Expression of Circulating MicroRNAs Associated with Obesity and their Relationships with Biochemical Parameters and Health-related Physical Fitness in Children 6 to 10 Years Old in Cali, Colombia.

BACKGROUND: Obesity is a public health problem worldwide; it has reached pandemic proportions in the last 40 years. Its prevalence in children and adolescents increased from 0.7% to 7.8% between 1975 and 2016. Recently, microRNAs (miRNAs) have been reported as regulatory factors related to molecular functions under different conditions. These can be used as biomarkers of a disease to estimate risks in the early stages. OBJECTIVE: This study aimed to determine the expression levels of miRNAs associated with childhood obesity and their relationships with biochemical parameters and Health-related Physical Fitness (HRPF). METHODS: This was a descriptive cross-sectional study in which a population of 40 children between 6 and 10 years of age of both sexes from Cali, Colombia, was evaluated; the children were classified as 20 normal-weight and 20 obese. Blood biochemistry, HRPF, and miRNA expression levels were determined (hsa-miR-122-5p, hsa-miR-15b-5p, hsa-miR-191-5p, hsa-miR-486-3p, hsa-miR-222-3p. Comparisons were made between the groups, miRNA associations between the studied variables, and linear regression analysis. RESULTS: Twenty normal-weight and 20 obese patients were evaluated. Both groups had an average age of eight years old. The miRNA hsa-miR-122-5p (p < 0.05) was overexpressed in the obese group. According to the linear regression analysis, the amount of adipose tissue may be associated with the production of miRNAs (hsa-miR-15b-5p, hsa-miR-222-3p, hsa-miR-122-5p, and hsamiR- 191-5p). CONCLUSION: Four miRNAs (hsa-miR-15b-5p, hsa-miR-222-3p, hsa-miR-122-5p, and hsa-miR- 191-5p) are associated with modifications in biochemical variables of HRPF in this group. Adipose tissue mass could be associated with the production of these miRNAs, thus making them biomarkers of childhood obesity risk.

Myometrial wall thickness ratio-A nomogram reference for diagnosing myometrial wall asymmetry.

OBJECTIVE: Defining the normal range for the anterior/posterior myometrial wall thickness ratio in a cohort of women without adenomyosis or any other uterine wall anomaly on ultrasound examination. METHODS: Anterior and posterior miometrial wall thickness was measured in 555 women (mean age 34.6 years old, range: 20-50 years) without any ultrasound findings of adenomiosis or other uterine pathology. Measurements were performed in the longitudinal plane of a stored 3D volume. Two observers made all measurements. The myometrial wall thickness ratio was estimated and distribution by centiles obtained. Correlation of myometrial thickness ratio with patient's age and parity was also estimated, using the Pearson's correlation coefficient. Intra- and inter-observer reproducibility were estimated using the intra-class correlation coefficient (ICC). RESULTS: The mean ratio of the myometrial walls thickness (understood as anterior thickness/posterior thickness ratio) was 0.99 (95% CI: 0.96-1.01). The distribution of the ratio by centiles were as follows: 5%: 0.64, 10%: 0.70, 25%: 0.82, 50%: 0.96, 75%: 1.12, 90%: 1.30 and 95%: 1.45). The myometrial wall thickness ratio was not related to patient's age (Pearson's coefficient: 0.039, p = 0.371), neither to patient's parity (Pearson's coefficient: 0.004, p = 0.923). The ICC was 0.94 and 0.88 for observers 1 and 2, respectively. Inter-observer reproducibility was high (ICC: 0.83). CONCLUSIONS: Myometrial thickness ratio in women with normal uterus at ultrasound examination is about 1. However, centile distribution shows that values as low as 0.64 or as high as 1.45 could be considered as normal.

Recombinant single-chain factor VIII in severe hemophilia: Long-term safety and efficacy in previously treated patients in the AFFINITY extension study.

