Histological changes caused by meclofenamic acid in androgen independent prostate cancer tumors: evaluation in a mouse model

ABSTRACT Meclofenamic acid is a nonsteroidal anti-inflammatory drug that has shown therapeutic potential for different types of cancers, including androgen-independent prostate neoplasms. The antitumor effect of diverse nonsteroidal anti-inflammatory drugs has been shown to be accompanied by histological and molecular changes that are responsible for this beneficial effect. The objective of the present work was to analyze the histological changes caused by meclofenamic acid in androgen-independent prostate cancer. Tumors were created in a nude mouse model using PC3 cancerous human cells. Meclofenamic acid (10 mg/kg/day; experimental group, n=5) or saline solution (control group, n=5) was administered intraperitoneally for twenty days. Histological analysis was then carried out on the tumors, describing changes in the cellular architecture, fibrosis, and quantification of cellular proliferation and tumor vasculature. Meclofenamic acid causes histological changes that indicate less tumor aggression (less hypercellularity, fewer atypical mitoses, and fewer nuclear polymorphisms), an increase in fibrosis, and reduced cellular proliferation and tumor vascularity. Further studies are needed to evaluate the molecular changes that cause the beneficial and therapeutic effects of meclofenamic acid in androgen-independent prostate cancer.

Violencia doméstica y riesgo de conducta suicida en universitarios adolescentes / Domestic violence and risk of suicidal behavior among university students

OBJETIVO: Estimar el grado de asociación entre violencia doméstica física, verbal y sexual con la conducta suicida en adolescentes universitarios. MATERIAL Y MÉTODOS: Estudio de casos y controles pareado en estudiantes universitarios de Colima. Los casos fueron 235 adolescentes que presentaron tanto ideación suicida como intento suicida; los controles fueron 470 individuos de la misma edad y sexo. RESULTADOS: El abuso sexual mostró el mayor grado de asociación con conducta suicida (RM= 27.4), seguido de violencia verbal (RM= 9.28), uso de drogas (RM= 8.6), violencia física (RM= 5.5) y tabaquismo (RM= 3.6). La regresión logística multivariada mostró que la violencia verbal se asoció con conducta suicida en forma independiente, mientras que violencia física, abuso sexual, tabaquismo y uso de drogas parecen depender de aquella. CONCLUSIONES: La violencia intrafamiliar, particularmente la verbal, está fuertemente asociada con la conducta suicida en adolescentes y debe ser considerada dentro de programas preventivos contra suicidio.

OBJECTIVE: To estimate the degree of association between domestic violence -physical, verbal or sexual- with suicidal behavior among university students. MATERIAL AND METHODS: A matched case-control study was done with students attending the University of Colima, Mexico. The cases were 235 teenagers who presented both suicidal ideation and suicide attempt; the controls were 470 individuals of the same age and sex. RESULTS: Sexual abuse showed the highest degree of association with suicidal behavior (OR= 27.4), followed by verbal violence (OR= 9.28), drug use (OR= 8.6), physical violence (OR= 5.5) and smoking (OR= 3.6). Multivariate logistic regression showed that verbal violence was associated with suicidal behavior independently of the other variables, while physical violence, sexual abuse, smoking and drug use seem to depend on verbal violence. CONCLUSIONS: Domestic violence, particularly verbal or sexual, is strongly associated with suicidal behavior in adolescents and should be considered in suicide prevention programs.

Frecuencia y factores de riesgo asociados a sobrepeso y obesidad en universitarios de Colima, México / The frequency of risk factors associated with obesity and being overweight in university students from Colima, Mexico

Objetivo Determinar la frecuencia y factores de riesgo para sobrepeso y obesidad en jóvenes universitarios. Métodos Se realizó un estudio transversal analítico en 821 alumnos inscritos de la Universidad de Colima. Entre las variables analizadas se encuentran: edad, género, alcoholismo, tabaquismo y utilización de medicamentos o sustancias para control de peso. Resultados Se estudiaron 821 alumnos (380 hombres y 441 mujeres) con una edad promedio de 20,9±2,5 años. Las frecuencias de sobrepeso y obesidad en hombres fueron de 27,8 por ciento y 14,7 por ciento y en mujeres de 17 por ciento y 5,2 por ciento. En hombres el tabaquismo (OR 2,1, IC 95 por ciento 1,4-3,8;p=0,01) y etilismo (OR 2,1, IC 95 por ciento 1,2-3,6;p=0,003), estuvieron asociados a sobrepeso y obesidad. Fueron factores protectores en ambos géneros el uso de sustancias para control de peso (OR 0,4, IC 95 por ciento 0,2-0,8;p=0,01); mientras que el control dietético fue un factor protector sólo en las mujeres (OR 2,2, IC 95 por ciento 1,1- 3,4;p=0,01). Conclusiones En estudiantes universitarios, el 31,6 por ciento presentó sobrepeso y obesidad. En hombres, el tabaquismo y etilismo se asociaron a sobrepeso y obesidad. El uso de sustancias para bajar de peso y control dietético fueron factores protectores.

