Juan José Rivera-Valdés

Introduction: The preoperative period is challenging in children due to increased anxiety. Preoperative anxiety results in increased postoperative pain, insomnia, nausea, fatigue, and reduced effectiveness of anesthesia and analgesia. Therefore, this study aimed to compare the efficacy of a play therapy intervention versus standard pharmacological premedication in reducing preoperative anxiety in pediatric patients undergoing inguinal hernioplasty. Methods: A randomized controlled trial was conducted at Dr. Juan I. Menchaca Civil Hospital, Guadalajara, Mexico, involving 32 pediatric patients aged 3 to 6 years undergoing inguinal hernioplasty. Patients were randomized into two groups: (1) an intervention group, which received play therapy involving a transport cart and toys, and (2) a control group, which received anxiolytic medication and standard care. Patient anxiety was assessed using the modified Yale Preoperative Anxiety Scale-short form (mYPAS-SF), as a primary outcome, and the Visual Analogue Anxiety Scale for Parents (VAS-P), as a secondary outcome, at three different times prior to surgery: initial contact, post-intervention, and transfer to the preoperative area. Results: VAS-P only showed significant differences at the final evaluation point, with lower anxiety scores observed in the control group. mYPAS showed significant differences in the score given at the post-intervention evaluation and in the number of patients considered anxious (>30 points), both of which were lower in the play therapy group. At the final evaluation, the number of patients considered anxious was lower in the play therapy group. Conclusion: Play therapy proves to be an effective and safe intervention for reducing anxiety in children during the preoperative period. Its incorporation into standard clinical practices for pediatric surgery could enhance emotional management and improve surgical outcomes.

Background: It is widely accepted that low-grade chronic inflammation in obesity worsens the metabolic state and threatens patients’ lives in a long-term manner. In fact, diet therapy is the first-line treatment in which relevant nutrients such as the omega-3 polyunsaturated fatty acids (ω-3 PUFA) must be adequately consumed to counteract the established inflammation. In particular, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been identified as agonists of cellular receptors, including the free fatty acid receptor 4 (FFAR4), which regulates anti-inflammatory pathways associated with enhanced insulin sensitivity. However, the expression and activation of this receptor in peripheral blood mononuclear cells (PBMC) remains poorly investigated in humans. Objective: This study aimed to evaluate the effect of a diet supplemented with marine ω-3 PUFA on FFAR4 receptor activation and inflammatory markers in peripheral blood mononuclear cells in subjects with obesity. Methodology: A double-blind, randomized clinical trial (NCT05068557) was conducted over two months (eight weeks) in 55 obese individuals (aged 25–59 years). Participants were randomly assigned to one of two groups: an active placebo group (1.6 g/day of alpha-linolenic acid) or a marine ω-3 group (1080 mg of EPA and 720 mg of DHA). Both groups followed a dietary regimen with progressive calorie restriction (−200 kcal/day during weeks 0–4 and −400 kcal/day during weeks 4–8) in addition to supplementation. Results: Following the intervention, both groups showed significant improvements in body composition and biochemical parameters. Supplementation with EPA and DHA enhanced FFAR4 activation at the end of the intervention. Moreover, there was a reduction in the expression of JNK and IKKβ genes, as well as in serum levels of TNF-α, IL-6, and IL-18. In contrast, IL-10 levels increased significantly both within and between the groups. Conclusions: Marine ω-3 PUFA supplementation, in the context of a dietary intervention, promotes FFAR4 activation, thereby contributing to the modulation of the inflammatory response in human PBMC.

