Maternal Supplementation with a Cocoa Extract during Lactation Deeply Modulates Dams' Metabolism, Increases Adiponectin Circulating Levels and Improves the Inflammatory Profile in Obese Rat Offspring.

High-flavonoid cocoa consumption has been associated with beneficial properties. However, there are scarce data concerning the effects of maternal cocoa intake on dams and in their progeny. Here, we evaluated in rats whether maternal supplementation with a high-flavan-3-ol cocoa extract (CCX) during lactation (200 mg.kg-1.day-1) produced beneficial effects on dams and in their normoweight (STD-CCX group) and cafeteria-fed obese (CAF-CCX group) adult male offspring. Maternal intake of CCX significantly increased the circulating levels of adiponectin and decreased the mammary gland lipid content of dams. These effects were accompanied by increased energy expenditure and circulating free fatty acids, as well as by a higher expression of lipogenic and adiponectin-related genes in their mammary glands, which could be related to a compensatory mechanism to ensure enough lipid supply to the pups. CCX consumption programmed both offspring groups towards increased plasma total adiponectin levels, and decreased liver weight and lean/fat ratio. Furthermore, CAF-CCX progeny showed an improvement of the inflammatory profile, evidenced by the significant decrease of the monocyte chemoattractant protein-1 (MCP-1) circulating levels and the mRNA levels of the gene encoding the major histocompatibility complex, class II invariant chain (Cd74), a marker of M1 macrophage phenotype, in the epididymal white adipose tissue. Although further studies are needed, these findings can pave the way for using CCX as a nutraceutical supplement during lactation.

A double-blinded, randomized, parallel intervention to evaluate biomarker-based nutrition plans for weight loss: The PREVENTOMICS study.

BACKGROUND & AIMS: Growing evidence suggests that biomarker-guided dietary interventions can optimize response to treatment. In this study, we evaluated the efficacy of the PREVENTOMCIS platform-which uses metabolomic and genetic information to classify individuals into different 'metabolic clusters' and create personalized dietary plans-for improving health outcomes in subjects with overweight or obesity. METHODS: A 10-week parallel, double-blinded, randomized intervention was conducted in 100 adults (82 completers) aged 18-65 years, with body mass index ≥27 but <40 kg/m2, who were allocated into either a personalized diet group (n = 49) or a control diet group (n = 51). About 60% of all food was provided free-of-charge. No specific instruction to restrict energy intake was given. The primary outcome was change in fat mass from baseline, evaluated by dual energy X-ray absorptiometry. Other endpoints included body weight, waist circumference, lipid profile, glucose homeostasis markers, inflammatory markers, blood pressure, physical activity, stress and eating behavior. RESULTS: There were significant main effects of time (P < 0.01), but no group main effects, or time-by-group interactions, for the change in fat mass (personalized: -2.1 [95% CI -2.9, -1.4] kg; control: -2.0 [95% CI -2.7, -1.3] kg) and body weight (personalized: -3.1 [95% CI -4.1, -2.1] kg; control: -3.3 [95% CI -4.2, -2.4] kg). The difference between groups in fat mass change was -0.1 kg (95% CI -1.2, 0.9 kg, P = 0.77). Both diets resulted in significant improvements in insulin resistance and lipid profile, but there were no significant differences between groups. CONCLUSION: Personalized dietary plans did not result in greater benefits over a generic, but generally healthy diet, in this 10-week clinical trial. Further studies are required to establish the soundness of different precision nutrition approaches, and translate this science into clinically relevant dietary advice to reduce the burden of obesity and its comorbidities. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov registry (NCT04590989).

Carcinoma ductal infiltrante de mama en el hombre. Presentación de un caso / Duct infiltrative carcinoma of mamma in men. A Case report

El cáncer mamario en hombres es una enfermedad rara e infrecuente, de investigación limitada. El primer caso documentado fue descrito en Inglaterra en el siglo XIV por John Arderne. Los factores que predisponen al riesgo parecen incluir la exposición a la radiación, la administración de estrógenos y las enfermedades relacionadas con el hiperestrogenismo, como la cirrosis o el síndrome de Klinefelter. Se presenta un paciente masculino de 61 años de edad procedente de área urbana con antecedentes aparentes de salud que notó ulceración en el pezón con secreción que machaba la camisa. Se aplicó protocolo de diagnóstico de cáncer de mama y se diagnosticó carcinoma ductal infiltrante. Se realizó tratamiento quirúrgico y quimioterapia. En estos momentos presenta evolución favorable con enfermedad estable y tratamiento adyuvante con tamoxifeno por cinco años.

Mammary cancer in men is a rare and infrequent, fact-finding limited disease. The first well-informed case was described in England in XIV century by John Arderne. The factors that predispose the risk seem to include the exposition to radiation, the administration of estrogens and diseases related with the hyperestrogenism, like cirrhosis or Klinefelter’s syndrome. A 61 year old patient is presented from an urban area with apparent background of health that noted ulceration in the nipple with secretion that was crushing the shirt. A diagnosis protocol of breast cancer was applied and a duct infiltrative carcinoma of mamma was diagnosed. Surgical treatment and chemotherapy were accomplished. In this moment he shows a favourable evolution with stable disease and adjuvant treatment with tamoxifeno.

Fístula sigmoidea vesical como forma de presentación de un cáncer urotelial en una mujer / Vesico-sigmoid fistula as a way of presentation of urothelial cancer in a woman

Desde el comienzo mismo de la humanidad, las fístulas urinarias constituyeron un problema insoluble en sus inicios. Las fístulas externas representaban una gran dificultad de salud; sin embargo, las internas no lo eran tanto, pues las enfermedades que la provocaban aceleraban la muerte del paciente, y los signos y síntomas causados por la comunicación fistulosa pasaban inadvertidos(AU)

Creación y funcionamiento de la comisión de formación continuada de las profesiones sanitarias y de su sistema acreditador / The Spanish Commission of Continuing Education of the National Health System

En el contexto de la introducción de la Formación Médica Continuada (FMC) sistematizada, que viene ocurriendo en los países occidentales en las últimas décadas, la implementación de un sistema de acreditación ha supuesto un avance considerable. Tal sistema, auspiciado por la Comisión de Formación Continuada del Sistema Nacional de Salud, en 1977, en España, ha supuesto un hito a nivel europeo, dado que únicamente Italia dispone de dicho sistema acreditador. El sistema español de acreditación se basa en la valoración de los Componentes Cualitativo y Cuantitativo de la actividad. El primero se valora mediante una escala cualitativa de Licker, por parte de evaluadores externos y el segundo tiene en cuenta el número de horas lectivas, convenientemente ponderado. En la actualidad, teniendo en cuenta la existencia de un marco legislativo adecuado, el futuro del sistema español de acreditación presenta unos indudables aspectos positivos, que permiten contemplar el futuro con optimismo (AU)

In the context of the Continuing Medical Education (CME) systems that are being introduced in Western countries in the last decades, the implementation of a CME accreditation system is a very important step. Such a system, promoted by the Spanish Commission of Continuing Education of the National Health System in 1997, represents a crucial feature at the European level, since only Italy and Spain have the aforementioned accreditation system. The Spanish CME accreditation system is mainly based on the assessment of two core elements: the Qualitative Factor and the Quantitative Factor. The former is assessed through a qualitative Licker scale applied by external assessors. The Quantitative Factor relates to the learning hours, adequately weighted. Currently, taking into account the existence of an adequate regulatory framework, the future of the Spanish CME accreditation system can be optimistically viewed, mainly based on its positive aspects (AU)