Efecto del compuesto N-2,6-dicloro-aralquil-2-Aminoindano en la conducta estereotipada de ratas. Acción dopaminérgica selectiva central sobre los ganglios basales más que en las estructuras límbicas / Effect of the compound N-2,6-dichloro-aralkyl-2-aminoindane on the stereotyped behavior of rats. Selective action on the central dopaminergic system in the basal ganglia over limbic structures

Resumen La dopamina 1, está implicada en trastornos neurodegenerativos que afectan al sistema nervioso central (SNC) tales como la enfermedad de Parkinson, entre otros. Aunque no se dispone aún de ningún fármaco capaz de prevenir, detener o curar la progresión de estas enfermedades, son numerosos los compuestos que han sido diseñados, sintetizados y evaluados farmacológicamente, que han aportado las generalizaciones farmacofóricas del receptor dopaminérgico, necesarias para la búsqueda de un fármaco capaz de mejorar o curar estas patologías. Los derivados 2-aminoindano-N-aralquílicos han mostrado tener actividad selectiva en el sistema dopaminérgico central, de modo tal que los compuestos clorhidratos de N-[(2,4-diclorofenil)-1-metil- etil]-2-aminoindano 2 y N-[(3,4-diclorofenil)-1-metil-etil]-2-aminoindano 3 demostraron tener actividad agonística mediada por mecanismos dopaminérgicos centrales. Con el propósito de contribuir en la búsqueda de nuevos fármacos que permitan restablecer la homeostasis de la transmisión dopaminérgica en la enfermedad de Parkinson, el compuesto N-2,6-dicloro-aralquil-2-aminoindano 4 fue diseñado a través de estrategias de la química medicinal, que contienen las aproximaciones farmacofóricas de los profármacos. La evaluación farmacológica del compuesto 4, en la conducta estereotipada en ratas macho de la cepa Sprague Dawley, demostró tener actividad agonística a través de la activación de los mecanismos dopaminérgicos centrales y mostró mayor selectividad en las respuestas de conductas estereotipadas propias de los ganglios basales sobre las respuestas conductuales propias de las estructuras límbicas.

Abstract Dopamine 1 is involved in neurodegenerative disorders affecting the central nervous system (CNS), such as Parkinson's disease. Despite the absence of some available drugs capable of preventing, stopping or curing the progression of such diseases, there are numerous compounds designed, synthesized, and pharmacologically tested which give rise to pharmacophoric generalizations about the dopaminergic receptor required for the search of a drug able to improve or cure those pathologies. N-aralkyl-2-aminoindane derivatives have shown selective activity in the central dopaminergic system. Both the N-[(2,4-dichlorophenyl)-1-methyl-ethyl]-2-aminoindane hydrochloride 2 and N-[(3,4-dichlorophenyl)-1-methyl-ethyl]-2-aminoindane hydrochloride 3 showed an agonistic activity mediated by central dopaminergic mechanisms. To contribute to the search of new drugs able to re-establish homeostasis in the dopaminergic transmission in Parkinson's disease, the compound N-2,6- dichloro-aralkyl-2-aminoindane 4 was designed through medicinal chemistry strategies that contain pharmacophoric approximations of prodrugs. The pharmacological evaluation of compound 4 in the stereotyped behavior of male Sprague Dawley rats showed agonistic activity through the activation of central dopaminergic mechanisms and a higher selectivity in the responses of stereo- typed behavior characteristic of the basal ganglia over the typical responses from limbic structures.

Glenoid Bone Loss in Shoulder Instability: Superiority of Three-Dimensional Computed Tomography over Two-Dimensional Magnetic Resonance Imaging Using Established Methodology

