Cardiac Pacing in Sub-Saharan Africa: JACC International.

Many parts of the developing world, especially Sub-Saharan Africa, completely lack access to cardiac pacing. The authors initiated a multinational program to implement cardiac pacing in 14 countries in Sub-Saharan Africa (1996 to 2018), aiming to eventually build self-sustainable capacity in each country. This was based on an "on-site training" approach of performing procedures locally and educating local health care teams to work within resource-limited settings, with prospective evaluation of the program. In 64 missions, a total of 542 permanent pacemakers were implanted. In 11 of these countries, the first pacemaker implant in the country was through the mission. More than one-half of those initially listed as suitable died before the mission(s) arrived. The proportion of implantations that were completely handled by local teams increased from 3% in 1996 to 98% in 2018. These findings demonstrate the feasibility and effectiveness of a proctorship-based approach to the development of local cardiac pacing capabilities in Sub-Saharan African nations.

Substandard drugs among five common antihypertensive generic medications: an analysis from 10 African countries.

OBJECTIVE: Hypertension results in more deaths than any other risk factor and has been on the rise in sub-Saharan Africa over the past few decades. Generic drugs have helped improve accessibility and affordability of antihypertensive therapy in developing countries. However, assessment of quality standards of these products is important. We performed a quality assessment of five commonly used antihypertensive generic drugs in 10 sub-Saharan African countries and studied the impact of price on quality. METHODS: Drug samples were prospectively collected using standardized methods between 2012 and 2014. We developed a validated reversed-phase liquid chromatography with tandem mass spectrometry method to accurately quantify the active ingredient in a certified public laboratory. Quality was defined based on the percentage ratio of measured to expected dosage of active ingredient. RESULTS: A total of 1185 samples were assessed, of which 70.0% were generic (n = 830). Among the generic drugs, the percentage of poor-quality drugs was 24.3% (n = 202/830). The percentage ratio of measured to expected dosage of active ingredient ranged from 49.2 to 111.3%; the majority (81.7%) of the poor-quality samples had insufficient quantity of the active ingredient. Moreover, poor quality was not associated with purchase price of the drug. CONCLUSION: In this study from 10 sub-Saharan African countries, nearly one-quarter of the available generic antihypertensive drugs were found to be of poor quality. Concerted measures to improve the quality of antihypertensive drugs could lead to major improvements in hypertension control with attendant reduction of its deleterious consequences in low-income and middle-income countries.

Pathophysiology of bronchial smooth muscle remodelling in asthma.

Whereas the role of bronchial smooth muscle remains controversial in healthy subjects its role is well established in asthmatics. Bronchial smooth muscle contraction induces airway narrowing. The smooth muscle also contributes to bronchial inflammation by secreting a range of inflammatory mediators, recruiting and activating inflammatory cells, such as mast cells or T-lymphocytes. In addition, bronchial smooth muscle mass is significantly increased in asthma. Such an increase has been related to a deposition of extracellular matrix proteins, and an increase in both cell size and number. However, the mechanisms of this smooth muscle remodelling are complex and not completely understood. The article will review recent data regarding the pathophysiology of bronchial smooth muscle remodelling in asthma.

Invaginación intestinal: cambio en su incidencia desde 1987 a 2008 / Intestinal invagination: change in its incidents from 1987 to 2008

En algunas series se ha apreciado una disminución en la incidencia de las invaginaciones intestinales en los últimos años. Además, la reciente introducción de nuevos tipos de vacunas contra el rotavirus hace que el seguimiento de la incidencia de las invaginaciones intestinales adquiera importancia. Para ello, son necesarios datos epidemiológicos locales fiables. Con el objetivo de conocer la evolución de la incidencia de las invaginaciones y su valor actual en nuestro área, hemos realizado un estudio retrospectivo de los pacientes menores de 3 años diagnosticados de Invaginación Intestinal y con confirmación por enema opaco o ecografía durante los últimos 21 años. En los resultados obtenidos se observa una disminución estadísticamente significativa de la tasa de incidencia, con una razón de incidencias de un año respecto al anterior de 0,82 (IC95% 0,78-0,86) pasando de una incidencia estimada para 1987 de 17,74 casos por cada 10.000niñas y 30,04 casos por cada 10.000 niños, a una incidencia estimada en 2008 de 0,27 casos por cada 10.000 niñas y 0,49 casos por cada 10.000niños.Concluimos que en nuestra serie se aprecia en el periodo estudiado un importante descenso de la incidencia de las invaginaciones intestinales, especialmente en los pacientes de menos de un año y estableciéndose la incidencia actual en 0,27 casos por cada 10.000 niñas y 0,49casos por cada 10.000 niños menores de 3 años (AU)

Some series have shown a decrease in the incidence of intestinal invaginations in last years. Moreover, the recent introduction of new types of rotavirus vaccines increases the interest of invagination’s incidence. To this purpose, reliable local epidemiological data are needed. In order to ascertain the trend in the incidence of invaginations and their current value in our area we have performed a retrospective review of patients under 3 years of age with the diagnosis of intussusception and confirms with barium enema or ultrasound examination during the past 21 years. Our results show a statistically significant decrease in the incidence rate, with an incidence rate of one year from the previous 0.82 (95%0,78-0, 86) from an estimated incidence for 1987 of 17.74 cases per10,000 girls and 30.04 cases per 10,000 boys, in 2008 an estimated incidence of 0.27 cases per 10,000 girls and 0.49 cases per 10,000 boys. We conclude that in our population during the study period a significant decrease of invagination’ s incidence has been seen, especially in patients younger than one year. The current incidence is 0.27 cases per 10,000 girls and 0.49 cases per 10,000 boys less than 3 years old (AU)

[Intestinal invagination: change in its incidence from 1987 to 2008]. / Invaginación intestinal: cambio en su incidencia desde 1987 a 2008.

