Galectin-3 as a novel biotarget in cardiovascular alterations associated to development of severe aortic stenosis.

Aortic stenosis is one of the most common heart valve diseases, as well as one of the most common causes of heart failure in the elderly. Currently, there are no medical therapies to prevent or slow the progression of the disease. When symptoms develop alongside severe aortic stenosis, there is a poor prognosis unless aortic valve replacement is performed. Aortic stenosis is a heterogeneous disease with a complex pathophysiology involving structural and biological changes of the valve, as well as adaptive and maladaptive compensatory changes in the myocardium and vasculature in response to chronic pressure overload. Galectin-3 serves important functions in numerous biological activities including cell growth, apoptosis, differentiation, inflammation and fibrosis. With evidence emerging to support the function of Galectin-3, the current review aims to summarize the latest literature regarding the potential of Galectin-3 as therapeutic target in aortic valve and cardiovascular alterations associated with aortic stenosis.

Galectin-3 inhibition prevents adipose tissue remodelling in obesity.

Extracellular matrix remodelling of the adipose tissue has a pivotal role in the pathophysiology of obesity. Galectin-3 (Gal-3) is increased in obesity and mediates inflammation and fibrosis in the cardiovascular system. However, the effects of Gal-3 on adipose tissue remodelling associated with obesity remain unclear. Male Wistar rats were fed either a high-fat diet (33.5% fat) or a standard diet (3.5% fat) for 6 weeks. Half of the animals of each group were treated with the pharmacological inhibitor of Gal-3, modified citrus pectin (MCP; 100 mg kg(-1) per day) in the drinking water. In adipose tissue, obese animals presented an increase in Gal-3 levels that were accompanied by an increase in pericellular collagen. Obese rats exhibited higher adipose tissue inflammation, as well as enhanced differentiation degree of the adipocytes. Treatment with MCP prevented all the above effects. In mature 3T3-L1 adipocytes, Gal-3 (10(-8 )m) treatment increased fibrosis, inflammatory and differentiation markers. In conclusion, Gal-3 emerges as a potential therapeutic target in adipose tissue remodelling associated with obesity and could have an important role in the development of metabolic alterations associated with obesity.

The potential role of leptin in the vascular remodeling associated with obesity.

BACKGROUND/OBJECTIVES: Extracellular matrix (ECM) participates in the vascular remodeling associated with obesity. We investigated the effects of leptin on the production of ECM components in primary cultured vascular smooth muscle cells (VSMCs) and whether leptin could be a mediator of obesity-induced vascular remodeling. METHODS: T he effects of leptin (100 ng ml(-1)) on ECM components and superoxide anion production (O(2)(.-)) were evaluated in presence or absence of the antioxidant melatonin (10(-)(3) mmol l(-1)) or the inhibitor of phosphatidylinositol 3'-kinase (PI3K), LY294002 (2 × 10(-)(4) mmol l(-1)) in VSMCs from adult rats in order to explore the role of both oxidative stress and the participation of PI3K/Akt pathway in the effects of leptin. ECM components and O(2)(.-) were quantified in the aortic media of male Wistar rats fed a high-fat diet (HFD; 33.5% fat), or a standard diet (CT; 3.5% fat) for 6 weeks. RESULTS: In VSMCs, leptin enhanced gene and protein levels of collagen I, fibronectin, transforming growth factor (TGF)-ß and connective tissue growth factor (CTGF) but did not change those of collagen III and galectin-3. Leptin also increased O(2)(.-) and Akt phosphorylation in VSMCs. These effects were prevented by the presence of either melatonin or LY294002, except O(2)(.-) production in the case of PI3K inhibition. The increase in body weight in HFD rats was accompanied by aorta thickening due to an increase in media area. The aortic fibrosis observed in HFD rats was associated with high levels of leptin, collagen type I, fibronectin, TGF-ß, CTGF, phosphorylated Akt and O(2)(.-). Aortic leptin levels were positively correlated with total collagen, collagen I, TGF-ß and CTGF levels. No differences were observed in the levels of collagen III, elastin or galectin-3 between both the groups. CONCLUSIONS: Leptin could participate in the vascular remodeling and stiffness associated with obesity by ECM production in VSMCs through the activation of oxidative stress-PI3K/Akt pathway and the production of the profibrotic factors TGF-ß and CTGF.