BACKGROUND: rVIII-SingleChain is a recombinant single-chain factor VIII used to treat people with hemophilia A. OBJECTIVES: The aim of this extension study was to investigate the long-term safety and efficacy of rVIII-SingleChain prophylaxis in ≥200 previously treated patients (PTPs) with hemophilia A with ≥100 exposure days (EDs). METHODS: In total, 222 patients were enrolled, of which 204 rolled over from prior rVIII-SingleChain studies. The median age was 21 years (range, 2-65 years), including 155 patients ≥12 years and 67 patients <12 years. Patients continued with their previously assigned dose and regimen, or switched at the investigator's discretion. Patients were treated for a mean duration of 31 months (range, 1-47 months), the mean ED was 342 (standard deviation, 135.5), and 212 (95.5%) patients achieved >100 EDs. When the study ended, most patients were on either a prophylaxis regimen of 34.9 (17-62) IU/kg, 3×/week (N = 88; 39.6%), or 37.2 (13-65) IU/kg, 2×/week regimen (N = 72; 32.4%). RESULTS: Hemostatic efficacy was rated excellent or good in 87.1% of assessed bleeds. The median (range) annualized bleeding rate was 1.21 (0.0-42.6), and the annualized spontaneous bleeding rate (AsBR) was 0.32 (0.0-33.0) for prophylaxis regimens. Median AsBR was similar for patients treated 3×/week and 2×/week (0.31 and 0.30, respectively). Surgical hemostatic efficacy was rated excellent or good in 100% of surgeries. No inhibitors, anaphylactic reactions, or thromboembolic events were reported in PTPs. CONCLUSION: These results confirm the safety and efficacy of rVIII-SingleChain as a long-term prophylaxis treatment modality for PTPs with severe hemophilia A.

Combination of arterial lactate levels and venous-arterial CO2 to arterial-venous O 2 content difference ratio as markers of resuscitation in patients with septic shock.

PURPOSE: To evaluate the prognostic value of the Cv-aCO2/Da-vO2 ratio combined with lactate levels during the early phases of resuscitation in septic shock. METHODS: Prospective observational study in a 60-bed mixed ICU. One hundred and thirty-five patients with septic shock were included. The resuscitation protocol targeted mean arterial pressure, pulse pressure variations or central venous pressure, mixed venous oxygen saturation, and lactate levels. Patients were classified into four groups according to lactate levels and Cv-aCO2/Da-vO2 ratio at 6 h of resuscitation (T6): group 1, lactate ≥2.0 mmol/L and Cv-aCO2/Da-vO2 >1.0; group 2, lactate ≥2.0 mmol/L and Cv-aCO2/Da-vO2 ≤1.0; group 3, lactate <2.0 mmol/L and Cv-aCO2/Da-vO2 >1.0; and group 4, lactate <2.0 mmol/L and Cv-aCO2/Da-vO2 ≤1.0. RESULTS: Combination of hyperlactatemia and high Cv-aCO2/Da-vO2 ratio was associated with the worst SOFA scores and lower survival rates at day 28 [log rank (Mantel-Cox) = 31.39, p < 0.0001]. Normalization of both variables was associated with the best outcomes. Patients with a high Cv-aCO2/Da-vO2 ratio and lactate <2.0 mmol/L had similar outcomes to hyperlactatemic patients with low Cv-aCO2/Da-vO2 ratio. The multivariate analysis revealed that Cv-aCO2/Da-vO2 ratio at both T0 (RR 3.85; 95 % CI 1.60-9.27) and T6 (RR 3.97; 95 % CI 1.54-10.24) was an independent predictor for mortality at day 28, as well as lactate levels at T6 (RR 1.58; 95 % CI 1.13-2.22). CONCLUSION: Complementing lactate assessment with Cv-aCO2/Da-vO2 ratio during early stages of resuscitation of septic shock can better identify patients at high risk of adverse outcomes. The Cv-aCO2/Da-vO2 ratio may become a potential resuscitation goal in patients with septic shock.

Influence of regular aerobic exercise on endothelium-dependent vasodilation and cardiorespiratory fitness in pregnant women.

