Phototherapy Induces an Improvement in Clinical and Biochemical Scores in Patients with Rheumatoid Arthritis

ABSTRACT Objective: Rheumatoid arthritis (RA) is a common autoimmune disease for which there is no known cure. Ultraviolet light can induce immunosuppressive effects. Our main objective was to ascertain whether a complementary treatment with phototherapy would improve changes in functional scales in patients with RA. Methods: Seven women with RA were enrolled for this study and submitted to phototherapy sessions with a 425-650 nm lamp. Results: The Karnofsky scale changed from requiring frequent medical care to being capable of normal activity with few symptoms or signs of disease (p = 0.018), the rheumatoid arthritis-specific quality of life questionnaire decreased abruptly from 29 to 0 points (p = 0.018), the Steinbrocker functional capacity rating changed from limited to little or none of the duties of usual occupation or self-care to complete ability to carry out all the usual duties without handicaps (p = 0.017). The pain was remitted after the treatment period. The acute inflammation variables showed a significant decrease after the indicated sessions, C-reactive protein (p = 0.042) and erythrocyte sedimentation rate (p = 0.018). Conclusion: The evaluated scales clearly show a benefit with the phototherapy in patients with RA. Thus, phototherapy seems to be a plausible complementary option to reduce the symptoms of RA.

Complications in pregnant women with autoimmune diseases

BACKGROUND: Autoimmune diseases complicate pregnancy in several manners. This study aimed at describing the most common complications in pregnant women with autoimmune diseases. METHODS: This was a descriptive and retrospective study. Two groups of pregnant women with autoimmune diseases were included: 1) Those who since the beginning of gestation received obstetrical care at a tertiary-level hospital and 2) Women who were treated first in a medical unit not specialized in rheumatological diseases. Odds ratio, logistic regression and multinomial logistic regression were used to determine risk of complicated pregnancy. RESULTS: The distribution of autoimmune diseases in our sample is as follows: systemic lupus erythematosus (SLE): 6, rheumatoid arthritis (RA): 4, primary anti-phospholipid syndrome (APS): 4, systemic sclerosis (SS): 2, mixed connective tissue disease (MCTD): 1. Eight patients were seen throughout their gestation at a tertiary-level hospital and nine were referred from other non-specialized hospitals. Patients in the first group had four complications, and those of the second group, 28. The Odds Ratio (OR) of having a complication in the hospitals of reference compared to the "Mónica Pretelini Sáenz" Maternal-Perinatal Hospital (HMPMPS) was of 29.8 (95% CI: 1.29-692.46; Z statistic 2.11, p = 0.03). In relation to the logistic regression, this test was not significant neither for the group nor the treatment scheme for the presence of at least one complication. The multinomial logistic regression did not show significant predictive probabilities of the different possible outcomes for the group and drug treatment scheme. CONCLUSION: Pregnant women with autoimmune diseases can have an OR up to 29.8 to develop complications when they are not cared for by specialized personnel

Estado nutricional, composición corporal e indicadores antropométricos de trabajadores mineros expuestos a hipoxia hipobárica crónica e intermitente a una altitud moderada (0-2500 msnm) / Nutritional status, body composition and anthropometric indicators of miners exposed to intermittent chronic hypobaric hypoxia at moderate altitude (0-2500 m)

RESUMEN Introducción En Chile, los trabajadores mineros están expuestos a condiciones laborales y ambientales particulares. Sin embargo, la normativa actual no considera estas condicionantes para evaluar el estado nutricional y riesgo cardiovascular de esta población. Objetivo Describir indicadores antropométricos de trabajadores mineros de la Región de Coquimbo, expuestos a un ambiente hipóxico hipobárico de manera crónica intermitente a una altitud moderada entre 0 a 2500 m. Metodología Se evaluaron 221 trabajadores a 0 m, 1600 m, y 2500 m. Se les midió peso, talla, pliegues cutáneos, perímetros de cintura y cuello. Con estas mediciones se determinó estado nutricional, composición corporal e indicadores antropométricos relacionados con riesgo cardiovascular. Resultados Los indicadores presentaron valores promedios superiores a la media nacional. Más aún, al separar los resultados por cota altitudinal, estos valores presentan un aumento a mayor altitud. Conclusión Este estudio mostró una alteración en los indicadores antropométricos, estado nutricional y composición corporal, con la altitud. Futuros estudios con un mayor tamaño muestral son necesarios para clarificar estos hallazgos.