Revisión de las esofagitis eosinofílicas en un hospital secundario en los últimos 4 años / Review of eosinophilic esophagitis in a secondary hospital in the last 4 years

Introducción. La esofagitis eosinofilica, es una inflamación crónica del esófago con una importante infiltración mucosa eosinofílica. Nuestro objetivo fue revisar las endoscopias con diagnóstico anatomopatológico de esofagitis eosinofílica y estudiar las características y evolución de los pacientes. Material y métodos. Estudio descriptivo retrospectivo, mediante revisión de informes clínicos desde enero del 2008 a diciembre de 2012 de pacientes pediátricos a los que se realizó estudio endoscópico con diagnóstico de esofagitis cosinofílica. El análisis se realizó mediante programa SPSS19. Resultados. Se registraron 13 pacientes. El 85% son varones. El síntoma principal fue la disfagia. La mayoría presentaban antecedentes personales y/o familiares de alergia. En el 100% se observaron > de 20 eosinófilos por campo de gran aumento. Los fármacos más usado fueron fluticasona y budesonida. En más de la mitad de los pacientes se realizó control endoscópico. Discusión y conclusiones. La esofagitis eosinofílica supone el 14,07% de las endoscopias realizadas en nuestro hospital en el tiempo registrado. Aunque es una patología poco frecuente, la falta de estudios sobre el tratamiento y pronóstico de la enfermedad hace necesaria la puesta en marcha de un protocolo de actuación que unifique el manejo de estos pacientes (AU)

Introduction. Eosinophilic esophagitis is a chronic inflammation of the esophageal mucosa with significant eosinophilic infiltration. Our objective was to review the endoscopy with pathological diagnosis of eosinophilic esophagitis and study the characteristics and patient outcomes. Material and methods. A retrospective review of clinical reports through form January 2008 to December 2012 pediatric patients undergoing endoscopy was performed with a diagnosis of eosinophilic esophagitis. The analysis was performed using SPSS 19 program. Results. 13 patients were recorded. 85% are male. The main symptom was dysphagia. Most families had a history of allergy. In 100% were observed > 20 eosinophils per high power field. The most commonly used drugs were fluticasome and budesonide. In more than half of patients endoscopic control was performed. Discussion and conclusions. Eosinophilic esophagitis represent 14,07% of endoscopies perfomed in our hospital at the time recorded. Although it is an uncommon condition, the lack of studies on the treatment and prognosis of the disease requires the implementation of a protocol that unifies the management of these patients (AU)

Estudio poblacional de los prematuros en el Hospital Universitario de Guadalajara años 2010 / Population study of premature infants in the University Hospital of Guadalajara year 2010

En las unidades de neonatología llama poderosamente la atención el aumento de hijos de padres inmigrantes y el incremento del número de prematuros tardíos. Actualmente, uno de cada cinco nacimientos en España se puede atribuir a la población inmigrante. El 69% de las mujeres inmigrantes tiene entre 15 y 49 años, comparado con el 48% de las españolas. Mientras que la tasa de prematuridad se mantiene constante en un 7-8% , los prematuros tardíos se han incrementado un 13% desde el 2001 suponiendo los prematuros tardíos un 75% de todos ellos. La prematuridad es la principal causa de muerte en el primer mes de vida y la segunda causa de morbilidad fetal o neonatal tras las malformaciones congénitas. La tasa de morbimortalidad en esta población es más baja de la de prematuros de EG más baja, pero mayor que en los recién nacidos a término, presentando sobre todo alta tasa de mal adaptación pulmonar, membrana hialiina, apneas, inestabilidad térmica, hipoglucemia, hipocalcemia, anemia, ictericia, problemas neurológicos (el volumen cerebral en la semana 34ª es el 65% del término). La razón por la que han aumentado en número no es bien conocida. Una hipótesis sería el aumento en las técnicas de reproducción asistida, que generarían un incremento en el número de embarazos múltiples. La segunda hipótesis son los avances en la práctica obstétrica que han llevado a un incremento en el número de intervenciones médicas y quirúrgicas durante el embarazo (AU)