Background@#Recent literature suggests that three-dimensional magnetic resonance imaging (3D MRI) can replace 3D computed tomography (3D CT) when evaluating glenoid bone loss in patients with shoulder instability. We aimed to examine if 2D MRI in conjunction with a validated predictive formula for assessment of glenoid height is equivalent to the gold standard 3D CT scans for patients with recurrent glenohumeral instability. @*Methods@#Patients with recurrent shoulder instability and available imaging were retrospectively reviewed. Glenoid height on 3D CT and 2D MRI was measured by two blinded raters. Difference and equivalence testing were performed using a paired t-test and two one-sided tests, respectively. The interclass correlation coefficient (ICC) was used to test for interrater reliability, and percent agreement between the measurements of one reviewer was used to assess intrarater reliability. @*Results@#Using an equivalence margin of 1 mm, 3D CT and 2D MRI were found to be different (p = 0.123). The mean glenoid height was significantly different when measured on 2D MRI (39.09 ± 2.93 mm) compared to 3D CT (38.71 ± 2.89 mm) (p = 0.032). The mean glenoid width was significantly different between 3D CT (30.13 ± 2.43 mm) and 2D MRI (27.45 ± 1.72 mm) (p < 0.001). The 3D CT measurements had better interrater agreement (ICC, 0.91) than 2D MRI measurements (ICC, 0.8). intrarater agreement was also higher on CT. @*Conclusions@#Measurements of glenoid height using 3D CT and 2D MRI with subsequent calculation of the glenoid width using a validated methodology were not equivalent, and 3D CT was superior. Based on the validated methods for the measurement of glenoid bone loss on advanced imaging studies, 3D CT study must be preferred over 2D MRI in order to estimate the amount of glenoid bone loss in candidates for shoulder stabilization surgery and to assist in surgical decision-making.

Glenoid Bone Loss in Shoulder Instability: Superiority of Three-Dimensional Computed Tomography over Two-Dimensional Magnetic Resonance Imaging Using Established Methodology

Background@#Recent literature suggests that three-dimensional magnetic resonance imaging (3D MRI) can replace 3D computed tomography (3D CT) when evaluating glenoid bone loss in patients with shoulder instability. We aimed to examine if 2D MRI in conjunction with a validated predictive formula for assessment of glenoid height is equivalent to the gold standard 3D CT scans for patients with recurrent glenohumeral instability. @*Methods@#Patients with recurrent shoulder instability and available imaging were retrospectively reviewed. Glenoid height on 3D CT and 2D MRI was measured by two blinded raters. Difference and equivalence testing were performed using a paired t-test and two one-sided tests, respectively. The interclass correlation coefficient (ICC) was used to test for interrater reliability, and percent agreement between the measurements of one reviewer was used to assess intrarater reliability. @*Results@#Using an equivalence margin of 1 mm, 3D CT and 2D MRI were found to be different (p = 0.123). The mean glenoid height was significantly different when measured on 2D MRI (39.09 ± 2.93 mm) compared to 3D CT (38.71 ± 2.89 mm) (p = 0.032). The mean glenoid width was significantly different between 3D CT (30.13 ± 2.43 mm) and 2D MRI (27.45 ± 1.72 mm) (p < 0.001). The 3D CT measurements had better interrater agreement (ICC, 0.91) than 2D MRI measurements (ICC, 0.8). intrarater agreement was also higher on CT. @*Conclusions@#Measurements of glenoid height using 3D CT and 2D MRI with subsequent calculation of the glenoid width using a validated methodology were not equivalent, and 3D CT was superior. Based on the validated methods for the measurement of glenoid bone loss on advanced imaging studies, 3D CT study must be preferred over 2D MRI in order to estimate the amount of glenoid bone loss in candidates for shoulder stabilization surgery and to assist in surgical decision-making.

Sarcopenia and Muscle Aging: A Brief Overview

The world is facing the new challenges of an aging population, and understanding the process of aging has therefore become one of the most important global concerns. Sarcopenia is a condition which is defined by the gradual loss of skeletal muscle mass and function with age. In research and clinical practice, sarcopenia is recognized as a component of geriatric disease and is a current target for drug development. In this review we define this condition and provide an overview of current therapeutic approaches. We further highlight recent findings that describe key pathophysiological phenotypes of this condition, including alterations in muscle fiber types, mitochondrial function, nicotinamide adenine dinucleotide (NAD+) metabolism, myokines, and gut microbiota, in aged muscle compared to young muscle or healthy aged muscle. The last part of this review examines new therapeutic avenues for promising treatment targets. There is still no accepted therapy for sarcopenia in humans. Here we provide a brief review of the current state of research derived from various mouse models or human samples that provide novel routes for the development of effective therapeutics to maintain muscle health during aging.