AIM: To evaluate the effect of regular aerobic exercise on the endothelial function and cardiorespiratory fitness in pregnant women. METHOD: This was a randomized, double-blinded, controlled clinical trial of 64 healthy primigravid women between 16 and 20 weeks' gestation. The experimental group took part in aerobic exercise at an intensity of 50-65% of their maximum heart rate for 60 min, three times a week for 16 weeks. The control group undertook their usual physical activity. The outcomes were the endothelial function evaluated by flow-mediated dilatation and cardiorespiratory fitness evaluated by the maximum indirect oxygen consumption (VO2max) in a 6-min walk test. RESULTS: Initially, no differences were found between the groups in any of the variables. At the end of the intervention, the participants that performed exercise showed a higher cardiorespiratory fitness, measured by the walked distance in the 6-min walk test (P = 0.014) and by the VO2max (P = 0.014). Also, the exercise group showed a lower heart rate at rest and a higher flow-mediated dilatation than the control group (P = 0.02). CONCLUSIONS: Regular aerobic exercise improves endothelium-dependent vasodilation in pregnancy. This intervention may be an early and effective alternative to strengthen the prevention of disorders associated to endothelial dysfunction.

A factorial randomized controlled trial to evaluate the effect of micronutrients supplementation and regular aerobic exercise on maternal endothelium-dependent vasodilatation and oxidative stress of the newborn.

BACKGROUND: Many studies have suggested a relationship between metabolic abnormalities and impaired fetal growth with the development of non-transmissible chronic diseases in the adulthood. Moreover, it has been proposed that maternal factors such as endothelial function and oxidative stress are key mechanisms of both fetal metabolic alterations and subsequent development of non-transmissible chronic diseases. The objective of this project is to evaluate the effect of micronutrient supplementation and regular aerobic exercise on endothelium-dependent vasodilation maternal and stress oxidative of the newborn. METHODS AND DESIGN: 320 pregnant women attending to usual prenatal care in Cali, Colombia will be included in a factorial randomized controlled trial. Women will be assigned to the following intervention groups: 1. CONTROL GROUP: usual prenatal care (PC) and placebo (maltodextrine). 2. Exercise group: PC, placebo and aerobic physical exercise. 3. Micronutrients group: PC and a micronutrients capsule consisting of zinc (30 mg), selenium (70 µg), vitamin A (400 µg), alphatocopherol (30 mg), vitamin C (200 mg), and niacin (100 mg). 4. Combined interventions Group: PC, supplementation of micronutrients, and aerobic physical exercise. Anthropometric measures will be taken at the start and at the end of the interventions. DISCUSSION: Since in previous studies has been showed that the maternal endothelial function and oxidative stress are related to oxidative stress of the newborn, this study proposes that complementation with micronutrients during pregnancy and/or regular physical exercise can be an early and innovative alternative to strengthen the prevention of chronic diseases in the population. TRIAL REGISTRATION: NCT00872365.

Efecto del ejercicio físico aeróbico sobre el consumo de oxígeno de mujeres primigestantes saludables: estudio clínico aleatorizado / The effect of aerobic exercise on oxygen consumption in healthy firtst-pregnancy females: a randomized clinical trial

Objetivo: evaluar, en mujeres primigestantes saludables, el efecto del ejercicio aeróbico sobre el consumo de oxígeno. Materiales y métodos: estudio clínico aleatorizado en 64 mujeres saludables, primigestantes, entre 16 y 20 semanas de gestación. Grupo de intervención: ejercicio aeróbico entre el 50% y 65% de la frecuencia cardíaca máxima, durante 45 min, 3 veces por semana durante 16 semanas. Grupo control: actividad física habitual. Mediciones: consumo de oxígeno VO2max por prueba de caminata de seis minutos y antropometría para peso, talla y ganancia relativa de peso. Resultados: en las mediciones iniciales, no se encontraron diferencias entre grupos en ninguna de las variables. Al finalizar la intervención, las participantes que realizaron ejercicio presentaban una mayor capacidad física, medida por la distancia recorrida en el test de caminata (p=0,043) y por el VO2max (p=0,023). No se encontraron diferencias significativas entre los grupos en las variables antropométricas. Conclusión: la práctica regular de ejercicio aeróbico y controlado, mejora la capacidad física en mujeres gestantes. Por esta razón, intervenciones como esta podrían ser una alternativa temprana y efectiva para fortalecer la prevención de patologías durante el embarazo asociadas al sedentarismo.

