The antioxidant and anti-inflammatory activities of caffeine effectively attenuate nonalcoholic steatohepatitis and thioacetamide-induced hepatic injury in male rats.

The antioxidant effect of caffeine, associated with its ability to upregulate the nuclear factor-E2-related factor-2 (Nrf2)-signaling pathway, was explored as a possible mechanism for the attenuation of liver damage. Nonalcoholic steatohepatitis (NASH) was induced in rats by the administration of a high-fat, high-sucrose, high-cholesterol diet (HFSCD) for 15 weeks. Liver damage was induced in rats by intraperitoneal administration of thioacetamide (TAA) for six weeks. Caffeine was administered orally at a daily dose of 50 mg/kg body weight during the period of NASH induction to evaluate its ability to prevent disease development. Meanwhile, rats received TAA for three weeks, after which 50 mg/kg caffeine was administered daily for three weeks with TAA to evaluate its capacity to interfere with the progression of hepatic injury. HFSCD administration induced hepatic steatosis, decreased Nrf2 levels, increased oxidative stress, induced the activation of nuclear factor-κB (NF-κB), and elevated proinflammatory cytokine levels, leading to hepatic damage. TAA administration produced similar effects, excluding steatosis. Caffeine increased Nrf2 levels; attenuated oxidative stress markers, including malondialdehyde and 4-hydroxynonenal; restored normal, reduced glutathione levels; and reduced NF-κB activation, inflammatory cytokine levels, and damage. Our findings suggest that caffeine may be useful in the treatment of human liver diseases.

Accelerating the discovery of rare tree species in Amazonian forests: integrating long monitoring tree plot data with metabolomics and phylogenetics for the description of a new species in the hyperdiverse genus Inga Mill.

In species-rich regions and highly speciose genera, the need for species identification and taxonomic recognition has led to the development of emergent technologies. Here, we combine long-term plot data with untargated metabolomics, and morphological and phylogenetic data to describe a new rare species in the hyperdiverse genus of trees Inga Mill. Our combined data show that Inga coleyana is a new lineage splitting from their closest relatives I. coruscans and I. cylindrica. Moreover, analyses of the chemical defensive profile demonstrate that I. coleyana has a very distinctive chemistry from their closest relatives, with I. coleyana having a chemistry based on saponins and I. cylindrica and I. coruscans producing a series of dihydroflavonols in addition to saponins. Finally, data from our network of plots suggest that I. coleyana is a rare and probably endemic taxon in the hyper-diverse genus Inga. Thus, the synergy produced by different approaches, such as long-term plot data and metabolomics, could accelerate taxonomic recognition in challenging tropical biomes.

Caffeine mitigates experimental nonalcoholic steatohepatitis and the progression of thioacetamide-induced liver fibrosis by blocking the MAPK and TGF-ß/Smad3 signaling pathways.

INTRODUCTION AND OBJECTIVES: Caffeine consumption is associated with beneficial effects on hepatic disorders. The objectives of this study were to evaluate the antifibrotic effects of caffeine on experimental nonalcoholic steatohepatitis (NASH) induced with a high-fat, high-sucrose, high-cholesterol diet (HFSCD), as well as to evaluate the ability of caffeine to prevent the progression of experimental liver fibrosis induced by the administration of thioacetamide (TAA) in rats and explore the mechanisms of action. METHODS: NASH and fibrosis were induced in rats by the administration of an HFSCD for 15 weeks, and liver fibrosis was induced by intraperitoneal administration of 200 mg/kg TAA 3 times per week, for 6 weeks. Caffeine was administered at a dose of 50 mg/kg body weight. The effects of diet, TAA, and caffeine on fibrosis were evaluated by biochemical and histological examinations. The profibrotic pathways were analyzed by western blotting and immunohistochemistry. RESULTS: Rats exhibited liver fibrosis after HFSCD feeding and the administration of TAA. Caffeine could reduce the hepatic level of collagen and the fibrotic area in the liver. Caffeine prevented the progression of liver fibrosis by decreasing transforming growth factor-beta (TGF-ß), connective tissue growth factor (CTGF), and alpha-smooth muscle actin (α-SMA) expression and by inhibiting the activation of mitogen-activated protein kinases (MAPKs) and Smad3 phosphorylation. CONCLUSIONS: Caffeine attenuates NASH and the progression of liver fibrosis due to its antifibrotic effects and modulating the MAPK and TGF-ß pathways. Therefore, caffeine could be a suitable candidate for treating liver diseases associated with fibrosis.

