Vascular reactivity and biomarkers of endothelial function in healthy subjects exposed to acute hypobaric hypoxia

Aims: The aim of this study was to evaluate the effects of acute hypobaric hypoxia (HH) on vascular reactivity and biochemical markers associated with endothelial function (EF). Main methods: Ten healthy subjects were exposed to a simulated altitude of 4,000. meters above sea level for 4. hours in a hypobaric chamber. Vascular reactivity was measured by the flow-mediated vasodilatation (FMVD) test. Endothelin-1, high sensitive-C reactive protein (hsCRP), vascular cell adhesion molecule 1, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), paraoxonase and adiponectin levels, and FMVD were evaluated before and after the exposure. Key findings: Subjects were young (age: 32±6years), lean [body mass index: 23.9±2.0kg/m2, waist circumference: 77(IQR: 72-80) cm], and presented normal clinical and biochemical parameters. No significant changes were evidenced in FMVD in response to HH (pre: 0.45 (0.20-0.70) vs. during: 0.50 (0.20-1.22) mm; p=0.594). On the other hand, endothelin-1 (+54%, p<0.05), hsCRP (+37%, p<0.001), IL-6 (+75%, p<0.05), TNF-α (+75%, p<0.05), and adiponectin (-39%, p<0.01) levels were significantly altered post-HH. FMVD was increased in 7 subjects, and it was decreased in 3 individuals during HH exposure. Interestingly, when EF biomarkers were compared between these two subgroups of subjects, only post exposure-adiponectin levels were significantly different (49±5 vs. 38±6μg/ml, respectively, p<0.05). Significance: HH exposure had an effect on endothelin-1, adiponectin, hsCRP, IL-6, and TNF-α concentration. However, adiponectin was the only biomarker associated with an altered vascular reactivity.Fil: Iglesias, Diego. Sociedad Argentina de Medicina de Montaña; Argentina. Hospital Italiano; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Gomez Rosso, Leonardo Adrián. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Vainstein, Nora. Hospital Italiano; ArgentinaFil: Meroño, Tomás. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Lezón, Christian Esteban. Sociedad Argentina de Medicina de Montaña; ArgentinaFil: Brites, Fernando Daniel. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Low plasma triiodothyronine levels in heart failure are associated with a reduced anabolic state and membrane damage

BACKGROUND: Low plasma triiodothyronine (T(3)) levels are considered a prognostic predictor of death in heart failure (HF) patients. AIM: To study an association between plasma T(3) levels and several cardiac, neurohormonal, and metabolic markers of HF. METHODS: A total of 133 ambulatory HF patients (114 males; mean age 63.2 years) with left ventricular ejection fraction <40% were enrolled. TSH, total tetraiodothyronine (T(4)) and T(3), N-terminal pro-brain natriuretic peptide (NT-proBNP), and other cardiac and metabolic parameters were measured. The lowest tertile of T(3) (group 1) was compared against the two upper ones (group 2). RESULTS: In simple logistic regression, the lowest T(3) tertile was associated with more advanced HF disease status: older (age: odds ratio (OR)=1.05; confidence interval (CI) 95% 1.01-1.09, P=0.004), lower functional capacity (walking test: OR=0.996; CI 95% 0.993-0.999, P=0.008), higher NT-proBNP (OR=1.64; CI 95% 1.19-2.27, P=0.003) and adiponectin levels (OR=1.07; CI 95% 1.02-1.11, P=0.004), lower DHEAS log-transformed (OR=0.50; CI 95% 0.31-0.80, P=0.004), and the presence of lower phase angle values as measured by body bioelectrical impedance analysis (OR=3.18; CI 95% 1.50-6.71, P=0.04) and worse renal function (OR=0.96; CI 95% 0.94-0.98, P=0.003). T(3) levels in the lowest tertile were independently associated with low phase angle values (OR=2.95, CI 95% 1.16-7.50, P=0.02) and the log transformation of DHEAS (OR=0.56; CI 95% 0.32-0.97, P=0.04). CONCLUSION: We have demonstrated an association between plasma T(3) levels in the lower range and other deranged hormonal and metabolic parameters in HF patients.Fil: Brenta, Gabriela. Gobierno de la Ciudad de Buenos Aires. Hospital César Milstein; ArgentinaFil: Thierer, Jorge. Instituto Cardiovascular de Buenos Aires; ArgentinaFil: Sutton, Marcela. Instituto Cardiovascular de Buenos Aires; ArgentinaFil: Acosta, Adriana. Instituto Cardiovascular de Buenos Aires; ArgentinaFil: Vainstein, Nora. Instituto Cardiovascular de Buenos Aires; ArgentinaFil: Brites, Fernando Daniel. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Boero, Laura. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Gomez Rosso, Leonardo Adrián. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Anker, Stefan. Istituto di Ricovero e Cura a Carattere Scientifico; Italia. Charité Universitätsmedizin Berlin; Alemani

