Remimazolam: ¿el agente ideal para sedación, inducción y mantenimiento de la anestesia? / Remimazolam: the ideal agent for sedation, induction and maintenance of anesthesia?

Resumen: El remimazolam es una nueva benzodiacepina que combina las propiedades farmacológicas de dos agentes utilizados en la anestesia: el efecto hipnótico del midazolam y el metabolismo del remifentanilo. El remimazolam se hidroliza por esterasas tisulares inespecíficas a metabolitos inactivos, permitiendo una alta depuración y recuperación rápida. Por sus propiedades farmacológicas, se ha propuesto su uso como un agente de acción ultracorta en procedimientos de sedación fuera de quirófano, inducción, mantenimiento de la anestesia y de sedación en la unidad de terapia intensiva. El perfil de seguridad del remimazolam es amplio, ya que sus efectos hemodinámicos y cardiorrespiratorios son menos marcados que otros fármacos empleados en dichos procedimientos. Como otras benzodiacepinas, los efectos del remimazolam pueden ser revertidos con flumazenil. Hasta el momento, el remimazolam ha demostrado ser un agente hipnótico eficaz; sin embargo, se requiere mayor investigación para establecer su utilidad clínica.

Abstract: Remimazolam is a new benzodiacepine that combines the pharmacological properties of two agents used in anesthesia: the hypnotic effect of midazolam and the metabolism of remifentanyl. Remimazolam is hydrolized by nonspecific tissue esterases into inactive metabolytes, allowing high clearance and fast recovery. Due to its pharmacological characteristics, it has been proposed as an ultra- short acting agent for sedation out operating room, induction and maintenance of anesthesia, as well as for sedation in the Intensive Care Unit. Remimazolam has an elevated safety profile, as it might that, it has less pronounced hemodynamic and cardiorespiratory effects in contrast to other drugs used in the same procedures. Like other benzodiacepines, remimazolam effects can be reversed with flumazenil. Remimazolam has proven to be an effective hypnotic agent, however further research and clinical evaluation is required to establish its use.

The effectiveness of serum S100B, TRAIL, and adropin levels in predicting clinical outcome, final infarct core, and stroke subtypes of acute ischemic stroke patients / Eficacia de los niveles séricos de S100B,TRAIL y adropina para predecir el resultado clínico, el núcleo del infarto final y los subtipos de ataque cerebrovascular de los pacientes con accidente cerebrovascular isquémico agudo

Introduction: More than half of all worldwide deaths and disabilities were caused by stroke. Large artery atherosclerosis is identified as a high etiological risk factor because it accounts for 20% of ischemic stroke. Objectives: To identify the significance of TRAIL and adropin release and the relative changes related to S100B levels, as well as the relationship between these biomarkers and the final infarct core, the clinical outcome, and the presence of large artery atherosclerosis in acute stroke patients. Materials and methods: Over a one-year period, demographic, clinical, and neuroimaging findings of 90 consecutive patients with acute ischemic stroke were evaluated. Results: The mean age of participants was 69.28 ± 10 and 39 patients were female. The increased level of S100B and the decreased levels of sTRAIL with adropin were significantly associated with moderate to severe neurologic presentation (p=0.0001, p=0.002, p=0.002, respectively). On the control CT, a large infarct core was significantly associated with decreased serum levels of sTRAIL and adropin (p=0.001 and p=0.000, respectively); however, the levels of S100B were not significantly associated with good ASPECTS score (p=0.684). Disability and an unfavorable outcome were significantly related to the decreased level of sTRAIL and adropin (p=0.001 and p=0.000 for THRIVE score>5, respectively). Decreased sTRAIL and adropin levels and an increased S100B level were correlated with the presence of large artery atherosclerotic etiologic factors (p=0.000, p=0.000, p=0.036, respectively). Conclusion: TRAIL and adropin serum levels were associated with poor clinical outcomes and greater infarcted area in acute ischemic stroke patients.