Acromegalia. A propósito de un caso

RESUMEN La acromegalia es un síndrome clínico producido por la secreción excesiva de hormona del crecimiento que afecta a prácticamente todos los órganos y tejidos. Tiene una baja incidencia (30 a 60 casos por millón de habitantes) y se requiere tener un alto nivel de sospecha por lo que su diagnóstico continúa siendo tardío a pesar de que físicamente los pacientes inician los signos y síntomas entre cinco y diez años previos al diagnóstico. Se presenta el caso de una paciente femenina, de 57 años, atendida en el Servicio de Endocrinología del Hospital Gustavo Aldereguia Lima de Cienfuegos con manifestaciones clínicas de crecimiento acral, hipertensión y diabetes mellitus. Se le realizó prueba de tolerancia oral a la glucosa midiendo hormona de crecimiento que confirmó el exceso hormonal, resonancia magnética contrastada con gadolinio que informó macroadenoma hipofisario. Se diagnosticó como acromegalia por un tumor hipofisario productor de hormona de crecimiento. Es indiscutible la importancia del diagnóstico precoz, dado que su asociación a comorbilidades como la hipertensión y la diabetes es muy importante, lo que resulta en una disminución de la esperanza y la calidad de vida. Estas razones motivaron la presentación del caso.

ABSTRACT Acromegaly is a clinical syndrome caused by excessive secretion of growth hormone that affects virtually all organs and tissues. It has a low incidence (30 to 60 cases per million inhabitants) and a high level of suspicion is required, which is why its diagnosis continues to be late despite the fact that patients physically initiate signs and symptoms between five and ten years prior to the diagnosis. A 57-years-old female patient treated at the Endocrinology Service of the Gustavo Aldereguia Lima Hospital in Cienfuegos with clinical manifestations of acral growth, hypertension and diabetes mellitus it is presented. She underwent an oral glucose tolerance test measuring growth hormone that confirmed hormonal excess, magnetic resonance imaging contrasted with gadolinium that reported pituitary macroadenoma. She was diagnosed as acromegaly from a growth hormone-producing pituitary tumor. The importance of early diagnosis is undoubted, since its association with comorbidities such as hypertension and diabetes is very important, which results in a decrease in hope and quality of life.

Traumatic cardiac arrest: should advanced life support be initiated?

BACKGROUND: Several studies recommend not initiating advanced life support in traumatic cardiac arrest (TCA), mainly owing to the poor prognosis in several series that have been published. This study aimed to analyze the survival of the TCA in our series and to determine which factors are more frequently associated with recovery of spontaneous circulation (ROSC) and complete neurologic recovery (CNR). METHODS: This is a cohort study (2006-2009) of treatment benefits. RESULTS: A total of 167 TCAs were analyzed. ROSC was obtained in 49.1%, and 6.6% achieved a CNR. Survival rate by age groups was 23.1% in children, 5.7% in adults, and 3.7% in the elderly (p < 0.05). There was no significant difference in ROSC according to which type of ambulance arrived first, but if the advanced ambulance first, 9.41% achieved a CNR, whereas only 3.7% if the basic ambulance first. We found significant differences between the response time and survival with a CNR (response time was 6.9 minutes for those who achieved a CNR and 9.2 minutes for those who died). Of the patients, 67.5% were in asystole, 25.9% in pulseless electrical activity (PEA), and 6.6% in VF. ROSC was achieved in 90.9% of VFs, 60.5% of PEAs, and 40.2% of those in asystole (p < 0.05), and CNR was achieved in 36.4% of VFs, 7% of PEAs, and 2.7% of those in asystole (p < 0.05). The mean (SD) quantity of fluid replacement was greater in ROSC (1,188.8 [786.7] mL of crystalloids and 487.7 [688.9] mL of colloids) than in those without ROSC (890.4 [622.4] mL of crystalloids and 184.2 [359.3] mL of colloids) (p < 0.05). CONCLUSION: In our series, 6.6% of the patients survived with a CNR. Our data allow us to state beyond any doubt that advanced life support should be initiated in TCA patients regardless of the initial rhythm, especially in children and those with VF or PEA as the initial rhythm and that a rapid response time and aggressive fluid replacement are the keys to the survival of these patients. LEVEL OF EVIDENCE: Therapeutic study, level IV; epidemiologic study, level III.

Factores presentes en la deserción universitaria en la Facultad de Psicología de la Universidad De San Buenaventura, sede Bogotá en el periodo comprendido entre 1998-2009 / Factors related to the college dropout in the Faculty of Psychology at San Buenaventura University Bogotá in the period 1998-2009

El objetivo del presente estudio fue describir los factores socio demográficos y las categorías del modelo psicológico de Ethington, presentes en la deserción universitaria, evaluados por medio de una encuesta telefónica diseñada con base en estas categorías y validada por jueces. Los participantes tenían entre 16 y 32 años, solteros, de estratos 3 y 4. Los resultados descriptivos permiten concluir que existen diversas causas para que se presente la deserción en la Facultad de Psicología de la Universidad San Buenaventura, sede Bogotá. Dificultades tales como incompatibilidad del horario de estudio con el horario de trabajo, escasa información respecto al programa elegido al ingresar a la Universidad y dificultades de salud. Es importante destacar que la categoría que presentó el porcentaje más alto fue la de apoyo económico familiar con un 95%.