Vascular reactivity and biomarkers of endothelial function in healthy subjects exposed to acute hypobaric hypoxia

Aims: The aim of this study was to evaluate the effects of acute hypobaric hypoxia (HH) on vascular reactivity and biochemical markers associated with endothelial function (EF). Main methods: Ten healthy subjects were exposed to a simulated altitude of 4,000 meters above sea level for 4 hours in a hypobaric chamber. Vascular reactivity was measured by the flow-mediated vasodilatation (FMVD) test. Endothelin-1, high sensitive-C reactive protein (hsCRP), vascular cell adhesion molecule 1, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), paraoxonase and adiponectin levels, and FMVD were evaluated before and after the exposure. Key findings: Subjects were young (age: 32±6 years), lean [body mass index: 23.9±2.0kg/m(2), waist circumference: 77(IQR: 72-80) cm], and presented normal clinical and biochemical parameters. No significant changes were evidenced in FMVD in response to HH (pre: 0.45 (0.20-0.70) vs. during: 0.50 (0.20-1.22) mm; p=0.594). On the other hand, endothelin-1 (+54%, p<0.05), hsCRP (+37%, p<0.001), IL-6 (+75%, p<0.05), TNF-α (+75%, p<0.05), and adiponectin (-39%, p<0.01) levels were significantly altered post-HH. FMVD was increased in 7 subjects, and it was decreased in 3 individuals during HH exposure. Interestingly, when EF biomarkers were compared between these two subgroups of subjects, only post exposure-adiponectin levels were significantly different (49±5 vs. 38±6μg/ml, respectively, p<0.05). Significance: HH exposure had an effect on endothelin-1, adiponectin, hsCRP, IL-6, and TNF-α concentration. However, adiponectin was the only biomarker associated with an altered vascular reactivity

Assessing the burden of osteoarthritis in Latin America: a rapid evidence assessment

This rapid evidence assessment (REA) was conducted to explore the burden of weight-bearing joint osteoarthritis in the developing countries of Latin America. REA methodology used a standardized search strategy to identify observational studies published from 2010 to 23 April 2020 that reported outcomes pertaining to the epidemiology and humanistic or economic burden of weight-bearing osteoarthritis. Relevant data from each included study were used to populate bespoke data extraction tables and qualitatively analyzed. Thirteen publications were identified that reported on knee and hip osteoarthritis in the Latin American region. Overall prevalence of physician-diagnosed symptomatic knee osteoarthritis in adults ranged from 1.55% in Peru to 7.4% in Ecuador. Total prevalence of grade ≥ 2 radiographic knee osteoarthritis was 22% among those ≥ 39 years of age in Brazil and 25.5% among those ≥ 40 years of age in Mexico. The prevalence of symptomatic/radiographic knee osteoarthritis was 7.1% in people ≥ 18 years of age in Mexico and 17.6% among those ≥ 40 years of age. Prevalence of hip osteoarthritis was similar to or slightly lower than knee osteoarthritis. The limited data available indicates weight-bearing osteoarthritis negatively affects quality of life and that the economic burden may vary between countries with different healthcare systems. The limited evidence found in the published literature suggests the burden of osteoarthritis in Latin America is substantial. Our analysis identified several evidence gaps, particularly for health-related quality of life and socioeconomic outcomes. Further research is of particular importance in areas where government-subsidized healthcare and resources are scarce.Fil: de Andrade, Daniel Ciampi. Hospital das Clínicas; BrasilFil: de Andrade, Daniel Ciampi. Aalborg University. Department of Health Science and Technology. Center for Neuroplasticity and Pain; DinamarcaFil: de Andrade, Daniel Ciampi. Universidade de São Paulo. Faculdade de Medicina. Pain Center. LIM‑62; BrasilFil: Saaibi, Diego. Universidad Autonoma de Bucaramanga; ColombiaFil: Sarría, Nicolas. Universidad Católica de Córdoba; ArgentinaFil: Sarría, Nicolas. Instituto Oulton; ArgentinaFil: Ruiz, Leslie Cano. Pfizer; ArgentinaFil: Espinosa, Rolando. National Institute of Rehabilitation. Rheumatology Department; MéxicoFil: Vainstein, Nora. Pfizer; Argentin

Resultados de un estudio multicéntrico, no controlado, de seguimiento sobre factores de riesgo cardiovascular

