Cocoa: a functional food that decreases insulin resistance and oxidative damage in young adults with class II obesity.

BACKGROUND/OBJECTIVES: Cocoa consumption is associated with health benefits due to its high content of polyphenols. However, the effects of short-term cocoa consumption remain unclear. We aimed to determine the effects generated by cocoa consumption (for 7 days) in young adults in normoweight and class II obesity. SUBJECTS/METHODS: Before-and-after study was carried out in normoweight (NW) (n = 15) and class II obesity (CIIO) (n = 15) young adults. The NW and CIIO participants consumed 25 and 39 g of cocoa, respectively, per day for 7 days. The effect of cocoa consumption was evaluated on the lipid profile, insulin resistance (IR), and inflammation. Oxidative damage was also examined by assessing the biomarkers of oxidative damage in plasma. In addition, recombinant human insulin was incubated with blood obtained from the participants, and the molecular damage to the hormone was analyzed. RESULTS: Cocoa consumption resulted in decreased low-density lipoprotein-cholesterol in both groups (P = 0.04), while the total cholesterol, high-density lipoprotein cholesterol, and triglycerides were maintained at the recommended levels. Initially, IR was detected in the CIIO group (homeostasis model assessment [HOMA] = 4.78 ± 0.4), which is associated with molecular damage to insulin. Interestingly, intervention with cocoa resulted in improved IR (HOMA = 3.14 ± 0.31) (P = 0.0018) as well as molecular damage to insulin. Finally, cocoa consumption significant decreased the arginase activity (P = 0.0249) in the CIIO group; this is a critical enzymatic activity in the inflammatory process associated with obesity. CONCLUSIONS: The short-term consumption of cocoa improves the lipid profile, exerts anti-inflammatory effects, and protects against oxidative damage. Results of this study indicate that cocoa consumption can potentially improve IR and restore a healthy redox status.

Prevalencia de obesidad posCovid-19 en jóvenes universitarios de Tabasco.

No disponible.

Comorbidities and laboratory parameters associated with SARS-CoV-2 infection severity in patients from the southeast of Mexico: a cross-sectional study.

Background. Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is the etiological agent of the coronavirus disease 2019 (COVID-19) pandemic. Among the risk factors associated with the severity of this disease is the presence of several metabolic disorders. For this reason, the aim of this research was to identify the comorbidities and laboratory parameters among COVID-19 patients admitted to the intensive care unit (ICU), comparing the patients who required invasive mechanical ventilation (IMV) with those who did not require IMV, in order to determine the clinical characteristics associated with the COVID-19 severity. Methods. We carried out a cross-sectional study among 152 patients who were admitted to the ICU from April 1 st to July 31 st, 2021, in whom the comorbidities and laboratory parameters associated with the SARS-CoV-2 infection severity were identified. The data of these patients was grouped into two main groups: "patients who required IMV" and "patients who did not require IMV". The nonparametric Mann-Whitney U test for continuous data and the χ2 test for categorical data were used to compare the variables between both groups. Results. Of the 152 COVID-19 patients who were admitted to the ICU, 66 required IMV and 86 did not require IMV. Regarding the comorbidities found in these patients, a higher prevalence of type 2 diabetes mellitus (T2DM), hypertension and obesity was observed among patients who required IMV vs. those who did not require IMV ( p<0.05). Concerning laboratory parameters, only glucose, Interleukin 6 (IL-6), lactate dehydrogenase (LDH) and C-reactive protein (CRP) were significantly higher among patients who required IMV than in those who did not require IMV ( p<0.05). Conclusion. This study performed in a Mexican population indicates that comorbidities such as: T2DM, hypertension and obesity, as well as elevated levels of glucose, IL-6, LDH and CRP are associated with the COVID-19 severity.

Niveles de procalcitonina y ferritina predicen la gravedad de Covid-19 en pacientes ingresados a la unidad de cuidados intensivos.

No disponible.

Conserved and divergent expression dynamics during early patterning of the telencephalon in mouse and chick embryos.

