Paulino Alberto Alonso

Bio: Paulino Alberto Alonso is an academic researcher. The author has contributed to research in topics: Circadian rhythm & CLOCK. The author has an hindex of 3, co-authored 4 publications receiving 54 citations.

Quantitative and qualitative analysis of collagen types in the fascia transversalis of inguinal hernia patients.

Abstract: BACKGROUND: Inguinal hernia is the second most common surgical case in our field. The anatomical factors alone are not enough to explain the inguinal hernia. Studies show changes in the proportion and quantity of collagen fibers in the developing of inguinal hernia. The greater production of collagen type III compared to the type I could justify the thinning of the fascia transversalis and its weakness. AIM: To determine the quantitative and qualitative changes of collagen in the fascia transversalis in inguinal hernia patients and compare them to findings from corpses without inguinal hernia. METHOD: Prospective case-control study based on the biopsy of fascia transversalis of 27 patients and 24 corpses. The technique used was hematoxylin-eosin and picrosirius colorimetry. RESULTS: The medium percent area of collagen (types I + III) and collagen type I, in both groups, show no statistic difference. The quantity of collagen type III was greater in the patients. Patients classified with Nyhus IIIa presented greater quantity of collagen type III. CONCLUSION: There is no significant difference in the quantity of collagen in the fascia transversalis of patients compared to the controls. An increase in the quantity of collagen type III was found in patients with inguinal hernia and a greater quantity in those patients classified with Nyhus IIIa.

Efeitos da cirurgia bariátrica sobre a síndrome metabólica

Abstract: RACIONAL: A obesidade morbida e um estado de resistencia a insulina associado ao excesso de gordura visceral, condicoes que contribuem para o desenvolvimento da sindrome metabolica. Na obesidade, os tratamentos conservadores promovem melhora da sindrome metabolica, mas a recuperacao de peso e frequente. A derivacao gastrica em Y-de-Roux resulta em perda de peso, mais significativa e sustentada, alem de promover melhora da sindrome metabolica, que e condicao de risco para o desenvolvimento de doenca aterosclerotica sistemica. OBJETIVO: Demonstrar que a cirurgia bariatrica promove a reversao da sindrome metabolica. METODOS: O estudo foi realizado com 74 pacientes obesos, submetidos a derivacao gastrica em Y-de-Roux por videolaparoscopia. Foram avaliados por meio de dados antropometricos e laboratoriais, com a afericao do peso, circunferencia abdominal, indice de massa corporal, pressao arterial sistemica e a dosagem de glicemia, triglicerides, colesterol total e sua fracao HDL, no pre-operatorio e ao longo de seis meses apos a operacao. Para comparacao de medias foi utilizado o teste nao parametrico de Friedman e, quando necessario, o teste de Wilcoxon, considerando nivel de significância valor de p<0,05. RESULTADO: Houve 52 mulheres e 22 homens, com a media de idade de 34,6 anos. O intervalo de seguimento foi de seis meses. A media do indice de massa corporal no pre-operatorio era de 42 e apos seis meses foi de 29,6. Demonstrou-se diferenca estatisticamente significativa entre os momentos, quanto a todas as variaveis quantitativas analisadas. CONCLUSAO: Pode-se inferir que a cirurgia bariatrica e meio eficaz de perda de peso e normalizacao precoce das alteracoes antropometricas e laboratoriais utilizadas no diagnostico da sindrome metabolica.

Expression of clock genes in human subcutaneous and visceral adipose tissues.

Abstract: Disrupted circadian rhythms are associated with obesity and metabolic alterations, but little is known about the participation of peripheral circadian clock machinery in these processes. The aim of the present study was to analyze RNA expression of clock genes in subcutaneous (SAT) and visceral (VAT) adipose tissues of male and female subjects in AM (morning) and PM (afternoon) periods, and its interactions with body mass index (BMI). Ninety-one subjects (41 ± 11 yrs of age) presenting a wide range of BMI (21.4 to 48.6 kg/m2) were included. SAT and VAT biopsies were obtained from patients undergoing abdominal surgeries. Clock genes expressions were evaluated by qRT-PCR. The only clock gene that showed higher expression (p < .0001) in SAT in comparison to VAT was PER1 of female (372%) and male (326%) subjects. Different patterns of expression between the AM and PM periods were observed, in particular REV-ERBα, which was reduced (p < .05) at the PM period in SAT and VAT of both women and men (women: ∼53% lo...

Radiographic study of patients submitted to total gastrectomy using Safatle reconstruction technique

Abstract: BACKGROUND: Ever since the first total gastrectomy, there has always been a great concern in increasing the survival of patients, and with the advance of techniques, in improving the quality of life of these patients. The most common reconstruction technique of the gastrointestinal transit is the Roux-en-Y. The reposition of a functional pouch in place of the resected stomach was proposed to minimize the postprandial symptoms, improve the nutritional grade and consequently, the quality of life. The Safatle reconstruction of the gastrointestinal transit technique consists of, in short, in the association of the interposition of the jejunal loop with partial transit through the duodenum, with an inverted Roux-en-Y and with the creation of a pouch which resembles the dynamics of the stomach, achieved by duodenojejunal segment which has an antiperistalsis emptying. AIM: To assess, by radiographic means, the emptying of the duodenojejunal pouch in patients submitted to total gastrectomy using the Safatle reconstruction technique. METHOD: Twelve patients submitted to total gastrectomy using the Safatle technique due to gastric cancer were studied. They were summoned to perform contrasted radiographies of the esophagus-duodenum-jejunum by the videofluoroscopic method during the months of July and August, 2005. RESULTS: All the patients presented satisfactory movement of the duodenojejunal pouch and an adequate emptying in antiperistalsis without food stasis. There has been an average 25-minute drainage time of the duodenojejunal pouch. CONCLUSION: The duodenojejunal pouch, in the patients submitted to total gastrectomy using the Safatle reconstruction, presented adequate emptying and movement.

