Plan de intervención fisioterápico en un paciente con linfedema secundario en ambas extremidades inferiores post-prostatectomía radical con linfadenectomía a propósito de un caso

Introducción: el linfedema se define como una acumulación de líquido rico en proteínas en el espacio intersticial debido a una alteración del transporte del sistema linfático, que se manifiesta por la hinchazón de una región del cuerpo. Los objetivos se centran en disminuir el volumen, reducir los síntomas y evitar la progresión y las complicaciones.Objetivos: describir el caso clínico de un paciente con linfedema secundario estadio 2 post prostatectomía y linfadenectomía hace 7 años. Llevar a cabo un plan de intervención para mejorar la capacidad funcional y reducir el volumen del edema.Metodología: se realiza una evaluación inicial (tanto física como psicosocial), cada 5 sesiones de tratamiento y final; se implementan 15 sesiones de fisioterapia que incluyen drenaje linfático manual, vendaje multicapa, tapiz rodante y ejercicios de movilidad.-Resultados: se produjo una reducción del volumen entorno al 4% en ambas extremidades inferiores; una reducción generalizada de la consistencia del edema; una ganancia de movilidad sobretodo en la flexión de cadera y de tobillo; una reducción de 7 puntos en la “Limphedema Life Impact Scale” y un incremento de 13 puntos en el valor total del SF-36.-Discusión: debido a la no disponibilidad de presoterapia y a la imposibilidad de llevar el vendaje multicapa 24 horas debido al carácter bilateral del edema, se incluye en el protocolo asistencial hospitalario, ejercicio físico con vendaje multicapa, tras el drenaje, con resultados satisfactorios. -Conclusiones: se han logrado los objetivos terapéuticos marcados tanto a nivel físico como psicosocial mejorando la capacidad funcional global del paciente.<br /

Infrared Thermography for Estimating Supraclavicular Skin Temperature and BAT Activity in Humans: A Systematic Review

Objective: Brown adipose tissue (BAT) is a thermogenic tissue with potential as a therapeutic target in the treatment of obesity and related metabolic disorders. The most used technique for quantifying human BAT activity is the measurement of 18F-fluorodeoxyglucose uptake via a positron emission tomography/computed tomography scan following exposure to cold. However, several studies have indicated the measurement of the supraclavicular skin temperature (SST) by infrared thermography (IRT) to be a less invasive alternative. This work reviews the state of the art of this latter method as a means of determining BAT activity in humans. Methods: The data sources for this review were PubMed, Web of Science, and EBSCOhost (SPORTdiscus), and eligible studies were those conducted in humans. Results: In most studies in which participants were first cooled, an increase in IRT-measured SST was noted. However, only 5 of 24 such studies also involved a nuclear technique that confirmed increased activity in BAT, and only 2 took into account the thickness of the fat layer when measuring SST by IRT. Conclusions: More work is needed to understand the involvement of tissues other than BAT in determining IRTmeasured SST; at present, IRT cannot determine whether any increase in SST is due to increased BAT activity.This study was supported by the Spanish Ministry of Economy and Competitiveness (MINECO) via the Fondo de Investigación Sanitaria del Instituto de Salud Carlos III (PI13/01393), Retos de la Sociedad (DEP2016-79512-R) and European Regional Development Funds (ERDF), the Fundación Iberoamericana de Nutrición (FINUT), the Redes Temáticas de Investigación Cooperativa RETIC (Red SAMID RD16/0022), the AstraZeneca HealthCare Foundation, the University of Granada Plan Propio de Investigación 2016 Excellence actions: Unit of Excellence on Exercise and Health (UCEES), and Plan Propio de Investigación 2018 and the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades (ERDF: SOMM17/6107/UGR). DSI is an Investigator of the Miguel Servet Fund from Carlos III National Institute of Health, Spain (CP15/00106). DJP is supported by grants from the Spanish Ministry of Science and Innovation-MINECO (RYC-2014-16938), MINECO/European Fund for Regional Development (FEDER) (DEP2016-76123-R), the Government of Andalusia, the Integrated Territorial Initiative 2014-2020 for the Province of Cádiz (PI-0002-2017), the European Union's ERASMUS+SPORT program (Grant Agreement 603121-EPP-1-2018-1-ES-SPO-SCP), and the EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI)

Cold-induced changes in plasma signaling lipids are associated with a healthier cardiometabolic profile independently of brown adipose tissue

