ABSTRACT
An increased extracellular water/intracellular water (ECW/ICW) ratio determined by bioimpedance has been related to mortality in patients undergoing hemodialysis. We aimed to evaluate the impact of body water distribution in patients with diabetes-related foot ulcers. Seventy-six patients were evaluated with bioimpedance, handgrip strength, and laboratory examinations. The ECW/ICW ratio is a prognostic factor for early mortality.
ABSTRACT
The molecular structure and solution-state molecular interactions in the popular non-steroidal anti-inflammatory drug, ketoprofen, are extensively studied with the aim of gaining a better understanding of the chemical behavior of its solution state and its connection to its nucleation pathway and crystallization outcome. Using as reference solid-state X-ray structures of enantiomeric and racemic forms of ketoprofen, a set of self-assembly models underpinned by density functional theory calculations has been considered for the analysis of spectroscopic data, infrared (IR) and vibrational circular dichroism (VCD), obtained for solutions of the samples as a function of composition and solvent. From our results it can be concluded that, contrary to the general belief for generic carboxylic acids, there are no cyclic dimeric structures of ketoprofen present in solution, but rather linear arrays made up of two (in high polar or diluted media) or more units (in low polar or low dilution media). This observation is in line with the idea that the weak contacts (other than H-bonding) would hold the key to molecular self-assembly, in agreement with recent studies on other aromatic carboxylic acids.
Subject(s)
Ketoprofen , Circular Dichroism , Spectroscopy, Fourier Transform Infrared , StereoisomerismABSTRACT
La concentración sérica de fósforo oscila entre 2,5 y 4,5 mg/dl (0,81-1,45 mmol/l) en adultos, con niveles más altos en la infancia, la adolescencia y durante la gestación. El fosfato intracelular está implicado en el metabolismo intermediario y otras funciones celulares esenciales, mientras que el extracelular es fundamental para la mineralización de la matriz ósea. La fosforemia se mantiene en un estrecho rango mediante la regulación de la absorción intestinal, la redistribución y la reabsorción tubular renal de fósforo. La hipofosfatemia y la hiperfosfatemia son situaciones clínicas frecuentes, aunque, en la mayoría de las ocasiones, se trata de alteraciones leves y poco sintomáticas. Sin embargo, pueden presentarse cuadros agudos y severos que requieren tratamiento específico. En este documento elaborado por miembros del Grupo de Trabajo de Metabolismo Mineral y Óseo de la Sociedad Española de Endocrinología y Nutrición se revisan los trastornos del fosfato y se proporcionan algoritmos de manejo clínico de la hipofosfatemia y la hiperfosfatemia
Serum phosphorus levels range from 2.5 and 4.5 mg/dL (0.81-1.45 mmol/L) in adults, with higher levels in childhood, adolescence, and pregnancy. Intracellular phosphate is involved in intermediary metabolism and other essential cell functions, while extracellular phosphate is essential for bone matrix mineralization. Plasma phosphorus levels are maintained within a narrow range by regulation of intestinal absorption, redistribution, and renal tubular absorption of the mineral. Hypophosphatemia and hyperphosphatemia are common clinical situations, although changes are most often mild and oligosymptomatic. However, acute and severe conditions that require specific treatment may occur. In this document, members of the Mineral and Bone Metabolism Working Group of the Spanish Society of Endocrinology and Nutrition review phosphate disorders and provide algorithms for adequate clinical management of hypophosphatemia and hyperphosphatemia
Subject(s)
Humans , Phosphates/metabolism , Hypophosphatemia/etiology , Hypophosphatemia/physiopathology , Hyperphosphatemia/etiology , Hyperphosphatemia/therapy , Hypophosphatemia/therapy , Phosphorus, Dietary , Rickets, Hypophosphatemic/diagnosis , Diagnosis, DifferentialABSTRACT
The synthesis of a series of vinylated analogues of sphingosine-1-phosphate together with their unambiguous configurational assignment by VCD methods is reported. Among them, compound RBM10-8 can irreversibly inhibit human sphingosine-1-phosphate lyase (hS1PL) while behaving also as an enzyme substrate. These findings, together with the postulated mechanism for S1PL activity, reinforce the role of RBM10-8 as a new mechanism-based hS1PL inhibitor.