Introducción. Más de la mitad de todas las muertes y discapacidades en todo el mundo fueron causadas por accidentes cerebrovasculares. La aterosclerosis de las grandes arterias se identifica como un factor de alto riesgo etiológico debido a que representa el 20 % de los accidentes cerebrovasculares isquémicos. Objetivo. Determinar la importancia de la liberación de TRAIL y adropina y los cambios relativos relacionados con los niveles de S100B, así como la relación entre estos biomarcadores y el núcleo final del infarto, el resultado clínico y la presencia de aterosclerosis de arterias grandes en pacientes con accidente cerebrovascular agudo. Materiales y métodos. Durante un año, se evaluaron los hallazgos demográficos, clínicos y de neuroimágenes de 90 pacientes con accidente cerebrovascular isquémico agudo. Resultados. La edad media de los pacientes fue de 69,28 ± 10 y 39 eran mujeres. El aumento del nivel de S100B y la disminución de los niveles de sTRAIL y adropina se asociaron significativamente con una presentación neurológica moderada a grave en los pacientes (p=0,0001, p=0,002 y p=0,002, respectivamente). En la TC de control, un gran núcleo de infarto se asoció significativamente con una disminución del nivel sérico de sTRAIL y adropina (p=0,001 y p=0,000, respectivamente); sin embargo, los niveles de S100B no se asociaron significativamente con una buena puntuación en el ASPECT (p=0,684). La discapacidad y el resultado desfavorable se relacionaron significativamente con la disminución de los niveles de sTRAIL y adropina (p=0,001 y p=0,000 para una puntuación >5 en el THRIVE, respectivamente). La disminución de los niveles de sTRAIL y adropina y el aumento del nivel de S100B, se correlacionaron con la presencia de un factor etiológico aterosclerótico de arterias grandes entre la población de estudio (p=0,000, p=0,000 y p=0,036, respectivamente). Conclusiones. Los niveles séricos de TRAIL y adropina se asociaron con un resultado clínico deficiente y una mayor área infartada en pacientes con ataque cerebrovascular isquémico agudo.

Combined effect of corn in the barrier crop and plant extracts against Cowpea mild mottle virus infecting soybean [Glycine max (L. ) Merr. ] in the field

Cowpea mild mottle virus (CpMMV) is one of the problems that can decrease soybean production. The research was conducted on the combined effects of corn in the barrier crop with plant extracts against CpMMV infecting soybean in the field. The field data was conducted using a Completely Randomized Design. The mean of disease incidence and disease severity is measured from total plants in each replicate plot on each treatment. Planting one or two of corn lines were grown at the edge four weeks before planting soybeans. Cashew nut shell (CNS), pagoda leaf, and rhizome of ginger extracts were applied using the sprayer and applied at 24 h before virus acquisition and transmission by whiteflies. The result showed that the virus incubation period ranged from 9−38 days after transmission longer than the untreated control. Planting two corn lines at the edge with CNS extract as bioactivator on soybean was the most extended incubation period of the virus and the lowest absorbance value DAS-ELISA of 0.20. There was a 73.11 % increase in the relative inhibition level of the virus. Planting corn at the edge with CNS extract proved to be more effective than soybean monoculture with CNS extract. However, soybean monoculture with CNS extract provides a better relative inhibition level of the virus (64.32 %) than planting two rows of corn on the edge combined with ginger of rhizome extract and planting two rows of corn on the edge with pagoda leaf extract as bioactivator on a soybean plant.

