of conflicts, decision making, even the need for changes or transformations in them? A fundamental problematic aspect about learning of any human practice. Second, don’t believe there is only one true way about learning and from this interpretation, take decisions in relation with the pedagogical practices. The article initially exposes arguments from the written discourses of a specific educational context – El Servicio Nacional de Aprendizaje SENA - to subsequently present the proposals from the literature of research in the field. In summary, it is intended to generate contextualized theoretical elements for the discussion of the topic, mainly in the professional development programs of the professors.Las prácticas pedagógicas vienen siendo objeto de múltiples estudios, y a veces fuertes críticas y presiones, dada su relación con los aprendizajes alcanzados por los estudiantes, los procesos de desarrollo profesional de los profesores, e incluso, por su papel en la implementación de nuevas políticas curriculares, entre otras incidencias. Este artículo, como un aporte al estudio sobre las prácticas pedagógicas, expone los argumentos de algunas perspectivas teóricas para explicar el aprendizaje, con fuerte o débil relación con la escuela y el aula de clase en particular. Para conseguirlo, se trazará un mapa entre cuatro perspectivas: como transmisión de saberes, como un procesamiento de la información, como una construcción social, cultural e históricamente situada y desde una perspectiva sociopolítica. Pero, ¿cuál es la importancia de reconocer diferentes perspectivas para explicar el aprendizaje en el estudio de las prácticas pedagógicas? Inicialmente se proponen dos razones: en primer lugar, evitar asumir el aprendizaje como un factor transparente no problemático, esto es, ¿se pueden estudiar las prácticas pedagógicas sin considerar el aprendizaje como fuente de conflictos, toma de decisiones, incluso, de necesidad de cambios o transformaciones en ellas?, cuestión discutible si se asume que el aprendizaje es un aspecto fundamental de cualquier práctica humana. Segundo, evitar asumir que existe una sola verdad frente al aprendizaje y desde ésta interpretar y tomar decisiones en relación con las prácticas pedagógicas. El artículo expone en un principio argumentos desde los discursos escritos de un contexto educativo específico - el Servicio Nacional de Aprendizaje SENA - para, posteriormente, presentar las apuestas desde la literatura de la investigación en el campo. Se pretende, en resumen, generar elementos teóricos contextualizados para la discusión frente al tema, principalmente en los programas de desarrollo profesional de los profesores

Designing Interactions with Multilevel Auditory Displays in Mobile Audio-Augmented Reality

Auditory interfaces offer a solution to the problem of effective eyes-free mobile interactions. In this article, we investigate the use of multilevel auditory displays to enable eyes-free mobile interaction with indoor location-based information in non-guided audio-augmented environments. A top-level exocentric sonification layer advertises information in a gallery-like space. A secondary interactive layer is used to evaluate three different conditions that varied in the presentation (sequential versus simultaneous) and spatialisation (non-spatialised versus egocentric/exocentric spatialisation) of multiple auditory sources. Our findings show that (1) participants spent significantly more time interacting with spatialised displays; (2) using the same design for primary and interactive secondary display (simultaneous exocentric) showed a negative impact on the user experience, an increase in workload and substantially increased participant movement; and (3) the other spatial interactive secondary display designs (simultaneous egocentric, sequential egocentric, and sequential exocentric) showed an increase in time spent stationary but no negative impact on the user experience, suggesting a more exploratory experience. A follow-up qualitative and quantitative analysis of user behaviour support these conclusions. These results provide practical guidelines for designing effective eyes-free interactions for far richer auditory soundscapes

Coronary Intimal Thickening: Once Again

In a letter to the Editor, Briana and Malamitsi-Puchner1 commented our recently published paper in which we showed that intimal thickening already begins in fetal life and progresses through childhood and adolescence.2 Our work is in line with studies by Barker about the fetal origins of adult disease which led to The Barker Hypothesis, indicating that the pathogenesis of cardiovascular (CV) disease begins in utero.3Briana et al.1 recently evaluated cord blood serum for potentially prognostic biomarkers for CV disease in large-for-gestational-age compared with appropriate-for-gestational-age neonates. Among other biomarkers, the authors studied serum cardiotrophin-1, a cardiomyocyte-produced chemokine that plays a fundamental role in fetal heart development and whose expression is increased by hypoxia, mechanical stress and proinflammatory cytokines such as interleukin (IL) 1b. The authors1 also studied serum levels of cardiac myocytesarcomeral protein titin, involved in sensing and responding to myocardial stress. As a result, Briana et al.1 propose that cord blood serum concentrations of both cardiotrophin-1 and titin could represent prognostic biomarkers for future CV disease.4In addition, another study by Milei et al.5 analyzed autopsy heart samples from 22 fetal sudden intrauterine death and 36 sudden infant death victims, all between the 32nd week of gestation and 1year of age. In 28 out of 58 cases, the mothers were smokers. Coronary lesions were detected in 10 of 12 fetuses and in 15 of 16 infants whose mothers smoked, while only 5cases (2 of 10 fetuses and 3 of 20 infants) arterial lesions were found in cases of nonsmoking mothers (p 1 artery, compared with 25% in the CoHD patients without surgery (p<0.001). Hence, these results suggest a higher rate of coronary intimal hyperplasia in surgically repaired CoHD patients as compared with non-repaired ones.6 This high incidence was correlated with intimal decrease in estrogen receptor α (ERα) expression, an increment in transforming growth factor β1 (TGF-β1) expression and in apolipoprotein B (apoB) deposition, which allowed us to conclude that a decrease in ERα and augmented expression of TGF-β1 expression may contribute to the development of atherosclerotic coronary artery disease in CoHD patients.6,7 A case report illustrating our findings described an aneurysm in the left main coronary artery of a 2-year-old patient. This aneurysm presented intimal hyperplasia and strong apoB deposition.8As mentioned in the Briana and Malamitsi-Puchner letter,1 it is important to search for early biomarkers of CV disease at an early age in order to implement preventive strategies. In this regard, we suggest that special attention should be given to children of smoking mothers and to CoHD patients, particularly if they underwent reparative surgery.Fil: Castilla Lozano, Maria del Rocio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Cardiológicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas; ArgentinaFil: Gutierrez, Christopher P. A.. Universidad de Buenos Aires; ArgentinaFil: Azzato, Francisco. Universidad de Buenos Aires; ArgentinaFil: Ambrosio, Giuseppe. Università di Perugia; ItaliaFil: Milei, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Cardiológicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas; Argentin