Different studies have recognized the existence of subtypes of obesity and normal weight, in which it is reported that not all patients show the same cardiometabolic risk, called "metabolically ...healthy" and "metabolically unhealthy". In several reviews, differences in the inflammatory profile have been studied, but there is not information on the relationship of body size phenotypes with thrombosis risk.
Determine the association between body size phenotypes and fibrinolytic activity by measuring the concentration of plasminogen activator inhibitor-1 (PAI-1).
A cross-sectional study was conducted in women aged 40 to 65 years. Anthropometric measurements and biochemical determinations were performed on all participants. The fibrinolytic activity was determined by measuring PAI-1 by ELISA. Karelis criteria were used to define metabolic status. Four groups were formed: Metabolically healthy normal weight (MHNW), Metabolically unhealthy normal weight (MUNW), Metabolically healthy obese (MHO) and Metabolically unhealthy obese (MUO).
230 women were included in our study with a mean age 52.3 ± 5.9 years. The concentration of PAI-1 showed a significant difference between the groups MHNW, MUNW, MHO, MUO 2.3 (0.08, 13.6), 12.7, (0.08, 33.1), 23.4 (2.6, 28.8) and 22.8 (2.0, 46.7) ng/mL, respectively, p = 0.006. Multiple regression analysis identified that BMI and HOMA-IR were independent factors influencing PAI-1 levels.
This study is the first one that recognizes differences in the fibrinolytic activity between body size phenotypes. The groups with the lowest fibrinolytic activity were MUO and MHO, however, MUNW also present alterations of fibrinolysis, thus suggesting a prothrombotic state.
•Mango seed (MS) is a valuable by-product rich in bioactive compounds and antioxidants.•Optimized UAE parameters yielded a MS extract with a gallic acid content of 1.97 mg/g.•Polyphenols profile ...modified in extraction method, with gallates and gallotannins predominating in MS.•DPPH and ABTS values were higher in thermal extract than optimized UAE extract.•Thermal and ultrasound extracts of MS can be used as functional ingredients.
The mango seed (MS) is a by-product with a high content of bioactive compounds and antioxidant capacity (AOX). Ultrasound-assisted extraction (UAE) has been recognized as an efficient technology for the extraction of bioactive compounds in plant materials. Nonetheless, it is essential to optimize the process conditions and compared with conventional technologies. The objective of this study was to compare the profile of bioactive compounds and AOX in an optimized ultrasound extract with a thermal extract. The optimized parameters for UAE included exposure to light, 1 s ultrasound pulse, 8 min extraction, 40 % amplitude, 60 °C extraction temperature, 20 % (v/v) ethanol, 35:1 (v/w) liquid-to-solid, and 850 µm particle size and showed gallic acid content of 1.97 mg/g MS. The thermal extract had a higher total soluble phenol content, mainly composed of gallates and gallotannins. Nevertheless, specific compounds, such as maclurin galloyl glucoside and quercetin xyloside, were uniquely identified in the UAE-optimized extract. DPPH and ABTS values were higher in the thermal extract. The half-maximal inhibitory concentration for the thermal treatment was 15.93 mg, while for UAE, it was 19.77 mg GAE/mL. Both thermal and ultrasound mango seed extracts exhibit significant potential as functional ingredients due to their high content of polyphenols and AOX.
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.
To assess thrombotic risk with PAI-1 levels in patients with COVID-19, to evaluate PAI-1 differences between hyperglycemic and/or Type 2 Diabetes Mellitus (T2DM) versus non-hyperglycemic patients, ...and to analyze the association of plasminogen activator inhibitor-1 (PAI-1) with hyperglycemia and T2DM.
A cross-sectional study carried out in 181 patients hospitalized for COVID-19. Two groups were formed: the patients with hyperglycemia at admission and/or previously diagnosed T2DM group and the non-hyperglycemic group. Fibrinolysis was assessed by measuring PAI-1 levels by ELISA.
The mean age was 59.4±16.1 years; 55.8% were male 54.1% of patients presented obesity, 38.1% had pre-existing T2DM and 50.8% had admission hyperglycemia and/or pre-existing T2DM. The patients with admission hyperglycemia and/or preexisting T2DM had higher PAI-1 compared with non-hyperglycemic patients 197.5 (128.8–315.9) vs 158.1 (113.4–201.4) ng/mL; p=0.031. The glucose levels showed a positive correlation with PAI-1 levels (r=0.284, p=0.041). A multivariate logistic regression analysis showed association of PAI-1 level and hyperglycemia and pre-existing T2DM with severity of COVID-19.
Patients hospitalized for COVID-19 infection with preexisting T2DM or hyperglycemia detected during their hospitalization presented a greater increase in PAI-1 levels, which suggests that hyperglycemia contributes directly to the hypercoagulable state and probably a worse outcome from the patients.