Sarcopenia and Muscle Aging: A Brief Overview

The world is facing the new challenges of an aging population, and understanding the process of aging has therefore become one of the most important global concerns. Sarcopenia is a condition which is defined by the gradual loss of skeletal muscle mass and function with age. In research and clinical practice, sarcopenia is recognized as a component of geriatric disease and is a current target for drug development. In this review we define this condition and provide an overview of current therapeutic approaches. We further highlight recent findings that describe key pathophysiological phenotypes of this condition, including alterations in muscle fiber types, mitochondrial function, nicotinamide adenine dinucleotide (NAD+) metabolism, myokines, and gut microbiota, in aged muscle compared to young muscle or healthy aged muscle. The last part of this review examines new therapeutic avenues for promising treatment targets. There is still no accepted therapy for sarcopenia in humans. Here we provide a brief review of the current state of research derived from various mouse models or human samples that provide novel routes for the development of effective therapeutics to maintain muscle health during aging.

Anatomic Evaluation of the Interportal Capsulotomy Made with the Modified Anterior Portal versus Standard Anterior Portal: Comparable Utility with Decreased Capsule Morbidity / 대한고관절학회지

PURPOSE: To identify potential differences in interportal capsulotomy size and cross-sectional area (CSA) using the anterolateral portal (ALP) and either the: (i) standard anterior portal (SAP) or (ii) modified anterior portal (MAP).MATERIALS AND METHODS: Ten cadaveric hemi pelvis specimens were included. A standard arthroscopic ALP was created. Hips were randomized to SAP (n=5) or MAP (n=5) groups. The spinal needle was placed at the center of the anterior triangle or directly adjacent to the ALP in the SAP and MAP groups, respectively. A capsulotomy was created by inserting the knife through the SAP or MAP. The length and width of each capsulotomy was measured using digital calipers under direct visualization. The CSA and length of the capsulotomy as a percentage of total iliofemoral ligament (IFL) side-to-side width were calculated.RESULTS: There were no differences in mean cadaveric age, weight or IFL dimensions between the groups. Capsulotomy CSA was significantly larger in the SAP group compared with the MAP group (SAP 2.16±0.64 cm2 vs. MAP 0.65±0.17 cm2, P=0.008). Capsulotomy length as a percentage of total IFL width was significantly longer in the SAP group compared with the MAP group (SAP 74.2±14.1% vs. MAP 32.4±3.7%, P=0.008).CONCLUSION: The CSA of the capsulotomy and the percentage of the total IFL width disrupted are significantly smaller when the interportal capsulotomy is performed between the ALP and MAP portals, compared to the one created between the ALP and SAP. Surgeons should be aware of this fact when performing hip arthroscopy.

Surgical Management of Shoulder and Knee Instability in Patients with Ehlers-Danlos Syndrome: Joint Hypermobility Syndrome

Ehlers-Danlos Syndrome (EDS) is a hereditary disorder of the connective tissue, which has been classified into numerous subtypes over the years. EDS is generally characterized by hyperextensible skin, hypermobile joints, and tissue fragility. According to the 2017 International Classification of EDS, 13 subtypes of EDS have been recognized. The majority of genes involved in EDS are either collagen-encoding genes or genes encoding collagen-modifying enzymes. Orthopedic surgeons most commonly encounter patients with the hypermobile type EDS (hEDS), who present with signs and symptoms of hypermobility and/or instability in one or more joints. Patients with joint hypermobility syndrome (JHS) might also present with similar symptomatology. This article will focus on the surgical management of patients with knee or shoulder abnormalities related to hEDS/JHS.

Balance autonómico basal y durante el ejercicio isométrico en jóvenes con diferente reactividad cardiovascular / Basal autonomic balance and during the isometric exercise in young people with different cardiovascular reactivity

