Excessive body mass index (BMI) has been linked to a low-grade chronic inflammation state. Unhealthy BMI has also been related to neuroanatomical changes in adults. Research in adolescents is ...relatively limited and has produced conflicting results. This study aims to address the relationship between BMI and adolescents' brain structure as well as to test the role that inflammatory adipose-related agents might have over this putative link.
We studied structural MRI and serum levels of interleukin-6, tumor necrosis factor alpha (TNF-α), C-reactive protein and fibrinogen in 65 adolescents (aged 12-21 years). Relationships between BMI, cortical thickness and surface area were tested with a vertex-wise analysis. Subsequently, we used backward multiple linear regression models to explore the influence of inflammatory parameters in each brain-altered area.
We found a negative association between cortical thickness and BMI in the left lateral occipital cortex (LOC) and the right precentral gyrus as well as a positive relationship between surface area and BMI in the left rostral middle frontal gyrus and the right superior frontal gyrus. In addition, we found that higher fibrinogen serum concentrations were related to thinning within the left LOC (β = -0.45, p < 0.001), while higher serum levels of TNF-α were associated to a greater surface area in the right superior frontal gyrus (β = 0.32, p = 0.045). Besides, we have also identified a trend that negatively correlates the cortical thickness of the left fusiform gyrus with the increases in BMI. It was also associated to fibrinogen (β = -0.33, p = 0.035).
These results suggest that adolescents' body mass increases are related with brain abnormalities in areas that could play a relevant role in some aspects of feeding behavior. Likewise, we have evidenced that these cortical changes were partially explained by inflammatory agents such as fibrinogen and TNF-α.
Tumor With a 40-Year History García-Montero, P; Segura Palacios, J M; de Troya Martín, M
Actas dermo-sifiliográficas (English ed.),
12/2017, Letnik:
108, Številka:
10
Journal Article
Members of "Asociación de Ecografía Digestiva" decided to carry out a multicenter retrospective study on fine-needle aspiration biopsy for pancreatic space-occupying lesions under ultrasonographic ...guidance and via the percutaneous route in order to assess this technique s performance versus endoscopic ultrasound-guided biopsy.
10 hospitals for a total of 222 patients with suspiciously malignant, 8-120-mm pancreatic lesions were included in the study.
The analysis of results shows a sensitivity of 89%, a specificity of 98%, a positive predictive value of 99%, and a negative predictive value of 74%, for an overall diagnostic accuracy of 91%. No major complications occurred.
Percutaneous fine-needle aspiration for pancreatic lesions is highly cost-effective and has few and mild complications.
RESUMEN El presente artículo parte de la pregunta ¿qué beneficio supone la presencia de un familiar durante el desarrollo de reanimación cardiopulmonar? Para resolver la pregunta se realizó una ...revisión de la literatura en PUBMED, IME, CINHAL, IBECS, MEDES, con los términos: family, protocol, family presence during resuscitation, witnesses, resuscitation, relatives, resuscitation policy., Hay argumentos a favor y en contra de esta medida o política en reanimación: A favor: El acompañamiento de los familiares durante la reanimación cardiopulmonar supone obtención rápida de la información sobre el paciente, celeridad y actitud más profesional por parte del personal de salud, y la disminución de la ansiedad por parte de los familiares. En contra: El ambiente hospitalario es de alto riesgo porque hay exposición a muchos accidentes biológicos, además puede ser un ambiente desconocido y atemorizante para los familiares, y se puede llegar a una mayor tensión en el equipo de reanimación, especialmente si el equipo está aún en formación y si el familiar tiene conocimientos y relación con este campo. Por otro lado, es importante la opinión previa del paciente a cerca de tener un familiar presente durante la atención, que en muchos casos es negativa. Se debe implementar y estandarizar protocolos institucionales donde se contemplen estos aspectos. Conclusión: son necesarios más estudios donde se tengan en cuenta las consideraciones de la reanimación a partir de las tres partes implicadas, el paciente, los familiares y el equipo de reanimación.
