Preventing organ damage in systemic lupus erythematosus: the impact of early biological treatment.

INTRODUCTION: One of the most important aims in the management of systemic lupus erythematosus (SLE) is to avoid or delay the accumulation of organ damage. The first five years after diagnosis are crucial for prognosis. AREAS COVERED: This manuscript reviews available data on organ damage accrual in SLE and early therapeutic intervention as a possible strategy to prevent its long-term accrual. EXPERT OPINION: Organ damage can be minimized by controlling disease activity and risk of flares, reducing the dose of glucocorticoids, and ensuring a proper therapeutic intervention with an early introduction of the right therapies. The current standard treatment cannot provide clinical remission in all patients with SLE. Therefore, there is a clinical need for introducing new therapeutic strategies able to achieve the main therapeutic objectives. The addition of biologic and other therapeutic agents to the standard of care is effective for controlling disease activity and for preventing severe flares, enabling a reduced use of glucocorticoids, and presumably reducing organ damage progression. Considering its efficacy and safety, early inclusion of biologic agents in the first lines of the treatment algorithm, at least in certain patients, could be considered as an innovative treatment approach to decrease disease burden in SLE patients.

Industrial-Scale Decontamination Procedure Effects on the Content of Acaricides, Heavy Metals and Antioxidant Capacity of Beeswax.

Beeswax is useful for the beekeeping sector but also for the agro-food, pharmaceutical or cosmetics sectors. Frequently, this bee product is contaminated with pesticides reducing its utility and causing the decline in its market. This study aimed to prove the effectiveness of an industrial-scale decontamination method in removing acaricides from beeswax. Chlorfenvinphos and coumaphos decrease was higher than 90%, whereas tau fluvalinate decrease was only 30%. No changes were observed in the beeswax content of hydrocarbons and monoesters, whereas a decrease in the concentrations of Ca, Fe, Zn, Hg, Mn and P, and an increase in the concentrations of As and Si were found after the decontamination. Filtration reduced total phenolics, flavonoids and the antioxidant capacity of the lipophilic extract. These results demonstrate that the industrial method used was as effective as the method previously tested on a laboratory scale. The study also contributes to a better knowledge and characterization of beeswax, specially related to trace and ultra-trace elements and antioxidant capacity. Moreover, it offers the chance to further develop a method to effectively detect wax adulterations based on the chemical elements profile.

Efectos de un protocolo HIIT con ejercicios funcionales sobre el rendimiento y la composición corporal / Effects of a HIIT protocol including functional exercises on performance and body composition

Introducción: El entrenamiento interválico de alta intensidad (HIIT) es uno de los medios más eficaces para mejorar la función metabólica y cardiorrespiratoria, así como para incrementar el rendimiento físico. Tradicionalmente se han utilizado protocolos HIIT basados en la carrera o el ciclismo, sin embargo pocos estudios han tratado de analizar los efectos de un protocolo HIIT que incluya ejercicios funcionales de fuerza. Objetivos: Comparar los efectos sobre el rendimiento y la composición corporal de dos protocolos diferentes de HIIT. Material y método: 14 varones jóvenes (edad: 21,67±1,61 años; altura: 1,73 ± 0,06 metros; peso: 76,07 ± 12,96 kg) participaron en el estudio y fueron divididos de forma balanceada y aleatoria en dos grupos experimentales: Grupo Ciclismo (GC) y Grupo Entrenamiento Funcional (GEF). Ambos grupos entrenaron 2 d/semana durante 4 semanas. El GC realizó 4 rep. x 30 seg. de sprint en bicicleta, con 3 min. de recuperación. El GEF realizó un circuito (30'' trabajo/ 15'' descanso) con 6 ejercicios funcionales de fuerza (elíptica, battle rope, escalera de agilidad, kettlebell, burpees y multisaltos). Esos ejercicios fueron repetidos 3 veces combinados con 3 minutos de recuperación. Las siguientes valoraciones fueron realizadas antes y después del programa de entrenamiento: Composición corporal, consumo máximo de oxígeno, T-Test, potencia máxima y potencia media en cicloergómetro, lactato, así como valores de frecuencia cardiaca, tensión arterial y hemoglobina. Resultados: En ambos grupos se observó un aumento significativo de los valores de VO2máx y potencia máxima, así como un descenso en el peso graso y en el porcentaje graso tras el programa de entrenamiento. Sin embargo, no se observaron diferencias significativas entre grupos. Conclusión: Un programa HIIT basado en ejercicios funcionales de fuerza produce mejoras sobre el rendimiento aeróbico, anaeróbico y la composición corporal similares a las conseguidas por un programa HIIT de sprint repetido en bicicleta

