Assessment of probiotic properties of lactic acid bacteria isolated from an artisanal Colombian cheese.

Lactic Acid Bacteria play an important role in the milk fermentation processes of traditional cheeses and have become an important target for the development of novel cheese cultures because of their ability to confer health benefits. This study aimed to evaluate the probiotic potential of 12 Lactic Acid Bacteria (LAB) strains previously isolated and molecularly identified from an artisanal Colombian Double-Cream Cheese. Probiotic properties, including safety (hemolysis and sensibility to antibiotics), pH and bile salt tolerance, auto-aggregation, cell surface hydrophobicity, antibacterial activity, and exopolysaccharide production, were examined. None of the strains were hemolytic, and Pediococcus (16, 18) and Lactobacillus (28, 29) were found to be sensitive to all antibiotics. Moreover, all the strains tolerated pH (3.0, 6.5 and 8.0) and bile salt conditions (0.3, 0.6 and 1.0 % w/v). Pediococcus pentosaceus (16), Leuconostoc citreum (17), Pediococcus acidilactici (18), Enterococcus faecium (21,22), Enterococcus faecalis (24) and Limosilactobacillus fermentum (29) exhibited medium autoaggregation and affinity to chloroform. Six of the strains exhibited a ropy exopolysaccharide phenotype. Antibacterial activity against foodborne pathogens, Salmonella Typhimurium ATCC 14028, Listeria monocytogenes ATCC 19111, Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 25923, was found to be strain dependent, with the strains 16, 18, 21, 26, 28 and 29 presenting a higher inhibition (>4 mm) against all of them. According to Principal Component Analysis, P. pentosaceus (16), Leu. mesenteroides (26), L. casei (28), L. fermentum (29), and E. faecium (21) showed strong probiotic properties. Our findings suggest that five strains out of the 12 sampled strains are potential probiotics that could be used in the processing of traditional dairy products on an industrial scale to improve their quality.

Usefulness of circulating EPAC1 as biomarkers of therapeutic response to GLP-1 receptor agonists.

AIMS: The response to Glucagon-like peptide-1 receptor agonists (GLP-1RAs) is highly varia-ble among patients. Thus, the identification of predictive biomarkers of therapeutic response to GLP-1 RA could help us to optimize the use of this class of drugs. GLP-1RAs increase exchange proteins directly activated by cAMP (EPAC). The aim of the present study was to assess whether the increase of EPAC1 after GLP-1RAs treatment could be a biomarker of clinical response. METHODS: After showing that GLP-1 (10 ng/mL) significantly increased the expression of EPAC1 in human endo-thelial vascular cells (HUVEC), a pilot clinical study was planned. For this purpose 49 patients with type 2 diabetes who started treatment with liraglutide were included. EPAC1 concentration was determined by ELISA before and at one month of liraglutide treatment. RESULTS: We found that serum concentration of EPAC1 increased significantly after treatment with liraglutide. Only in those patients in whom EPAC1 increased (64%), a significant decrease in HbA1c, LDL-C, body mass index (BMI), and waist circumference was shown. CONCLUSIONS: This pilot study suggests that the increase of circulating EPAC1 after GLP-1RAs treatment could be a useful biomarker to predict clinical GLP1-RAs response.

Efficacy of Insulclock in Patients with Poorly Controlled Type 1 Diabetes Mellitus: A Pilot, Randomized Clinical Trial.

Insulclock® is an electronic device designed to improve treatment adherence and insulin injection tracking. This randomized, single-center, pilot study assessed the clinical impact of Insulclock on glycemic control and variability, treatment adherence, and satisfaction in patients with uncontrolled type 1 diabetes mellitus (T1DM). We also compared these outcomes between the Active and Masked groups (with or without receiving reminders and app alerts). Sixteen patients completed the study: 10 in the Active group and 6 in the Masked group. Insulclock use was associated with a decrease in mean glucose (-27.0 mg/dL [1.5 mmol/L]; P = 0.013), glucose standard deviation (-14.4 mg/dL [0.8 mmol/L]; P = 0.003), and time above range (-12.5%; P = 0.0026), and an increase in time in range (TIR) (+7%; P = 0.038) in the overall population. The use of app information and alerts in the Active group was associated with an increase in TIR (+8%; P = 0.026). We observed a -3.9 (P = 0.1352) and -5.4 (P = 0.032) reduction per month in the number of missed and mistimed insulin doses in the overall population, respectively. Most of the items of the Insulin Treatment Satisfaction Questionnaire (ITSQ) improved after 4 weeks of Insulclock use. This pilot study points out an improvement in glycemic levels, adherence, and satisfaction in T1DM patients, supporting the development of clinical trials powered to confirm these effects.