The mechanism of plant gall induction by insects: revealing clues, facts, and consequences in a cross-kingdom complex interaction

Galls are defined as modifications of the normal developmental design of plants, produced by a specific reaction to the presence and activity of a foreign organism. Although different organisms have the ability to induce galls in plants, insect-induced galls are the most elaborate and diverse. Some hypotheses have been proposed to explain the induction mechanism of plant galls by insects. The most general hypothesis suggests that gall formation is triggered by the action of chemical substances secreted by the gall inducer, including plant growth regulators such as auxins, cytokinins, indole-3-acetic acid (IAA), and other types of compounds. However, the mode of action of these chemical substances and the general mechanism by which the insect could control and manipulate plant development and physiology is still not known. Moreover, resulting from the complexity of the induction process and development of insect galls, the chemical hypothesis is very unlikely a complete explanation of the mechanism of induction and morphogenesis of these structures. Previous and new highlights of insect gall systems with emphasis on the induction process were analyzed on the basis of the author's integrated point of view to propose a different perspective of gall induction, which is provided in this article. Due to the extraordinary diversity of shapes, colors, and complex structures present in insect galls, they are useful models for studying how form and structure are determined at the molecular level in plant systems. Furthermore, plant galls constitute an important source of material for the study and exploration of new chemical substances of interest to humans, due to their physiological and adaptive characteristics. Considering the finely tuned control of morphogenesis, structural complexity, and biochemical regulation of plant galls induced by insects, it is proposed that an induction mechanism mediated by the insertion of exogenous genetic elements into the genome of plant gall cells could be involved in the formation of this kind of structure through an endosymbiotic bacterium.

Las agallas se definen como modificaciones del diseño y desarrollo normal de las plantas debido a una reacción específica a la presencia y actividad de un organismo foráneo. Aunque diferentes grupos de organismos tienen la habilidad de inducir agallas en plantas, las agallas inducidas por insectos son las más elaboradas y diversas. Algunas hipótesis han sido propuestas para explicar el mecanismo de inducción de las agallas de insectos. La hipótesis más general sugiere que la formación de las agallas es disparada por la acción de sustancias químicas secretadas por el insecto inductor, incluyendo reguladores de plantas como auxinas, citoquininas, ácido-3-indolacético (AIA) o bien otros tipos de compuestos. No obstante, el modo de acción de estas sustancias químicas y el mecanismo general por medio del cual el insecto podría controlar y manipular el desarrollo y fisiología de la planta es aún desconocido. Más aún, como resultado de la complejidad del proceso de inducción y desarrollo de las agallas de plantas inducidas por insectos, la hipótesis química es una explicación insuficiente e incompleta en relación con el mecanismo de inducción y morfogénesis de estas estructuras. Previas y nuevas evidencias relacionadas con el sistema de agallas de insectos, con énfasis en el proceso de inducción, fueron analizadas desde un punto de vista integral del autor para proponer en este artículo una perspectiva diferente sobre la inducción de este tipo de estructuras. Debido a la extraordinaria diversidad de formas, colores y estructuras complejas presentes en las agallas de insectos, las mismas constituyen modelos útiles para estudiar cómo la forma y la estructura son determinadas a nivel molecular en los sistemas vegetales. Además, las agallas de plantas son un importante origen de material para el estudio y exploración de nuevas sustancias químicas de interés humano, debido a las características fisiológicas y adaptativas que presentan. Considerando el control fino del proceso de morfogénesis, regulación bioquímica y complejidad estructural de las agallas de insectos, se propone que un mecanismo de inducción mediado por la inserción de elementos genéticos exógenos dentro del genoma de las células de la planta que forman la agalla podría estar involucrado en la formación de este tipo de estructuras, vía una bacteria endosimbiótica.

Endozoochory by Didelphis albiventris Lund, 1840 (Mammalia, Didelphimorphia) in a Semideciduous Seasonal Forest remnant in the South of Brazil / Endozoocoria por Didelphis albiventris Lund, 1840 (Mammalia, Didelphimorphia) em remanescente de Floresta Estacional Semidecidual no sul do Brasil