Obesity is a global public health concern characterized by low-grade chronic inflammation and metabolic dysregulation. Ginger (Zingiber officinale Roscoe) contains bioactive compounds that have demonstrated potential anti-obesity and immunomodulatory effects. This review aims to synthesize the current evidence regarding the immunometabolic effects of ginger supplementation in obesity, integrating findings from in vitro, in vivo, and clinical studies. Evidence indicates that ginger and its principal compounds, such as 6-gingerol and 6-shogaol, inhibit adipocyte differentiation and lipid accumulation, reduce pro-inflammatory cytokines including tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), and the chemoattractant protein of monocytes-1 (MCP-1), improve lipid profiles, and enhance anti-inflammatory adipokines like adiponectin. Clinical trials report improvements in insulin sensitivity, reductions in inflammatory markers, and body weight management in individuals with obesity. This review paper also highlights the cellular and molecular mechanisms of immunometabolic effects of ginger and its bioactive compounds. Therefore, ginger supplementation exhibits promising immunometabolic effects with the potential to support the prevention and treatment of obesity and its comorbidities. However, further rigorous clinical trials are necessary to confirm its efficacy and safety as well as its role in complementing existing strategies for obesity management.

Mitochondrial abundance and activity in adipocytes are critical for adequate adipose tissue function and whole-body energy homeostasis. Mitochondrial dysfunction in adipocytes impairs lipid metabolism, insulin sensitivity, and thermogenesis, leading to metabolic diseases. Enhancing mitochondrial function and density in adipose tissue may provide a promising therapeutic approach for metabolic diseases. This study evaluates the effects of a ginger phenol mixture on mitochondrial density and function, AMPK activation, lipid droplet content, and lipolysis markers in adipocytes differentiated in vitro. Pre-adipocytes isolated from the inguinal adipose tissue of Wistar rats were differentiated and assigned to three experimental groups: vehicle (0.2% DMSO), gingerol mixture (6 μg/mL), and positive control (1 mmol/m³ AMPK activator 5-Aminoimidazole-4-carboxamide ribonucleoside). Mitochondrial density and lipid content were assessed by MitoTracker and Bodipy staining respectively, while mitochondrial respiration was evaluated in an Extracellular Flux Analyzer. Protein abundance and basal lipolysis were evaluated by Western blotting and free fatty acids determination in supernatant, respectively. The gingerol mixture significantly enhanced mitochondrial density and respiration, including both maximal and ATP-linked capacities. Additionally, it activated AMPK, upregulated the expression of mitochondrial complexes, enhanced lipolysis markers, and reduced lipid droplet content. These findings suggest that the gingerol mixture enhances mitochondrial function, stimulates lipolysis, and reduces lipid accumulation in adipocytes, contributing to metabolic homeostasis in adipose tissue. This highlights its potential use as a complementary therapeutic agent for the management of obesity.

This work successfully synthesized green zinc oxide nanoparticles using extracts from strawberry guava leaves (Psidium cattleianum Sabine). Additionally, the reducing effect of the antioxidant extracts obtained through traditional techniques, such as infusion and maceration, was studied and compared against an emerging unconventional technology like ultrasound assisted extraction. Regarding the physical and chemical characteristics, it was found that all three systems were confined within a wavelength range of 357 to 370 nm (UV-vis) and sizes from 60 to 140 nm for the ultrasound-assisted nanoparticles (SEM), corroborated with DLS (134 ± 60 nm). Through X-ray diffraction, the hexagonal wurtzite structure was elucidated, and it was observed that ultrasound favored a higher percentage of crystallinity (98%) compared to the infusion (84%) and maceration (72%). This could be correlated with different functional groups via FTIR and with thermal events associated with thermogravimetric curves, where the total biomass weight loss was lower for nanoparticles using ultrasound extract (6.25%), followed by maceration (15.55%) and infusion (18.01%) extracts. Furthermore, these nanostructures were evaluated against clinically relevant pathogens, including Salmonella enteritidis, Staphylococcus aureus, Escherichia coli O157:H7, and Pseudomonas aeruginosa, assessing bacterial growth inhibition using the microdilution technique, and achieving inhibitions of 75%. Biofilm activity was evaluated through Congo red and crystal violet assays, where ultrasound-derived NPs proved to be good inhibitors for all pathogens. Finally, the toxicity of the nanoparticles was analyzed against peripheral blood leukocytes from goats as well as on the 3 T3-L1 cell line used in anti-obesity assays; the nanoparticles proved to be suitable in all concentrations reaching around 100% cell viability, positioning them as good candidates for diverse industrial applications that align with the principles of green chemistry towards a circular economy.