Hipofosfatemia severa por hierro intravenoso en paciente intervenida de bypass gástrico / Intravenous iron induced severe hypophophatemia in a gastric bypass patient

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Insulclock: A Novel Insulin Delivery Optimization and Tracking System.

BACKGROUND: Achieving and maintaining controlled glycemic levels are challenging in people with insulin-treated diabetes mellitus, suboptimal insulin injections being the main obstacle to treatment success. METHODS: This research article presents the main functionalities and performance tests on Insulclock®, an electronic device plugged into insulin pens and connected with a smartphone app to improve insulin management. Insulclock tracks the date, time of day, dose, type of insulin, temperature, and duration of insulin injections. Information is stored in the device memory and is available for analysis by patients and health care providers. Insulclock device also has a reminder system with visual and acoustic alerts to reduce insulin omissions and mistiming. RESULTS: The main performance tests reveal that Insulclock can detect seven types of insulin pens with a 97% correct classification rate. Among 556 injections, most of the doses were accurately detected (deviation = 0), with relative errors ranging from 3% to 7% across different dosages. The duration of injections recorded by this device strongly correlated with that detected by an external chronometer (R2 = 0.99, root-mean-square deviation [RMSD] = 0.39). Moreover, the precision of the temperature sensor was evidenced by high correlation of temperatures detected by Insulclock and by an external thermometer (Pearson's R2 = 0.90, RMSD = 0.45). CONCLUSIONS: Insulclock is a novel device capable of tracking dosing, timing, and missing insulin injections. The promising capabilities it offers for diabetes mellitus self-management may help health care providers, researchers, and insulin users avoid frequent errors in insulin administration.

Safety and Efficacy of DPP4 Inhibitor and Basal Insulin in Type 2 Diabetes: An Updated Review and Challenging Clinical Scenarios.

The safety and efficacy of dipeptidyl peptidase-4 (DPP4) inhibitors as monotherapy or in combination with other oral antidiabetic agents or basal insulin are well established. DPP4 inhibitors stimulate glucose-dependent insulin secretion and inhibit glucagon production. As monotherapy, they reduce the hemoglobin A1c level by about 0.6-0.8%. The addition of a DPP4 inhibitor to basal insulin is an attractive option, because they lower both postprandial and fasting plasma glucose concentrations without increasing the risk of hypoglycemia or weight gain. The present review summarizes the extensive evidence on the combination therapy of DPP4 inhibitors and insulin-based regimens in patients with type 2 diabetes. We focus our discussion on challenging clinical scenarios including patients with chronic renal impairment, elderly persons and hospitalized patients. The evidence indicates that these drugs are highly effective and safe in the elderly and in the presence of mild, moderate and severe renal failure improving glycemic control with low risk of hypoglycemia. In addition, several randomized-controlled trials have shown that the use of DPP4 inhibitors in combination with basal insulin represents an alternative to the basal-bolus insulin regimen in hospitalized patients with type 2 diabetes.

Opciones reproductivas en pacientes con osteogénesis imperfecta. A propósito de 2 casos de la misma familia con una nueva mutación en COL1A1 / Reproductive options in osteogenesis imperfecta. A two cases report in the same family with a new mutation in COL1A1

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Adenocarcinoma de tipo glándula salivar y adenoma paratiroideo intratiroideos en paciente con bocio multinodular / Intrathyroid salivary adenocarcinoma not otherwise specified and parathyroid adenoma in multinodular goiter

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¿Cuándo sospechar una parálisis periódica? A propósito de un caso / When to suspect periodic paralysis: report of clinical case

La parálisis periódica es una patología excepcional que afecta a los canales iónicos musculares por diferentes causas. Produce una pérdida de fuerza muscular de manera llamativa y brusca, más evidente en la zona proximal de miembros inferiores. El hallazgo de hipopotasemia coincidiendo con estos ataques nos orienta al diagnóstico y nos muestra su diana terapéutica inicial (AU)

Periodic paralysis (PP) is an unusual disease related to a defect in muscle ion channels and caused by different pathologies. It is characterized by abrupt muscle weakness affecting rather proximal than distal muscles in lower limbs. The finding of hypokalemia during these attacks leads us to a diagnosis of hypokalemic PP and shows its initial therapeutic target (AU)