Abstract Seed dispersal is a process that is fundamental to maintenance of forest ecosystems, enabling plants to successfully germinate in sites that are favorable to their growth, minimizing risks of competition, the action of pathogens and predation by herbivores. Intraspecific and seasonal variations in fruit consumption by Didelphis albiventris, and its contribution to dispersal and germination of endozoochorous seeds were analyzed in a Semideciduous seasonal forest. The study was conducted at Morro do Coco, which is a hilly area in the municipal district of Viamão, RS, Brazil, bordering the shore of Guaíba lake (30º16'15"S, 51º02'54"W), between June 2013 and May 2014, with a total sampling effort of 2992 trap-nights. A total of 18 individuals were captured and 24 fecal samples were collected. Fruits were identified in 96% of the samples, corresponding to 18 plant species, belonging to 10 families. The most common species were Ficus cestrifolia and Syagrus romanzoffiana, which occurred in 66% of the samples, followed by Banara parviflora and Cecropia pachystachya, both with a 25% rate of occurrence. There were no differences between the richness of fruit consumed by males and females (t = 0.083; DF = 32; p = 0.934) and there were no seasonal variations (H = 3.165; p = 0.367). The greatest breadth of dietary niche occurred during the summer, when twice as many fruit species were recorded in the diet than during the autumn, which was the season with the smallest breadth. Both germination percentage and germination velocity of Ficus cestrifolia and Psidium sp. seeds increased after passage through the animals' digestive tracts (percentage germination increased more than 40% and velocity was up to 7 times highest). Didelphis albiventris can be considered a frugivorous-omnivorous species, since fruit are an important item of its diet, and it contributes to dispersal of a large quantity of small endozoochorous seeds, increasing both germination percentage and germination velocity of some species.

Resumo A dispersão de sementes é um processo fundamental à manutenção de ecossistemas florestais, favorecendo o sucesso germinativo de plantas em locais adequados ao seu crescimento, minimizando a competição, a ação de patógenos e a predação por herbívoros. Variações intra-específicas e sazonais no consumo de frutos por Didelphis albiventris, bem como sua contribuição à dispersão e germinação de sementes endozoocóricas foram avaliados em Floresta Estacional Semidecidual. O estudo foi realizado no Morro do Coco, localizado no município de Viamão, RS às margens do Lago Guaíba (30º16'15"S, 51º02'54"W), entre junho de 2013 a maio de 2014, resultando em um esforço amostral de 2992 armadilhas-noite. Foram capturados 18 indivíduos e coletadas 24 amostras fecais. Frutos estiveram presentes em 96% das amostras e corresponderam a 18 espécies vegetais, pertencentes a 10 famílias. As espécies mais frequentes foram Ficus cestrifolia e Syagrus romanzoffiana, que ocorreram em 66% das amostras, seguidas de Banara parviflora e Cecropia pachystachya, ambas com 25% de ocorrência. Machos e fêmeas não diferiram quanto à riqueza de frutos consumidos (t = 0.083; DF = 32; p = 0.934), o que também não variou sazonalmente (H = 3.165; p = 0.367). A maior amplitude de nicho trófico ocorreu no verão, registrando-se duas vezes mais frutos na dieta do que no outono, estação com a menor amplitude. Tanto a porcentagem quanto a velocidade de germinação das sementes de Ficus cestrifolia e Psidium sp. aumentaram após a passagem pelo trato digestório do animal (a porcentagem de germinação aumentou mais de 40% e a velocidade foi até 7 vezes maior). Didelphis albiventris pode ser considerada uma espécie frugívora-onívora, uma vez que frutos representam um item importante na dieta, e contribui para a dispersão de grande quantidade de sementes endozoocóricas pequenas, aumentando tanto o percentual quanto a velocidade de germinação de algumas espécies.

Fístula cutánea: un caso clínico / Cutaneous fistula: a clinical case

Objetivo: diagnosticar y tratar la presencia de una fístula cutánea. Caso clínico: un paciente de sexo masculino, de 9 años de edad, consultó por una lesión cutánea en la zona mandibular del lado izquierdo. Concusiones: una fístula cutánea requiere un diagnóstico diferencial preciso, a fin de determinar su etiología y planificar el procedimiento endodóntico correcto. Como consecuencia de una mortificación pulpar, la presencia de bacterias dentro del conducto radicular puede generar una periodontitis perirradicular crónica de origen endodóntico.

