Abstract. Peroxisome proliferator-activated receptors (PPARs) belong to a family of transcription factors of which three isotypes, PPARα, PPARδ (ß) and PPARγ, are known. These play a central role in regulating intermediate metabolism and in incidences of inflammation. In recent years, a greater understanding of their mechanisms of action and their effects, principally in the management of cardiovascular disease, has been achieved. PPAR agonists, catalysts and agents have been used since the 1990s, when it was confirmed that fibrates possess lipid modifying properties when selectively activating PPARα. In addition, thiazolidinediones, structures analogous to fibrates, showed PPARγ activity with an insulin-sensitizing effect, leading to their use in the control and even prevention of diabetes mellitus type 2. Currently, studies are oriented to the development of agents that activate multiple PPAR isoforms -not only dual (PPARα/γ), but also PPAR pan-agonists (α/γ/δ). The purpose of this review is to explain the mechanisms of the molecular action and the effects of PPAR agonists, and also to analyze existing and current studies concerning their use in cardiovascular and metabolic illnesses.

Introduction In our country, amateur diving is a frequent summer activity in young people. Spinal injuries after diving in recreational context can lead to catastrophic consequences, mostly in young and economically active population. Patients and Methods We reviewed 34 patients hospitalized in our center who were admitted to the neurosurgery unit between 2006 and 2014, with spinal injuries because of driving accidents. Data were collected from their initial admission and from follow-up records. Statistical analysis was performed using Microsoft Excel 2010 and STATA v10. Results Of the total number of patients evaluated, 97% (33/34) sustained injuries. Mean age was 30 (SD, 15–54) years. All reported injuries occurred during summer. Alcohol consumption was present in 44% of cases. The most affected segment was cervical (88%), and the most common injuries were C4–C5 dislocation and fracture (18%) and C5–C6 dislocation and fracture (12%). Overall, 32% of patients presented severe neurological compromise (ASIA A, B, and C) at time of admission. Surgical treatment was required in 50% of cases, the majority using an anterior cervical approach. The other 50% underwent orthopedic management. NASCIS 2 methylprednisolone protocol was used in 18% of cases. Overall, 29% of patients received steroid therapy. Thirty-day mortality for the cohort was 8.8%, all ASIA A. Mean hospital stay was 22 (SD, 1–354) days. Conclusion Driving accidents in Los Angeles, Chile, while uncommon can result in spinal injuries with drastic consequences, including permanent physical disability, mortality, and a profound socioeconomic impact. In our experience, early surgical and orthopedic management resulted in best clinical results. The consumption of alcohol worsen the outcomes prevention strategies should be implemented to reduce the incidence and impact of this problem.