ABSTRACT Introduction In Chile, miners are exposed to specific labor and environmental conditions. However, current regulations do not consider these conditions in the assessment of nutritional status and cardiovascular risk of this population. Objective To describe anthropometric indicators of miners in the Coquimbo Region who are exposed to chronic intermittent hypobaric hypoxia at moderate altitudes (between 0 and 2500 m). Methodology We evaluated 221 workers at 0 m, 1600 m, and 2500 m. We measured weight, height, skin fold, waist and neck circumference. With these measurements, we determined nutritional status, body composition and anthropometric indicators related to cardiovascular risk. Results The assessed indicators showed average values higher than national ones. Furthermore, values increased by altitude. Conclusion This study showed an alteration with the altitude in the anthropometric indicators, nutritional condition and body composition. Further studies with a high sample size are necessary to clarify these findings.

Consenso Mexicano para el Tratamiento de la Hepatitis C / The Mexican consensus on the treatment of Hepatitis C

El objetivo del Consenso Mexicano para el Tratamiento de la Hepatitis C fue el de desarrollar un documento como guía en la práctica clínica con aplicabilidad en México. Se tomó en cuenta la opinión de expertos en el tema con especialidad en: gastroenterología, infectología y hepatología. Se realizó una revisión de la bibliografía en MEDLINE, EMBASE y CENTRAL mediante palabras claves referentes al tratamiento de la hepatitis C. Posteriormente se evaluó la calidad de la evidencia mediante el sistema GRADE y se redactaron enunciados, los cuales fueron sometidos a voto mediante un sistema modificado Delphi, y posteriormente se realizó revisión y corrección de los enunciados por un panel de 34 votantes. Finalmente se clasificó el nivel de acuerdo para cada oración. Esta guía busca dar recomendaciones con énfasis en los nuevos antivirales de acción directa y de esta manera facilitar su uso en la práctica clínica. Cada caso debe ser individualizado según sus comorbilidades y el manejo de estos pacientes siempre debe ser multidisciplinario.

The aim of the Mexican Consensus on the Treatment of Hepatitis C was to develop clinical practice guidelines applicable to Mexico. The expert opinion of specialists in the following areas was taken into account: gastroenterology, infectious diseases, and hepatology. A search of the medical literature was carried out on the MEDLINE, EMBASE, and CENTRAL databases through keywords related to hepatitis C treatment. The quality of evidence was subsequently evaluated using the GRADE system and the consensus statements were formulated. The statements were then voted upon, using the modified Delphi system, and reviewed and corrected by a panel of 34 voting participants. Finally, the level of agreement was classified for each statement. The present guidelines provide recommendations with an emphasis on the new direct-acting antivirals, to facilitate their use in clinical practice. Each case must be individualized according to the comorbidities involved and patient management must always be multidisciplinary.

