Effect of sodium dichloroacetate as single agent or in combination with cisplatin in normal and human cervical cancer cell lines

Purpose: To evaluate the synergistic cytotoxicity of sodium dichloroacetate (DCA) in combination with cisplatin (CIS) against human cervical cancer cell lines. Methods: Cervical cancer SiHa and HeLa cells and normal cells (Hek-293, Vero, peripheral blood mononuclear and human erythrocytes) were treated in vitro with DCA and CIS individually or their combination. Cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) method while hemolytic activity was evaluated from the released hemoglobin. Halfmaximal inhibitory concentration (IC50) of DCA or CIS was obtained. Results: The combination of DCA + CIS decreased the cell viability of SiHa, Hek-293, Vero, and PBMC cells, but not of Hela cells (p < 0.05). Furthermore, the individual treatments alone or in combination did not cause significant hemolysis (p < 0.05). Conclusion: The combination of DCA + CIS increases the damage caused by CIS alone on SiHa cells. It also decreases the cell viability of Hek-293 and Vero without affecting peripheral blood mononuclear and human erythrocyte integrity. The results suggest that the combination of DCA and CIS can induce synergistic antitumor effect in different types of cancer cell lines. However, further studies are required to determine the biological effects of the combination of DCA and CIS in vivo. Keywords: Cervical cancer, Sodium dichloroacetate, Cisplatin, Viability, Hemolysi

Malnutrition management of hospitalized patients with diabetes/hyperglycemia and COVID-19 infection

COVID-19; Diabetes; Medical nutritionCOVID-19; Diabetes; Nutrición médicaCOVID-19; Diabetis; Nutrició mèdicaDiabetes mellitus and/or hyperglycemia are highly prevalent medical conditions in patients hospitalized for coronavirus disease 2019 (COVID-19) and are associated with adverse outcomes. In addition, COVID-19 itself can provoke fluctuating and high glucose levels that can be difficult to manage upon hospitalization. Hospitalized patients with COVID-19 are at high risk of malnutrition due to an increase in nutritional requirements and a severe acute inflammatory response. The management of patients with diabetes/hyperglycemia and COVID-19 is challenging and requires a specific nutritional approach, the purpose of which is to fulfill the nutritional requirements while maintaining an optimal glycemic control. In this study, an expert group of nutritional endocrinologists carried out a qualitative literature review and provided recommendations based on evidence and guidelines, when available, or on their own experience. The optimal care based on these recommendations was compared with the routine bedside care as reported by a panel of physicians (mainly, endocrinologists, geriatricians, and internists) treating patients with diabetes/hyperglycemia and COVID-19 in their daily practice. Early screening and diagnosis, a diabetes-specific therapeutic approach, and a close malnutrition monitoring are essential to improve the clinical outcomes of these patients. In conclusion, the proposed recommendations are intended to provide a useful guide on the clinical management of malnutrition in patients with COVID-19 and diabetes/hyperglycemia, in order to improve their outcomes and accelerate their recovery. The comparison of the recommended optimal care with routine clinical practice could aid to identify gaps in knowledge, implementation difficulties, and areas for improvement in the management of malnutrition in this population.This study was funded by Abbott. Abbott Nutrition was the sponsor of the study, but it didn’t participate in the design, research, data collection and data review

Malnutrition management of hospitalized patients with diabetes/hyperglycemia and concurrent pathologies

