Detección de alto riesgo de desarrollar diabetes mellitus tipo 2 mediante el cuestionario FINDRISC en personal de enfermería del Hospital Schestakow de San Rafael, Mendoza / Detection of high risk of developing type 2 diabetes mellitus using FINDRISC test in nursing staff at the Schestakow Hospital in San Rafael, Mendoza

Resumen Introducción: la diabetes mellitus tipo 2 (DM2) tiene gran importancia para la salud pública mundial, porque es una de las enfermedades no transmisibles más frecuentes, por la severidad y diversidad de sus complicaciones crónicas. Objetivo: el objetivo fue determinar el riesgo de desarrollar DM2 en personal de enfermería del Hospital T. J. Schestakow, San Rafael. Materiales y método: se realizó un estudio descriptivo de tipo transversal, se tomó una muestra no probabilística, que incluyó 109 enfermeros. Se evaluó el estado nutricional a través del índice de masa corporal (IMC) y la circunferencia de cintura (CC). Los datos personales y los obtenidos del cuestionario FINDRISC fueron adquiridos a través de un cuestionario realizado a los enfermeros. Resultados: el riesgo de desarrollar DM2 según las categorías de FINDRISC fue bajo en un 35,6% (n=41), ligeramente aumentado en un 39,4% (n=43), moderado en un 10,1% (n=11), alto y muy alto riesgo en un 12,9% (n=14). Esto está fuertemente influenciado por los antecedentes familiares de primer grado, la actividad física, la medicación antihipertensiva recibida, la glucemia elevada, el IMC, la circunferencia de cintura y la edad. El consumo de frutas y verduras no fue un factor determinante del riesgo de diabetes en la muestra estudiada (p>0,05). En cuanto a la CC y el IMC, ambos se correlacionaron de manera moderada-alta con el puntaje de FINDRISC, por lo cual estos indicadores fueron mejores predictores del riesgo para desarrollar diabetes. Conclusión: el riesgo de padecer DM2 es latente y constante, por lo que el uso de instrumentos fáciles y rápidos para su detección, como lo es el cuestionario FINDRISC, pueden ayudar en la prevención y toma de conciencia del autocuidado.

Abstract Introduction: type 2 diabetes mellitus (T2DM) has a great importance for global public health, because it is one of the most frequent non-communicable diseases, due to the severity and diversity of its chronic complications. Objective: the objective of this study was to determine the risk of developing T2DM in nursing staff of the T. J. Schestakow Hospital, San Rafael. Material and methods: a descriptive cross-sectional study was carried out, a non-probabilistic sample was taken, which included 109 nurses. Nutritional status was assessed through body mass index (BMI) and waist circumference (WC). Personal data and data obtained from the FINDRISC test were acquired through a questionnaire administered to nurses. Results: the risk of developing T2DM according to the Findrisc categories was low in 35.6% (n=41), slightly increased in 39.4% (n=43), moderate in 10.1% (n=11), high and very high risk in 12.9% (n=14). This is strongly influenced by first-degree family history, physical activity, antihypertensive medication, elevated blood glucose, BMI, waist circumference, and age. The consumption of fruits and vegetables was not a determinant of diabetes risk in the studied sample (p>0.05). Regarding WC and BMI, both were moderately to high correlated with the Findrisc score so these indicators were better predictors of the risk of developing diabetes. Conclusion: the risk of suffering from T2DM is latent and constant, so the use of quick and easy tools for its detection, such as the FINDRISC questionnaire, can help in the prevention and awareness of self-care.

NOSH-aspirin (NBS-1120) inhibits pancreatic cancer cell growth in a xenograft mouse model: Modulation of FoxM1, p53, NF-κB, iNOS, caspase-3 and ROS.

