Naringin reduces body weight, plasma lipids and increases adiponectin levels in patients with dyslipidemia.

Naringin is a citrus-flavonoid which has been shown to have positive metabolic and anti-inflammatory effects. For this reason, we believe it would be interesting to study the effects of Naringin administration on body weight, BMI, lipid profile and adiponectin levels in patients with dyslipidemia, especially considering that dyslipidemias along with obesity and subsequent cardiometabolic complications are some of the most important public health issues plaguing our society today. A double-blind, randomized clinical trial was conducted in a group of 28 adult patients previously diagnosed with dyslipidemia who attended the Institute of Experimental and Clinical Therapeutics. Patients were divided into two groups; the first group (n = 14) received 450 mg of naringin every 24 hours, in the mornings, while the second group (n = 14) was given a homologated placebo over the course of a 90-day period. Significant differences were observed in naringin group compared to the placebo group in terms of decreased BMI (30.6 ± 3.19 vs 33.3 ± 3.23 kg/m2; p = 0.03), total cholesterol (182 ± 20.2 vs 245 ± 24.1 mg/dl; p < 0.01), LDL cholesterol (100 ± 17.5 vs 125 ± 38.3 mg/dl; p = 0.03) and an increase in adiponectin levels (0.82 ± 0.25 vs 0.59 ± 0.19 µg/ml; p = 0.01). Our results support the use of Naringin as a potential therapeutic agent which could play an important role in the management of metabolic disorders.

El perímetro de cuello y su relación con los factores de riesgo cardiometabólico en las mujeres / Neck´s perimeter and its relation with the cardiometabolic risk factors in women

RESUMEN Introducción: El perímetro de cuello en la actualidad es una medida útil asociada de manera significativa a la resistencia a la insulina y al riesgo cardiometabólico. Objetivo: Determinar la relación entre el perímetro de cuello y los factores de riesgo cardiometabólico en mujeres de 45 a 60 años de edad. Métodos: Se realizó un estudio en 270 mujeres aparentemente sanas, de 45 a 60 años de edad. Se tomaron medidas antropométricas como peso corporal, índice de masa corporal, perímetro de cintura, perímetro de cuello y el tejido adiposo visceral por bioimpedancia. Se determinaron niveles séricos de glucosa, perfil lipídico (colesterol, triglicéridos, HDL-colesterol, LDL-colesterol), HbA1c, insulina y proteína C reactiva. Resultados: El índice de masa corporal de las participantes fue de 28,2 ± 4,2. Se encontró que 38,1 por ciento de las mujeres presentaban síndrome metabólico y mayor perímetro de cuello, en comparación con las participantes sin síndrome (36,8 + 2,1 vs 35,1 + 1,6 cm, respectivamente, p< 0,0001). El perímetro de cuello se asoció positivamente con índice de masa corporal (r= 0,690, p= 0,0001), tejido adiposo visceral (r= 0,548, p= 0,0001), circunferencia de Cintura (r= 0,640, p< 0,0001), glucosa (r= 0,251, p= 0,0001), triglicéridos (r= 0,143, p= 0,019), HbA1c (r= 0,160, p= 0,010) y proteína C reactiva (r= 0,342, p= 0,001). Conclusiones: Las mujeres con incremento en el perímetro de cuello presentan un perfil de riesgo cardiometabólico aumentado. La medición del perímetro de cuello representa un método útil y práctico en la predicción del riesgo cardiometabólico(AU)

ABSTRACT Introduction: Neck´s perimeter is nowadays a useful measure significantly associated to insulin resistance and to cardiometabolic risk. Objective: To determine the relation between the neck´s perimeter and the cardiometabolic risk factors in women from 45 to 60 years old. Methods: A study was performed in 270 apparently healthy women, aging 45 to 60 years old. Anthropometric measurements were taken such as weight, body mass index, waist circumference, neck´s perimeter and visceral adipose tissue by bioelectrical impedance analysis. There were identified serum levels of glucose, lipid profile (cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol), HbA1c, insulin and C-reactive protein. Results: The body mass index of the participants was 28.2 ± 4.2. It was found that 38.1 percent of the women had a metabolic syndrome and a higher perimeter of neck, in comparison with participants without the syndrome (36.8 + 2.1 vs 35.1 + 1.6 cm, respectively, p< 0.0001). The neck´s perimeter was positively associated with body mass index (r = 0.690, p= 0.0001), visceral adipose tissue (r = 0.548, p= 0.0001), waist circumference (r = 0.640, p< 0.0001), glucose (r = 0.251, p= 0.0001), triglycerides (r = 0.143, p = 0.019), HbA1c (r = 0.160, p = 0.010) and C-reactive protein (r = 0.342, p = 0.001). Conclusions: Women with an increase in the neck´s perimeter have a profile of increased cardiometabolic risk. The measurement of neck´s perimeter represents a useful and practical method for the prediction of cardiometabolic risk(AU)

Circulating levels of plasminogen activator inhibitor-1 are associated with metabolic syndrome rather than with menopause.