Introduction: High Intensity Interval Training (HIIT) is one of the most effective ways to improve metabolic and cardiorespiratory factors, as well as to increase physical performance. Running or cycling HIIT protocols have been usually performed, but there are few research related to the effects of a HIIT protocol including functional strength exercises Objectives: To compare the effects of two different HIIT protocols on the performance and the body composition. Material and Method: 14 young males (years: 21,67 ±1,61; height 1,73 ± 0,06 m; weight: 76,07 ± 12,96 kg) took part in the study and they were divided into two randomly balanced groups: Cycling Group (GC) and Functional Training Group (GEF). Both groups worked out 2 days a week during a 4-week-period. GC performed 4 rep. x 30 seconds of bicycle sprint with 3 minutes recovery time. GEF performed a trial based on 30’’ work (high intensity)/15’’rest, with 6 functional strength exercises consisting of elliptical bike, battle rope, agility ladder, kettlebell, burpees and jumps. These exercises were repeated 3 times in combination with 3 minutes recovery time. The following measurements were carried out before and after the training: Body composition, maximum oxygen uptake, T-test, maximum and mean power on cycle ergometer, blood lactate, as well as hear rate, blood pressure and hemoglobin. Results: Significant changes were observed in the values referred to VO2max, maximum power, fat weight and fat percentage for both groups. Nevertheless, no significant difference was observed between groups. Conclusion: A HIIT program based on functional strength exercises improved aerobic, anaerobic performance and body composition in a similar way than the HIIT program on a bicycle

Are by-products from beeswax recycling process a new promising source of bioactive compounds with biomedical properties?

During the process of beeswax recycling, many industrial derivatives are obtained. These matrices may have an interesting healthy and commercial potential but to date they have not been properly studied. The aim of the present work was to evaluate the proximal and phytochemical composition, the antioxidant capacity and cytotoxic effects of two by-products from beeswax recycling process named MUD 1 and MUD 2 on liver hepatocellular carcinoma. Our results showed that MUD 1 presented the highest (P < .05) fiber, protein, carbohydrate, polyphenol and flavonoid concentration, as well as the highest (P < .05) total antioxidant capacity than the MUD 2 samples. MUD1 exerted also anticancer activity on HepG2 cells, by reducing cellular viability, increasing intracellular ROS levels and affecting mitochondrial functionality in a dose-dependent manner. We showed for the first time that by-products from beeswax recycling process can represent a rich source of phytochemicals with high total antioxidant capacity and anticancer activity; however, further researches are necessary to evaluate their potentiality for human health by in vivo studies.

Echocardiographic hemodynamic monitoring in the critically ill patient.

Echocardiography has shown to be an essential diagnostic tool in the critically ill patient's assessment. In this scenario the initial fluid therapy, such as it is recommended in the actual clinical guidelines, not always provides the desired results and maintains a considerable incidence of cardiorrespiratory insufficiency. Echocardiography can council us on these patients' clinical handling, not only the initial fluid therapy but also on the best-suited election of the vasoactive/ inotropic treatment and the early detection of complications. It contributes as well to improving the etiological diagnosis, allowing one to know the heart performance with more precision. The objective of this manuscript is to review the more important parameters that can assist the intensivist in theragnosis of hemodynamically unstable patients.

Sepsis-induced cardiomyopathy.

Myocardial dysfunction is one of the main predictors of poor outcome in septic patients, with mortality rates next to 70%. During the sepsis-induced myocardial dysfunction, both ventricles can dilate and diminish its ejection fraction, having less response to fluid resuscitation and catecholamines, but typically is assumed to be reversible within 7-10 days. In the last 30 years, It's being subject of substantial research; however no explanation of its etiopathogenesis or effective treatment have been proved yet. The aim of this manuscript is to review on the most relevant aspects of the sepsis-induced myocardial dysfunction, discuss its clinical presentation, pathophysiology, etiopathogenesis, diagnostic tools and therapeutic strategies proposed in recent years.