Expresión de calreticulina en placenta canina / Calreticulin expression in canine placenta

La placenta es un anexo embrionario de los mamíferos que tiene por función principal el intercambio de nutrientes y gases y proteger al concepto de un potencial daño inmune provocado por diferencias alogénicas en los Complejos Principales de Histocompatibilidad paternos. Se han descrito diversas proteínas asociadas a su función, siendo Calreticulina una de ellas. Si bien existen estudios de la presencia de Calreticulina en placenta humana, no existen reportes de esta proteína en la placenta canina. Se obtuvieron muestras de placenta canina de las que se extrajo el contenido proteico total y se determinó la presencia de Calreticulina por western blot e inmunohistoquímica. Los resultados mostraron presencia de Calreticulina en placenta canina con un peso molecular aparente de 60 kDa, concordante con lo descrito para la molécula por otros autores. El análisis inmunohistoquímico mostró que Calreticulina canina está presente principalmente en el trofoblasto de las vellosidades, no existiendo diferencias en cuanto a su localización al compararla con placenta humana, pese a sus diferencias morfológicas e histológicas. Esta información permitirá establecer un protocolo estandarizado de extracción de Calreticulina desde placenta, así como orientar acerca de los posibles roles de esta molécula en la placenta.

The placenta is an embryonic organ present in mammals, whose main functions are the exchange of nutrients and gases and to protect the fetus from potential immune damage mediated by paternal and maternal allogeneic differences in the Major Histocompatibility Complex. Several proteins associated with its function have been described, being Calreticulin one of them. Although there are studies on the presence of Calreticulin in human placenta, there are no reports of this protein in canine placenta. Samples from canine placenta were obtained, proteins extracted and Calreticulin was subsequently detected by western blot and immunohistochemistry. The results showed the presence of Calreticulin in canine placenta with an apparent molecular weight of 60 kDa, in agreement with the results from other authors. The immunohistochemical analysis showed that canine Calreticulin is present mainly in the trophoblast of the villi, and there is no difference in its localization when compared with a blood-filled placenta such as human one, despite its morphological and histological differences. We also propose a standardized protocol for the extraction of Calreticulin from placenta, given its abundant expression in this organ. Future studies are aimed at elucidating possible roles of this protein in placenta.

Pulmonary tuberculosis in patients with chronic renal failure at Zagazig University Hospitals

The incidence of active TB and attendant mortality is increased in patients with impaired cellular immunity, such as HIV infected patients, solid organ and stem cell transplant recipients and patients with end-stage renal failure. The relative risk for TB varies with the type of immunodeficiency and mortality rates may be as high as 75%. End-stage renal disease [ESRD] and particularly uraemia is a known contributor to immunosuppression. The aim of this work was to evaluate the increasing risk of pulmonary tuberculosis among patients with chronic renal failure and the impact of hemodialysis. This study was carried at both Nephrology Unit and Chest Department, Zagazig University Hospitals during the period from April 2012 to Jan 2013. The study included a total number of 140 patients with chronic renal failure [92 males and 48 females], with mean age of 49 +/- 6.4 years. Patients were classified to three groups: Group 1: Included 40 Patients with chronic renal failure and not on dialysis. Group 2: Included 50 Patients with chronic renal failure and on regular hemodialysis three sittings per week for less than 1 year. Group 3: Included 50 Patients with chronic renal failure and on regular hemodialysis three sittings per week for more than 1 year. All patients were subjected to: history taking and medical evaluation including general and local examinations, routine laboratory investigations, Plain chest X-ray; Posteroanterior and lateral views for all patients, Sputum Ziehl-Neelsen staining and Sputum induction in patients who had chest X-ray suspecting pulmonary TB without expectoration and Tuberculin skin testing. Selected cases were subjected to fiberoptic bronchoscopy to obtain BAL for ZN staining 16 patients [11.4%] proved to have pulmonary tuberculosis by + ve ZN stain for acid fast bacilli in either sputum or BAL, 28 patients [20%] were suspected to have pulmonary tuberculosis by radiological suspension and -ve sputum ZN for acid fast bacilli, 6 patients [4.3%] proved to have extra-pulmonary TB while 90 patients [64.3%] were free from tuberculosis. There were no significant differences among different groups as regards infection by TB. Patients with chronic renal failure are at increased risk for pulmonary and extra pulmonary tuberculosis and should be screened routinely and carefully for early detection of TB infection

[Reccurrent desmoid tumor of the gluteal area]

Desmoids tumors are fibrous infiltrates recurrent proliferations but not metastasizing. It is about a 40-year-old patient who presented a tumor of the right gluteal area, operated twice for a tumor at the right gluteal area and its histopathologic examination confirmed the diagnosis of a desmoid tumor. A standard X-ray as well as a scanner of the pond objectivized a third recurrence of the desmoid tumor. Given that the clinical signs are not alarming, a surgical abstention was recommended with a regular follow-up of the patient. Desmoids tumors are a port of deep fibromatosis. These kinds of tumors rarely attack young adults with a net feminine predominance. Clinically, the tumor appears in the form of a mass badly limited, of a slow growth, little or not sensitive. The scanner and especially the resonance nuclear magnetic represent radiological examinations of choice. The confirmation diagnosis remains based on the histopathologic study of surgical specimen. The surgery treatment stays the base treatment, the indication of adjuvant treatment based on radiotherapy and medical treatment is limited and the results are uncertain. These tumor rare gluteral; their diagnosis is mostly histological, the treatment is especially based on surgery