Ensino sem erro e aprendizagem de discriminação / Errorless learning and discrimination learning / Aprendizaje sin error y la discriminación aprendizaje

O termo aprendizagem sem erro tem sido utilizado para se referir, de maneira ampla, à programação de contingências de ensino que resultam em desempenhos precisos ou com pouco erro. A ocorrência de erros durante a aprendizagem tem sido considerada uma parte importante e necessária à aprendizagem na cultura e no meio acadêmico. Na Análise do Comportamento os erros e suas implicações para a aprendizagem são investigados em estudos sobre controle de estímulos e os resultados indicam que erros podem interferir na precisão de desempenhos já aprendidos, gerar comportamentos emocionais, esquiva da tarefa e/ou do professor. Neste estudo, são apresentados diferentes procedimentos de modificação gradual de estímulos para ensinar discriminações, que podem gerar aprendizagem sem erro, e os fatores que afetam a eficácia dessas contingências de ensino. Esses procedimentos necessitam ser mais amplamente divulgados, por serem contribuições importantes da Análise do Comportamento para contextos aplicados, especialmente para o desenvolvimento de tecnologias de ensino quando métodos tradicionais fracassam.

The term errorless learning is largely used to refer to programming teaching contingencies which result in accurate performances or learning without errors. The occurrence of errors during learning has been considered an important and necessary part of learning in cultural and academic contexts. Errors and their implications for learning are investigated in behavioral analytic studies on stimuli control and their results indicate that errors can affect the accuracy of an already established performance, generate emotional behaviors, and avoidance of the task or teacher. The present study describes different procedures with gradual stimulus change, to teach discrimination skills with none or few errors, and the factors that affect the efficacy of those discriminative training. Such procedures are a relevant contribution from behavior analysis to applied contexts, especially for the development of educational technologies when traditional methods fail.

El término aprendizaje sin error se ha utilizado para referirse, en general, la programación de contingencias de enseñanza que se traducen en rendimientos precisos o con poco errores. La ocurrencia de errores durante el aprendizaje se ha considerado importante y necesario para el aprendizaje en la cultura y en la academia. En el Análisis de la Conducta errores y sus implicaciones para el aprendizaje son investigados en los estudios sobre control de estímulos y los resultados indican que errores puede afectar la precisión de rendimiento ya aprendido, generar comportamientos emocionales, evitación de la tarea o del maestro. En este texto, se presentarán diferentes procedimientos de modificación gradual de estímulos para enseñar la discriminación, que puede generar el aprendizaje sin error y los factores que afectan la efectividad de estas contingencias. Estos procedimientos deben difundirse más ampliamente, constituyen importantes contribuciones para contextos de análisis aplicado del comportamiento, especialmente para el desarrollo de tecnologías educativas cuando fallan los métodos tradicionales.

Tumor mesenquimatoso fosfatúrico de fosa nasal con compromiso intracraneano: reporte de un caso y revisión de la literatura / Nasal fossa phosphaturic mesenchymal tumor with intracraneal compromise: case report and review of the literature

El tumor mesenquimatoso fosfatúrico (TMF) es una enfermedad extremadamente rara. Según evidencia reciente es causado por la sobreexpresión del factor de crecimiento fibroblástico 23 (FGF23), el cual genera hipofosfemia y osteomalacia. A continuación presentamos el caso de un paciente de 42 años con un tumor mesenquimatoso fosfatúrico de fosa nasal izquierda con extenso compromiso intracraneano. Cabe destacar que hasta la fecha hay 142 casos reportados de TMF en la literatura de los cuales solo 11 se ubican en fosa nasaly cavidades sinusales, y sólo dos de ellos ubicados en fosa nasal¹. El paciente tuvo una exitosa resolución quirúrgica con la consecuente normalización de parámetros analíticos (incluido el FGF23), mejoría sintomática y ausenia de recidiva hasta la fecha.