Obesity is a globally prevalent metabolic disorder characterized by an increased number of adipose cells and excessive fat in adipocytes. Herbal medicines, such as ginger, have shown potential in treating obesity by inhibiting adipogenesis and reducing adipocyte hypertrophy. Ginger contains bioactive compounds, particularly gingerols, which have demonstrated anti-adipogenic and/or lipolytic effects. However, research on the effects of 10-gingerol on adipose tissue remains limited. This study aimed to evaluate the effect of 10-gingerol on lipid content, lipolysis markers, and the expression of genes related to lipid metabolism in 3T3-L1 adipocytes. Three groups were analyzed: a negative control (preadipocytes), a positive control (mature adipocytes), and a group treated with 10-gingerol (10-G). Results showed that 10-G reduced lipid accumulation by 42.16% in mature adipocytes compared to the control, without affecting cell viability. Additionally, 10-G increased glycerol release and downregulated lipogenic genes such as Pparγ, Acaca, Fabp4, and Mtor, while upregulating genes related to fatty acid oxidation, including Cebpα, Cpt1a, Lipe, and Prkaa1. In conclusion, 10-gingerol reduces lipid content in mature adipocytes by downregulating lipogenesis, increasing lipolysis, and enhancing fatty acid oxidation.

Background: Obesity increases reactive oxygen species production and alters adipokines levels, resulting in a low-grade chronic inflammation state, which contributes to tissue metabolic dysfunction. 10-gingerol, a phenol present in ginger, has shown potential anti-obesogenic effects in vitro. However, the antioxidant and anti-inflammatory properties of 10-gingerol have not been approached. The aim of this study was to investigate the effects of 10-gingerol on antioxidant enzymes’ expression and adipokine production in 3T3-L1 adipocytes in response to lipopolysaccharide (LPS)-induced inflammation. Methods: 10-gingerol antioxidant capacity was assessed through Oxygen Radical Absorbance Capacity (ORAC) , Ferric Reducing Antioxidant Power (FRAP), and radical scavenging activity of 2,2-diphenyl-2-picrylhydrazyl (DPPH) assays. 3T3-L1 cells were differentiated and stimulated with 100 ng/mL LPSs. Then, 15 µg/mL 10-gingerol was added for 48 h. The mRNA expression and protein abundance of antioxidant enzymes were evaluated by qPCR and Western blot, respectively. Adipokine levels were determined by ELISA. Results: 10-gingerol showed low FRAP and DPPH values but a moderate ORAC value. Moreover, 10-gingerol increased Gpx1 and Sod1 but downregulated Cat expression. Additionally, 10-gingerol significantly increased CAT and GPx1 levels but not SOD-1. Finally, adiponectin and leptin concentrations were increased while resistin and tumor necrosis factor alpha (TNFα) were decreased by 10-gingerol. Conclusions: 10-gingerol presented antioxidant potential by increasing antioxidant enzymes and attenuated LPS-induced inflammation by modulating adipokines in 3T3-L1 adipocytes.

Obesity is defined as excessive fat accumulation that can be detrimental to health and currently affects a large part of the global population. Obesity arises from excessive energy intake along with a sedentary lifestyle and leads to adipocytes with aggravated hypertrophy. Strategies have been designed to prevent and treat obesity. Nutrigenomics may serve a role in prevention of obesity using bioactive compounds present in certain foods with anti‑obesogenic effects. Ginger (Zingiber officinale Roscoe) contains gingerols, key bioactive compounds that inhibit hypertrophy and hyperplasia of adipocytes. The present study aimed to evaluate the antiadipogenic activity of 10‑gingerol (10‑G) in the 3T3‑L1 cell line. Three study groups were formed: Negative (3T3‑L1 preadipocytes) and positive control (mature 3T3‑L1 adipocytes) and 10‑G (3T3‑L1 preadipocytes stimulated with 10‑G during adipogenic differentiation). Cell viability and lipid content were evaluated by MTT assay and Oil Red O staining, respectively. mRNA expression of CCAAT enhancer‑binding protein α (C/ebpα), peroxisome proliferator‑activated receptor γ (Pparγ), mechanistic target of rapamycin complex (Mtor), sterol regulatory element binding transcription factor 1 (Srebf1), acetyl‑coenzyme A carboxylase (Acaca), fatty acid binding protein 4 (Fabp4), and 18S rRNA (Rn18s), was quantified by quantitative PCR. The protein expression of C/EPBα was analyzed by western blot. In the 10‑G group, lipid content was decreased by 28.83% (PC/ebpα (PAcaca (PFabp4 (PMtor (PSrebf1 (PPparγ did not present significant changes. The presence of 10‑G notably decreased C/EBPα protein levels in 3T3‑L1 adipocytes. In summary, the antiadipogenic effect of 10‑G during the differentiation of 3T3‑L1 cells into adipocytes may be explained by mRNA downregulation of adipogenic transcriptional factors and lipid metabolism‑associated genes.