Desnutrición; Diabetes; Tratamiento nutricionalMalnutrition; Diabetes; Medical nutritionDesnutrició; Diabetis; Tractament nutricionalLa diabetes mellitus tipo 2 es una enfermedad muy prevalente en todo el mundo y genera una carga clínica y económica creciente debido a sus complicaciones micro- y macrovasculares. Con frecuencia, las personas con diabetes son hospitalizadas por diversas patologías. Estos pacientes tienen, por lo general, un mayor riesgo de complicaciones, de estancias prolongadas y de mortalidad. Un factor adicional que empeora el pronóstico en estos pacientes es la presencia de desnutrición, sobre todo en personas de edad avanzada. Todo ello hace que el manejo de estos pacientes sea complejo y requiera un abordaje nutricional específico, cuya finalidad sea cubrir los requerimientos nutricionales manteniendo siempre el control glucémico. La finalidad de este trabajo es generar, en base a los datos disponibles en la bibliografía y la experiencia clínica, recomendaciones consensuadas por parte de dieciocho expertos en Endocrinología y Nutrición sobre el abordaje nutricional de pacientes hospitalizados con diabetes/hiperglucemia y comparar el manejo óptimo basado en estas recomendaciones con la atención habitual a pie de cama, según un panel de médicos españoles encuestados sobre su práctica clínica diaria. En este primer artículo de este número extraordinario de la revista Nutrición Hospitalaria, se describe la metodología seguida y los resultados obtenidos sobre las cuestiones comunes para todas las patologías.Type 2 diabetes mellitus is a highly prevalent disease worldwide, generating an increasing clinical and economic burden due to its micro- and macrovascular complications. Frequently, people with diabetes are hospitalized for various pathologies. These patients generally have higher risk of complications, prolonged hospitalizations and mortality. An additional factor that worsens the prognosis in these patients is the concurrence of malnutrition, especially in elderly people. All this makes the management of these patients challenging and requires a specific nutritional approach, whose purpose is to cover the nutritional requirements while always maintaining glycemic control. The purpose of this work is to provide, based on the evidence available in the literature and clinical experience, consensus recommendations by eighteen experts in Endocrinology and Nutrition on the nutritional approach of hospitalized patients with diabetes/ hyperglycemia and compare the optimal management, based on these recommendations with bedside usual care according to a panel of Spanish doctors surveyed about their daily clinical practice. This first article of this extraordinary issue of the journal Nutrición Hospitalaria describes the methodology of the study and the results obtained regarding common issues for all pathologies

Malnutrition management of hospitalized patients with diabetes/hyperglycemia and heart failure

Diabetes; Insuficiencia cardíaca; Tratamiento nutricionalDiabetis; Insuficiència cardíaca; Tractament nutricionalDiabetes; Heart failure; Medical nutritionLa insuficiencia cardíaca (IC) es una de las principales causas de morbilidad y mortalidad entre las personas mayores, lo que la convierte en un importante problema de salud pública. Las enfermedades cardiovasculares en general, y la IC en particular, son comorbilidades frecuentes en personas con diabetes tipo 2 (DM2). La presencia de DM2 e IC se asocia con síntomas y signos clínicos más graves, y peor calidad de vida y pronóstico. Además, debido al estado hipercatabólico y los trastornos de la absorción de nutrientes, la desnutrición está presente en muchos casos de IC. El presente artículo describe los resultados del consenso de expertos y las respuestas de los panelistas sobre el manejo nutricional en la práctica clínica habitual de los pacientes con diabetes/hiperglucemia hospitalizados en planta (no críticos) con IC.Heart failure (HF) is one of the leading causes of morbidity and mortality among older people, making it a major public health problem. Cardiovascular diseases in general, and HF in particular, are common comorbidities in people with type 2 diabetes (DM2). The concurrence of DM2 and HF is associated with more severe clinical symptoms and signs, and poorer quality of life and prognosis. Furthermore, due to the hypercatabolic state and nutrient absorption disorders, malnutrition is present in many HF cases. This article describes the results of the expert consensus and the responses of the panelists on the nutritional management in routine clinical practice of patients with diabetes/hyperglycemia hospitalized (non-critically ill) with HF

Comparison of Mg/Ca concentration series from Patella depressa limpet shells using CF-LIBS and LA-ICP-MS