Objective Determining risk factor frequency regarding obesity and being overweight in university students. Methods A cross-sectional analytic study was carried out on 821 students from the University of Colima. Some variables analysed were age, gender, alcoholism, smoking and weight-control drug use. Results 821 students were included (380 male, 441 female), 20.9±2.5 average age. 27.8 percent of males were overweight and 14.7 percent suffered from obesity; this was 17 percent and 5.2 percent in females, respectively. Smoking (2.1 OR; 1.4-3.8 95 percent CI; p=0.01) and alcoholism (2.1 OR; 1.2-3.6 95 percent CI; p=0.003) were associated with being overweight and being obese. Weight-control drug use was a protective factor in both genders (0.4 OR; 0.2-0.8 95 percent CI; p=0.01); diet control was only a protective factor in women (2.2. OR; 1.1-3.4 95 percent CI; p=0.01). Conclusions 31.6 percent of university students were overweight and suffered from obesity. Smoking and alcoholism in males were associated with being overweight and suffering from obesity. Weight-control and diet-control drug use were protective factors.

Peritonitis bacteriana espontánea por Listeria monocytogenes, en un paciente con cirrosis hepática: Caso clínico / Spontaneous bacterial peritonitis caused by Listeria in a patient with cirrhosis: Case report

Infections caused by Listeria monocytogenes are usually found in cattle and occasionally appear in humans, particularly pregnant women and immunocompromised individuals. Peritonitis by Listeria monocytogenes is a rare but dangerous condition that must be recognized early, since it requires a specific treatment. We report a 31 year-old male with alcoholic cirrhosis that developed ascites with abdominal pain and fever. The peritoneal fluid culture yielded Listeria monocytogenes. The patients was initially treated with cefotaxim and later with ampicillin and levofloxacin. The patient voluntarily abandoned treatment and died at home two weeks later.

Reporte de un caso de dengue neonatal / Neonatal dengue. Case report

Introducción. Existe poca información sobre los efectos por dengue en el embarazo y feto, a pesar de que el riesgo se incrementa durante epidemias, por lo cual los reportes son pocos a pesar del número documentadas de éstas en países tropicales. La transmisión vertical del dengue se ha descrito poco. En Colombia se reportó una frecuencia de 0.3% en 10 años en recién nacidos y ningún caso en Guinea. Caso clínico. Nace al quinto día de enfermedad febril materna, parto eutócico, de 40 semanas, masculino, calificación de Apgar 8/9 en tiempos convencionales, peso, talla y perímetro cefálico en percentil 50, exploración física normal. Al tercer día de vida (octavo día de dengue hemorrágico materno), presentó fiebre, se sospechó sepsis neonatal y se inició antibióticos; al cuarto día de vida requirió fototerapia y presentó leucopenia, irritabilidad, llanto intenso e hiperreflexia, con sospecha de neuroinfección. Se agregó cefotaxima (sin punción lumbar por trombocitopenia y TPT prolongado). Hemocultivo negativo. Serología IgM positiva para virus del dengue del binomio madre-producto. A los 12 días de vida se encuentra asintomático y con exámenes de laboratorio normales. Conclusión. Las embarazadas con dengue clásico por lo general presentan un parto y puerperio normales, como en este caso. En el dengue hemorrágico existe mayor riesgo de retardo en el crecimiento intrauterino, amenazas de aborto y parto pretérmino, ruptura prematura de membranas, preeclampsia y muerte materno-fetal.