The Effects of Light at Night on Circadian Clocks and Metabolism

Abstract: Most organisms display endogenously produced ∼ 24-hour fluctuations in physiology and behavior, termed circadian rhythms. Circadian rhythms are driven by a transcriptional-translational feedback loop that is hierarchically expressed throughout the brain and body, with the suprachiasmatic nucleus of the hypothalamus serving as the master circadian oscillator at the top of the hierarchy. Appropriate circadian regulation is important for many homeostatic functions including energy regulation. Multiple genes involved in nutrient metabolism display rhythmic oscillations, and metabolically related hormones such as glucagon, insulin, ghrelin, leptin, and corticosterone are released in a circadian fashion. Mice harboring mutations in circadian clock genes alter feeding behavior, endocrine signaling, and dietary fat absorption. Moreover, misalignment between behavioral and molecular circadian clocks can result in obesity in both rodents and humans. Importantly, circadian rhythms are most potently synchronized to the external environment by light information and exposure to light at night potentially disrupts circadian system function. Since the advent of electric lights around the turn of the 20th century, exposure to artificial and irregular light schedules has become commonplace. The increase in exposure to light at night parallels the global increase in the prevalence of obesity and metabolic disorders. In this review, we propose that exposure to light at night alters metabolic function through disruption of the circadian system. We first provide an introduction to the circadian system, with a specific emphasis on the effects of light on circadian rhythms. Next we address interactions between the circadian system and metabolism. Finally, we review current experimental and epidemiological work directly associating exposure to light at night and metabolism.

Connective tissue alteration in abdominal wall hernia

Abstract: Background: The aetiology and pathogenesis of abdominal wall hernia formation is complex. Optimal treatment of hernias depends on a full understanding of the pathophysiological mechanisms involved in their formation. The aim of this study was to review the literature on specific collagen alterations in abdominal wall hernia formation. Methods: A computer-assisted search of the medical databases PubMed and Embase was performed, together with a cross-reference search of eligible papers. Results: Fifty-two papers were included. Collagen alteration depended on the type of hernia; there were more pronounced changes in patients with a direct inguinal hernia than in those with an indirect inguinal hernia, recurrent inguinal hernia or incisional hernia. A consistent finding was a significant increase in immature type III collagen relative to the stronger type I collagen in patients with a hernia. This resulted in thinner collagen fibres with a correspondingly diminished biomechanical strength. It has been suggested that these alterations are due to variation in the synthesis, maturation or degradation of collagen by matrix metalloproteinases, in combination or alone. Conclusion: Hernia formation and recurrence is associated with altered collagen metabolism manifested by a decreased type I:III collagen ratio. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Pelvic organ prolapse and collagen-associated disorders

Abstract: Introduction and hypothesis Pelvic organ prolapse (POP) and other disorders, such as varicose veins and joint hypermobility, have been associated with changes in collagen strength and metabolism. We hypothesized that these various disorders were more prevalent in both POP patients and their family members.

Etiology of Inguinal Hernias: A Comprehensive Review

Abstract: Background The etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias Results Lateral and medial hernias seem to have common as well as different etiologies A patent processus vaginalis and increased cumulative mechanical exposure are risk factors for lateral hernias Patients with medial hernias seem to have a more profoundly altered connective tissue architecture and homeostasis compared with patients with lateral hernias However, connective tissue alteration may play a role in development of both subtypes Inguinal hernias have a hereditary component with a complex inheritance pattern, and inguinal hernia susceptible genes have been identified that also are involved in connective tissue homeostasis Conclusion The etiology of lateral and medial hernias are at least partly different, but the final explanations are still lacking on certain areas Further investigations of inguinal hernia genes may explain the altered connective tissue observed in patients with inguinal hernias The precise mechanisms why processus vaginalis fails to obliterate in certain patients should also be clarified Not all patients with a patent processus vaginalis develop a lateral hernia, but increased intraabdominal pressure appears to be a contributing factor

Circadian Clocks, Food Intake, and Metabolism

Abstract: Circadian rhythmicity that has been shaped by evolution over millions of years generates an internal timing controlling the sleep-wake and metabolism cycles. The daily variations between sleep/fasting/catabolism and wakefulness/feeding/anabolism are coordinated by a master hypothalamic clock, mainly reset by ambient light. Secondary clocks, including liver and adipose tissue, are normally synchronized by the master clock, but they are also sensitive to feeding time, especially when meals take place during the usual resting period. Cellular metabolism and circadian clocks are tightly interconnected at the molecular levels. Although the suprachiasmatic clock is not shifted by mealtime under light-dark conditions, nutritional cues can feedback onto it and modulate its function under hypo- and hypercaloric (high-fat) conditions. Food-related reward cues are other modulators of the master clock. Circadian disturbances (e.g., desynchronization induced by shift work or chronic jet lag) are frequently associated with metabolic dysfunctions (chronobesity) and vice versa. Pharmacological tools and natural synchronizers (i.e., light and mealtime) can be useful as chronotherapeutic treatments to limit the occurrence of metabolic risk factors.