RESUMEN Introducción: El sistema nervioso autónomo desempeña un papel importante en los reajustes cardiovasculares al ejercicio. En la hiperreactividad cardiovascular existe una mayor sensibilidad del sistema simpático ante diferentes estímulos estresantes. Objetivo: Determinar las características del control autonómico cardíaco en adultos jóvenes con diferentes grados de reactividad cardiovascular en condiciones basales y durante el ejercicio isométrico. Método: La muestra estuvo constituida por 97 individuos de ambos sexos, y se dividió en tres grupos: normorreactivos, hiperreactivos y con respuesta hipertensiva, de acuerdo a la respuesta presora a la prueba del peso sostenido. A todos los individuos se les realizó un estudio de variabilidad de la frecuencia cardíaca en reposo y durante la prueba isométrica. Se estudiaron las variables en el dominio de la frecuencia: baja, alta, relación baja/alta en reposo, y los parámetros del diagrama de Poincaré en reposo y durante el ejercicio (valores de desviación estándar 1 [SD1], 2 [SD2], y la razón entre ambos). Resultados: En estado basal los individuos hiperreactivos y con respuesta hipertensiva presentaron un predominio simpático sobre la función cardíaca y una menor variabilidad de la frecuencia cardíaca. Durante el ejercicio isométrico disminuyeron los valores de los ejes SD1 y SD2 en todos los grupos y la razón SD1/SD2 decreció en individuos normorreactivos y con respuesta hipertensiva; pero apenas se modificó en los hiperreactivos. Conclusiones: En los individuos con hiperreactividad cardiovascular ya está presente un desbalance autonómico en estado basal y existe una reducción de la modulación autonómica vagal durante el ejercicio, que puede favorecer el desarrollo de la hipertensión arterial.

ABSTRACT Introduction: The autonomic nervous system plays an important role in cardiovascular readjustments to exercise. In cardiovascular hyperreactivity there is a greater sensitivity of the sympathetic system to different stressors. Objective: To determine the characteristics of cardiac autonomic control in young adults with different degrees of cardiovascular reactivity under basal conditions and during isometric exercise. Method: The sample consisted of 97 individuals of both sexes, and was divided into three groups: normoreactive, hyperreactive and with hypertensive response, according to the pressor response to weight-bearing tests. The individuals underwent a complete study of heart rate variability at rest and during isometric test. The frequency domain for the variables was: low, high, low/high resting ratio, and the parameters of Poincaré plots at rest and during exercise (values of standard deviation 1 [SD1], 2 [SD2], and the reason between them). Results: Under basal conditions, hyperreactive individuals with a hypertensive response had a sympathetic predominance over cardiac function and lower heart rate variability. During the isometric exercise SD1 and SD2 axes values decreased in all groups and SD1/SD2 ratio decreased in normoreactive individuals with hypertensive response; but it was hardly modified in those hyper-reactive. Conclusions: Individuals with cardiovascular hyperreactivity have a prior autonomic imbalance under basal conditions and a reduction of autonomic vagal modulation during exercise that may favor the development of arterial hypertension.

Aprendizaje Basado en Problemas en el desarrollo de competencias transversales en programas del área de la salud de una Institución de Educación Superior de Barranquilla-Colombia / Problem-based learning for the development of cross-sectional competences regarding health area programs at a higher education institution in Barranquilla, Colombia

Introducción: El aprendizaje basado en problemas es una estrategia pedagógica basada en el estudiante como protagonista de su propio aprendizaje, la cual constituye una nueva perspectiva de la enseñanza. A nivel universitario es una estrategia que se perfila como uno de los enfoques más innovadores en la formación académica actual, cobrando cada vez más espacio en las universidades del mundo. Objetivo: Analizar la estrategia de aprendizaje basado en problemas en el desarrollo de las competencias transversales, instrumentales, sistémicas en estudiantes Universitarios de primer semestre de programas del área de la salud. Métodos: La muestra fue de 465 estudiantes. Todos ellos desarrollaron el tema de valores y medio ambiente en el curso de biología empleando aprendizaje basado en problemas, posterior a lo cual, mediante el cuestionario de evaluación de las competencias transversales se evaluó el desarrollo que lograron en cada una de las competencias. Resultados: Sugirieron un mayor desarrollo de las competencias sistémicas con la implementación de esta estrategia. Conclusiones: Ésta estrategia posiblemente favorece el trabajo colaborativo, en los estudiantes(AU)

Introduction: The Problem-based learning is a pedagogic strategy based on the student as the primary author of his own learning, this strategy constitutes a new perspective of teaching. At college level Problem-based learning is outlined like one of the most innovative approaches in the current academic education. Objective: The aim of this research was to analyze the strategy of Problem-based learning in the development of transversal, instrumental and systemic competencies in college first semester students, in the healthy area. Methods: The sample was composed by 465 students. All of them developed the topic about values and environment in the frame of biology course employing Problem-based learning. following that they completed an evaluation questionnaire about transversal competencies, which evaluated the development achieved in each of the competences. Results: The results suggest a greater development of the systemics competences with the use of the Problem-based learning strategy. Conclusions: We concluded that this strategy Problem-based learning possibly helps to favor the collaborative work in college students(AU)