Modification of nutritional value during storage of infant formulas elaborated with different intact and partially hydrolyzed proteins and carbohydratese / Modificación del valor nutricional durante el almacenamiento de fórmulas infantiles elaboradas con diferentes proteínas intactas, parcialmente hidrolizadas y carbohidratos

Background: Human milk is considered the best source of nutrition for young infants. However, if mothers cannot provide adequate breast milk or if infants are premature or have a low birth weight, breast-feeding must often be replaced or complemented with infant formulas (IFs). The interactions between infant formula components (proteins, fats, carbohydrates, vitamin and minerals) mainly affect carbohydrates and proteins (Maillard reaction, MR), but those involving proteins are especially important in products used in infant feeding because of the high protein requirements of infants. On the other hand, fatty acids (FAs) are considered important in infant development. Objectives: The aim of the present work was to test the stability of IFs made with different ingredients, analyzing the available lysine losses (for protein stability) and the FAs content and the peroxide value (for fat stability) during stored at normal and adverse conditions and to propose a faster control of that stability. Methods: Available lysine analyzed by high-performance liquid chromatography (HPLC), lipid oxidation by titrimetric method and FAs profile by gas chromatography (GC) were determined in four types of IFs prepared with intact and partially hydrolyzed proteins and different carbohydrates (lactose or maltodextrins) during storage at 4, 20 and 30 ºC for 24 months at normal water activity (Aw=0.1-0.4), and at Aw of 0.65 at 20 and 30 ºC for 4 weeks. These IFs were prepared twice (IF1 and IF2) in different batches by a Spanish dietary product company. Results: At 30ºC, available lysine losses were 40-50% in all IFs analyzed. The behavior and percentage lysine loss between 1 and 4 weeks of storage at 30 °C with Aw=0.65 was similar to those obtained after 24 months of storage at 30 °C. No significant changes were observed in fatty acid profile during storage. Oxidation was only observed in opened packs and after 4 weeks/30 °C/Aw=0.65. Conclusions: The losses of available lysine increase to higher time and storage temperatures. The FAs shows a good stability for any storage condition; however peroxide values prove more sensitive than FAs changes for evaluating fat oxidation during the storage of IFs.

Antecedentes: La leche materna es la mejor fuente nutricional para niños recién nacidos. Sin embargo, cuando las madres no pueden proveer leche, o si los niños son prematuros o tienen bajo peso al nacer, la lactancia debe ser reemplazada o complementada con fórmulas infantiles (IFs). La interacción entre los componentes de las IFs (proteínas, grasas, carbohidratos, vitaminas y minerales) principalmente afecta carbohidratos y proteínas (Reacción de Maillard, MR), pero los que implican proteínas son especialmente importantes en alimentación infantil debido a los altos requerimientos de proteína de los lactantes. Por otra parte, los ácidos grasos (FAs) son considerados importantes en el desarrollo de los niños. Objetivos: El objetivo fue evaluar la estabilidad de IFs elaboradas con diferentes ingredientes, analizando lisina útil (para estabilidad de proteínas), contenido de FAs y valor de peróxidos (para estabilidad de grasas) durante el almacenamiento bajo condiciones normales y adversas, y proponer un control más rápido de la estabilidad. Metodos: Los análisis de lisina útil por cromatografía liquida de alta resolución (HPLC), oxidación lipídica por el método de titulación y el perfil de FAs por cromatografía de gases (GC) fueron determinados en cuatro tipos de IFs preparadas con proteínas intactas y parcialmente hidrolizadas con diferentes carbohidratos (lactosa y maltodextrinas) durante el almacenamiento a 4, 20 y 30ºC por 24 meses a actividad de agua normal (Aw=0,1-0,4), y a Aw de 0,65 a 20 y 30 ºC por 4 semanas. Estas IFs fueron preparadas dos veces (IF1 y IF2 ) en baches diferentes por una empresa Española de productos dietarios. Resultados: A 30ºC, las pérdidas de lisina útil fueron de 40-50% en todas las IFs analizadas. El comportamiento y porcentaje de pérdidas de lisina entre la 1 y 4 semana de conservación a 30 °C con Aw=0,65 fue similar a las obtenidas tras 24 de almacenamiento a 30 °C. No se observaron cambios significativos en el perfil de FAs durante el almacenamiento. Oxidación solo se observo en los envases abiertos y después de 4 semanas/30 °C/Aw=0.65. Conclusiones: Las pérdidas de lisina útil incrementan a mayor tiempo y temperatura de almacenamiento. Los FAs muestran una buena estabilidad para cualquiera de las condiciones de almacenamiento, sin embargo el valor de peróxidos evidencia mayor sensibilidad que los cambios en FAs para evaluar la oxidación de las grasas durante el almacenamiento de IFs.

