Publications by authors named "Sylvia Totsuka-Sutto"

13 Publications

  • Page 1 of 1

Aortic stiffness and central hemodynamics in treatment-naïve HIV infection: a cross-sectional study.

BMC Cardiovasc Disord 2020 10 7;20(1):440. Epub 2020 Oct 7.

Arterial Stiffness Laboratory, Department of Physiology, Universidad de Guadalajara, Sierra Mojada 950, Building Q, Ground Floor, District Independencia, 44340, Guadalajara, Jalisco, Mexico.

Background: Human immunodeficiency virus (HIV) infection is associated with a greater risk of cardiovascular disease (CVD). HIV infection causes a chronic inflammatory state and increases oxidative stress which can cause endothelial dysfunction and arterial stiffness. Aortic stiffness measured by carotid femoral-pulse wave velocity (cfPWV) and central hemodynamics are independent cardiovascular risk factors and have the prognostic ability for CVD. We assessed cfPWV and central hemodynamics in young individuals with recent HIV infection diagnosis and without antiretroviral therapy. We hypothesized that individuals living with HIV would present greater cfPWV and central hemodynamics (central systolic blood pressure and pulse pressure) compared to uninfected controls.

Methods: We recruited 51 treatment-naïve individuals living with HIV (HIV(+)) without previous CVD and 51 age- and sex-matched controls (HIV negative (-)). We evaluated traditional CVD risk factors including metabolic profile, blood pressure (BP), smoking, HIV viral load, and CD4 T-cells count. Arterial stiffness and central hemodynamics were evaluated by cfPWV, central systolic BP, and central pulse pressure (cPP) via applanation tonometry.

Results: HIV(+) individuals presented a greater prevalence of smoking, reduced high-density lipoprotein cholesterol, and body mass index. 65.9% of HIV(+) individuals exhibited lymphocyte CD4 T-cells count < 500 cells/μL. There was no difference in brachial or central BP between groups; however, HIV(+) individuals showed significantly lower cPP. We observed a greater cfPWV (mean difference = 0.5 m/s; p < 0.01) in HIV(+) compared to controls, even after adjusting for heart rate, mean arterial pressure and smoking.

Conclusion: In the early stages of infection, non-treated HIV individuals present a greater prevalence of traditional CVD risk factors, arterial stiffness, and normal or in some cases central hemodynamics.
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http://dx.doi.org/10.1186/s12872-020-01722-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7542972PMC
October 2020

Serum Neuropeptide Y Levels Are Associated with TNF- Levels and Disease Activity in Rheumatoid Arthritis.

J Immunol Res 2020 16;2020:8982163. Epub 2020 Apr 16.

Programa de Doctorado en Farmacología, CUCS, Universidad de Guadalajara, 44340 Guadalajara, Jalisco, Mexico.

Background: Neuropeptide Y (NPY) is a sympathetic neurotransmitter with effects on the regulation of inflammatory cells. The role of NPY on autoimmune inflammatory diseases such as rheumatoid arthritis (RA) is not completely understood. Therefore, we evaluate if NPY levels are markers of disease activity in RA and if there is a correlation between NPY levels and tumor necrosis factor-alpha (TNF-), leptin, and interleukin 6 (IL-6) levels.

Methods: Cross-sectional design, including 108 women with RA. We assessed disease activity by DAS28-ESR (considering active disease a score of ≥2.6). Serum NPY levels and anti-CCP2 antibody, TNF-, IL-6, and leptin levels were quantified (ELISA).

Results: Sixty-eight RA had an active disease (RA-active), and 40 were in remission (RA-remission). RA-active patients had higher NPY levels vs. RA-remission (22.8 ± 13.6 vs. 17.8 ± 10.3; = 0.04). NPY levels correlated with increased TNF- levels ( = 0.32, = 0.001). Leptin or IL-6 did not correlate with NPY levels. In the logistic regression analysis, NPY increased the risk of disease activity (OR: 1.04, 95% CI 1.006-1.09, and = 0.03).