Knowledge and attitudes of Singapore schoolchildren learning cardiopulmonary resuscitation and automated external defibrillator skills

<p><b>INTRODUCTION</b>Victims of out-of-hospital cardiac arrests require timely cardiopulmonary resuscitation (CPR) and early defibrillation. Callers to emergency medical services are asked to provide dispatcher-guided responses until an ambulance arrives. Knowing what to expect in such circumstances should reduce both delay and confusion.</p><p><b>METHODS</b>This study was conducted among schoolchildren aged 11-17 years using ten-item pre- and post-training surveys. We aimed to observe any knowledge and attitude shifts regarding CPR and automated external defibrillator (AED) use subsequent to the training.</p><p><b>RESULTS</b>A total of 1,196 students across five schools completed the pre- and post-training surveys. Survey questions tested basic CPR knowledge and attitudes towards CPR and AED use. The overall response rate was 80.8% and 81.5% in the pre- and post-training surveys, respectively. There was a statistically significant improvement in the students' CPR knowledge. The number of students who selected all the correct answers for the knowledge-based questions in the post-training survey increased by 64.7% (95% confidence interval 61.9%-67.5%; p < 0.001). There was also an improvement in their willingness to administer CPR (likely/very likely to administer CPR pre-training vs. post-training: 13.0% vs. 71.0%; p < 0.001) and use AED (likely/very likely to administer AED pre-training vs. post-training: 11.7% vs. 78.0%; p < 0.001) after training.</p><p><b>CONCLUSION</b>The training programme imparted new information and skills, and improved attitudes towards providing CPR and using AED. However, some concerns persisted about hurting the victim while performing CPR.</p>

Measuring the effectiveness of a novel CPRcard™ feedback device during simulated chest compressions by non-healthcare workers

<p><b>INTRODUCTION</b>There is a need for a simple-to-use and easy-to-carry CPR feedback device for laypersons. We aimed to determine if a novel CPRcard™ feedback device improved the quality of chest compressions.</p><p><b>METHODS</b>We compared participants' chest compression rate and depth with and without feedback. Compression data was captured through the CPRcard™ or Resusci Anne's SimPad® SkillReporter™. Compression quality was defined based on 2010 international guidelines for rate, depth and flow fraction.</p><p><b>RESULTS</b>Overall, the CPRcard group achieved a better median compression rate (CPRcard 117 vs. control 122, p = 0.001) and proportion of compressions within the adequate rate range (CPRcard 83% vs. control 47%, p < 0.001). Compared to the no-card and blinded-card groups, the CPRcard group had a higher proportion of adequate compression rate (CPRcard 88% vs. no-card 46.8%, p = 0.037; CPRcard 73% vs. blinded-card 43%, p = 0.003). Proportion of compressions with adequate depth was similar in all groups (CPRcard 52% vs. control 48%, p = 0.957). The CPRcard group more often met targets for compression rate of 100-120/min and depth of at least 5 cm (CPRcard 36% vs. control 4%, p = 0.022). Chest compression flow fraction rate was similar but not statistically significant in all groups (92%, p = 1.0). Respondents using the CPRcard expressed higher confidence (mean 2.7 ± 2.4; 1 = very confident, 10 = not confident).</p><p><b>CONCLUSION</b>Use of the CPRcard by non-healthcare workers in simulated resuscitation improved the quality of chest compressions, thus boosting user confidence in performing compressions.</p>

Long-term outcomes of saphenous vein graft stenting compared with native coronary artery stenting in patients with previous coronary artery bypass graft surgery / Stents en vasos coronarios nativos comparados con endoprótesis en injertos de vena safena en pacientes con cirugía de revascularización coronaria previa. Evolución a largo plazo