Correlates of early sexual activity among Hispanic children in middle adolescence

OBJECTIVE: We analyzed early sexual activity among Hispanic 14 to 15-year-old adolescents residing in a poor neighborhood in Puerto Rico. METHODS: Information from a sample of 325 adolescents was collected from a randomized sample of community households. Logistic regression analysis was used to identify the variables that help explained adolescents' sexual behavior. RESULTS: Adolescents whose parents reported poor communication and poor parent control were more likely to engage in early sexual activity that those peers that did not report this type of family relationship. Adolescents who reported poor parent bonding and lack of discipline were more likely to engage in early sexual relationships. CONCLUSIONS: Intervention and prevention programs need to be aware and address the role of the Hispanic culture in gender differences in early sexual activity in adolescence. If sexual norms related to gender role are changing in Puerto Rico, is a question that needs to be answered in future research.

Uso de cianocrilato como tratamiento conservador en microperforaciones corneales / Cyanocrilate as a conservative treatment in corneal microperforations

Reportar nuestra experiencia con el uso de Cianocrilato en el tratamiento de lesiones perforantes corneales. Se evaluaron 5 pacientes con perforaciones corneales, que acudieron a la emergencia del Hospital Miguel Pérez Carreño Caracas-Venezuela. Se realizó bajo anestesia tópica la colocación de Cianocrilato en un segmento de látex de 5mm sobre la lesión, posteriormente se colocó un lente de contacto terpéutico. Se realizaron controles seriados. Se observó al cabo de cinco días cierre de la lesión corneal en todos de los pacientes y en 3 pacientes no ameritaron procedimientos secundarios. El Cianocrilato es excelente alternativa como tratamiento conservador de microperforaciones corneales

Mortality among Hispanic drug users in Puerto Rico

This paper assesses mortality rate for a cohort of drug users in Puerto Rico compared with that of the Island's general population, examining causes of death and estimating relative risk of death. Date and cause of death were obtained from death certificates during 1998. Vital status was confirmed through contact with subjects, family, and friends. HIV/AIDS was the major cause of death (47.7%), followed by homicide (14.6%), and accidental poisoning (6.3%). Females had higher relative risk of death than males in all age categories. Not living with a sex partner and not receiving drug treatment were related to higher mortality due to HIV/AIDS. Drug injection was the only variable explaining relative risk of death due to overdose. Puerto Rico needs to continue developing programs to prevent HIV/AIDS among drug users. Special attention should be given to young women, who appear to be in greatest need of programs to prevent early mortality.

Consecuencias de la inhibición de la bomba de sodio en neuronas y su relevancia en la fisiopatología del daño celular producido por isquemia anóxica / Consecuences of sodium pump inhibition in neurons, and its relevance in the physiopathology of cellular damage by anoxic ischemia

Se estudió el efecto que sobre la conductancia total de la membrana (Gm)tiene la alteración del gradiente electroquímico del Na+ en neuronas de Helix aspersa. La sustitución del Na+ extracelular por un catión impermeante (glucamina) produjo una disminución inicial de Gm (4.6 ñ 2.9 por ciento), seguida de un sostenido aumento de la misma (30.3 ñ 10.5 por ciento), acompañado por una hiperpolarización de la membrana. Se sugiere que la eliminación del Na+ extracelular provoca la inversión del intercambiador Na+/Ca++, produciendo un aumento en la concentración intracelular de calcio iónico, [Ca++]i, que incrementa la permeabilidad de la membrana al K+. La inhibición de la bomba de Na+ con mabaína (lmM), también produjo un aumento en Gm, coincidente con un eflujo de K+ previamente descrito. Se modeló matemáticamente la conducta del intercambiador Na+/Ca++, encontrándose que aumentos modestos en la [Na+]i producen cambios, significativos en la [Ca++]i, congruentes con resultados previos. Se postula que la inhibición de la bomba de Na+ provoca un aumento en la [Ca++]i que dispara la permeabilidad al K+. La salida de K+ (junto con aniones y agua), produce una disminución del volumen celular acuoso. Se sugiere que al inhibir la bomba de Na+, el Ca++ entra a las neuronas vía intercambiador Na+/Ca++ y canales de Ca++. Los resultados se discuten en relación a los cambios que ocurren en el tejido nervioso durante isquemia anóxica.