The phosphaturic mesenchymal tumor (PMT) is an extremely rare disease. According to recent evidence is caused by overexpression of fibroblast growth factor 23 (FGF23) which generates hypophosphatemia and osteomalacia. We report the case of a 42 year old patient with a left nasal fossa phosphaturic mesenchymal tumor with intracranial involvement. Should be noted that to date there are 142 reported cases of PMT in the literature of which only 11 are located in nasal fossa and sinus cavities, two of them located in nasal fossa¹. The patient had a successful surgical resolution with consequent normalization of analytical parameters (including FGF23), absence of symptoms and no recurrence to date.

Effects from mechanical stimulation and osteogenic chemical inductor on osteoblastic differentiation of rat bone mesenchymal stem cells / 医用生物力学

Objective To investigate the effect from mechanical stimulation and osteogenic chemical inductor on osteoblastic differentiation markers and formation of calcified nodules in rat bone mesenchymal stem cells (rBMSCs). Method The rBMSC were cultured in medium contained with or without osteogenic chemical inductor. The cyclic biaxial mechanical strain (2%), at a frequency of 1 Hz, was applied to the rBMSCs for periods of 2 hours each time, at intervals of 2 hours, 3 times every day, lasting 3 days and 6 days, respectively. The mRNA expression of alkaline phosphatase (ALP), collagen type I (COL I) and osteocalcin (OCN) were analyzed with real time fluorescent quantitation reverse transcription polymerase chain reaction(qRT-PCR) and formation of calcified nodules were detected with alizarin red staining method. Results The mRNA expression of ALP, COL I and OCN were significantly increased in induced group compared with that in the corresponding uninduced group and calcified nodule was observed in the osteogenic chemical inductor group after 6 days with mechanical stimulation. Conclusions Osteogenic chemical inductor and mechanical stimulation can promote the osteoblastic differentiation of rBMSCs.

Effect of ionizing radiation combined with inhibitors or inducer of autophagy and apoptosis on MCF7 cell / 中华放射医学与防护杂志

Objective To detect the inhibiting effects of ionizing radiation combined with inhibitors or inducer of autophagy and apoptosis on MCF7 cell line,and to provide the evidence for human breast cancer therapy radiation.Methods MCF7 cells were exposed to X-rays and randomly divided into 4 groups,including 0 Gy,4 Gy,4 Gy+rapamycin,4 Gy+3-MA,and 4 Gy+z-VAD-fmk groups,including 0 Gy,4 Gy,4 Gy+rapamycin,4 Gy+3-MA,and 4 Gy+z-VAD-fmk groups,respectively.The growth doubling time was calculated by MTT method.The specific protein expressions of LC3 autophagy and beclinl were detected by using Western blot and the difference of Drotein contents wasLC3 autophagy and beclinl were detected by using Western blot and the difference of Drotein contents was compared.The percentage of apoptosis of MCF7 cells was measured by flow cytometry (FCM).Resuits The growth doubling time of MCF7 cells in 4 Gy group wag longer than that in O Gy group(t=4.41,P<O.05),but shorter than that in 4 Gy+rapamycin group(t=4.35,P<0.05).Compared to 4 Gy+rapamycin group,both of the growth doubling time in 4 Gy+3-MA and 4 Gy+z-VAD-fmk groups were shorter(t=4.32,P<O.05).The expressions of beclinl and LC3-Ⅱ proteins in 4 Gy+rapamycin group were the highest,while those in 4 Gy+3-MA group the lowest.Except for 4 Gy+3-MA and 4 Gv+z-VAD-fmk groups,there were significant differences among the other groups in two protein expressions(t=3.9 1-4.78,P<0.05).Conclusions Ionizing radiation could induce MCF7 cell autophagy,ptomote the apoptosis of tumor ceils in combination with autophagy inducer.Ionizing radiation combined with autophagy inhibitor might inhibit the development of autophagy,and delay the apoptosis of tumor cells.