Subject(s)
Aldehyde-Lyases/antagonists & inhibitors , Enzyme Inhibitors/pharmacology , Aldehyde-Lyases/chemistry , Amino Acid Sequence , Enzyme Inhibitors/chemical synthesis , Enzyme Inhibitors/chemistry , Molecular Structure , StereoisomerismABSTRACT
Serum phosphorus levels range from 2.5 and 4.5mg/dL (0.81-1.45 mmol/L) in adults, with higher levels in childhood, adolescence, and pregnancy. Intracellular phosphate is involved in intermediary metabolism and other essential cell functions, while extracellular phosphate is essential for bone matrix mineralization. Plasma phosphorus levels are maintained within a narrow range by regulation of intestinal absorption, redistribution, and renal tubular absorption of the mineral. Hypophosphatemia and hyperphosphatemia are common clinical situations, although changes are most often mild and oligosymptomatic. However, acute and severe conditions that require specific treatment may occur. In this document, members of the Mineral and Bone Metabolism Working Group of the Spanish Society of Endocrinology and Nutrition review phosphate disorders and provide algorithms for adequate clinical management of hypophosphatemia and hyperphosphatemia.
Subject(s)
Hyperphosphatemia/diagnosis , Hyperphosphatemia/therapy , Hypophosphatemia/diagnosis , Hypophosphatemia/therapy , Decision Trees , Homeostasis , Humans , Phosphates/physiologyABSTRACT
Prochloraz is a widely used imidazole fungicide that has to be analyzed together with its metabolites or transformation products for food safety monitoring purposes in the European Union. Although the focus in food of plant origin has been set on metabolites BTS 44595 and BTS 44596, we consider relevant the study of BTS 40348 metabolite, too, because it has been detected in both raw and processed foods based on citrus fruits in the EU. Metabolite BTS 40348 should be monitored in surface water due to its ecotoxicological effects. In this work, the synthesis and structural characterization of BTS 40348 metabolite of fungicide prochloraz is presented, because the structure is closely related to the chemistry and biological activity of the substance. Characterization using 13C and 1H NMR, infrared (IR), and Raman spectroscopy is detailed, together with confirmation by electrospray mass spectrometry analysis.
Subject(s)
Fungicides, Industrial/chemistry , Fungicides, Industrial/metabolism , Imidazoles/chemistry , Imidazoles/metabolism , European Union , Fast Foods/analysis , Food Contamination/analysis , Magnetic Resonance Spectroscopy , Molecular Structure , Pesticide Residues/chemistry , Pesticide Residues/metabolism , Spectrum Analysis, Raman , Water Pollutants/chemistrySubject(s)
Anorexia Nervosa/diagnosis , Anorexia Nervosa/therapy , Binge-Eating Disorder/diagnosis , Binge-Eating Disorder/therapy , Bulimia Nervosa/diagnosis , Bulimia Nervosa/therapy , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/therapy , Nutrition Assessment , Consensus , Hospitalization , Humans , Nutrition Therapy , Patient Education as TopicABSTRACT
No disponible
Subject(s)
Humans , Feeding and Eating Disorders/diet therapy , Feeding and Eating Disorders/diagnosis , Anorexia Nervosa/diet therapy , Bulimia Nervosa/diet therapy , Binge-Eating Disorder/diet therapy , Nutrition Assessment , Nutritional StatusABSTRACT
Eating disorders (ED) are characterized by persistent changes in eating habits that negatively affect a person's health and psychosocial abilities. They are considered psychiatric disorders, highly variable in their presentation and severity, with a huge impact on nutrition, which conditions various therapeutic approaches within a key multidisciplinary context. A group of experts in nutrition, we decided to set up a task force adscribed to the "Sociedad Española de Nutrición Parenteral y Enteral" (SENPE), which has stated as one of its goals the development of a consensus document to generate a protocol based on the best scientific evidence and professional experience available in order to improve health care in this field.