Ligadura de bula pulmonar por videotoracoscopia en neumotórax espontáneo / Ligature of pulmunary bulla by videothoracocospy in spontaneous pneumothorax

El neumotórax espontaneo primario, es una enfermedad relativamente frecuente, cuya causa es la ruptura de una bula enfisematosa de la cual no se conoce completamente su etiopatogenia. Hasta el momenta el tratamiento usual consiste en el drenaje del neumotórax por taracostomia cerrada y en casos de su persistencia o recaida, se ha recomendado la toracotomia. En el presente articulo se informa el caso de una paciente joven con neumotórax espontaneo, a quien se le practicó ligadura de la bula pulmonar rota, mediante videotoracoscopia, evitando asi un procedimiento más invasor como es la toracotomia.

Neisseria gonorrhoeae resistente a la penincilina en la ciudad de México / Penicillin-resistance of Neisseria gonorrhoeae in México City

From July to December 1986, 607 adults of both sexes with urethral and cervicovaginal symptoms visited a venereal disease center in México City. Urethral mucosa and cervical canal smears were taken from 148 selected individuals from whom Neisseria gonorrhoeae had been isolated and who had not been treated with antimicrobials for at least the three previous weeks. Gonococci strains were identified by the morphological characteristics of the colonies staining by Gram's method, the oxidase test, and carbohydrate breakdown, and the penicillin-resistance of the isolated strains was determined. It was found that 26.3 per cent of the N. gonorrhoeae strains were penicillinase producing (PPNG) and 4.7 per cent had chromosome-mediated resistance (CMRNG). There was no significant difference in the distribution of PPNG strains in serogroups 1A (WI) and 1B (WII/III); however, all the CMRNG strains belonged to the 1B group and were isolated from males. Treatment with penicillin, ampicilin, and other antimicrobials was ineffective in one out of every three patients in the study group. For high-risk patients in whom this treatment is unsuccessful, such as the subjects of this study, the use of spectinomycin is recomended. To prevent an increase in penicillin-resistan strains, the authors suggest laboratory identification and monitoring of infected persons, follow-up of patients and identification of contacts

Actividad citotoxica de Entamoeba histolytica sobre celulas linfoides de bazo de raton. / Cytotoxic activity of Entamoeba histolytica on lymphoid cells of rat spleen

Se analizo la capacidad citotoxica de Entamoeba histolytica empleando el metodo de liberacion de 51Cr de celulas linfoides de bazo de raton como celulas blanco. Se utilizaron trofozoitos de las cepas HM1 y HK-9 y de la clona 2C1 obtenida esta en nuestro laboratorio a partir de la cepa HM1. Las celulas linfoides de bazo de raton se marcaron con 51Cr y se mezclaron con los trofozoitos de las diferentes cepas en el medio TYI-S-33 para lisis. Se calculo el porcentaje de lisis especifica a partir de la medicion de 51 Cr liberado al sobrenadante. La actividad citotoxica en los trofozoitos se determino en las diferentes fases de la curva de crecimiento. Se observo que la actividad citotoxica es dependiente de la cepa utilizada, de la fase de crecimiento y de la proporcion de amiba por celula blanco probada. La actividad citotoxica medida fue mayor para la cepa HM1 y menor para la cepa HK-9