The elemental composition of marine mollusk shells can offer valuable information about environmental conditions experienced by a mollusk during its lifespan. Previous studies have shown significant correlations between Mg/Ca concentration ratios measured on biogenic carbonate of mollusk shells and sea surface temperature (SST). Here we propose the use of Laser-Induced Breakdown Spectroscopy (LIBS) and the validation of the Calibration-Free LIBS (CF-LIBS) approach for the rapid measurement and estimation of Mg/Ca molar concentration profiles within Patella depressa Pennant, 1777 limpet shells. To achieve these objectives, results derived from CF-LIBS methodology are compared with those obtained from an established analytical technique for this purpose, such as Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS). Concentration series obtained with both methodologies show defined temporal patterns and reflect the season-of-capture in each specimen. The results evidence a significant correlation (R2 = 0.63–0.81) between CF-LIBS and LA-ICP-MS Mg/Ca molar concentration profiles within four live-collected P. depressa shells. Averaged error for the molar concentration estimated with CF-LIBS was lower than 10% in every specimen. The comparison between the results obtained from two techniques used in this study has allowed us to demonstrate for the first time that Mg/Ca molar concentration measured in biogenic carbonates were accurately inferred using CF-LIBS technique. The CF-LIBS approach validation represents great potential for the rapid and large-scale paleoenvironmental and archaeological analysis of this mollusk species, which is frequently found in archaeological sites.1. Introduction 2. Materials and methods 2.1. Sample preparation 2.2. LA-ICP-MS setup and analyses 2.3. LIBS setup and measurements 2.4. CF-LIBS application 3. Results and discussion 3.1. LA-ICP-MS concentration profiles 3.2. CF-LIBS approach results 3.3. CF-LIBS and LA-ICP-MS comparison 3.4. Implications for paleoclimatology and archaeology 4. Conclusion

A chrono-cultural reassessment of El Cuco rock-shelter: a new sequence for the Late Middle Paleolithic in the Cantabrian Region (northern Iberia)

A large number of sites dated to the Late Middle Paleolithic and the Early Upper Paleolithic have been recorded in the Cantabrian region (northern Iberia), making this area a key location to investigate the lifeways of the last Neanderthals and the first anatomically modern humans. The stratigraphic sequence from El Cuco rock-shelter was originally attributed to the Early Upper Paleolithic based on radiocarbon dates performed on bone apatite. However, new radiocarbon dates on shell carbonates from the lower levels produced inconsistent dates with those previously published. In order to clarify this anomaly, a reassessment of the chronology of levels VI to XIV was undertaken. The review was based on new radiocarbon dates performed on bones and shells, and a re-evaluation of the lithic assemblages. Bone samples did not produce radiocarbon dates due to lack of collagen preservation but radiocarbon dating of shell carbonates provided dates ranging from 42.3 to 46.4 ka BP. These dates are significantly older than that previously obtained for level XIII using biogenic apatite from bones (~30 ka uncal BP), suggesting that the bone apatite used for radiocarbon dating was rejuvenated due to contamination with secondary carbonate. Lithic assemblages, defined in the first place as Evolved Aurignacian, have now been now confidently attributed to the Mousterian techno-complex. These results suggest a Middle Paleolithic chronology for this part of the sequence. The new chronology proposed for El Cuco rock-shelter has significant implications for the interpretation of Neanderthal subsistence strategies and settlement patterns, especially for coastal settlement and use of marine resources, not only in northern Iberia, but also in Atlantic Europe

The registry of home artificial nutrition and ambulatory of the Spanish society of parenteral and enteral nutrition: Swot analysis

Objetivo: Evidenciar mediante un análisis DAFO-R realizado por consenso de expertos las características más acuciantes del registro de Nutrición Artificial Domiciliaria y Ambulatoria. Material y método: Análisis DAFO-R por consenso de expertos. Se solicitó la participación de los miembros del grupo NADYA activos en los últimos 5 años bajo la premisa de estructurar el DAFO-R sobre las características del registro NADYA desde su inicio. Resultados: Han participado 18 expertos de diferentes hospitales de la geografía española. El análisis interno se inclina positivamente presentando al registro con recursos importantes. En el análisis externo no son numerosas las amenazas, hay factores de gran potencia, “la voluntariedad del registro” y la “dependencia externa de financiación”. Las oportunidades identificadas son importantes. Las recomendaciones se dirigen a la estabilización del sistema disminuyendo las amenazas como foco principal de las estrategias a desarrollar al mismo tiempo que se debe potenciar los puntos identificados en oportunidades y fortalezas. Conclusiones: El registro NADYA se muestra en el análisis con gran potencialidad de mejora. Las recomendaciones propuestas deberán estructurarse para continuar la tendencia de desarrollo y perfeccionamiento de la calidad que ha caracterizado al registro NADYA desde su inicio.Objective: To evidence by means of a SWOT-R analysis performed by an expert consensus the most worrying characteristics of the register on Home-based and Outpatient Artificial Nutrition. Material and methods: SWOT-R analysis with expert consensus. We requested the participation of the active members of the NADYA group within the last 5 years with the premise of structuring the SWOT-R based on the characteristics of the NADYA registry from its beginning. Results: 18 experts from hospitals all over Spain have participated. The internal analysis seems to be positive, presenting the registry as having important resources. The external analysis did not show a great number of threats, there are very potent factors, “the voluntariness” of the registry and the “dependence on external financing”. The opportunities identified are important. The recommendations are aimed at stabilizing the system by decreasing the threats as one of the main focus of the strategies to develop as well as promoting the items identified as opportunities and strengths. Conclusions: The analysis shows that the NADYA register shows a big potentiality for improvement. The proposed recommendations should be structured in order to stay on the track of development and quality improvement that has characterized the NADYA register from the beginnin