The mammalian and the avian telencephalon are nearly indistinguishable at early embryonic vesicle stages but differ substantially in form and function at their adult stage. We sequenced and analyzed RNA populations present in mouse and chick during the early stages of embryonic telencephalon to understand conserved and lineage-specific developmental differences. We found approximately 3000 genes that orchestrate telencephalon development. Many chromatin-associated epigenetic and transcription regulators show high expression in both species and some show species-specific expression dynamics. Interestingly, previous studies associated them to autism, intellectual disabilities, and mental retardation supporting a causal link between their impaired functions during telencephalon development and brain dysfunction. Strikingly, the conserved up-regulated genes were differentially enriched in ontologies related to development or functions of the adult brain. Moreover, a differential enrichment of distinct repertoires of transcription factor binding motifs in their upstream promoter regions suggest a species-specific regulation of the various gene groups identified. Overall, our results reveal that the ontogenetic divergences between the mouse and chick telencephalon result from subtle differences in the regulation of common patterning signaling cascades and regulatory networks unique to each species at their very early stages of development.

Recomendaciones en rehabilitación respiratoria 2018: Sección Rehabilitación Respiratoria Asociación Argentina Medicina Respiratoria / Recommendations in Respiratory Rehabilitation 2018: Respiratory Rehabilitation Section Argentine Association of Respiratory Medicine

La Rehabilitación Respiratoria (RR), dirigida a las personas con enfermedad respiratoria crónica, reduce las exacerbaciones y hospitalizaciones, mejora los síntomas, la tolerancia al ejercicio y calidad de vida. Miembros de la Sección de RR de la Asociación Argentina de Medicina Respiratoria, se reunieron con el objetivo de preguntarse cuáles son los temas principales de controversia para dar respuesta desde la medicina basada en evidencia (sistema GRADE). Se eligieron diez preguntas. Resultados: La RR se debe indicar en pacientes con EPOC estadio GOLD 1 (1C). La adherencia es fundamental y se relaciona a sus beneficios (1C). La actividad física debe ser evaluada y estimulada (1B). Los beneficios de la RR dentro del mes posterior a una exacerbación de EPOC, reduce los síntomas y exacerbaciones y mejora la calidad de vida (1B). La RR está indicada en algunas enfermedades respiratorias crónicas no-EPOC (1B). Se deben indicar estrategias de entrenamiento especiales en desnutridos (3B) y obesos (3C). Los pacientes deben ser evaluados con prueba de ejercicio, escalas de disnea y calidad de vida (1A). El rol del entrenador de salud es novedoso ya que disminuye hospitalizaciones y mejora la calidad de vida (2C). Las comorbilidades afectan el resultado de la RR (3B). La RR reduce la mortalidad (1B) y la ansiedad-depresión (2B). La RR domiciliaria es efectiva (1A). La RR es fundamental en el tratamiento de enfermedades respiratorias crónicas. Se han actualizado las recomendaciones en RR en base a la evidencia científica con el objetivo que la RR pueda aplicarse en nuestro país.

Respiratory Rehabilitation (RR) is indicated in patients with chronic pulmonary diseases to reduce exacerbations and hospitalizations, and to improve symptoms, exercise tolerance and quality of life. Members of RR Section of the Asociación Argentina de Medicina Respiratoria, joined to review critical issues and controversies by an evidence-based system (GRADE). Ten questions were elected.213 Results: RR must be indicated in GOLD 1 COPD (1C). Adherence in RR is critical and related to benefits (1C). Physical activity must be evaluated and stimulated (1B). RR implemented after one month of COPD exacerbation hospitalization, reduces symptoms and exacerbations and improves quality of life(1B). RR is indicated in some no-COPD chronic respiratory diseases (1B). Special training strategies must be used in undernourished (3B) and obeses patients (3C). Exercise tests, dyspnea and quality of life questionnaires must be used to evaluate patients (1A). Health trainer is an original strategy to reduce hospitalizations and improve quality of life (2C). Comorbilities impacts on RR outcomes (3B). RR reduces mortality (1B) and ansiety-depression (2B). Domiciliary RR is efective (1A). RR is a key component of chronic pulmonary diseases treatment. Based in new scientific evidence, local recomendations have been done regarding to improve access in our country.