Background Cardiovascular disease is still one of the leading causes of mortality in our country. It has been well documented that adequate changes in lifestyle are beneficial for primary and secondary prevention. However, it is difficult to apply or maintain these measures in the real world. The ENASE study was developed as a program to train physicians in the knowledge of good dietary habits and exercise to help patients to incorporate healthy behaviors in everyday life. Objective To evaluate if a plan designed to train attending physicians can produce changes in the patients. Material and Methods We conducted a prospective, multicenter and uncontrolled study on 508 patients with a follow-up of three years in 17 provinces and in the Autonomous City of Buenos Aires. Statistical analysis was performed using the paired Student�s t test and the Wilcoxon test. Results With the help of primary physicians, this population increased physical activity and made significant changes in eating habits. Blood pressure, triglycerides, LDL-cholesterol and blood sugar levels decreased significantly and progressively from the first to the third year of follow-up. HDL-cholesterol increased significantly while body weight showed a slight and non-significant reduction. The prescription of medical treatment did not change during the three years, except for a greater use of statins in accordance with the recommendations suggested by national guidelines. Conclusions This study demonstrates that a plan focused on educating and training physicians produces significant benefits on the cardiovascular health of patients.Introducción La enfermedad cardiovascular sigue siendo una de las principales causas de muerte en nuestro país y está bien documentado que cambios adecuados en el estilo de vida son favorables tanto en términos de prevención primaria como secundaria. Sin embargo, en el mundo real, estas medidas no son de fácil instrumentación o mantenimiento. Esto llevó al desarrollo del estudio ENASE, que se concibió como un programa de entrenamiento del médico en el conocimiento de buenos hábitos de alimentación y ejercicio y en cómo ayudar al paciente a que pueda incorporarlos en forma metódica en la vida cotidiana. Objetivo Evaluar si un plan de educación del médico asistencial puede producir cambios en los pacientes. Material y métodos Estudio prospectivo, no controlado, multicéntrico, con seguimiento a 3 años en 17 provincias y en la Ciudad Autónoma de Buenos Aires, que incluyó 508 pacientes. Para el análisis estadístico se emplearon la prueba de la t de Student para muestras apareadas y la prueba de Wilcoxon. Resultados Con la guía del médico de cabecera, esta población en estudio incrementó la actividad física y realizó cambios significativos en la alimentación. A partir del primer año y con progreso adicional hasta los 3 años, se observó una reducción significativa de la presión arterial, los triglicéridos, el colesterol LDL y de la glucemia respecto de los datos basales. El colesterol HDL se incrementó en forma significativa, en tanto que el peso sólo mostró un leve descenso, no significativo. No hubo cambios en la prescripción de fármacos durante los 3 años, con excepción de un incremento en el uso de estatinas, acorde al mayor espectro de indicaciones sugeridas por las normativas nacionales. Conclusiones Este estudio demuestra que un plan de educación y entrenamiento del médico para actuar en el paciente produce beneficios significativos en la salud cardiovascular

Effects of Consumption of Beef from Variably Fed Cattle on Anthropometric Measurements, Serum Parameters and Fatty Acid Composition in Healthy Men and Women

Background: Despite the large body of convincing evidence and the leaner beef cuts now available, controversy over the relationship between red meat consumption and coronary heart disease risk factors continues. Several reports have shown that, as compared with grain-fed beef, pasture-fed beef contains increased concentrations of β-carotene and α- tocopherol, high levels of long chain n-3 PUFAs, a more desirable n-6/n-3 ratio and increased levels of CLA all substances reported to have favourable biological effects on human health. Objective: The objective of the present study was to investigate the effects of lean beef from three different cattle production systems, pasture-fed beef [P], pasture and grain supplemented-beef [M] and feedlot-beef [F] on anthropometric measurements, serum parameters and fatty acid composition in healthy men and women. Design: Forty-eight apparently healthy subjects [24 men and 24 women], were randomly assigned to consume a balanced diet [from a catering service] each of the three beef types for four weeks. Each participant consumed each diet with a period of wash up of 21 days between the different diets. Three groups of 16 subjects [8 men and 8 women] rotated through the three experimental periods. Results: In men systolic blood pressure was lower in P [109.8 vs 115.8 mmHg] than in F. The other anthropometric measurements were not affected by the beef type in either sex. However, the three diets caused significant changes from the baseline values of weight, systolic pressure, BMI and PM in both men and women. No significant differences were detected in the serum parameters and fatty acid proportion between the three diets. However, significant differences with the baseline values were found. Conclusions: No significant differences were found in the different variables studied between the three experimental diets. However, all the diets significantly affected the baseline values of the variables studied which followed a similar trend but with variable intensity according to the beef diet and sex.Fil: Tartaglione, Jorge E.. Instituto de Promoción de la Carne Vacuna Argentina; ArgentinaFil: Alves de Lima, Alberto Enrique. Instituto Cardiovascular de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Vainstein, Nora. Instituto Cardiovascular de Buenos Aires; ArgentinaFil: Conde, Diego. Instituto Cardiovascular de Buenos Aires; ArgentinaFil: Labruna, Maria Cristina. Instituto Cardiovascular de Buenos Aires; ArgentinaFil: Belardi, Jorge. Instituto Cardiovascular de Buenos Aires; ArgentinaFil: Rodriguez, Gladys C.. Instituto Cardiovascular de Buenos Aires; ArgentinaFil: Garcia, Pilar Teresa. Instituto Nacional de Tecnología Agropecuaria; Argentin