Cold exposure activates brown adipose tissue (BAT) and potentially improves cardiometabolic health through the secretion of signaling lipids by BAT. Here, we show that 2 h of cold exposure in young adults increases the levels of omega-6 and omega-3 oxylipins, the endocannabinoids (eCBs) anandamide and docosahexaenoylethanolamine, and lysophospholipids containing polyunsaturated fatty acids. Contrarily, it decreases the levels of the eCBs 1-LG and 2-LG and 1-OG and 2-OG, lysophosphatidic acids, and lysophosphatidylethanolamines. Participants overweight or obese show smaller increases in omega-6 and omega-3 oxylipins levels compared to normal weight. We observe that only a small proportion (~4% on average) of the cold-induced changes in the plasma signaling lipids are slightly correlated with BAT volume. However, cold-induced changes in omega-6 and omega-3 oxylipins are negatively correlated with adiposity, glucose homeostasis, lipid profile, and liver parameters. Lastly, a 24-week exercise-based randomized controlled trial does not modify plasma signaling lipid response to cold exposure.Junta de Andalucía, Consejería de Transformación Económica, Industria, Conocimiento y Universidades Dirección General de Investigación y Transferencia del Conocimiento (ref. P18-RT-4455, ref. SOMM17/6107/UGR, and DOC 01151) and European Regional Development Funds (ERDF)Spanish Ministry of Economy and Competitiveness via the Fondo de Investigación Sanitaria del Instituto de Salud Carlos III (PI13/01393)PTA-12264, Retos de la Sociedad (DEP2016-79512-R)Spanish Ministry of Education (FPU19/01609)Fundación Iberoamericana de Nutrición (FINUT)Redes Temáticas de Investigación Cooperativa RETIC (Red SAMID RD16/0022)AstraZeneca HealthCare FoundationUniversity of Granada Plan Propio de Investigación 2016 Excellence actions: Unit of Excellence on Exercise and Health (UCEES)Chinese Scholarship Council fellowships (no. 201707060012 and no. 201607060017)Grant for the requalification of the Spanish university system from the Ministry of Universities of the Government of Spain, financed by the European Union, NextGeneration EU (María Zambrano program, reference RR_C_2021_04

Biallelic germline mutations in MAD1L1 induce a syndrome of aneuploidy with high tumor susceptibility.

Germline mutations leading to aneuploidy are rare, and their tumor-promoting properties are mostly unknown at the molecular level. We report here novel germline biallelic mutations in MAD1L1, encoding the spindle assembly checkpoint (SAC) protein MAD1, in a 36-year-old female with a dozen of neoplasias. Functional studies demonstrated lack of full-length protein and deficient SAC response, resulting in ~30 to 40% of aneuploid blood cells. Single-cell RNA analysis identified mitochondrial stress accompanied by systemic inflammation with enhanced interferon and NFκB signaling both in aneuploid and euploid cells, suggesting a non-cell autonomous response. MAD1L1 mutations resulted in specific clonal expansions of γδ T cells with chromosome 18 gains and enhanced cytotoxic profile as well as intermediate B cells with chromosome 12 gains and transcriptomic signatures characteristic of leukemia cells. These data point to MAD1L1 mutations as the cause of a new variant of mosaic variegated aneuploidy with systemic inflammation and unprecedented tumor susceptibility.This work is supported by Spanish Ministry of Science, Juan de la Cierva programme (C.V.-B.); Spanish Ministry of Science and Innovation, Agencia Estatal de Investigacion (MCI-AEI), BIO2017-91272-EXP (S.R.-P.); Spanish National Research and Development Plan, ISCIII, and FEDER, PI17/02303, PI20/01837, and DTS19/00111 (S.R.-P.); Spanish National Research and Development Plan, ISCIII, and FEDER, PI21/01641 (R.T.-R.); Fundacion Cientifica de la Asociacion Espanola contra el Cancer, LABAE20049RODR (S.R.-P.); MCI-AEI/FEDER, RTI2018-095582-B-I00, and RED2018-102723-T (M.M.); Comunidad de Madrid iLUNG and scCANCER programmes, B2017/BMD-3884 and Y2020/BIO-6519 (M.M.); and MCI-AEI, Severo Ochoa Center of Excellence, CEX2019-000891-S (S.R.-P., M.M., and M.U.).S