Propósito del estudio: el objetivo primario del estudio fue valorar la tasa de eventos cardiacos mayores después de cirugía de revascularización coronaria por angioplastia con stent en el injerto de vena safena, comparados con los de angioplastia con stent en la arteria coronaria nativa, tanto en el periodo de hospitalización como a largo plazo. Métodos: estudiamos a 127 pacientes, 49 con stent en injerto de vena safena (grupo 1) y a 78 con stent en arterias coronarias innatas (grupo 2). Resultados: no hubo diferencias significativas en la edad, ni en frecuencia de diabetes, tabaquismo, hipertensión arterial, dyslipidemia, fracción de expulsión del ventrículo izquierdo o clase funcional entre los grupos. La incidencia del fenómeno de no reflujo persistente fue mayor en el grupo 1 (10.2% contra 1.2%, p = 0.0001) y la suma de eventos cardiacos sólo fue distinta durante el primer mes (10.2% contra 2.5%, p = 0.041). La supervivencia sin eventos cardiacos a 36 meses fue menor en los pacientes del grupo 1 (65.0% contra 89.1%, p = 0.024). Conclusiones: La suma de eventos cardiacos mayores fue mayor en el grupo 1 y la supervivencia sin dichos eventos a 3 años fue superior en los pacientes con endoprótesis en arteria coronaria natural.

Objective: Our main objective was to compare the in-hospital and long-term outcomes of saphenous vein graft stenting and native coronary artery stenting in patients with previous coronary artery bypass grafting. Methods: We studied 127 patients who had prior coronary artery bypass; they were divided in two groups, according to the kind of percutaneous coronary intervention performed. The first group included 49 patients with saphenous vein graft stenting and the second group included 78 patients who underwent native coronary artery stenting. Results: There was no significant difference in age, incidence of diabetes, smoking, arterial hypertension, dyslipidemia, left ventricular ejection fraction or in the New York Heart Association functional class between both groups. The incidence of no reflow phenomenon was higher in group 1 (10.2% vs. 1.2%, p = 0.0001). The cumulative incidence of major adverse cardiac events was different between groups at 1 month (10.2% vs. 2.5%, p = 0.041). There was a lower MACE (major adverse cardiovascular events) free survival at 36 months in the saphenous vein graft stenting group (65.0% vs. 89.1%, p = 0.024). Conclusions: Major in-hospital complications occurred more frequently in the saphenous vein graft stented group. MACE-free survival at 3 years was higher in the native coronary artery stent patients.

Integrative content-driven concepts for bioinformatics "beyond the cell".

Bioinformatics has delivered great contributions to genome and genomics research, without which the world-wide success of this and other global ('omics') approaches would not have been possible. More recently, it has developed further towards the analysis of different kinds of networks thus laying the foundation for comprehensive description, analysis and manipulation of whole living systems in modern "systems biology". The next step which is necessary for developing a systems biology that deals with systemic phenomena is to expand the existing and develop new methodologies that are appropriate to characterize intercellular processes and interactions without omitting the causal underlying molecular mechanisms. Modelling the processes on the different levels of complexity involved requires a comprehensive integration of information on gene regulatory events, signal transduction pathways, protein interaction and metabolic networks as well as cellular functions in the respective tissues / organs.

Traumatismos craneoencefálicos relación causa-efecto en niños del Hospital Central San Cristóbal 1994 - 1998 / Tarumatismos craneoencefálicos relationship cause-effect in children of the Central Hospital San Cristóbal 1994 - 1998

Con la finalidad de corroborar el comportamiento epidemilógico de los Traumatismos Craneoencafálicos en niños preescolares y escolares admitidos en la Unidad de Cuidados Especiales Pediátricos del Hospital Central de San Cristóbal durante un período de 5 años, se realizó un trabajo retrospectivo y documental recabando la información a partir de las historias. Se incluyeron 79 niños, 69 por ciento de varones. El drupo etareo predominante fue el escolar con 44 casos. Todos pertenecientes al nivel Graffar IV, 63,29 por ciento de los pacientes provenían del medio rural. Los principales mecanismos involucrados fueron las caídas (56.9 por ciento). Las complicaciones registradas con mayor frecuencia son fracturas de cráneo (18.98 por ciento). Se concluye que los factores socioculturales juegan un papel importante en la génesis de los traumatismos craneoencefálicos

Disease concomitance in psoriasis: a clinical study of 61 cases.