Pancreatic cancer has poor survival rates and largely ineffective therapies. Aspirin is the prototypical anti-cancer agent but its long-term use is associated with significant side effects. NOSH-aspirin belongs to a new class of anti-inflammatory agents that were designed to be safer alternatives by releasing nitric oxide and hydrogen sulfide. In this study we evaluated the effects of NOSH-aspirin against pancreatic cancer using cell lines and a xenograft mouse model. NOSH-aspirin inhibited growth of MIA PaCa-2 and BxPC-3 pancreatic cancer cells with IC50s of 47 ± 5, and 57 ± 4 nM, respectively, while it did not inhibit growth of a normal pancreatic epithelial cell line at these concentrations. NOSH-aspirin inhibited cell proliferation, caused G0/G1 phase cycle arrest, leading to increased apoptosis. Treated cells displayed increases in reactive oxygen species (ROS) and caspase-3 activity. In MIA PaCa-2 cell xenografts, NOSH-aspirin significantly reduced tumor growth and tumor mass. Growth inhibition was due to reduced proliferation (decreased PCNA expression) and induction of apoptosis (increased TUNEL positive cells). Expressions of ROS, iNOS, and mutated p53 were increased; while that of NF-κB and FoxM1 that were high in vehicle-treated xenografts were significantly inhibited by NOSH-aspirin. Taken together, these molecular events and signaling pathways contribute to NOSH-aspirin mediated growth inhibition and apoptotic death of pancreatic cancer cells in vitro and in vivo.

NMR-based metabonomic approach reveals changes in the urinary and fecal metabolome caused by resveratrol.

An untargeted NMR-based metabonomics approach was used to evaluate the effects of pure resveratrol (RSV, 50 and 250 mg/kg per os) on the urinary and faecal metabolome of normal female Wistar rats. Multivariate data analysis on both the endogenous and xenobiotic metabotype of RSV provided an insight into its metabolic fate and influence on endogenous metabolites. The xenobiotic trajectory shows that RSV is highly metabolized within the first 12 h, the period of the most significant variation of endogenous metabolites. The results reveal alterations in gut microbiota co-metabolites, mainly at the high dose of RSV, such as hippurate, phenylacetyl glycine (PAG), p-cresyl glucuronide (p-CG), p-cresyl sulfate (p-CS) and 3-indoxylsulfate (3IS), as well as in osmolytes (creatine, creatinine, taurine and proline betaine). This metabolic variation could mean that RSV modulates the composition and/or function of the gut microbiota as well as its interaction with the host through the gut-microbiome-liver-kidney axis. For instance, RSV may interact with conjugating enzymes present in the intestine and liver. There were also modifications in metabolites of the tricarboxylic acid (TCA) cycle and energy metabolism (2-oxoglutarate, lactate and alanine), and diet-derived metabolites (pantothenate and trans-aconitate). These effects of RSV are perhaps related to its capacity to control energy homeostasis, provide renal protection, and downregulate some biomarkers of oxidative stress (e.g., glycoproteins). Such changes contribute to reduced oxidative stress and inflammation, which are associated with RSV-induced biological activity to improve various conditions, including metabolic disorders, obesity, and chronic and cardiovascular diseases.

The Effects of Low-Intensity Therapeutic Ultrasound on Measurable Outcomes: A Critically Appraised Topic.

Clinical Scenario: Therapeutic ultrasound (US) is a popular modality among health care professionals and is used to treat a variety of musculoskeletal conditions. A new technology has been established to allow for the miniaturization of the US unit. Patients receive treatment with the device secured to them, eliminating the portability constraint of traditional US units. Early studies suggest that this portable unit can deliver low-intensity acoustic energy achieving the same temperature increase and pain relief that come from traditional US units, in a more versatile and patient-friendly manner. CLINICAL QUESTION: What effects does low-intensity therapeutic ultrasound (LITUS) have on measurable outcomes? Summary of Key Findings: The literature was searched for level 4 evidence or higher that investigated the effectiveness of LITUS. The literature search produced 3 possible studies related to the clinical question: 2 randomized controlled trials and 1 case series met the inclusion and exclusion criteria. Of the included studies, 1 study investigated the effects of LITUS on tissue temperature, 2 studies investigated the effects of LITUS on pain, and 1 study investigated LITUS effects on function. Clinical Bottom Line: The evidence supports the use of the LITUS unit to increase tissue temperature, decrease pain, and increase function. Therefore, practitioners may consider the use of the LITUS unit in patient populations over the use of the traditional high-intensity US treatment. Strength of Recommendation: In accordance with the 2009 Centre for Evidence-Based Medicine levels of evidence, there is grade I (insufficient) evidence to support the positive effects of the LITUS device for improving the following clinical outcomes: tissue temperature, decreasing pain, and increasing function. The inconsistency in the measured outcomes across the 3 studies only allows for minimal support of the LITUS device, warranting further research. Although clinical outcomes were different in each study, consistent evidence ranging from 4 to 1B levels were found in the 3 included studies.