Objective: evaluating the effect of aerobic exercise on oxygen consumption by healthy first-pregnancy females. Materials and methods: a randomized clinical trial was carried out on 64 healthy first-pregnancy females (16 to 20 weeks pregnant). Intervention group: aerobic exercise involving 50% to 65% maximum heart rate for 45 min, 3 times a week over a 16-week period. Control group: habitual physical activity. Measurements used: maximum oxygen consumption capacity test (VO2max) involving 6-minute walking test and anthropometric weight, height and relative weight gain indicators. Results: no differences were found in initial measurements between groups regarding any of the variables. By the end of the 16-week intervention, participants engaging in regular exercise presented greater physical capacity as measured by the distance covered in the walking (p=0.043) and VO2max (p=0.023) tests. No significant differences were found between groups regarding the anthropometric variables. Conclusion: engaging in regular controlled aerobic exercise improved physical capacity in pregnant females. Interventions like this could thus represent an early effective alternative for strengthening the prevention of physical inactivity pathologies during pregnancy.

Caracterización de pacientes con prediabetes en instituciones de servicio de salud de primer nivel en Cali, Colombia / Characterization of patients with pre-diabetes in first-level health care service institutions Cali, Colombia

Introduction: Type 2 diabetes (DM 2) is one of the first ten causes of mortality in Colombia. Pre-diabetes is a state of hyperglycemia that associated with other risk factors appears 5-10 years before this disease. It has been reported that controlling the diet and exercise decreases the probability of suffering DM 2 by 60%. This intervention requires establishing the risk in pre-diabetic patients.Objectives: To detect patients with pre-diabetes who are members of a private health care provider (EPS for its name in Spanish) in Cali and to describe the clinical and epidemiological characteristics related to the risk of developing DM 2.Materials and methods: This is a cross-sectional descriptive study in patients with altered glucemias (Impaired fasting glucose: 100-125 mg/dl and impaired glucose tolerance: 140-199 mg/dl). Clinical histories were reviewed and surveys on risk factors, habits and perception of knowledge were conducted. We determined: fasting glucose, vital signs, and anthropometric measures.Results: 111 patients were included (64% women) whose most common occupation was home duties (39.6%). The descriptive analysis reported high risk; the results were: noticeable presence of associate pathological antecedents as follows: Diabetes in the family (64%), obesity (54.1%), dyslipidemia (72.1%), and hypertension (66.7%) in a population with a mean age at 51 years and 10.8% were under 40 years of age. This great proportion of overweight or obesity (86.5%), according to BMI, influenced the determination of the high cardio-metabolic risk (81%, agreeing with the WHO). When evaluating diet with consumption frequency, we still found the intake of simple carbohydrates and animal fats; when reviewing physical activity, 53.2% of the patients reported activity in the last 7 days according to the International Physical Activity Questionnaire (IPAQ). Conclusions: 66% of pre-diabetics did not have diagnosis of some disorder of the metabolism of carbohydrates.