Subject(s)
Nutrition Assessment , Nutrition Disorders/therapy , Consensus , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/therapy , Humans , Nutrition Disorders/diagnosis , Nutrition Disorders/epidemiology , Nutrition Therapy , Nutritional Support , Patient Education as TopicABSTRACT
Anorexia nervosa is the most common psychiatric disease among young women and it is assumed to be of multifactorial origin. Diagnostic criteria have recently been modified; therefore amenorrhea has ceased to be a part of them. This disease shows a large variability in its presentation and severity which conditions different therapeutic approaches and the need to individualize the treatment, thus it is indispensable a multidisciplinary approach. The goals are to restore nutritional status (through an individualized diet plan based on a healthy consumption pattern), treat complications and comorbidities, nutritional education (based on healthy eating and nutritional patterns), correction of compensatory behaviors and relapse prevention. The treatment will vary according to the patient's clinical situation, and it may be performed in outpatient clinics (when there is clinical stability), in a day hospital or ambulatory clinic (intermediate mode between traditional outpatient treatment and hospitalization) or hospitalization (when there is outpatient management failure or presence of serious medical or psychiatric complications). Artificial nutrition using oral nutritional supplements, enteral nutrition and exceptionally parenteral nutrition may be necessary in certain clinical settings. In severely malnourished patients the refeeding syndrome should be avoided. Anorexia nervosa is associated with numerous medical complications which determines health status, life quality, and is closely related to mortality. There is little clinical evidence to assess the results of different treatments in anorexia nervosa, when most of the recommendations are being based on expert consensus.
Subject(s)
Anorexia Nervosa/diet therapy , Nutrition Assessment , Nutrition Therapy/methods , Adolescent , Anorexia Nervosa/complications , Anorexia Nervosa/epidemiology , Anorexia Nervosa/psychology , Consensus , Female , Humans , Male , Nutritional Status , Precision Medicine , Refeeding Syndrome/therapy , Young AdultABSTRACT
Bulimia nervosa and binge eating disorder are unique nosological entities. Both show a large variability related to its presentation and severity which involves different therapeutic approaches and the need to individualize the treatment, thus it is indispensable a multidisciplinary approach. Patients with bulimia nervosa may suffer from malnutrition and deficiency states or even excess weight, while in binge eating disorders, it is common overweight or obesity, which determine other comorbidities. Many of the symptoms and complications are associated with compensatory behaviors. There are many therapeutic tools available for the treatment of these patients. The nutritional approach contemplates the individualized dietary advice which guarantees an adequate nutritional state and nutritional education. Its objective is to facilitate the voluntary adoption of eating behaviors that promote health and allow the long-term modification of eating habits and the cessation of purgatory and bingeing behaviors. Psychological support is a first-line treatment and it must address the frequent disorder of eating behavior and psychiatric comorbidities. Psychotropic drugs are effective and widely used although these drugs are not essential. The management is carried out mainly at an outpatient level, being the day hospital useful in selected patients. Hospitalization should be reserved to correct serious somatic or psychiatric complications or as a measure to contain non-treatable conflict situations. Most of the guidelines' recommendations are based on expert consensus, with little evidence which evaluates clinical results and cost-effectiveness.