Comparación de costo-efectividad entre dos técnicas anestésicas: anestesia con sevofluorane-remifentanil frente a isofluorane-remifentanil / Cost-Effective Comparison Between Two Anesthesia Techniques: Sevofluorane-Remifentanyl vs Isofluorane-Remifentanyl

Nos encontramos en la era de la optimización de costos, por lo que es necesario realizar estudios farmacoeconómicos para identificar la costo- efectividad de los anestésicos actuales. Metodología: este estudio prospectivo, cegado al paciente, comparó los costos directos, los tiempos de recuperación y satisfacción de 45 pacientes que se asignaron aleatoriamente a dos grupos de anestesia balanceada (grupo sevofluoraneremifentanil n = 24 o grupo isofluoraneremifentanil n = 21) que iban a ser sometidos a cirugías de otorrinolaringología. Resultados: los tiempos de recuperación temprana (apertura ocular, respuesta a comandos, extubación, orientación y salida de sala) fueron menores en el grupo ISO y tuvieron diferencia estadísticamente significativa. Se encontraron datos variables en los costos de adquisición de los halogenados gastados, que fueron menores para el isofluorane, lo cual hacía también menos costosos los insumos anestésicos durante las cirugías; sin embargo, los costos en la sala de cirugía, en recuperación y sala de ambulatorios y los costos totales no mostraron diferencias significativas. La satisfacción fue similar entre los dos grupos. Conclusiones: una técnica basada en sevofluorane-remifentanil no es más costo-efectiva que utilizar isofluorane-remifentanil para pacientes ambulatorios sometidos a cirugías de otorrinolaringología.

We are in the of costs optimization era, reason why it is necessary to make pharmaceutical economics studies to identify the costeffectiveness of today's anesthetics. Methods: this prospective study, blinded to the patient, compared the direct costs, recovery times and satisfaction of 45 patients randomly assigned to two balanced anesthesia groups (sevofluoraneremifentanil group n = 24 or isofluoraneremifentanil group n = 21) submitted to otorhinolaringology surgical procedures. Results: the times of early recovery (ocular opening, answer to commandos, extubación, orientation and room leave) were smaller in ISO group and had statistically significant difference. Variable data was found in acquisition costs of halogenados gastados, lesser for isofluorane, which also made the anesthetic supplies less expensive during surgical procedures; nevertheless, costs in the delivery room, in recovery and ambulatory room, and the total costs did not show significant differences. Satisfaction was similar between both groups. Conclusions: a sevofluorane-remifentanil based technique is not more cost-effective than to use isofluoraneremifentanil for ambulartory patients submitted to otorhinolaringology surgical procedures.

[ common peroneal nerve compression by a synovial cyst]

The synovial cyst compressing the fibular common nerve is a little known entity at the origin of diagnosis mistakes. The authors recall about a new case the clinical symptomatology: pain of the knee followed by steppage. The palpation can recover a swelling at the level of the fibular neck. The electromyogram permits to localize the nervous lesion comfortably . Our observation puts in evidence the interest of the magnetic resonance imaging. The surgical intervention must search for a possible communication of the cyst with the proximal tibio-fibular joint. The neurological prognosis is generally good in case of recent deficit

Predictors of vascular endothelial dysfunction in systemic lupus erythematosus

Vascular endothelium of patients with systemic lupus erythematosus [SLE] after prolonged exposure to circulating immune complexes shows generative changes, which are significant source of mortality and morbidity. To access the endothelial function in patients with SLE and to find the risk factors that may deteriorate that function, three indices of endothelial function were studied including: carotid artery intima/ media thickness, brachial artery diameter and endothelial dependent [EDD] and independent dilatation [EID] of the brachial artery by measuring flow mediated dilatation of the artery before and after sublingual glyceryl trinitrate. Risk factors including: SLE-dependent [disease duration. steroid use, C-reactive protein, double stranded DNA antibody [anti-dsDNA], complement [C3,C4],antibody to Sjogrens syndrome A [SSA[Ro]] and SLE independent [blood pressure, cholesterol, triglycerides, fasting blood sugar, body mass index] were also studied. Thirty women were selected with mean SLE duration was 7.1 +/- 2.6 years, the mean brachial artery diameter was 0.50 +/- 0.03 cm. and the mean carotid artery intima/media thickness was 0.8 +/- 0.03 mm. Our patients with SLE had significantly impaired endothelial dependent dilatation compared with controls. SLE patients show higher incidence of hypertension, hyperlipidemia, thicker carotid intima media thickness and brachial artery diameter. Hypertriglyceridemia, higher levels of C-reactive protein, Anti-dsDNA, SSA [Ro] antibody and lower levels of C3, C4 all are associated with thicker carotid intima/media. Severe degree of SLE is associated with significant decrease in EDD and EID of brachial artery. In conclusion SLE patients are more liable to hypertension, hypertriglyceridemia and hyperglycemia that predisposed to degenerative vascular changes. Longer SLE duration, prolonged steroid use, high fasting blood sugar, high triglycerides, C-reactive protein, antidsDNA, antiSSA [Ro] are strong predictors of endothelial dysfunction. Severe degree of SLE is associated with more impairment in endothelial dependent dilatation and endothelial independent dilatation of brachial artery