Introducción: La diabetes tipo 2 (DM 2) es una de las diez primeras causas de mortalidad en Colombia. La prediabetes es un estado de hiperglucemia que, asociado con otros factores de riesgo, se presenta 5-10 años antes de dicha enfermedad. Se ha informado que controlar la dieta y el ejercicio disminuye la probabilidad de padecer DM 2 hasta en 60%. Identificar y caracterizar el riesgo en los pacientes prediabéticos contribuye en la prevención de la DM 2.Objetivos: Detectar los pacientes con prediabetes afiliados a una EPS privada de Cali, evaluar y describir su estado de riesgo.Materiales y métodos: Se realizó estudio descriptivo transversal en pacientes con glucemias alteradas (glucemia en ayunas, 100-125 mg/dl y glucemia post-carga, 140-199 mg/dl). Se revisaron historias clínicas y se realizó encuesta de factores de riesgo, hábitos y percepción de conocimientos. Se determinaron glucemia en ayunas, signos vitales y medidas antropométricas.Resultados: Se incluyeron 111 pacientes (64% mujeres), con edad promedio de 51 años y 10.8% menor de 40 años, cuya mayor ocupación fue el hogar (39.6%). Se encontró alto riesgo para desarrollar DM 2 de acuerdo con los siguientes resultados: alta proporción de antecedentes patológicos asociados como diabetes familiar (64%), obesidad (54.1%), dislipidemias (72.1%) e hipertensión (66.7%). La gran proporción de sobrepeso u obesidad según IMC hallado (86.5%), influyó en la determinación del alto riesgo cardiometabólico (81% según criterios de la OMS). Al evaluar dieta con frecuencia de consumo, se encontró todavía ingesta de carbohidratos simples y grasas animales; luego de revisar actividad física, 53.2% informó actividad en la semana antes del Cuestionario Internacional de Actividad Física (IPAQ).Conclusiones: Del total de los prediabéticos, 66% no tenía diagnóstico de algún desorden del metabolismo de los carbohidratos.

El ejercicio físico aeróbico incrementa la vasodilatación dependiente del endotelio y el consumo de oxígeno de mujeres primigestantes saludables: ensayo clínico controlado, aleatorizado: NCT00741312 / Aerobic physical exercise increases endothelium-dependent vasodilation and oxygen consumption in healthy primigravida: controlled randomized clinical trial: NCT00741312

OBJETIVO: evaluar el efecto del ejercicio aeróbico en la función dependiente del endotelio (VDE) y en el consumo de oxígeno en mujeres primigestantes. MÉTODOS: ensayo clínico controlado, enmascarado y aleatorizado, llevado a cabo en 67 mujeres saludables, primigestantes, entre 16 a 20 semanas de gestación. Grupo de intervención: ejercicio aeróbico entre 50 percentage y 65 percentage de la frecuencia cardiaca máxima, durante 45 minutos, tres veces por semana, durante dieciséis semanas. Grupo control: actividad física habitual. Mediciones: VDE: vasodilatación mediada por flujo (VMF), consumo de oxígeno VO2max: prueba de caminata de seis minutos; antropometría: peso y talla. RESULTADOS: en las mediciones iniciales no se encontraron diferencias entre grupos en ninguna de las variables. Al finalizar la intervención, las participantes que realizaron ejercicio tenían mayor capacidad física, medida por la distancia recorrida en el test de caminata (p=0,043) y por el VO2max (p=0,023). Además, el grupo de ejercicio tuvo menor frecuencia cardiaca en reposo y mayor VMF que el grupo control (p<0,05). Ambos grupos aumentaron la frecuencia cardiaca en reposo, el diámetro basal y el diámetro post-hiperemia de la arteria braquial al final de la intervención (p<0,05). CONCLUSIÓN: la práctica regular de ejercicio aeróbico y controlado, mejora la función endotelial y la capacidad física en mujeres gestantes. Por esta razón, intervenciones como esta podrían ser una alternativa temprana y efectiva para fortalecer la prevención de patologías durante el embarazo asociadas con disfunción endotelial.