EDF-1 downregulates the CaM/Cn/NFAT signaling pathway during adipogenesis.

The endothelial differentiation factor-1 (EDF-1) is a calmodulin binding protein that regulates calmodulin-dependent enzymes. In endothelial cells, this factor can form a protein complex with calmodulin. We analyzed the relationship between this factor and the members of calmodulin/calcineurin/nuclear factor of activated T-cells (NFAT) signaling pathway during adipogenesis of 3T3-F442A cells. We found that the expression of edf1 is upregulated during early adipogenesis, whereas that of calcineurin gene is lowered, suggesting that this pathway should be downregulated to allow for adipogenesis to occur. We also found that EDF-1 associates with calmodulin and calcineurin, most likely inactivating calcineurin. Our results showed that EDF-1 inactivates the calmodulin/calcineurin/NFAT pathway via sequestration of calmodulin, during early adipogenesis, and we propose a mechanism that negatively regulates the activation of calcineurin through a complex formation between EDF-1 and calmodulin. This finding raises the possibility that modulating this pathway might offer some alternatives to regulate adipose biology.

[New argentine consensus of respiratory rehabilitation 2008]. / Nuevo Consenso Argentino de Rehabilitación Respiratoria ActualizaciOn 2008.

Respiratory rehabilitation (RR) is a multidisciplinary program of care for patients with chronic respiratory impairment, individually tailored, designed to optimize physical and social performance and patient autonomy. It is particularly indicated in chronic obstructive pulmonary disease (COPD) patients with exercise intolerance. The objectives of respiratory rehabilitation are: reduction in symptoms and exercise intolerance, improvement of health-related quality of life, and reduction of health costs. A group of neumonologists, nutritionists and physical therapists performed a systematic review of the evidence in RR to update previous local guidelines. Inclusion and exclusion criteria, guidelines for initial evaluation and follow up and resources needed are defined. Training characteristics are recommended regarding frequency of the visits, intensity, progression and duration of the exercise training. Aerobic training was recommended for lower limb (1A), upper limb (1B). Strength training must be added (1B). Respiratory muscle training and other physiotherapy techniques were recommended only for specific patients (1C). In addition recommendations have been made for educational objectives of the program including smoking cessation, nutritional and psychological support. The positive impact of RR on reductions of health care costs and reductions on hospitalizations (Evidence A) and mortality (Evidence B) were analized. Respiratory rehabilitation is a key component in the modern treatment of COPD patients. This consensus statement was prepared based on the most recent scientific evidence and adjusted to the local environment with the aim of being implemented nationally.

Nuevo consenso argentino de rehabilitación respiratoria: Actualización 2008 / New Argentine Consensus of Respiratory Rehabilitation 2008

La rehabilitación respiratoria (RR) es un tratamiento multidisciplinario para pacientes con enfermedad respiratoria crónica, adaptado individualmente y diseñado para optimizar la capacidad física, la actividad social y la autonomía de los mismos. Está especialmente indicado en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). Los objetivos de la RR son: reducir los síntomas, mejorar la tolerancia al ejercicio físico y la calidad de vida. Un grupo de neumonólogos, nutricionistas y kinesiólogos realizó un análisis sistemàtico de la evidencia científica con el objetivo de actualizar las normativas anteriores de RR. Se definieron los criterios de inclusión y exclusión, la evaluación inicial y de seguimiento como así también los elementos y material necesarios. Las características del entrenamiento en cuanto a la frecuencia de las visitas, la intensidad, progresión y duración del ejercicio han sido revisadas. Se recomendó el entrenamiento de los miembros inferiores (1A), miembros superiores (1B), complementando el entrenamiento de fuerza (1B). El entrenamiento de músculos respiratorios, otras técnicas kinesiológicas y pautas nutricionales se recomiendan sólo para casos particulares (1C). Se fijan también objetivos educativos para los programas de rehabilitación que incluyen la cesación de fumar, aspectos nutricionales y apoyo psicológico. La RR ha demostrado reducir las exacerbaciones, hospitalizaciones y costos (Evidencia A), y mejoraría la sobrevida (Evidencia B). La RR es un componente fundamental en el tratamiento moderno de la EPOC. Estas pautas basadas en la más reciente evidencia científica, adaptadas al medio local tienen por objetivo que la RR pueda aplicarse en todo el país.