Compostos bioativos fenólicos de frutos nativos da famí­lia Myrtaceae: Avaliação da bioacessibilidade e do potencial funcional relacionado às doenças cardiovasculares / Bioactive phenolic compounds of native fruits from Myrtaceae family: Evaluation of bioaccessibility and functional potential related to cardiovascular diseases

As doenças cardiovasculares (DCV) são responsáveis pela maioria das mortes ocorridas em todo o mundo. Os riscos para o desenvolvimento destas patologias podem ser amenizados, em parte, por meio de uma dieta rica em alimentos de origem vegetal. Neste sentido, os frutos nativos brasileiros, como os pertencentes à família Myrtaceae, podem contribuir para melhorar a qualidade da alimentação, pois apresentam altos teores de compostos bioativos, entre eles, os fenólicos (CBF). Pouco se sabe sobre os efeitos dos polifenóis destes frutos para redução do risco de desenvolvimento das DCV. Sendo assim, este trabalho buscou avaliar a bioacessibilidade dos CBF presentes em polpas de cambuci e jabuticaba e seus efeitos in vitro sobre mecanismos de ação relacionados às DCV. Para tanto, extratos ricos em polifenóis foram obtidos a partir de extrações em fase sólida (C18 e PA) das polpas de ambos os frutos, submetidas ou não à simulação da digestão gastrointestinal. Estes extratos tiveram seus efeitos inibitórios sobre a atividade da Enzima Conversora de Angiotensina I (ECA) e a agregação plaquetária induzida por adenosina difosfato avaliados in vitro. De acordo com os resultados obtidos, a digestão in vitro foi capaz de liberar os CBF da matriz alimentar. Tal bioacessibilidade parece ter sido importante apenas para a inibição da agregação plaquetária, uma vez que a capacidade inibitória destes compostos sobre a atividade da ECA não melhorou depois da digestão in vitro. Quanto aos resultados obtidos pelos extratos provenientes das colunas PA e C18, observa-se que as maiores concentrações de taninos nestes últimos não foram suficientes para melhorar a capacidade antiagregante, mas foram importantes para aumentar a inibição da atividade da ECA. Comparando-se as respostas apresentadas pelos dois frutos, os CBF presentes no cambuci exibiram, predominantemente, potenciais anti-hipertensivo e antiagregantedo maiores do que os da jabuticaba. Neste contexto, o consumo de cambuci e jabuticaba, bem como a utilização de seus polifenóis purificados, podem ser adjuvantes para a redução dos riscos relacionados ao desenvolvimento das DCV

The cardiovascular diseases (CVD) are the leading cause of death worldwide. The risk of development of these disorders can be reduced, partially, by a vegetal-based diet. In this way, the Brazilian native fruits from Myrtaceae family may contribute to improve the diet quality, once they have high quantity of bioactive compounds, such as the phenolic (PC). The knowledge about the cardioprotective effects of consuming these fruit polyphenols is limited, so this study aimed to evaluate the bioaccessibility of the cambuci and jaboticaba PC and their in vitro potential on CVD-related mechanisms. First, gastrointestinal digestion simulation of each fruit pulp was done, and then the polyphenols rich extracts were obtained by solid phase extractions, before and after the pulps digestion. The polyphenols rich extracts had their phenolic concentrations determined and were used to evaluate the capacity of PC in inhibit the Angiotensin Converting Enzyme (ACE) activity and the platelet aggregation induced by ADP. The results were expressed as IC50, considering the total phenolic content per milliliter of reaction. According to the results, the in vitro digestion process was able to release the polyphenols from the food matrix. Therefore, the bioaccessibility had no significant effect on ACE activity, but decreased the IC50 values of platelet aggregation. In relation to the extracts from PA and C18 columns, the higher tannin concentration In comparison to the IC50 values presented by PA extracts, the higher concentrations of tannins in the last one were not enough to improve the antiaggregant effect, but were important to increase the inhibition of ACE activity. Cambuci polyphenols presented higher antihypertensive and antiaggregant potentials than the jaboticaba compounds. In this respect, the ingestion of cambuci and jaboticaba and the use of their purified polyphenols can be of particular importance in reducing the risk for the CVD development