One out of five births actually in Spain is due to foreign parents, which is higher tan the proportion of immigrants in the whole population. This can be explained by a higher fecundity rate and because this population is younger than Spanish (69% of immigrants women have an age between 15 and 49, compare to 48% of Spanish women). The number of preterm births has increased too in the last years up to 7-8%, specially late preterm infants, (define by birth at 34 0/7 through 36 6/7 weeks gestation), which have increased a 13% from 2001. The characteristics of late-preterm infants predispose them to a higher risk of morbidity and mortality than term infant greater risk of respiratory distress, apnea, hypoglycemia, temperature instability, anemia, jaundice, feeding difficulties, cerebral palsy and neurodevelopmental handicaps. The reason for the increase in late-preterm births during the last decade is not well understood. One hypothesis is that it may be attributable to increased use of reproductive technologies, and an increase in multifetal pregnancies. An-other hypothesis is that advances is obstetric practice have led to an increase in surveillance and medical interventions during pregnancy (AU)

Rotura traqueal como complicación de una intubación endotraqueal / Tracheal rupture as complication after endotracheal intubation

La rotura traqueal postintubación (RTP) es una complicación infrecuente, que exige un alto grado de sospecha clínica debido a su elevada morbimortalidad. Debe sospecharse en los pacientes que presentan enfisema subcutáneo, neumotórax y/o neumomediastino tras la intubación. Actualmente no existe consenso sobre su tratamiento, quirúrgico o conservador. Presentamos un caso de RTP que respondió favorablemente al tratamiento conservador(AU)

Post-intubation tracheal rupture (PTR) is a rare complication that requires a high degree of clinical suspicion due to its high morbidity and mortality. It should be suspected in all patients who present subcutaneous emphysema, pneumothorax, and/or pneumomediastinum after intubation. There is no current consensus on surgical or conservative treatment. We report 1 case of PTR that responded favorably to conservative treatment(AU)

Microadenomas hipofisarios: distintas formas de presentación / Pituitary microadenomas: different presentation forms

Los adenomas hipofisarios son tumores dependientes de la glándula pineal, que pueden ser hallazgos casuales o presentarse con clínica. Describimos tres casos de microadenomas hiposfisarios con diferente forma de debut y evolución (AU)

Pituitary adenomas are tumors dependent ton the pineal gland, which may be causal findings or occur with symptoms. We present three cases of pituitary microadenomas with different presentation forms and evolution (AU)

Infarto cerebral en recién nacido a término: a propósito de un caso / Cerebral infarction in full-term newborn: a case report

El periodo neonatal es una época de riesgo aumentada para la aparición de infartos isquémicos cerebrales, con una incidencia de aproximadamente 1 por cada 4.000 recién nacidos a término. La forma de presentación más frecuente son las crisis en las primeras 48-72 horas de vida. Los factores de riesgo incluyen alteraciones trombóticas hereditarias o adquiridas y factores ambientales. Las nuevas técnicas de neuroimagen han facilitado el diagnóstico precoz de esta patología (AU)

The few days before and after birth are a time of special risk for stroke in both mother and infant, probably related to activation of coagulation mechanisms in this critical period. Arterial ischaemic stroke around the time of birth is recognized in about one in 4,000 full-term infants. Neonatal seizures are most commonly the clinical finding that triggers assessment. Risk factors for perinatal stroke include hereditary or acquired thrombophilia’s and environmental factors. Perinatal arterial (ischemic) stroke (PAS) is more often recognized with the increased use of sophisticated neuroimaging tecniques (AU)

[A campaign for detection of beta-thalassemia minor and prevention of beta-thalassemia major in the island of Minorca. 2 years' experience]. / Campaña para la detección de la betatalasemia minor y prevención de la major en la isla de Menorca. Experiencia de dos años.

The high prevalence of beta-thalassemia minor and the occurrence of thalassemia major in Minorca prompted us to develop a prevention campaign. The selected population consisted of primary school students. The campaign was operative during the terms 1986-87 and 1987-88 and had three stages: 1.) informative; 2.) analytical study and diagnosis of carriers; 3.) report of the results and genetic counselling. We studied overall 1862 schoolchildren. The prevalence of beta-thalassemia minor was 3.38%. We discuss the methodology, the results and the effectiveness of the campaign.