Conclusion: Higher NPY levels are an independent marker of disease activity in RA. This study encourages the quantification of NPY levels as a surrogate marker for RA-active. Future studies evaluating the role of NPY levels interacting with other proinflammatory cytokines are required.
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http://dx.doi.org/10.1155/2020/8982163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182972PMC
February 2021

Effect of Telmisartan in the Oxidative Stress Components Induced by Ischemia Reperfusion in Rats.

Oxid Med Cell Longev 2019 2;2019:1302985. Epub 2019 Jul 2.

Instituto de Terapéutica Experimental y Clínica, Departamento de Fisiología, CUCS, Universidad de Guadalajara, Calle Sierra Mojada 950, Colonia Independencia, CP 44340 Guadalajara, Jalisco, Mexico.

The therapeutic effects of telmisartan, an angiotensin II receptor antagonist and a peroxisome proliferator-activated receptor- (PPAR-) agonist, have been demonstrated in several disorders. It has antioxidant and immune response modulator properties and has shown promising results in the treatment of an ischemia/reperfusion (I/R) lesion. In this study, a skeletal muscle (right gastrocnemius muscle) I/R lesion was induced in rats and different reperfusion times (1 h, 24 h, 72 h, 7-day, and 14-day subgroups) were assessed. Furthermore, levels of oxidative markers such as enzymatic scavengers (catalase (CAT) and superoxide dismutase (SOD)) and metabolites (nitrates and 8-oxo-deoxyguanosine) were determined. The degree of tissue injury (total lesioned fibers and inflammatory cell count) was also evaluated. We observed an increase in CAT and SOD expression levels under telmisartan treatment, with a decrease in injury and oxidative biomarker levels in the 72 h, 7-day, and 14-day subgroups. Telmisartan reduced oxidative stress and decreased the damage of the I/R lesion.
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http://dx.doi.org/10.1155/2019/1302985DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6636510PMC
February 2020

[Reliability of an automatic monitor for blood pressure measurement].

Rev Med Chil 2018 Feb;146(2):190-195

Instituto de Terapéutica Experimental y Clínica, Departamento de Fisiología del Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México.

Background A correct blood pressure (BP) measurement is essential for the diagnosis and control of high BP.

Aim: To evaluate the agreement and repeatability of BP measurements with the OMRON HEM-7320-LA device compared to a mercury sphygmomanometer.

Material And Methods: A cross-sectional study comparing BP measurements made by two randomly selected trained nurses and an automatic oscillometric device. The mercurial sphygmomanometer was connected to the automated device via a "T" type connector and a dual-head stethoscope was used, allowing simultaneous measurements. The results were analyzed with one-factor analysis of variance, Bland-Altman's test, repeatability coefficient (RC), and intra-class correlation coefficient (ICC).

Results: Forty-nine participants aged 56 ± 19 years were included. Nineteen had hypertension (38%). We did not observe a significant difference in either systolic (SBP) or diastolic blood pressure (DBP) pressure measurements between the observers and the device. The mean difference was -0.09 mmHg (95% confidence intervals (CI)-0.9 to 0.7) for SBP and -0.9 mmHg (95% CI -1.7 to -0.13) for DBP. The RC for SBP (6.2, 5.2 and 5.8 mmHg) and DBP (4.7, 4.2 y 5.2 mmHg) was similar between the observers and the device. The ICC for SBP was 0.990 (95% CI 0.983 to 0.995, p < 0.01) and 0.986 (95% CI 0.977 to 0.991, p < 0.01) for DBP.

Conclusions: There was a high level of agreement and similar measurement repeatability in the measurements performed by the automatic device and the mercurial sphygmomanometer. No differences in BP measurements were observed.
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http://dx.doi.org/10.4067/s0034-98872018000200190DOI Listing
February 2018

Efficacy and safety of the combination of isosorbide dinitrate spray and chitosan gel for the treatment of diabetic foot ulcers: A double-blind, randomized, clinical trial.

Diab Vasc Dis Res 2018 07 23;15(4):348-351. Epub 2018 Apr 23.

1 Instituto de terapéutica experimental y clínica, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico.

Aim: To evaluate whether a combination of isosorbide dinitrate spray and chitosan gel (10%) topically applied can have additive benefits for management of diabetic foot ulcers.