Subject(s)
Binge-Eating Disorder/therapy , Bulimia Nervosa/therapy , Nutrition Assessment , Nutrition Therapy/methods , Adult , Binge-Eating Disorder/diagnosis , Binge-Eating Disorder/epidemiology , Binge-Eating Disorder/psychology , Bulimia Nervosa/complications , Bulimia Nervosa/diagnosis , Bulimia Nervosa/psychology , Consensus , Female , Guidelines as Topic , HumansABSTRACT
No disponible
Subject(s)
Humans , Feeding and Eating Disorders/diet therapy , Nutrition Therapy/methods , Anorexia Nervosa/diet therapy , Bulimia Nervosa/diet therapy , Binge-Eating Disorder/diet therapy , Food and Nutrition EducationABSTRACT
La anorexia nerviosa es la enfermedad psiquiátrica más frecuente entre las mujeres jóvenes y se asume de origen multifactorial. Los criterios diagnósticos han sido recientemente modificados de forma que la amenorrea deja de formar parte de ellos. Esta enfermedad muestra una gran variabilidad en su presentación y gravedad, lo que condiciona diferentes abordajes terapéuticos y la necesidad de individualizar el tratamiento, haciéndose indispensable un enfoque multidisciplinar. Los objetivos persiguen restaurar el estado nutricional (a través de un plan dietético individualizado y basado en un patrón de consumo saludable), tratar las complicaciones y comorbilidades, la educación nutricional (basada en patrones alimentarios y nutricionales sanos), corrección de las conductas compensatorias y la prevención de recaídas. El tratamiento variará según la situación clínica del paciente, pudiendo realizarse en consultas externas (cuando existe estabilidad clínica), en hospital de día (modalidad intermedia entre el tratamiento ambulatorio tradicional y la hospitalización) o en hospitalización (fracaso del manejo ambulatorio o presencia de complicaciones médicas o psiquiátricas graves). La nutrición artificial a través del empleo de suplementos nutricionales orales, nutrición enteral y excepcionalmente nutrición parenteral puede ser necesaria en determinados escenarios clínicos. En pacientes severamente desnutridos se debe evitar el síndrome de realimentación. La anorexia nerviosa está asociada a numerosas complicaciones médicas que condicionan el estado de salud, la calidad de vida y que se relacionan estrechamente con la mortalidad. Existe poca evidencia clínica para evaluar los resultados de los distintos tratamientos en la anorexia nerviosa, estando basados la mayoría de las recomendaciones en consenso de expertos
Anorexia nervosa is the most common psychiatric disease among young women and it is assumed to be of multifactorial origin. Diagnostic criteria have recently been modified; therefore amenorrhea has ceased to be a part of them. This disease shows a large variability in its presentation and severity which conditions different therapeutic approaches and the need to individualize the treatment, thus it is indispensable a multidisciplinary approach. The goals are to restore nutritional status (through an individualized diet plan based on a healthy consumption pattern), treat complications and comorbidities, nutritional education (based on healthy eating and nutritional patterns), correction of compensatory behaviors and relapse prevention. The treatment will vary according to the patient's clinical situation, and it may be performed in outpatient clinics (when there is clinical stability), in a day hospital or ambulatory clinic (intermediate mode between traditional outpatient treatment and hospitalization) or hospitalization (when there is outpatient management failure or presence of serious medical or psychiatric complications). Artificial nutrition using oral nutritional supplements, enteral nutrition and exceptionally parenteral nutrition may be necessary in certain clinical settings. In severely malnourished patients the refeeding syndrome should be avoided. Anorexia nervosa is associated with numerous medical complications which determines health status, life quality, and is closely related to mortality. There is little clinical evidence to assess the results of different treatments in anorexia nervosa, when most of the recommendations are being based on expert consensus
Subject(s)
Humans , Feeding and Eating Disorders/diet therapy , Nutrition Therapy/methods , Anorexia Nervosa/diet therapy , Food and Nutrition Education , Nutritional Support/methods , Dietary Supplements , Refeeding Syndrome/prevention & control , Anorexia Nervosa/classification , Nutrition Assessment , Nutritional Status , Anorexia Nervosa/complicationsABSTRACT