Este estudio busca evaluar el riesgo de trombosis en pacientes con COVID-19 mediante la medición de los niveles de inhibidor del activador del plasminógeno tipo 1 (PAI-1). También buscamos comparar los niveles de PAI-1 entre pacientes con hiperglucemia y/o diabetes mellitus tipo 2 (T2DM) y aquellos sin hiperglucemia. Además de investigar la relación entre los niveles de PAI-1 y la presencia de hiperglucemia y T2DM.
Es un estudio transversal con 181 pacientes hospitalizados por COVID-19. Los pacientes se dividieron en dos grupos: aquellos con hiperglucemia al ingreso o con diagnóstico previo de T2DM, y aquellos sin hiperglucemia. Los niveles de PAI-1 fueron cuantificados mediante ELISA para evaluar la actividad fibrinolítica.
La edad promedio fue de 59,4±16,1 años, con 55,8% de participantes masculinos. El 54,1% tenía obesidad, el 38,1% tenía antecedentes de diabetes mellitus y el 50,8% presentaba hiperglucemia al ingreso o diabetes mellitus preexistente. Los pacientes con hiperglucemia o T2DM preexistente mostraron niveles significativamente más altos de PAI-1 en comparación con los pacientes sin hiperglucemia (197,5 128,8-315,9 vs. 158,1 113,4-201,4 ng/mL; p=0,031). Se observó una correlación positiva entre los niveles de glucosa y PAI-1 (r=0,284, p=0,041). El análisis de regresión logística multivariante mostró una asociación entre los niveles de PAI-1 y la presencia de hiperglucemia y T2DM preexistente con la gravedad de la COVID-19.
Los pacientes hospitalizados por COVID-19 con T2DM preexistente o que desarrollan hiperglucemia durante la hospitalización experimentan un aumento significativo en los niveles de PAI-1. Esto sugiere que la hiperglucemia contribuye directamente al estado de hipercoagulabilidad, con posibles implicaciones en el pronóstico desfavorable de los pacientes.
The waters around the Galápagos Marine Reserve (GMR) are important fishing grounds for authorized artisanal vessels fishing within the reserve as well as for national and foreign industrial fleets ...operating in the wider Ecuadorian Insular Exclusive Economic Zone (IEEZ). Although it was not originally designed for fisheries management, Automatic Identification System (AIS) data provides useful, open access, near real-time and high-resolution information that allows for increased monitoring, particularly around Marine Protected Areas (MPAs) and in Areas Beyond National Jurisdiction. This study uses AIS data provided by Global Fishing Watch to assess the spatial distribution and seasonal dynamics of fishing effort by vessel flag within the GMR and the IEEZ from 2012 to 2021. Based on kernel density estimation analysis, we determinate the core-use areas (50%) and spatial extent (95%) of fishing activities by fleets (Ecuadorian and foreign), gear types and seasons (warm, from December to May; and cold, from June to November). Our results show that the Ecuadorian fleet recorded the most observed fishing hours in the study area, with 32,829 hours in the IEEZ and 20,816 hours within the GMR. The foreign flags with the most observed fishing hours in the IEEZ were Panama (3,245 hours) and Nicaragua (2,468.5 hours), while in the GMR were the 'Unknown flag' (4,991.4 hours) and Panama (133.7 hours). Vessels fished employing different fishing gears, but the waters of the GMR and IEEZ were mostly targeted by tuna purse-seiners and drifting longlines. The spatial distribution of the fishing effort exhibits marked seasonal variability, likely influenced by seasonal migrations of target species such as tunas (e.g., Thunnus albacares, T. obesus and Katsuwonus pelamis), marlins (e.g., Makaira nigricans) and sharks (e.g., Alopias pelagicus). The collection and use of this type of spatial and seasonal information is an essential step to understand the dynamics of fishing activities in national waters and improve fisheries management, particularly in less studied areas and fisheries.
A large group of countries constitute Latin American (LATAM) countries, where hemophilia care is as varied as the landscape of this region. To better understand the care provided to persons with ...bleeding disorders, especially hemophilia, a symposium was organized as part of the CLAHT Congress 2021 in Colombia to highlight the issues of hemophilia care and challenges faced by persons with hemophilia in four LATAM countries, Colombia, Peru, Argentina, and Mexico. A summary of the symposium is provided. Four clinicians highlighted the issues in their own country, the status, and the path forward to bring the standard of care to the international level in each of these countries. The geography of the country, the health infrastructure, and the resources available are obstacles in these countries to provide state‐of‐the‐art care to the bleeding disorder community. However, depending on the country, its infrastructure and the resources available, progress is being made to upend the care provided. Indeed, the care of persons with hemophilia has been greatly improved, including personalized prophylaxis. The information summarized here first emphasizes how the geography of a country and the different healthcare infrastructures play a major role in how care is offered. It also provides a path for other countries to evaluate these issues in their own realities. In parallel, these data provide hope to many developing countries; despite obstacles, strides can be made in the care of the bleeding disorder community.