Methods: In a randomized, placebo-controlled, double-blinded clinical trial, 68 patients were divided into four groups: Group 1: treated with chitosan gel; Group 2: isosorbide dinitrate spray; Group 3: combination of isosorbide dinitrate spray and chitosan gel; Group 4: placebo.

Results: Histological analyses showed a significant regeneration in all groups ( p < 0.001). On the final assessment of the ulcer, using the combination was found a wound closure percentage of 71 ± 30, 70 ± 27 using isosorbide dinitrate, 58 ± 30 with chitosan and 50 ± 16 with placebo. The number of patients who achieved complete ulcer closure was six using the combination, four with isosorbide dinitrate, three with chitosan and one with placebo. The progression in the healing process of the ulcer showed marked inmunohistochemical differences of Von Willebrand Factor, desmin, vascular endothelial growth factor-A and α-smooth muscle actin in all groups ( p < 0.001), but without notable differences between them.

Conclusion: The combination was better than placebo to reduce the dimensions of the ulcer, accelerate healing and increase the number of patients who achieved complete closure of the ulcer, but the combination was not better than chitosan or isosorbide dinitrate used separately.
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http://dx.doi.org/10.1177/1479164118769528DOI Listing
July 2018

Effect of Alpha-Lipoic Acid on Clinical and Neurophysiologic Recovery of Carpal Tunnel Syndrome: A Double-Blind, Randomized Clinical Trial.

J Med Food 2018 May 22;21(5):521-526. Epub 2018 Jan 22.

1 Institute of Experimental and Clinical Therapeutics, Health Science University Center, University of Guadalajara , Guadalajara, Jalisco, México .

The objective of our study was to examine the effect of alpha-lipoic acid (ALA) on clinical and neurophysiologic outcomes after surgery for idiopathic carpal tunnel syndrome (CTS). We conducted a randomized, double-blind, placebo-controlled clinical trial in 20 adults diagnosed with idiopathic CTS after clinical and neurophysiologic assessment. Eligible participants took 600 mg ALA or placebo per day for 1 month before surgery, and for 2 months afterward. Further clinical and neurophysiologic assessments were undertaken immediately before surgical decompression, and at 12 weeks postoperatively with additional clinical assessments at the 4th and 8th week after surgery. Clinical outcome measures were taken by Boston Questionnaire score, the presence or absence of Tinel's sign, and Phalen's test findings. Median nerve conduction studies were also undertaken and interpreted according to Dumitru's reference values. Nineteen patients completed the study; one member of the placebo group was lost during follow-up. There were significant improvements in clinical and neurophysiologic variables in the ALA treatment group, present even before surgery. Boston Questionnaire scores had improved significantly in both groups. In the ALA group, none of the participants had positive Phalen's or Tinel's signs at 12 weeks, and motor and sensory fiber latency and amplitude had significantly improved; in the placebo group, only the sensory distal latency had improved significantly. In conclusion, ALA administered 1 month before open decompression and for 2 months afterward improves the clinical and neurophysiologic outcomes after surgery.
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http://dx.doi.org/10.1089/jmf.2017.0056DOI Listing
May 2018

Validation of the Omron HEM-7320-LA, upper arm blood pressure monitor with Intelli Wrap Technology Cuff HEM-FL1 for self-measurement and clinic use according to the European Society of Hypertension International Protocol revision 2010 in the Mexican population.

Blood Press Monit 2017 Dec;22(6):375-378

Arterial Stiffness Laboratory, Department of Physiology, University of Guadalajara, Guadalajara, Mexico.

Objective: The aim of this study was to determine the accuracy of the Omron HEM-7320-LA with Intelli Wrap technology cuff HEM-FL1 for self-measurement and clinic blood pressure (BP) measurement according to the European Society of Hypertension International Protocol revision 2010.

Participants And Methods: The evaluation was performed in 39 individuals. The mean age of the participants was 47.9±14 years; systolic BP was 145.2±24.3 mmHg (range: 97-190), diastolic BP was 90.9±12.9 mmHg (range: 68-120), and arm circumference was 30.8±4 cm (range: 25-38.5).