La bulimia nerviosa y el trastorno por atracón constituyen entidades nosológicas propias. Ambas muestran una gran variabilidad en su presentación y gravedad, lo que implica la individualización del tratamiento y la necesidad de equipos multidisciplinares. Los pacientes con bulimia nerviosa pueden presentar desde desnutrición y estados carenciales a exceso de peso, mientras que en los trastornos por atracón es habitual el sobrepeso u obesidad, que condiciona a su vez otras comorbilidades. Muchos de los síntomas y complicaciones derivan de las conductas compensatorias. Se dispone de diversas herramientas terapéuticas para el tratamiento de estos pacientes. El abordaje nutricional contempla el consejo dietético individualizado que garantice un adecuado estado nutricional y la correcta educación nutricional. Su objetivo es facilitar la adopción voluntaria de comportamientos alimentarios que fomenten la salud y que permitan la modificación a largo plazo de los hábitos alimentarios y el cese de conductas purgantes y atracones. El soporte psicológico es el tratamiento de primera línea y debe abordar el trastorno de la conducta alimentaria y las comorbilidades psiquiátricas que frecuentemente presentan. Los psicofármacos, aunque eficaces y ampliamente utilizados, no son imprescindibles. El manejo se realiza principalmente a nivel ambulatorio, siendo el hospital de día útil en pacientes seleccionados. Se debe reservar la hospitalización para corregir aquellas complicaciones somáticas o psiquiátricas graves o como medida de contención de las situaciones conflictivas no tratables de forma ambulatoria. La mayoría de las recomendaciones de las guías se basan en consensos de expertos, existiendo poca evidencia que evalúe los resultados clínicos y de coste-eficacia
Bulimia nervosa and binge eating disorder are unique nosological entities. Both show a large variability related to its presentation and severity which involves different therapeutic approaches and the need to individualize the treatment, thus it is indispensable a multidisciplinary approach. Patients with bulimia nervosa may suffer from malnutrition and deficiency states or even excess weight, while in binge eating disorders, it is common overweight or obesity, which determine other comorbidities. Many of the symptoms and complications are associated with compensatory behaviors. There are many therapeutic tools available for the treatment of these patients. The nutritional approach contemplates the individualized dietary advice which guarantees an adequate nutritional state and nutritional education. Its objective is to facilitate the voluntary adoption of eating behaviors that promote health and allow the long-term modification of eating habits and the cessation of purgatory and bingeing behaviors. Psychological support is a first-line treatment and it must address the frequent disorder of eating behavior and psychiatric comorbidities. Psychotropic drugs are effective and widely used although these drugs are not essential. The management is carried out mainly at an outpatient level, being the day hospital useful in selected patients. Hospitalization should be reserved to correct serious somatic or psychiatric complications or as a measure to contain non-treatable conflict situations. Most of the guidelines' recommendations are based on expert consensus, with little evidence which evaluates clinical results and cost-effectiveness
Subject(s)
Humans , Feeding and Eating Disorders/diet therapy , Nutrition Therapy/methods , Bulimia Nervosa/diet therapy , Binge-Eating Disorder/diet therapy , Nutrition Assessment , Nutritional Status , Nutritional Support/methods , Food and Nutrition Education , Feeding and Eating Disorders of Childhood/diet therapy , Pica/diet therapy , Feeding and Eating Disorders/classification , Diagnosis, Differential , Cost-Benefit AnalysisABSTRACT
La hipercalcemia hipocalciúrica familiar representa una causa benigna de hipercalcemia de herencia autosómica dominante que no precisa normalmente tratamiento. Presentamos el caso de un varón de 21 años con perfil bioquímico típico de hipercalcemia hipocalciúrica familiar: hipercalcemia leve, niveles normales de PTH e hipocalciuria. Se solicitó el estudio genético del gen CASR, que objetivó en heterocigosis una variante no descrita previamente en la literatura. El padre, con hipercalcemia leve, también era portador de dicha variante. Aunque se trata de una enfermedad sin repercusiones clínicas importantes, es de utilidad realizar la confirmación genética de la hipercalcemia hipocalciúrica familiar para diferenciarla del hiperparatiroidismo primario y para ofrecer un asesoramiento genético adecuado a los pacientes (AU)