Introduction. There is little information about the effects of dengue infection upon the fetus, although the risk for this event increases during epidemic outbreaks. The vertical transmission of dengue is a rare event, a case is described below. Case report. The patient was a male, born after 40 weeks of gestation and on the 5th day of a maternal febrile illness. His Apgar score was 8/9, with weight, size and cephalic perimeter in the range of the 50 percentile. On the first 24 hours after the delivery the patient developed fever and antibiotics was given for neonatal sepsis. On the postpartum day 4 he showed irritability, intense crying and hypereflexia, meanwhile the laboratory revealed thrombocytopenia and leucopoenia. Neuroinfection was presumed and treatment with phototherapy and cefotaxime was begun (the lumbar puncture was avoided because thrombocytopenia and prolonged TPT). The blood culture was negative. IgM antibodies for dengue virus were positive in both, mother and neonate. On postpartum day 12, both, mother and child were discharged from the hospital, asymptomatic and with normal laboratory values. Conclusions. Usually, pregnant women with classic dengue have normal parturition and puerperium, as in this case. However, in the hemorrhagic dengue form there is an increased risk of delayed intrauterine growth, abortion, prematurity, premature rupture of membranes, preeclampsia and maternal or fetal death. The neonatal transmission of dengue is very rare, even in endemic countries with large epidemics; however it is an important condition that needs to be considered in the differential diagnosis of septic new-borns in endemic areas.

Reporte de cinco casos pediátricos de histoplasmosis diseminada / Systemic histoplasmosis. Report of five pediatric cases

Introducción. La histoplasmosis constituye la micosis sistémica de mayor prevalencia en el ser humano, predomina en menores de 2 años de edad y en pacientes inmunodeprimidos. Caso clínico. Los 5 casos encontrados fueron del sexo femenino. Las edades variaron de 30 meses a 16 años. La enfermedad principal de los pacientes fue VIH/SIDA en 3/5 casos, lupus eritematoso sistémico 1 caso. El cuadro clínico incluyó: fiebre, tos, dificultad respiratoria, hepatoesplenomegalia, trastornos hematológicos con anemia, leucopenia o trombocitopenia. Las radiografías de tórax mostraron imágenes nodulares múltiples diseminadas a ambos campos pulmonares. Los pacientes fueron manejados con anfotericina B, y todos fallecieron. Las muestras que mostraron Histoplasma capsulatum fueron biopsia de médula ósea y lavado bronquioalveolar. Conclusiones. La histoplasmosis sistémica se asoció en pacientes pediátricos con deterioro del sistema inmunológico, con manifestaciones caracterizadas por síndrome infeccioso, infiltrativo y afección pulmonar, por lo que se debe prestar especial atención a esta etiología en la población en riesgo (especialmente pacientes con VIH/SIDA).

Introduction. Histoplasmosis is one of the most prevalent systemic mycosis in humans. Those younger than 2 years of age, and individuals whose immune systems are compromised, are more likely to develop symptoms. Case reports. All 5 cases were female. The ages of the patients varied from 30 months to 16 years. Concomitant diseases included HIV infection (3) and lupus erythematosus (1). Clinical symptoms were: fever, cough, respiratory distress and hepatosplenomegaly. All had hematologic disorders, anemia, decreased leukocytes count and decreased platelets. Chest roentgenogram showed multiples infiltrates. All the patients received amphotericin B, and all of them died. The clinical specimens that showed Histoplas-ma capsulatum were bone marrow biopsy and bronchoalveolar lavage. Conclusions. Systemic histoplasmosis was associated with patients with deteriorated immunologic system. The patients had clinical evidence of infection, respiratory symptoms and pulmonary infiltrates. In immunocompromised patients with signs and symptoms suggestive of histoplasmosis, empiric antifungal therapy is warranted.

Hemoglobin measured by Hemocue and a reference method in venous and capillary blood: a validation study

Objective. To assess the comparability of hemoglobin concentration (Hb) in venous and capillary blood measured by Hemocue and an automated spectrophotometer (Celldyn) and to document the influence of type of blood (capillary or venous) and analysis method on anemia prevalence estimates. Material and Methods. Between February and May 2000, capillary and venous samples were collected from 72 adults and children at Hospital del Niño Morelense (Morelos State Children's Hospital) in Cuernavaca, Morelos, Mexico, and assessed for Hb using the Hemocue and Celldyn methods. Estimated Hb levels were compared using the concordance correlation coefficient and Student's t test for paired data. The sensitivity and specificity for anemia diagnosis were estimated and compared between type of blood and method of assessment. Results. Capillary blood had higher Hb (+0.5g/dl) than venous blood in adults and children, as did samples assessed by Celldyn compared to Hemocue (+0.3g/dl). Specificity to detect anemia was adequate (>0.90) but sensitivity was low for capillary blood assessed by Hemocue (<0.80). Conclusions. The difference in Hb between venous and capillary blood is likely related to biological variability. Hemoglobin concentration in capillary blood assessed by Hemocue provides an adequate estimation of population anemia prevalence but may result in excess false negative diagnoses among individuals. The results of this study stress the importance of sample collection technique, particularly for children. Method of analysis and sampling site need to be taken into consideration in field studies.