Conducta suicida en pacientes atendidos en un Centro de Urgencias / Suicide conduct in patients attended at an emergency center

Se estudiaron 85 pacientes que realizaron intento suicida y se atendieron en el Centro de Urgencias del Hospital Militar Central "Dr. Carlos J. Finlay", durante enero y junio de 2003. Predominó el sexo femenino (57 %), con edades entre 10 y 19 años (35 %), pertenecientes a la raza blanca, escolaridades de secundaria terminada (49 %), seguidas del nivel medio superior, dedicadas preferentemente al estudio o como amas de casa. El conflicto inductor principal estuvo asociado con problemas relacionados con el grupo primario de apoyo (46 %), seguido de los problemas relacionados con el ambiente familiar, con antecedentes patológicos personales y familiares de trastornos psiquiátricos, así como de intentos suicidas. El método más empleado fue el uso de psicofármacos, seguido de otras sustancias, y después de realizado el acto, solicitaron ayuda. Como trastornos psiquiátricos predominaron los trastornos situacionales, seguidos de los trastornos de personalidad. La conducta tomada por el terapeuta en primera opción fue la de remitir al paciente a su área de atención primaria, seguida de la decisión de ingresarlo.

85 patients who attempted suicide and received attention at the Emergency Center of "Dr. Carlos J. Finlay" Military Central Hospital from January to June 2003, were studied. There was a prevalence of white females (57 %) with ages between 10-19 years old (35 %) and middle level education concluded (49 %), followed by higher middle level. Most of them were students or housewives. The main conflict inducing them to take this decision was associated with problems related to the primary support group (46 %), followed by the problems related to family environment, with personal and family pathological history of psychiatric disorders, as well as with suicide attempts. . The most used method was the use of psychotropic drugs and other substances. After attempting suicide, they asked for help. Among the psychiatric disorders, it was observed a predominance of the situational disorders , followed by the personality disorders. The first option used by the therapist was to refer the patient to his primary health care area, whereas the second one was to hospitalize him.

Dexametasona: inductor de maduración pulmonar fetal / Dexametasone: fetal lung maduration inductor

La incierta prevención del parto pretérmino, por el vacío científico aún existente, nos hace responsables de mejorar las condiciones de adaptación a la vida extrauterina en neonatos prematuros, lo que facilitaremos mediante inducción de maduración pulmonar fetal, administrándole sustancias idóneas en toda patología que sospechemos exista probabilidad de obtener un producto de 24 a 34 semanas de gestación. Han sido numerosas las sustancias usadas como inductor de maduración pulmonar; pero los glucocorticoides de maduración como la dexametasona por su acción anatómica y fisiológica son los que mejores efectos han demostrado. Por esta razón debemos conocer los mecanismos de acción, indicaciones, contraindicaciones, beneficios y efectos adversos de su uso dentro de los esquemas de prematuridad.

The uncertain prevention of preterm delivery, because of the existence of a scientific emptiness make us responsible to improve the adaptative conditions to extrauterine life in preterm neonates. This will be facilitated trough induction of fetal lung maduration. A lot of substances have been used as inductors, but corticoids as dexametasone are the best, for their anatomic and physiologic actions. For this reason, we should know the mechanisms of action, indications, contraindications, benefits and adverse reactions of their use in the prematurity schemes.

A cliucal observation of treatment with bifdobiogen in early neonatal hyperbilirubinemia / 中国综合临床

Objective To compare the effects of bifidobiogen with enzyme inductor(luminal, nikethamidum) in treatment early neonatal hyperbilirubinemia. Methods 92 babies with early neonatal hyperbilirubinemia were divided into 2 groups, randomly. 49 patients were treated with bifidobiogen 350 mg/(kg. d) and phototherapy. Other 43 patients were treated with enzyme lnductor luminal 5mg/(kg. d) ; nikethamidum 100mg/(kg. d)and phototherapy as the control group. Results The total effective rate in the treatment gr0up(77. 6% ) was higher than that in the control group (44. 2% ), P