Familial hypocalciuric hypercalcemia is a benign cause of hypercalcemia of autosomal dominant inheritance that does not normally require treatment. The case is presented on a 21 year-old male with a typical familial hypocalciuric hypercalcemia biochemical profile: mild hypercalcaemia, normal PTH levels, and hypocalciuria. A genetic study was requested on the CASR gene, which showed a heterozygous variant not previously described in the literature. The father, with mild hypercalcaemia, was also a carrier of this variant. Although it is a disease with no significant clinical repercussions, it is useful to perform genetic confirmation of familial hypocalciuric hypercalcemia to differentiate it from primary hyperparathyroidism and to provide adequate genetic counselling to patients (AU)
Subject(s)
Humans , Male , Young Adult , Hypercalcemia/diagnosis , Hypercalcemia/genetics , Mutagenesis/genetics , Genetic Counseling/methods , Hyperparathyroidism/diagnosis , Preconception Care/organization & administration , Preconception Care/standards , Magnetic Resonance Spectroscopy/instrumentationABSTRACT
The hydrogen-bond-assisted self-association process of a chiral semirigid carboxylic acid, namely, (+)-(S)-ketopinic acid, has been studied. The multiconformational monomer/dimer equilibrium has been evaluated by means of a concentration-dependent FTIR study that enabled the experimental equilibrium constants of the dimer formation reaction (Kdim ) to be determined in two solvents of different polarity. In CDCl3 , dimeric forms predominate, even in diluted solutions (KdimCF =5.074), whereas in CD3 CN the self-association process is hindered and monomers are always the main species, irrespective of solute concentration (KdimAN =0.194). The reliability of the dimerization constants and the derived mono- and dimeric experimental fractions have been proven by means of accurate matching between the experimental vibrational circular dichroism spectra of the species and the theoretical spectra generated by considering the simultaneous weighted contributions of the concomitant monomers and dimers.
ABSTRACT
Thermochemical kinetics of hydrolysis reactions of compounds with transannular intramolecular M N bonds, i.e., atranes RM(OCH2CH2)3N and ocanes R2M(OCH2CH2)2NH (M = Si, Ge; R = F, Cl, Me), is studied at the B3LYP/aug-cc-pVDZ theoretical level. Several DFT methods are assessed for the reproduction of the experimental activation barrier for the Si-O bond cleavage of 1-methylsilatrane. Activation barriers for atranes and ocanes show the tendency for their growth with the decrease of the electronegativity of a substituent R on going from F to Me and their decrease from Si to Ge. Hydrolysis activation barriers of atranes and ocanes are compared with those of their acyclic analogs RM(OCH3)3 and R2M(OCH2)2NH in order to study the role of transannular M N bonds in the stability of these molecules to hydrolysis. Substantially larger barriers for atranes support the opinion that stability of atranes may be explained by the formation of intramolecular bonds; however, the strengthening of transannular M N bonds results in lower M-O cleavage barriers. It was proposed that the M-O cleavage barrier height is determined not by a weak M N bonding itself, but rather by the contribution of a nitrogen lone pair to the antibonding orbitals of M-O bonds. The NBO analysis show that this interaction increases with the decrease of the electronegativity of a substituent R and decreases on going from atranes to ocanes. In ocanes, the presence of M N bonds does not kinetically hinder the hydrolytic process; M-O cleavage activation barriers for acyclic analogs are higher. M-Hal cleavage barriers are substantially higher than those for M-O cleavage for R = F, but lower for R = Cl. Graphical Abstract The experimental barrier height of the Si-O bond cleavage in 1-methylsilatrane is well reproduced when three explicit water molecules are included in the B3LYP/aug-cc-pVDZ theoretical model.
ABSTRACT
The implementation of a strategy comprising the use of vibrational circular dichroism spectroscopy and DFT calculations allows determination of the solution-state conformational distribution in (-)-S-cotinine, giving further proof of the extra conformer-discriminating potential of this experimental technique, which may offer unique molecular fingerprints of subtly dissimilar molecular conformers of chiral samples. Natural bond orbital electronic structure calculations of the rotational barrier height between the two main conformers of the species indicate that hyperconjugative effects are the key force governing the conformational equilibrium. The negligible effect of the solvent's polarity over both structure and conformational energy profile supports this result.