Objetivo. Evaluar la comparabilidad de la concentración de hemoglobina (Hb) en sangre venosa y capilar medida por Hemocue y por espectrofotómetro automatizado (Celldyn), así como documentar la influencia del tipo de sangre (capilar o venosa) y del método de análisis sobre la prevalencia de anemia. Material y métodos. De febrero a mayo de 2000, se recolectaron muestras de sangre capilar y venosa en 72 adultos y niños en el Hospital del Niño Morelense, Cuernavaca, Morelos, México. Se determinaron los niveles de Hb con los métodos Hemocue y Celldyn. Las cifras de Hb estimadas se compararon con el coeficiente de concordancia y la prueba pareada de t de Student. También se comparó la sensibilidad y especificidad para el diagnóstico de anemia, utilizando sangre de los dos tipos y métodos de análisis. Resultados. La Hb fue mayor en sangre capilar comparada con sangre venosa (+0.5g/dl) en adultos y niños, y en las determinaciones por Celldyn comparadas con las de Hemocue (+0.3 g/dl). La especificidad para el diagnóstico de anemia fue adecuada (>0.90), mientras que la sensibilidad fue baja para las muestras capilares medidas por Hemocue (<0.80). Conclusiones. Es probable que la diferencia en la Hb entre sangre venosa y capilar refleje variabilidad biológica. La Hb en sangre capilar medida por Hemocue provee una estimación adecuada de la prevalencia de anemia en poblaciones, pero podría resultar en un exceso de diagnósticos falsos negativos. Los resultados de este estudio ponen énfasis en la importancia de la técnica de recolección de la muestra, particularmente en niños. Los métodos de análisis y tipos de muestra de sangre deben ser tomados en cuenta en estudios de campo.

Resurgimiento de enfermedad hemorrógica del recién nacido. Implicaciones para su prevención / Re-emergence of hemorrhagic disease in newborns. Implications for its prevention

OBJECTIVE: To describe the occurrence of hemorrhagic disease of the newborn (HDN) at a tertiary care pediatric hospital of Morelos state. MATERIAL AND METHODS: A retrospective case series study was conducted between 1997-2000 at Hospital del Niño Morelense (Morelos State Children's Hospital), in 46 newborns aged under 12 weeks. Study subjects were referred from peripheral units with a diagnosis of HDN. RESULTS: The severe late-onset form of HDN was present in 91 of the cases. Fifty-two percent of childbirths were assisted by a physician and 48 by an empiric midwife. Application of vitamin K was unknown in 61 of cases, in 39 it was not applied and in 4 it was applied. The majority of infants presented severe symptoms due to intra-cranial bleeding, 11 died, and 41 had severe disease sequelae. CONCLUSIONS: Given the high prevalence of HDN in the State of Morelos, reproductive health programs should be reviewed and training programs intensified to promote the utilization of vitamin K by physicians and nurses for preventing this disease.

Estudio multicéntrico abierto con ibuprofeno (Motrin) para valorar eficacia y tolerancia clínica como antipirético en Niños / Open multicentric investigation with ibuprofeno (Motrin) to evaluate efecctiveness and clinical tolerance as antipiretic in children

Se realizó un estudio abierto, prospectivo, multicéntrico, para evaluar la eficacia y tolerancia clínica del ibuprofeno como antipirético en niños de 6 meses a 6 años de edad. Se incluyeron 203 niños con fiebre de etiología diversa en cinco centros. Se administró dosis inicial de ibuprofeno calculada a 10 mg/kg. Se registró la temperatura ótica (termómetro digital) antes de la administración del medicamento y a los 10, 20, 30 y 45 minutos, después de una hora, y en cada hora hasta completar 8 horas. Los resultados indican que la fiebre disminuye significativamente (p<0.01) desde los 10 minutos después de la administración de ibuprofeno, y que tiene 88.6 por ciento de eficacia a las 8 horas. Se administró una segunda dosis si a las 6 horas había disminución de la temperatura pero sin normalización (= 38.1ºC). El índice de falla terapéutica fue de 5.5 por ciento, y en cuanto a tolerancia clínica, sólo 2 pacientes (1 por ciento) presentaron hipotermia que se resolvió sin medicamentos. En 23 pacientes (11.33 por ciento) se requirió de una segunda dosis por no lograr la normalización a pesar de haber conseguido disminución de la temperatura. En conclusión, con base en los resultados de este estudio, se puede afirmar que el ibuprofeno es altamente efectivo como antipirético en iños con fiebre de diversa etiología, con un excelente perfil de tolerancia clínica.