Respiratory rehabilitation (RR) is a multidisciplinary program of care for patients with chronic respiratory impairment, individually tailored, designed to optimize physical and social performance and patient autonomy. It is particularly indicated in chronic obstructive pulmonary disease (COPD) patients with exercise intolerance. The objectives of respiratory rehabilitation are: reduction in symptoms and exercise intolerance, improvement of health-related quality of life, and reduction of health costs. A group of neumonologists, nutritionists and physical therapists performed a systematic review of the evidence in RR to update previous local guidelines. Inclusion and exclusion criteria, guidelines for initial evaluation and follow up and resources needed are defined. Training characteristics are recommended regarding frequency of the visits, intensity, progression and duration of the exercise training. Aerobic training was recommended for lower limb (1A), upper limb (1B). Strength training must be added (1B). Respiratory muscle training and other physiotherapy techniques were recommended only for specific patients (1C). In addition recommendations have been made for educational objectives of the program including smoking cessation, nutritional and psychological support. The positive impact of RR on reductions of health care costs and reductions on hospitalizations (Evidence A) and mortality (Evidence B) were analized. Respiratory rehabilitation is a key component in the modern treatment of COPD patients. This consensus statement was prepared based on the most recent scientific evidence and adjusted to the local environment with the aim of being implemented nationally.

Cumplimiento con las guías nacionales en pacientes hospitalizados con neumonía adquirida en la comunidad: Resultados del estudio capo en Argentina / Adherence with National Guidelines in hospitalized patients with community-acquired pneumonia: Results of CAPO study in Argentina

Un comité de seis sociedades científicas en Argentina desarrolló guías para la atención de pacientes con neumonía adquirida en la comunidad (NAC). El objetivo de este estudio fue evaluar el nivel de cumplimiento con el cuidado recomendado en las guías nacionales en pacientes hospitalizados con NAC en Argentina. Usando indicadores de calidad, la atención de 436 pacientes hospitalizados en 12 centros de Argentina fue evaluada en las áreas de hospitalización, oxigenoterapia, terapia antibiótica empírica, terapia switch, alta hospitalaria y prevención. El nivel de cumplimiento fue clasificado como óptimo (>90%), intermedio (60% a 90%), y bajo (<60%). La selección de antibióticos empíricos y la administración dentro de las primeras ocho horas de admisión tuvieron una adherencia superior al 80%. Se identificó un nivel de cumplimiento bajo en las áreas del pasaje de antibióticos de la vía endovenosa a la vía oral (53%), la prevención con vacunación antineumocóccica (51%) y el ofrecimiento para dejar de fumar (29%). Usando indicadores de calidad se pueden identificar áreas específicas de atención en pacientes con NAC con un bajo nivel de cumplimiento con las guías nacionales. En Argentina se deben desarrollar inicialmente intervenciones enfocadas a mejorar el manejo del pasaje de antibióticos de la vía endovenosa a la vía oral y prevención de la NAC.

A committee of six scientific organizations from Argentina developed guidelines for the management of patients with community-acquired pneumonia (CAP).The objective of this study was to evaluate the level of adherence with the recommended care suggested by the guidelines in patients hospitalized with CAP in Argentina. Using quality indicators the management of 436 patients who were hospitalized in 12 Argentinean institutions was evaluated. The care given among the following areas was reviewed: need for hospitalization, need for oxygen therapy, empiric antibiotic therapy, switch therapy, hospital discharge, and prevention. The level of adherence was classified as optimal (>90%), intermediate (60% to 90%), and low (<60%).The selection of the empiric antibiotic therapy and the administration of antibiotics between the first 8 hours after arrival had an adherence greater to 80%. A low level of adherence was found in the areas of switch therapy (53%), prevention of CAP with pneumococcal vaccine (51%) and smoking cessation offered (29%). Using quality indicators it is possible to identify specific areas of management in patients with CAP to a low level of adherence with national guidelines. In Argentina interventions to improve switch therapy and prevention of CAP should be developed.