Aim
Further to its pivotal role in haemostasis, factor Xa (FXa) promotes effects on the vascular wall. The purpose of the study was to evaluate if FXa modifies the expression level of energy ...metabolism and oxidative stress‐related proteins in femoral arteries obtained from type 2 diabetic patients with end‐stage vasculopathy.
Methods
Femoral arteries were obtained from 12 type 2 diabetic patients who underwent leg amputation. Segments from the femoral arteries were incubated in vitro alone and in the presence of 25 nmol l−1 FXa and 25 nmol l−1 FXa + 50 nmol l−1 rivaroxaban.
Results
In the femoral arteries, FXa increased triosephosphate isomerase and glyceraldehyde‐3‐phosphate dehydrogenase isotype 1 expression but decreased pyruvate dehydrogenase expression. These facts were accompanied by an increased content of acetyl‐CoA. Aconitase activity was reduced in FXa‐incubated femoral arteries as compared with control. Moreover, FXa increased the protein expression level of oxidative stress‐related proteins which was accompanied by an increased malonyldialdehyde arterial content. The FXa inhibitor, rivaroxaban, failed to prevent the reduced expression of pyruvate dehydrogenase induced by FXa but reduced acetyl‐CoA content and reverted the decreased aconitase activity observed with FXa alone. Rivaroxaban + FXa but not FXa alone increased the expression level of carnitine palmitoyltransferase I and II, two mitochondrial long chain fatty acid transporters. Rivaroxaban also prevented the increased expression of oxidative stress‐related proteins induced by FXa alone.
Conclusions
In femoral isolated arteries from type 2 diabetic patients with end‐stage vasculopathy, FXa promoted disruption of the aerobic mitochondrial metabolism. Rivaroxaban prevented such effects and even seemed to favour long chain fatty acid transport into mitochondria.
Background and ImportanceCancer patients with comorbidities are usually excluded from clinical trials. Real-life observational studies are of particular interest to elucidate the safety of these new ...therapies.Safety of pembrolizumab +/- chemotherapy in metastatic non-small-cell lung carcinoma (NSCLC) was assessed in KEYNOTE-024, 189 and 407 pivotal trials.Aim and ObjectivesTo assess the safety of pembrolizumab +/- platinum-based chemotherapy in first-line treatment of metastatic NSCLC in real-world practice.Material and MethodsObservational, retrospective, single-centre study including 130 adult patients with stage IV NSCLC treated in first-line from 1 December 2017 to 31 December 2022, without EGFR or ALK mutations, autoimmune diseases or brain metastases, and performance status 0–1.Patients with PD-L1 ≥ 50% received pembrolizumab 200 mg or 2 mg/kg IV every 3 weeks. Those with non-squamous histology and PD-L1 < 50% received pembrolizumab + cisplatin IV 75 mg/m2 or carboplatin IV 6 AUC plus pemetrexed IV 500 mg/m2 every 3 weeks for 4 cycles plus maintenance with pembrolizumab + pemetrexed. Squamous cells and PD-L1 < 50% received pembrolizumab + IV carboplatin 6 AUC and IV paclitaxel 200 mg/m2 every 3 weeks for 4 cycles plus maintenance with pembrolizumab. Treatments were prolonged until progression or toxicity for a maximum of 2 years.A database was created to record adverse events (AEs) obtained from electronic medical records and according to Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0.ResultsIn total, 491 AE of any grade and 78 of grade 3–4 were recorded. 10 patients discontinued treatment due to toxicity. AEs with incidence > 15% were (any grade – grade 3–4): anaemia (36–11), anorexia (51–2), asthenia (96–10), nausea (43–3), diarrhoea (25 -2), constipation (20–0), mucositis (21–2), neurotoxicity (22–1). Immune-mediated AEs were (any grade – grade 3–4): hepatotoxicity (7–3), nephritis (3–1), myocarditis (1–1), duodenojejunitis (1–1), pneumonitis (1–0).Conclusion and RelevanceMost patients suffered more than one AE. Even so, no deaths were related to toxicity (there were no grade 5 AEs). The six grade 3–4 immune-mediated AEs should be highlighted.References and/or AcknowledgementsConflict of InterestNo conflict of interest.
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