Results: The device successfully fulfilled the established criteria of the validation protocol. The device overestimated systolic BP by 0.6±5.7 mmHg and diastolic BP by 2.2±5.1 mmHg. The specially designed cuff HEM-FL1 to cover a broad range of arm circumferences and self-placement fulfilled the requirements of the International Protocol.
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http://dx.doi.org/10.1097/MBP.0000000000000290DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680989PMC
December 2017

Serum levels of P-glycoprotein and persistence of disease activity despite treatment in patients with systemic lupus erythematosus.

Clin Exp Med 2018 Feb 27;18(1):109-117. Epub 2017 Feb 27.

Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Sierra Mojada 950, Col. Independencia, 44340, Guadalajara, Jalisco, Mexico.

Around 25% of patients with systemic lupus erythematosus (SLE) could be refractory to conventional therapies. P-glycoprotein expression on cell surface has been implied on drug resistance, however, to date, it is unknown if P-gp serum levels are associated with SLE disease activity. Evaluate the association of serum P-gp levels and SLE with disease activity despite treatment. A cross-sectional study was conducted on 93 female SLE patients, all receiving glucocorticoids at stable doses for the previous 6 months before to baseline. SLE patients were classified into two groups: (a) patients with active disease [SLE disease activity index (SLEDAI) ≥ 3] despite treatment, and (b) patients with inactive disease (SLEDAI < 3) after treatment. Forty-three healthy females comprised the control group. Serum P-gp, anti-DNA, and both anti-nucleosome antibody levels were measured using ELISA. Active-SLE patients despite treatment had higher P-gp levels compared with inactive-SLE after treatment (78.02 ng/mL ± 114.11 vs. 33.75 ng/mL ± 41.11; p = 0.018) or versus reference group subjects (30.56 ng/mL ± 28.92; p = 0.011). P-gp levels correlated with the scores of SLEDAI (r = 0.26; p = 0.01), Mexican-SLEDAI (MEX-SLEDAI) (r = 0.32; p = 0.002), SLICC/ACR damage index (r = 0.47; p < 0.001), and with prednisone doses (r = 0.33; p = 0.001). In the multivariate model, the high P-gp levels were associated with SLICC/ACR score (p = 0.001), and SLEDAI score (p = 0.014). Our findings support a relationship between serum P-gp levels and SLE with disease activity despite treatment, but it requires further validation in longitudinal studies.
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http://dx.doi.org/10.1007/s10238-017-0459-0DOI Listing
February 2018

Alternative Interventions to Prevent Oxidative Damage following Ischemia/Reperfusion.

Oxid Med Cell Longev 2016 28;2016:7190943. Epub 2016 Dec 28.

Instituto de Terapéutica Experimental y Clínica, Departamento de Fisiología, CUCS, Universidad de Guadalajara, Calle Sierra Mojada 950, Colonia Independencia, 44340 Guadalajara, Jal, Mexico.

Ischemia/reperfusion (I/R) lesions are a phenomenon that occurs in multiple pathological states and results in a series of events that end in irreparable damage that severely affects the recovery and health of patients. The principal therapeutic approaches include preconditioning, postconditioning, and remote ischemic preconditioning, which when used separately do not have a great impact on patient mortality or prognosis. Oxidative stress is known to contribute to the damage caused by I/R; however, there are no pharmacological approaches to limit or prevent this. Here, we explain the relationship between I/R and the oxidative stress process and describe some pharmacological options that may target oxidative stress-states.
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http://dx.doi.org/10.1155/2016/7190943DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225393PMC
March 2017

Effectiveness of degradable and non-degradable implants to close large septal perforations in an experimental model.

J Plast Surg Hand Surg 2016 Aug 16;50(4):222-6. Epub 2016 Mar 16.

a Instituto de Terapéutica Experimental y Clínica, Departamento de Fisiología, CUCS , Universidad de Guadalajara , Guadalajara Jalisco , México.