Variations in levels of some adipokines, myokines, osteokines, hepatokines and inflammatory cytokines contribute to abnormal glucose and lipid metabolism. The aim of this study was to determine the ...pattern of adiponectin, osteocalcin (OCN), irisin, FGF-21, and MCP-1 according to the body size phenotype of middle-aged women, and their associations with BMI, visceral adipose tissue (VAT), and HOMA-IR. A cross-sectional study in 265 women aged from 40 to 65 years was performed. The biochemical characteristics were evaluated in metabolically healthy normal weight, metabolically unhealthy normal weight, metabolically healthy obese, and metabolically unhealthy obese women. There was an association of OCN with BMI (r = −0.107; p = 0.047); adiponectin with BMI (r = −0.217; p = 0.001), insulin (r = −0.415; p = 0.0001), HOMA-IR (r = −0.429; p = 0.0001), and VAT (r = −0.134; p = 0.025); irisin with BMI (r = 0.604; p = 0.001), insulin (r = 0.446; p = 0.0001), HOMA-IR (r = 0.452; p = 0.0001), and VAT (r = 0.645; p = 0.0001); FGF−21 with insulin (r = −0.337; p= 0.030) and HOMA-IR (r = −0.341; p = 0.03); and MCP-1 with BMI (r = 0.481; p = 0.0001), VAT (r = 0.497; p = 0.001), insulin (r = 0.298; p= 0.001), and HOMA-IR (r = 0.255; p = 0.004). A multivariate analysis showed that an elevation of OCN (OR 1.4 (95%CI 1.06–1.81)) and a reduction of adiponectin (OR 0.9 (0.84–0.96)) were associated factors for a metabolic unhealthy phenotype in normal weight participants. Likewise, higher irisin (OR 1.007 (1.003–1.011)) and MCP-1 (1.044 (1.008–1.083)) were risk factors for a metabolic unhealthy phenotype in woman with obesity. OCN, adiponectin, irisin, FGF-21, and MCP-1 are associated with some metabolic parameters such as BMI, HOMA-IR, and VAT, and could be possible biomarkers of an unhealthy metabolic phenotype in middle-aged women.
Cancer is a significant cause of death worldwide. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is spreading rapidly globally. Information on coronavirus disease 2019 ...(COVID-19) and its complications in cancer patients are still limited. It is relevant to consider that some chemotherapeutic agents have secondary immunosuppressive effects. Approximately 35% of hematologic cancer patients develop pneumonia caused by community respiratory viruses. People older than 65 years-old or with severe neutropenia or lymphopenia are at higher risk. Cancer patients with pneumonia infected by parainfluenza virus showed a higher risk of mortality compared to non-cancer patients (p < 0.05; 12.3% vs. 3.8%) or coronavirus infections (p < 0.01; 24% vs. 30%). Complications associated with SARS-COV2 infection in cancer patients are limited to descriptive studies, with those who received myeloablative, immunosuppressive or monoclonal antibody therapies being more susceptible.
Principales modificaciones asociadas a la esplenectomía Ramos-Peñafiel, Christian Omar; Gallardo-Rodríguez, Adán Germán; Martínez-Tovar, Adolfo ...
Revista colombiana de cirugía,
04/2023, Letnik:
38, Številka:
3
Journal Article
Odprti dostop
El bazo es un órgano linfoide implicado en el reconocimiento antigénico, la depuración de patógenos y la remoción de eritrocitos envejecidos o con inclusiones citoplasmáticas. La esplenectomía es una ...técnica utilizada tanto para el diagnóstico (linfomas), tratamiento (trombocitopenia inmune, anemia hemolítica adquirida) y la curación (microesferocitosis hereditaria) de diversas enfermedades. Los cambios posteriores a la esplenectomía pueden considerarse como inmediatos: aparición de cuerpos de Howell-Jolly, trombocitosis y la presencia de leucocitosis durante las primeras dos semanas. Otras complicaciones incluyen la presencia de trombosis, en especial en pacientes con factores de riesgo o un estado hipercoagulable, siendo tanto el flujo de la vena porta como el volumen esplénico los principales factores de riesgo para su aparición. Las complicaciones tardías incluyen la alteración en la respuesta inmune, aumentando el riesgo de infecciones por bacterias encapsuladas en conjunto con una reducción en los niveles de IgM secundario a la ausencia de linfocitos B a nivel de bazo, debido al riesgo de infecciones principalmente por Streptococcus pneumoniae, la esplenectomía parcial se ha considerado una opción. Una adecuada valoración de la indicación de esplenectomía y la identificación precoz de complicaciones son fundamentales para reducir la mortalidad asociada a la esplenectomía.
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