The plasminogen activator inhibitor type 1 (PAI-1) is the major determinant of fibrinolytic activity. PAI-1 concentrations are elevated in obesity, type 2 diabetes and metabolic syndrome (MetS). On the other hand, during menopause, fibrinolytic activity decreases and, consequently, PAI-1 concentration increases; however, it is debated whether menopause is an independent determinant factor of PAI-1 levels. The objective of this study was to evaluate the effect of hormonal and metabolic status on the concentration of PAI-1 in pre-and post-menopausal women. A case-control study was conducted in ninety pre-and post-menopausal women aged 45 to 55 years, matched by body mass index (BMI). Anthropometric measurements and biochemical determinations were performed on all participants. The fibrinolytic activity was determined by measuring PAI-1 by ELISA. Of all the women, 30% presented MetS. Women with MetS had higher values of PAI-1 (36.0 ± 19.1 vs 19.3 ± 14.8 ng/mL, p < .001); in contrast, no differences were observed when compared by hormonal status (20.7 ± 18.10 vs 20.2 ± 17.0 ng/mL, NS). The results of this study suggest that in women, MetS plays a more important role in the deterioration of the fibrinolytic mechanisms rather than their hormonal status. Therefore, the identification of cardio-metabolic factors is relevant to reduce the presence of thrombosis in post-menopausal women.

Seguridad en anestesia: error en la administración de fármacos LASA / Safety in anesthesia: an error in the administration of LASA drugs / Segurança na anestesia: um erro na administração de drogas LASA

La seguridad del paciente es prioritaria en el ámbito anestésico quirúrgico. El error en la administración de fármacos es una causa frecuente de incidentes críticos en el perioperatorio. Una forma de error, es la administración del medicamento equivocado debido a las presentaciones similares. El objetivo de este trabajo es la descripción de fallas en las barreras de prevención de incidentes críticos con medicamentos, en base al estudio de un caso clínico y al análisis de sus consecuencias. Metodología : Descripción de un caso clínico y estudio sistemático de la situación de riesgo en base al análisis taxonómico del paciente, individuo, tarea, equipo humano, lugar de trabajo y organización (PITELO) sugerido por el Sistema Español de Notificación en Seguridad en Anestesia y Reanimación (SENSAR). Resultados : Mujer sana que presentó paro respiratorio luego de la administración intravenosa de un fármaco en el postoperatorio. Se requirió 24 hs de terapia intensiva y múltiples estudios, luego de lo cual se diagnosticó un error en la administración de fármaco. La confusión se presentó con una dupla de ampollas LASA (del inglés: look-alike, sound-alike) de los fármacos atracurio y ranitidina. La documentación fotográfica evidencia la similitud y el diagrama identifica fallas latentes del sistema. Se estimaron los costos del error y se realizaron propuestas de mejora. Discusión y conclusiones : Se evidencia una falla en las barreras de prevención de eventos adversos y en el sistema de reporte de los mismos. Es necesario incrementar la cultura de seguridad en todos los niveles del sistema: regulatorio, institucional y personal.

Patient safety is a priority in the surgical anesthetic area, and errors in drug administration area frequent cause of critical incidents in the perioperative period. One type of error is the administration of the wrong medication due to similar presentations. The objective of this study is to describe the failure of barriers to prevent critical drug incidents; this is based on the study of a clinical case and an analysis of its consequences. Methodology . Description of a clinical case and systematic study of the risk situation based on the taxonomic analysis of the patient, individual, task, human team, workplace, and organization (PITELO), as suggested by the Spanish System of Safety Notification in Anesthesia and Resuscitation (SENSAR). Results . A healthy woman presented in respiratory arrest after the intravenous administration of a drug in the postoperative period. It took 24 hours of intensive care and multiple studies before an error in drug administration was diagnosed. The confusion was presented with a pair of LASA (look-alike, sound-alike) ampoules of atracurium and ranitidine drugs. Photographic documentation evidences the similarity of the ampoules themselves, and the diagram identifies latent system failures. The costs of the error are estimated and proposals for improvement are provided. Discussion and Conclusions . There is evidence of a failure in the barriers to the prevention of adverse events and in the reporting system. It is necessary to increase the safety culture at all levels of the system: regulatory, institutional, and personal.