[Adherence with national guidelines in hospitalized patients with community-acquired pneumonia. Results of CAPO study in Argentina]. / Cumplimiento con las guías nacionales en pacientes hospitalizados con neumonía adquirida en la comunidad. Resultados del estudio CAPO en Argentina.

A committee of six scientific organizations from Argentina developed guidelines for the management of patients with community-acquired pneumonia (CAP).The objective of this study was to evaluate the level of adherence with the recommended care suggested by the guidelines in patients hospitalized with CAP in Argentina. Using quality indicators the management of 436 patients who were hospitalized in 12 Argentinean institutions was evaluated. The care given among the following areas was reviewed: need for hospitalization, need for oxygen therapy, empiric antibiotic therapy, switch therapy, hospital discharge, and prevention. The level of adherence was classified as optimal (>90%), intermediate (60% to 90%), and low (<60%).The selection of the empiric antibiotic therapy and the administration of antibiotics between the first 8 hours after arrival had an adherence greater to 80%. A low level of adherence was found in the areas of switch therapy (53%), prevention of CAP with pneumococcal vaccine (51%) and smoking cessation offered (29%). Using quality indicators it is possible to identify specific areas of management in patients with CAP to a low level of adherence with national guidelines. In Argentina interventions to improve switch therapy and prevention of CAP should be developed.

[Argentine Consensus of Respiratory Rehabilitation]. / Consenso Argentino de Rehabilitación Respiratoria.

A group of pulmonologists and physical therapists from the Asociacion Argentina de Medicina Respiratoria revised the scientific literature on Respiratory Rehabilitation (RR) to elaborate evidence-based national recommendations to promote its use. RR is a multidisciplinary program of care for patients with chronic respiratory impairment, individually tailored, designed to optimize physical and social performance and autonomy of patients. It is particularly indicated in patients with Chronic Obstructive Pulmonary Disease (COPD) with exercise intolerance. Inclusion and exclusion criteria, guidelines for initial evaluation and follow up have been defined. The resources needed were defined. It was recommended a hospital ambulatory program with domiciliary complement. A pulmonologist and physical therapist were required for the program as minimum. Aerobic training was recommended for lower limb (LL) (Evidence A) and upper limb (UL) (Evidence B), strength training for LL and UL (Evidence C), as well as respiratory muscles training by resistive inspiratory threshold load (Evidence D) and other physiotherapy techniques were recommended for specific patients. In addition recommendations have been made for educational objectives of the program, nutritional and psychological support. The positive impact of RR on health care was analyzed through the reduction in exacerbation of COPD, length of hospital stay and cost. RR is a key component in the treatment of COPD patients. This evidenced-based consensus statement was prepared to provide recommendations to be implemented nationally.

Consenso argentino de rehabilitacion respiratoria / Argentine consensus of respiratory rehabilitation

Un grupo de neumonólogos y kinesiólogos asociados a la Asociación Argentina de Medicina Respiratoria se reinieron con el objetivo de revisar la evidencia científica en Rehabilitacíón Respiratoria (RR), elaborar recomendaciones basadas en la evidencia para su aplicación local y promover su uso. RR es um programa multidisciplinario para el cuidado de pacientes con una alteración respiratoria crónica, ajustado individualmente, con el objetivo de lograr el máximo de actividad física, social y la independencia funcional de paciente a través de la actividad física supervisada. La RR está particularmente indicada en pacientes con Enfermedad Pulmonar Obstructiva Crónica (EPOC) que presentem intolerancia al esfuerzo. Se han definidi los criterios de inclusión y exclusión, las mínimas pautas de evaluaíón y cómo realizar el control posterior a la RR. Se elaboraron normativas sobre los recursos para montar un programa. Se recomendó un programa ambulatorio hospitalario con complemento domiciliario, y al personal mínimo necesario (un neumonólogo y un kinesiólogo). Se recomendó para todos los pacientes el entrenamiento aeróbico de resistencia para miembros inferiores (MI) (Evidencia A) y de miembros superiores (MS) (Evidencia B), de fuerza de MI y MS (Evidencia C), como así también para determinados pacientes el entrenamiento muscular respiratorio a carga resistiva umbral inspiratoria (Evidencia D), y otras técnicas kinésicas. Se hicieron recomendaciones sobre los objetivos educativos, apoyo nutricional y psicológico en todo programa de RR. El beneficio de la RR también fue analizado a través de la reducción de las exacerbaciones, hospitalizaciones y costos para el sitema de salud de los programas de RR. La RR es un componente fundamental del tratamiento de un paciente con EPOC. Este Consenso ha elaborado recomendaciones basadas en la evidencia para ser aplicada a nivel local. (AU)