OBJECTIVE: evaluate the effect of aerobic exercise on endothelium-dependent function (EDF) and oxygen consumption in primigravida. METHODS: double-blind, randomized controlled clinical trial carried out in primigravida between 16 to 20 weeks of gestation. The intervention group had aerobic exercise between 50 percentage to 65 percentage of the maximum heart rate during 45 minutes, three times a week for sixteen weeks. The control group had habitual physical activity. MEASUREMENTS REALIZED: EDF: flow-mediated dilation (FMD), oxygen consumption VO2max: 6 minute walking test, anthropometry: weight and size. RESULTS: no differences were found between the two groups in any variables in the initial measurements. At the end of the intervention, participants who exercised had greater physical capacity, measured by the distance covered in walking test (p = 0.043) and VO2max (p = 0.023). In addition, the exercise group had lower resting heart rate and increased FMD than the control group (p <0.05). Both groups increased the resting heart rate, basal diameter and post-hyperemia diameter of the brachial artery at the end of the intervention (p <0.05). CONCLUSION: regular practice of controlled aerobic exercise improves endothelial function and physical capacity in primigravida. For this reason, interventions like this could be an early and effective alternative to strengthen prevention of pathologies associated with endothelial dysfunction during pregnancy.

Ganglioside GD1a increases the excitability of voltage-dependent sodium channels.

The effect of the negatively charged ganglioside GD1a, one of the major brain gangliosides [H. Beitinger, W. Probst, R. Hilbig, H. Rahmann, Seasonal variability of sialo-glycoconjugates in the brain of the Djungarian hamster (Phodopus sungorus). Comp. Biochem. Physiol., B 86 (1987) 377-384] on the function of brain derived BTX-modified voltage-dependent sodium channel was studied using the planar lipid bilayer system. Bilayers were formed either with a mixture of neutral phospholipids (4 phosphoethanolamine (PE):1 phosphocholine (PC)) alone or with one containing 6% of the disialoganglioside GD1a. The permeation and activation properties of the channels were measured in the presence of symmetrical 200 mM NaCl. We found that the single channel conductance was not affected by GD1a, whereas the steady-state activation curve displayed a hyperpolarizing shift in the presence of GD1a. Since the lipid distribution in these membranes is symmetrical, then the GD1a effect on sodium channels may result either from an induction of channel conformational changes or from an asymmetrical interaction between the channel (extracellular vs. intracellular channel aspect) and GD1a. Regardless of the mechanism, the data indicate that differences in ganglioside content in neuronal cells may contribute to the previously observed sodium channel functional variability within (soma, dentritic, axon hillock) and between neuronal cells as well as to excitability changes in those physiological and pathological conditions where changes in the neuronal ganglioside content occur.

Importancia de los probióticos y prebióticos en la salud humana / Importance of the probiotics and prebiotics in the human health

Los probióticos son microorganismos gram positivos, microaerófilos, fermentadores de carbohidratos, que producen especialmente ácido láctico, razón por la cual también se les considera "bacterias ácido lácticas" siendo los Lactobacilos y Bifidobacterias los de mayor importancia en la actualidad; estos microorganismos son considerados bioterapéuticos por los beneficios en la salud humana tales como: facilitar la digestión de la lactosa, proteger contra enfermedades gastrointestinales, del tracto urogenital y respiratorio, equilibrar el sistema inmunológico, prevenir y tratar enfermedades dermatológicas y proteger contra el cáncer de colon. Para lograr estos beneficios a largo plazo, en el organismo humano, se requiere del consumo de alimentos con ingredientes prebióticos tales como cebolla, banano, avena, puerros y alcachofa porque ellos son la principal fuente de carbono para estas bacterias . El presente trabajo recopila algunas revisiones bibliográficas de investigaciones y artículos relacionados con este tema durante un período de 26 años, comprendido entre 1977 y 2003.

Conservación de Alimentos por Campos Eléctricos Pulsados de Alto Voltaje / Food Preservation Using High-Intensity Pulsed Electric Fields

Se presenta una revisión bibliográfica sobre la utilización de campos eléctricos de alta intensidad (CEAI) en la conservación de alimentos; se detallan los mecanismos de acción de los CEAI para inactivar microorganismos, ilustrando las variables más importantes en el proceso y la tecnología necesaria para la generación de pulsos de muy corta duración y alta intensidad del orden de microsegundos y KV/cm; se da una mirada general al estado del arte de esa tecnología y sus posibilidades de implementación en Colombia, teniendo en cuenta la capacidad tecnológica local