A segurança do paciente é prioritária no âmbito anestésico cirúrgico. O erro na administração de fármacos é uma causa frequente de incidentes críticos no perioperatório. Uma forma de erro é a administração de medicação errada devido a uma apresentação similar. O objetivo deste trabalho é a descrição de falhas nas barreiras de prevenção de incidentes críticos com medicamentos, em base no estudo de um caso clínico e ao análise de suas consequências. Metodologia . Descrição de um caso clínico e estudo sistemático da situação de risco em base ao análises taxonômico do doente, tarefa, equipamento humano, lugar de trabalho e organização (PITELO) sugerido pelo Sistema Espanhol de Notificação em Segurança em Anestesia e Reanimação (SENSAR). Resultados . Mulher sem patologia que apresentou paro respiratório a pois a administração intravenosa de um fármacos no pós-operatório. Requereu-se de 24 hs na UTI e múltiplos estudos, logo dos quais foi diagnosticado um erro na administração do fármaco. A confusão se apresentou como causa deduplas ampolas LASA (do inglês: aparência parecida com o som) dos fármacos atracurio y ranitidina. A documentação fotográfica evidencia a similitude e o diagrama identificafalhas latentes no sistema. Foram analisados os custos do erro e realizou-se propostas de melhora. Discussão y conclusões . Evidencia-se uma falla nas barreiras de prevenção de eventos adversos e no sistema de reporte dos mesmos. É necessário incrementar a cultura de segurança em todos os níveis do sistema: regulatório, institucional e pessoal.

Impact of Cassia acutifolia Infusion on Glucose Levels in Obesity and Diabetes Rat Model.

OBJECTIVES: The aim of this study was to investigate the effects of Cassia acutifolia on the obesity and the glucose levels in a rat model of obesity and diabetes. METHODS: By random selection, 36 Wistar male rats were divided in two control groups, the positive and the negative control groups, and into four experimental groups receiving different infusions of Cassia acutifolia in water ad libitum. RESULTS: The results revealed a statistically significant anti-obesogenic effect (P = 0.02), although this was not considered clinically significant. Additionally, Cassia acutifolia lowered the glucose levels by 30 mg/dL to 90 mg/dL (P = 0.05). However, we observed adverse effects in the liver, a two-fold increase in transaminase levels (P = 0.002), and in the kidneys, decreased creatinine levels (P = 0.001), and these adverse effects had no viable explanation. CONCLUSION: Cassia acutifolia has anti-hyperglycemic effects in obese diabetic rats. However, Cassia acutifolia also has adverse effects, so it should not be administered to patients.

Hypocellularity in the Murine Model for Down Syndrome Ts65Dn Is Not Affected by Adult Neurogenesis.

Down syndrome (DS) is caused by the presence of an extra copy of the chromosome 21 and it is the most common aneuploidy producing intellectual disability. Neural mechanisms underlying this alteration may include defects in the formation of neuronal networks, information processing and brain plasticity. The murine model for DS, Ts65Dn, presents reduced adult neurogenesis. This reduction has been suggested to underlie the hypocellularity of the hippocampus as well as the deficit in olfactory learning in the Ts65Dn mice. Similar alterations have also been observed in individuals with DS. To determine whether the impairment in adult neurogenesis is, in fact, responsible for the hypocellularity in the hippocampus and physiology of the olfactory bulb, we have analyzed cell proliferation and neuronal maturation in the two major adult neurogenic niches in the Ts656Dn mice: the subgranular zone (SGZ) of the hippocampus and the subventricular zone (SVZ). Additionally, we carried out a study to determine the survival rate and phenotypic fate of newly generated cells in both regions, injecting 5'BrdU and sacrificing the mice 21 days later, and analyzing the number and phenotype of the remaining 5'BrdU-positive cells. We observed a reduction in the number of proliferating (Ki67 positive) cells and immature (doublecortin positive) neurons in the subgranular and SVZ of Ts65Dn mice, but we did not observe changes in the number of surviving cells or in their phenotype. These data correlated with a lower number of apoptotic cells (cleaved caspase 3 positive) in Ts65Dn. We conclude that although adult Ts65Dn mice have a lower number of proliferating cells, it is compensated by a lower level of cell death. This higher survival rate in Ts65Dn produces a final number of mature cells similar to controls. Therefore, the reduction of adult neurogenesis cannot be held responsible for the neuronal hypocellularity in the hippocampus or for the olfactory learning deficit of Ts65Dn mice.