Fish Oil Enriched Intravenous Lipid Emulsions Reduce Triglyceride Levels in Non-Critically Ill Patients with TPN and Type 2 Diabetes. A Post-Hoc Analysis of the INSUPAR Study

There are no studies that have specifically assessed the role of intravenous lipid emulsions (ILE) enriched with fish oil in people with diabetes receiving total parenteral nutrition (TPN). The objective of this study was to assess the metabolic control (glycemic and lipid) and in-hospital complications that occurred in non-critically ill inpatients with TPN and type 2 diabetes with regard to the use of fish oil emulsions compared with other ILEs. We performed a post-hoc analysis of the Insulin in Parenteral Nutrition (INSUPAR) trial that included patients who started with TPN for any cause and that would predictably continue with TPN for at least five days. The study included 161 patients who started with TPN for any cause. There were 80 patients (49.7%) on fish oil enriched ILEs and 81 patients (50.3%) on other ILEs. We found significant decreases in triglyceride levels in the fish oil group compared to the other patients. We did not find any differences in glucose metabolic control: mean capillary glucose, glycemic variability, and insulin dose, except in the number of mild hypoglycemic events that was significantly higher in the fish oil group. We did not observe any differences in other metabolic, liver or infectious complications, in-hospital length of stay or mortality

Regular insulin added to total parenteral nutrition vs subcutaneous glargine in non-critically ill diabetic inpatients, a multicenter randomized clinical trial: INSUPAR trial

Background: There is no established insulin regimen in T2DM patients receiving parenteral nutrition. Aims: To compare the effectiveness (metabolic control) and safety of two insulin regimens in patients with diabetes receiving TPN. Design: Prospective, open-label, multicenter, clinical trial on adult inpatients with type 2 diabetes on a non-critical setting with indication for TPN. Patients were randomized on one of these two regimens: 100% of RI on TPN or 50% of Regular insulin added to TPN bag and 50% subcutaneous Gl. Data were analyzed according to intention-to-treat principle. Results: 81 patients were on RI and 80 on GI. No differences were observed in neither average total daily dose of insulin, programmed or correction, nor in capillary mean blood glucose during TPN infusion (165.3 +/- 35.4 in RI vs 172.5 +/- 43.6 mg/dL in GI; p = 0.25). Mean capillary glucose was significantly lower in the GI group within two days after TPN interruption (160.3 +/- 45.1 in RI vs 141.7 +/- 43.8 mg/dL in GI; p = 0.024). The percentage of capillary glucose above 180 mg/dL was similar in both groups. The rate of capillary glucose <= 70 mg/dL, the number of hypoglycemic episodes per 100 days of TPN, and the percentage of patients with non-severe hypoglycemia were significantly higher on GI group. No severe hypoglycemia was detected. No differences were observed in length of stay, infectious complications, or hospital mortality. Conclusion: Effectiveness of both regimens was similar. GI group achieved better metabolic control after TPN interruption but non-severe hypoglycemia rate was higher in the GI group. (C) 2019 The Author(s). Published by Elsevier Ltd