The purpose of this study was to describe the categories as well as the socio-demographic aspects of Ethington's psychological model, present in the university dropout. In order to do that, those aspects were assessed using a telephone survey validated by judges. Participants were between 16 and 32 years, single, from 3 and 4 social stratum. The results show that there are various reasons for dropout in the Faculty of Psychology at the University of San Buenaventura, such as: incompatibility between study and work schedules, unsuitable or insufficient information when going to University and finally, health difficulties.

Buprenorfina transdérmica en el manejo del dolor crónico nociceptivo y neuropático no oncológico en ortopedia / Buprenorfine transdermal matrix patch in the treatment of chronic nociceptive non malignant pain and neurophatic pain in the orthopaedic patology

Objetivo: siendo el año del dolor musculoesquelético, es importante evitar el subtratamiento, dado la prevalencia de dolor crónico, los costos, limitación funcional y disminución de la calidad de vida en el paciente ortopédico, requiriéndose de vías menos invasivas, como la administración transdérmica, a través de sistema matricial de buprenorfina, en base a su liposolubilidad, y biodisponibilidad, sin riesgo de hiperalgesia ni afectación del sistema inmune, considerando su efecto techo en depresión respiratoria, y su empleo en comorbilidad renal y hepática. Material y métodos: estudio longitudinal, prospectivo, aleatorizado, de septiembre de 2008 a febrero de 2010, en el servicio de algología de orthocaz, unidad de ortopedia. N=108 de ambos sexos bajo consentimiento informado. Resultados: prevalencia de dolor en consulta externa de ortopedia r= 60-80 por ciento, x = 70, el crónico nociceptivo mayor de 30 por ciento y neuropático 1, 5 por ciento con predominio en el sexo femenino de 53,8 por ciento y, etiológicamente, el síndrome de columna fallida ocupa 40,7 por ciento, osteoartrosis 44, 4 por ciento, edad X= 66,59 años r= 20-85, dolor neuropático crónico secundario a metástasis en columna lumbar 3,7. La causa más común fue cáncer prostático, síndrome complejo regional 3,7 por ciento, el tamaño del efecto (EZ) fue de 1,2 el NNT= 4, a la 3ra semana se incrementó el dolor incidental e irruptivo, a partir del 10º día disminuyeron los efectos secundarios, como la somnolencia y nausea. Discusión y conclusiones: la osteoartritis, el síndrome de columna fallida, conducto lumbar estrecho mixto, síndrome complejo regional, secuelas de fracturas, prótesis fallidas, secuelas de displasia del desarrollo de la cadera, síndrome doloroso lumbar crónico, son padecimientos musculoesqueléticos en el que se aceptan el manejo de opiodes clase 3 de la OMS, de libración prolongada, como la buprenorfina...

Objetive: being the international year of the pain skeletal muscle, it is important to avoid the sub treatment, dice the prevalence of chronic pain, with the costs, functional limitation and diminution of the quality of life in the orthopedic patient requiring itself of less invasive routes as it is it the transdermal administration through matrix system of buprenorfina, on the basis of his high lip solubility without risk of hiperalgesia nor affectation of inmune system, considering his effect ceiling in respiratory depression, and its use in renal and hepatic comorbidity. Material and methodology: longitudinal, prospective study, randomized, of September of the 2008 to February 2010, in the service of algology of Orthocaz unit of N= orthopedics 108 both sexes, under informed consent. Results: Prevalence of pain in external consultation of orthopedics r= 60-80 per cent, x =70, the chronic greater nociceptive of 30 percent and neurophatic 1,5 percent with predominance in 53,8 percent feminine sex etiology the syndrome of insolvent column occupies 40,7 percent, osteoartrosis 44,4 percent, X= age 66,59 years, r= 20-85, secondary chronic neuropathic pain to metastasis in 3,7 lumbar column the cause most common prostate cancer, regional complex syndrome 3,7 percent the size of effect (EZ) the EU of 1,2 NNT= 4, to third week increase the incidental and irruptive pain, from the 10 day diminished the indirect effect, as drowsiness and feels nauseous. Discussion and and conclusions osteoarthritis, syndrome of insolvent column, lumbar conduit narrow compound, regional complex syndrome, sequels of fractures, prosthesis insolvent, sequels of dysplasia of the developement of the hip, chronic lumbar painful syndrome, are sufferings skeletal muscle in wich the handing of opiods is accepted class III, of the WHO of liberation prolonged as it is it buprenorfina transdermal, wih progressive degree, and to allow tolerability.