Background Reparation of large nasal septum perforations continues to be challenging. Bipedicled mucoperichondrial and inter-positional grafts currently show the most promising results. New implants have emerged to be used as a support membrane to carry on the mucosal cells, taking advantage of the innate proliferative properties of the mucosal tissue. Objective To compare the effectiveness of two kinds of material; non-absorbable dimethylsiloxane (silicone elastomers) and absorbable porcine small intestinal submucosa (Surgisis), both used as an inter-positional graft without neighbouring flaps to close nasal septal perforations in an experimental model. Methods Fifteen dogs were divided into three groups. One group received Surgisis, the other sheets of dimethylsiloxane and the last group a sham group. The dogs were followed for 6 weeks. Results The initial perforation of the nasal septum showed complete mucosal closure in the dimethylsiloxane group. The Surgisis group, on the other hand, had a smaller reduction than that at the beginning (final mean area = 23.0 ± 5.4 mm(2) (p < 0.05); however, complete closure was not achieved. Sham animals showed an inconstant and slight reduction in dimension from 100 mm(2) to 70 ± 16 mm(2) of mucosa and cartilage, but closure was not achieved. A significantly higher number of capillaries were observed in the Surgisis group compared to the dimethylsiloxane group (p < 0.05) without differences in inflammation, fibrosis, or necrosis. Conclusions The non-absorbable implant; dimethylsiloxane facilitates a better closure of the nasal septum.
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http://dx.doi.org/10.3109/2000656X.2016.1152973DOI Listing
August 2016

[Prognostic value of the lethal triad among patients with multiple trauma].

Rev Med Chil 2013 Nov;141(11):1420-6

Background: Patients who have suffered multiple traumatic injuries, have a serious risk for death. Hypothermia, acidosis and coagulopathy are three complications in these patients, whose presence is known as lethal triad and indicates bad prognosis.

Aim: To determine if the lethal triad in multiple trauma patients is associated with higher mortality and Injury Score Severity (ISS).

Material And Methods: One hundred multiple trauma patients aged 26 to 56 years (90 males), admitted to an emergency room, were studied. Body temperature, prothrombin time, partial thromboplastin time, platelet count and blood gases were determined on admission.

Results: Twenty six patients had the lethal triad and 15% died in the emergency room within the first 6 hours. No death was recorded among the 74 patients without the lethal triad. The mean ISS among patients with and without the lethal triad was 31.7 and 25.6, respectively (p < 0.05).

Conclusions: The presence of the lethal triad among patients with multiple trauma is associated with a higher mortality and ISS.
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http://dx.doi.org/10.4067/S0034-98872013001100008DOI Listing
November 2013

[Association of hyperinsulinemia with left ventricular hypertrophy and diastolic dysfunction in patients with hypertension].

Rev Med Chil 2007 Sep 15;135(9):1125-31. Epub 2007 Nov 15.

Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México.

Background: Hypertension is the main independent cardiovascular risk factor. However, there are additional factors that induce organic damage.

Aim: To assess the association between hyperinsulinemia, ventricular hypertrophy and left ventricular diastolic function.

Patients And Methods: Seventy-four patients aged 30 to 65 years, with mild or moderate systemic hypertension, with overweight or mild obesity and normal glucose tolerance curve (GTC), were studied. Serum insulin was measured during GTC. The maximum levels of insulin and glucose were observed 60 minutes after the oral glucose load and they were expressed as rG/1. Patients were stratified in three groups according to their glucose and insulin fasting levels (I0) and post-glucose challenge levels (rG/I): Group 1 (normoinsulinemic patients) I0 <17 mU/mL and rG/I >2 (2.45+0.4). Group 2 (post-prandial hyperinsulinemic patients) I0 <17 mU/mL and rG/I <2> 1 (1.34+0.3). Group 3 (persistently hyperinsulinemic patients) I0 >17 mU/mL and <1 (0.7+0.3). Left ventricular mass and its diastolic function were measured by Doppler echocardiography.

Results: No differences in blood pressure or age were observed between groups. There was a negative correlation between ventricular mass and rG/1 (r =-0.282, p =0.015). Left ventricular diastolic dysfunction was significantly more deteriorated in group 3, as compared with group 1 (p <0.001 ANOVA). There was a significant correlation between g/GI and diastolic dysfunction (r =0.232 p =0.047).

Conclusions: Fasting, post challenge hyperinsulinemia and a rG/I <1 are associated with higher ventricular mass and left ventricular diastolic dysfunction, independent of blood pressure and age.
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http://dx.doi.org/10.4067/s0034-98872007000900005DOI Listing
September 2007