The n-3 polyunsaturated fatty acids (PUFAs) can reduce inflammatory markers and may therefore be useful in obesity management. The aim of this study was to analyze the effect of supplementation with n-3 PUFAs on total fatty acid profile in red blood cells (RBCs), as well as biochemical and inflammatory markers, in subjects with obesity. The study consisted in a randomized placebo-controlled, double-blind clinical trial involving 41 subjects with obesity during a 4-month follow-up. Individuals were randomly assigned to two groups: n-3 PUFA supplementation (1.5 g fish oil) and placebo (1.5 g sunflower oil). Anthropometric, biochemical, dietetic, cytokine and total fatty acid profiles in RBCs were measured. Both groups increased their PUFA intake and DHA incorporation in RBCs. However, the placebo group showed a reduction in serum IL-8 and MCP-1 at the end of the study. A multiple linear regression model adjusted by body fat mass and sex showed that an increase in DHA in RBCs decreased the serum IL-8 levels in both study groups at the end of the study. Our results highlight the role of dietary DHA and n-3 supplementation usefulness in exerting beneficial anti-inflammatory effects.

The prevalence of obesity has increased rapidly worldwide. Obesity is characterized by excessive adipose tissue in the body, which is related to hyperplasia and hypertrophy in adipocytes. Ginger (Zingiber officinale Roscoe) is a medicinal plant that possesses an anti‑obesogenic effect mostly attributed to gingerols, the most abundant bioactive compounds in ginger. The anti‑adipogenic and lipolytic effects of these phenols have been shown when investigated individually. Therefore, the present study aimed to evaluate the lipolytic and anti‑adipogenic activity of a mix of the main ginger phenols 6‑gingerol, 8‑gingerol, 10‑gingerol, 6‑shogaol, 8‑shogaol and 10‑shogaol on the 3T3‑L1 cell line. A total of four study groups were designed: Negative control (3T3‑L1 preadipocytes); positive control (mature 3T3‑L1 adipocytes); phenols‑pre (3T3‑L1 cells stimulated with the phenols mix during adipogenic differentiation); and phenols‑post (mature 3T3‑L1 adipocytes stimulated with the phenols mix). MTT viability cell assay and Oil Red O staining were performed. Glycerol concentration supernatants were determined using the VITROS 350 Chemistry System. Expression of mRNA was measured using qPCR. The treatment with a 2 µg/ml ginger phenol dose reduced the lipid content by 45.52±7.8 and 35.95±0.76% in the phenols‑pre and ‑post group, respectively, compared with that in the positive control group. The phenols‑post group presented a higher glycerol concentration in the supernatant compared with that in the positive control and the phenols‑pre groups. The mRNA expression levels of CCAAT/enhancer‑binding protein alpha, peroxisome proliferator activated receptor‑γ, fatty acid‑binding protein 4 and fatty acid synthase were higher in the phenols‑pre and lower in the phenols‑post groups, compared with those in the positive control group. To the best of our knowledge, the current study demonstrated for the first time the anti‑adipogenic and lipolytic effects of a mix of the main bioactive compounds found in ginger, and it also established the basis to use this mix of phenols in in vivo studies and clinical trials.