Noninvasive measurement of eye retraction during blinking.

We present a noninvasive technique for high-speed measuring of eye retraction and eyelid position during blinking. The anterior chamber of the eye is illuminated by the slit lamp of a biomicroscope and eye dynamics during a blinking sequence are captured with a high-speed camera working at 500 frames per second. Digital image processing allows quantitative analysis of cornea and eyelid positions during the closing and opening phases of the blinking process. Our method allows simultaneous measuring of corneal retraction, duration of down and up phases, total blinking duration, and average and peak speeds of the eyelids in both phases, thus providing a complete analysis of the blink's transversal motions.

Assessing evidence for a pervasive alteration in tropical tree communities.

In Amazonian tropical forests, recent studies have reported increases in aboveground biomass and in primary productivity, as well as shifts in plant species composition favouring fast-growing species over slow-growing ones. This pervasive alteration of mature tropical forests was attributed to global environmental change, such as an increase in atmospheric CO2 concentration, nutrient deposition, temperature, drought frequency, and/or irradiance. We used standardized, repeated measurements of over 2 million trees in ten large (16-52 ha each) forest plots on three continents to evaluate the generality of these findings across tropical forests. Aboveground biomass increased at seven of our ten plots, significantly so at four plots, and showed a large decrease at a single plot. Carbon accumulation pooled across sites was significant (+0.24 MgC ha(-1) y(-1), 95% confidence intervals [0.07, 0.39] MgC ha(-1) y(-1)), but lower than reported previously for Amazonia. At three sites for which we had data for multiple census intervals, we found no concerted increase in biomass gain, in conflict with the increased productivity hypothesis. Over all ten plots, the fastest-growing quartile of species gained biomass (+0.33 [0.09, 0.55] % y(-1)) compared with the tree community as a whole (+0.15 % y(-1)); however, this significant trend was due to a single plot. Biomass of slow-growing species increased significantly when calculated over all plots (+0.21 [0.02, 0.37] % y(-1)), and in half of our plots when calculated individually. Our results do not support the hypothesis that fast-growing species are consistently increasing in dominance in tropical tree communities. Instead, they suggest that our plots may be simultaneously recovering from past disturbances and affected by changes in resource availability. More long-term studies are necessary to clarify the contribution of global change to the functioning of tropical forests.

The importance of demographic niches to tree diversity.

Most ecological hypotheses about species coexistence hinge on species differences, but quantifying trait differences across species in diverse communities is often unfeasible. We examined the variation of demographic traits using a global tropical forest data set covering 4500 species in 10 large-scale tree inventories. With a hierarchical Bayesian approach, we quantified the distribution of mortality and growth rates of all tree species at each site. This allowed us to test the prediction that demographic differences facilitate species richness, as suggested by the theory that a tradeoff between high growth and high survival allows species to coexist. Contrary to the prediction, the most diverse forests had the least demographic variation. Although demographic differences may foster coexistence, they do not explain any of the 16-fold variation in tree species richness observed across the tropics.

Testing metabolic ecology theory for allometric scaling of tree size, growth and mortality in tropical forests.

The theory of metabolic ecology predicts specific relationships among tree stem diameter, biomass, height, growth and mortality. As demographic rates are important to estimates of carbon fluxes in forests, this theory might offer important insights into the global carbon budget, and deserves careful assessment. We assembled data from 10 old-growth tropical forests encompassing censuses of 367 ha and > 1.7 million trees to test the theory's predictions. We also developed a set of alternative predictions that retained some assumptions of metabolic ecology while also considering how availability of a key limiting resource, light, changes with tree size. Our results show that there are no universal scaling relationships of growth or mortality with size among trees in tropical forests. Observed patterns were consistent with our alternative model in the one site where we had the data necessary to evaluate it, and were inconsistent with the predictions of metabolic ecology in all forests.

Comparing tropical forest tree size distributions with the predictions of metabolic ecology and equilibrium models.

Tropical forests vary substantially in the densities of trees of different sizes and thus in above-ground biomass and carbon stores. However, these tree size distributions show fundamental similarities suggestive of underlying general principles. The theory of metabolic ecology predicts that tree abundances will scale as the -2 power of diameter. Demographic equilibrium theory explains tree abundances in terms of the scaling of growth and mortality. We use demographic equilibrium theory to derive analytic predictions for tree size distributions corresponding to different growth and mortality functions. We test both sets of predictions using data from 14 large-scale tropical forest plots encompassing censuses of 473 ha and > 2 million trees. The data are uniformly inconsistent with the predictions of metabolic ecology. In most forests, size distributions are much closer to the predictions of demographic equilibrium, and thus, intersite variation in size distributions is explained partly by intersite variation in growth and mortality.