Consenso argentino de rehabilitacion respiratoria / Argentine consensus of respiratory rehabilitation

Un grupo de neumonólogos y kinesiólogos asociados a la Asociación Argentina de Medicina Respiratoria se reinieron con el objetivo de revisar la evidencia científica en Rehabilitacíón Respiratoria (RR), elaborar recomendaciones basadas en la evidencia para su aplicación local y promover su uso. RR es um programa multidisciplinario para el cuidado de pacientes con una alteración respiratoria crónica, ajustado individualmente, con el objetivo de lograr el máximo de actividad física, social y la independencia funcional de paciente a través de la actividad física supervisada. La RR está particularmente indicada en pacientes con Enfermedad Pulmonar Obstructiva Crónica (EPOC) que presentem intolerancia al esfuerzo. Se han definidi los criterios de inclusión y exclusión, las mínimas pautas de evaluaíón y cómo realizar el control posterior a la RR. Se elaboraron normativas sobre los recursos para montar un programa. Se recomendó un programa ambulatorio hospitalario con complemento domiciliario, y al personal mínimo necesario (un neumonólogo y un kinesiólogo). Se recomendó para todos los pacientes el entrenamiento aeróbico de resistencia para miembros inferiores (MI) (Evidencia A) y de miembros superiores (MS) (Evidencia B), de fuerza de MI y MS (Evidencia C), como así también para determinados pacientes el entrenamiento muscular respiratorio a carga resistiva umbral inspiratoria (Evidencia D), y otras técnicas kinésicas. Se hicieron recomendaciones sobre los objetivos educativos, apoyo nutricional y psicológico en todo programa de RR. El beneficio de la RR también fue analizado a través de la reducción de las exacerbaciones, hospitalizaciones y costos para el sitema de salud de los programas de RR. La RR es un componente fundamental del tratamiento de un paciente con EPOC. Este Consenso ha elaborado recomendaciones basadas en la evidencia para ser aplicada a nivel local.

Consenso Argentino de Rehabilitación Respiratoria. / [Argentine Consensus of Respiratory Rehabilitation]

A group of pulmonologists and physical therapists from the Asociacion Argentina de Medicina Respiratoria revised the scientific literature on Respiratory Rehabilitation (RR) to elaborate evidence-based national recommendations to promote its use. RR is a multidisciplinary program of care for patients with chronic respiratory impairment, individually tailored, designed to optimize physical and social performance and autonomy of patients. It is particularly indicated in patients with Chronic Obstructive Pulmonary Disease (COPD) with exercise intolerance. Inclusion and exclusion criteria, guidelines for initial evaluation and follow up have been defined. The resources needed were defined. It was recommended a hospital ambulatory program with domiciliary complement. A pulmonologist and physical therapist were required for the program as minimum. Aerobic training was recommended for lower limb (LL) (Evidence A) and upper limb (UL) (Evidence B), strength training for LL and UL (Evidence C), as well as respiratory muscles training by resistive inspiratory threshold load (Evidence D) and other physiotherapy techniques were recommended for specific patients. In addition recommendations have been made for educational objectives of the program, nutritional and psychological support. The positive impact of RR on health care was analyzed through the reduction in exacerbation of COPD, length of hospital stay and cost. RR is a key component in the treatment of COPD patients. This evidenced-based consensus statement was prepared to provide recommendations to be implemented nationally.