Sixty-one patients with psoriasis were studied for concomitant diseases and compared with 61 age and sex-matched controls. Concomitant cutaneous diseases most often seen with psoriasis were lichen simplex chronicus (16.3%), verruca vulgaris (9.8%) and me Iasina (4.9%). Of the systemic disorders, diabetes showed the highest frequency (13.1%) followed by hypertension (8.1%). Two patients had HIV infection (3.2%). Both the patients had severe and atypical lesions.

relationship between zinc/cadmium ratio in the human semen: effect on immune response

Objective of study: To investigate the re l a t i o n s h i p between seminal levels of zinc and cadmium and spermatozoal quality, and their effects on the immune response. Study Design and Methodology: Forty-five infertile and 16 fertile males were included in this study. Investigations included semen analysis, a hypo-osmotic swelling test, antisperm antibodies by immunobeads, trace elements with atomic absorption spectroscopy and TNF- and interleukin-4 with ELISA. A high zinc/cadmium [Zn/Cd] ratio of more than 200 was associated with a normal sperm count and motility. There was an inverse relationship between the Zn/Cd ratio and impairment of spermatozoa motility. A high Zn/Cd ratio was associated with a low incidence of antisperm antibodies, especially IgA and IgM, a positive correlation with seminal IL-4 but inverse relationship with TNF-. The Zn/Cd ratio may be a better index of sperm quality than seminal zinc and cadmium, independently, through a differential reduction of the humoral immunity and enhancement of the T helper-2 cytokine Interleukin-4 as well as a down regulation of the T helper-1 cellular immune response

Human leukocyte antigens profile in women with pre-eclampsia

To evaluate the frequencies of HLA Classes 1 and 2 antigens in women with obvious pre-eclampsia when compared to normotensive controls to demonstrate evidence of genetic factor contribution in the etiology of pre-eclampsia. In this prospective case-control study all the patients were managed at the Maternity Hospital, Kuwait. About 14 ml of blood was withdrawn from 25 women with pre-eclampsia and 25 normotensive controls. HLA phenotyping was done using a Terasaki microlymphotoxicity test for both classes, land II. In HLA Class 1, A31, A34, Cw8 antigens were more common in pre-eclamptic women [p<.0.4], while A28, Bw7 and Bw8 antigens were more common in the controls [p<0.02]. In HLA Class II, DR4, DRw14, DQw14, and DQw3 were more common in the pre-eclamptic women than in the controls [p<0.05]. The Relative Risk Ratios were significant for Al, Aw24, A31, A36, B27, Bw42, Cw5, Cw7 and Cw8, as well as DR2, DR3, DR4, DRw11, DQw2 and DQ4. Pre-eclamptic women differ genetically from controls with HLA Class 1 and Class 2

Prospective randomized study comparing nifedipine versus ritodrine for the suppression of preterm labour

Nifedipine is a dihydropyridine and a calcium channel blocker during the second phase of the action potential of uterine smooth muscle cells, and ritodrine is a beta-sympathomimetic. Objective of Study: To compare the efficacy and side-effects of oral nifedipine to ritodrine in the inhibition of preterm labour. Methodology: Sixty parturients admitted to the Maternity Hospital with preterm labour who fulfilled the inclusion criteria were randomized into two equal therapy groups: [a] oral nifedipine [n = 30] and [b] intravenous ritodrine [n = 30]. During the period, the parturients were under continuous monitoring of fetal well-being, maternal uterine contractions, blood pressure, and pulse and respiratory rates. Both groups were given dexamethasone and followed up through delivery and the early neonatal period. The incidence of preterm deliveries during the study period was 6.5%. Ritodrine had a quicker onset of inhibition of uterine contractions, especially between 20 and 40 min after initiation of tocolytic therapy [p < 0.04]. Labour was delayed on the average for 40 h in the nifedipine group compared to 24 h in the ritodrine group [p < 0.05]. Eighteen patients [60%] in the nifedipine group had cessation for more than 48 h compared to 7 [30.4%] in the ritodrine group [p < 0.05]. Nifedipine inhibited uterine contractions for more than 7 days in more patients than ritodrine [13 versus 5, p < 0.05]. Ten patients in the nifedipine group went beyond 36 weeks of gestation compared to 4 in the ritodrine group [p < 0.03]. In 5 [17.9%] of the ritodrine group compared to none in the nifedipine group, treatment was abandoned because of severe side-effects of nausea [11 versus 2, p < 0.01] and palpitations [16 versus 3, p < 0.004]. There were no significant differences in the Apgar scores and neonatal morbidity. More infants in the ritodrine group [17, 73.9%] than in the nifedipine group [14, 46.1%, p < 0.05] were admitted to the neonatal unit. Nifedipine is recommended for aborting preterm contractions because it has fewer side-effects, superior efficacy and greater ease of administration than intravenous ritodrine