Some series have shown a decrease in the incidence of intestinal invaginations in last years. Moreover, the recent introduction of new types of rotavirus vaccines increases the interest of invagination' s incidence. To this purpose, reliable local epidemiological data are needed. In order to ascertain the trend in the incidence of invaginations and their current value in our area we have performed a retrospective review of patients under 3 years of age with the diagnosis of intussusception and confiemes with barium enema or ultrasound examination during the past 21 years. Our results show a statistically significant decrease in the incidence rate, with an incidence rate of one year from the previous 0.82 (95% 0,78-0, 86) from an estimated incidence for 1987 of 17.74 cases per 10,000 girls and 30.04 cases per 10,000 boys, in 2008 an estimated incidence of 0.27 cases per 10,000 girls and 0.49 cases per 10,000 boys. We conclude that in our population during the dtudy period a significant decrease of invagination' sincidence has been seen, especially in patients younger than one year. The current incidence is 0.27 cases per 10,000 girls and 0.49 cases per 10,000 boys less than 3 years old.

P300 endogen evoked potentials in somatization disorder: a controlled study.

INTRODUCTION: Somatization disorder (SD) is considered the most valid, reliable and consistent disorder over time from the entire group of somatoform disorders and the most disabling and expensive for the health system. The aim of this paper is to assess the discriminative, attentional and cognitive process in SD patients by auditory-stimulus P300 evoked potential. DESIGN: case-control study. SAMPLE: cases group is made up of 25 patients, selected from the Miguel Servet University Hospital Somatoform Disorder Unit, that fulfill DSM-IV-TR criteria of SD using EPEP psychiatric interview. Twenty-five healthy and volunteer individuals without psychiatric or neurological disorders or history of disease were selected as control group. Both groups were matched by gender and age. RESULTS: Mean P300 latency was significantly (p<0.01) higher in SD patients than in healthy people. The rest of variables studied (N100 latency, P200 latency, P300 amplitude in Pz) did not show any significant differences. CONCLUSIONS: SD patients show electrophysiological disturbances in the cognitive process of information.

Potenciales evocados endógenos P300 en el trastorno de somatización: un estudio controlado / P300 endogen evoked potentials in somatization disorder: a controlled study

Introducción. El trastorno por somatización (TS) se considera la entidad más válida, fiable y consistente a lo largo del tiempo de todo el grupo de trastornos somatomorfos, así como el más invalidante y el que mayor gasto sanitario produce. El objetivo de este trabajo es evaluar el procesamiento cognitivo atencional y discriminativo en pacientes diagnosticados de trastorno de somatización mediante el registro del potencial P300 con estímulo auditivo. Métodos. Diseño: estudio caso-control. Población: el grupo de casos está formado por 25 pacientes, seleccionados de forma sucesiva, procedentes de la Unidad de Trastornos Somatomorfos del Hospital Universitario Miguel Servet de Zaragoza y diagnosticados de trastorno de somatización según criterios DSM-IV-TR mediante la Entrevista Psiquiátrica Estandarizada Polivante (EPEP). Como grupo control se escogieron 25 sujetos sanos al azar, libres de patología psiquiátrica o neurológica, apareados por sexo y edad. Resultados. Se observa que la media de latencia de P300 es significativamente superior (p < 0,01) en pacientes con trastorno de somatización respecto al grupo control. En el resto de variables estudiadas (latencia de N100, latencia de P200 y amplitud de P300 en Pz) no se observan diferencias entre los dos grupos. Conclusiones. En los pacientes con TS existe una alteración electrofisiológica de los niveles del procesamiento cognitivo de la información

Introduction. Somatization disorder (SD) is considered the most valid, reliable and consistent disorder over time from the entire group of somatoform disorders and the most disabling and expensive for the health system. The aim of this paper is to assess the discriminative, attentional and cognitive process in SD patients by auditory-stimulus P300 evoked potential. Methods. Design: case-control study. Sample: cases group is made up of 25 patients, selected from the Miguel Servet University Hospital Somatoform Disorder Unit, that fulfill DSM-IV-TR criteria of SD using EPEP psychiatric interview. Twenty-five healthy and volunteer individuals without psychiatric or neurological disorders or history of disease were selected as control group. Both groups were matched by gender and age. Results. Mean P300 latency was significantly (p<0.01) higher in SD patients than in healthy people. The rest of variables studied (N100 latency, P200 latency, P300 amplitude in Pz) did not show any significant differences. Conclusions. SD patients show electrophysiological disturbances in the cognitive process of information

[Magnetic liquid influence upon some plant species of pharmaceutical interest]. / Influenta lichidelor magnetice asupra unor specii de plante de interes farmaceutic.

It was accomplished a study on the influence of a petroleum magnetic liquid upon two plant species of pharmaceutical interest: Papaver somniferum L. and Chelidonium majus L. Experimental observation aimed: callus accumulation, seed germination, mitotic index and fluorescence of the photosynthesis pigments. The plant samples were taken from in vitro cultures obtained from different explant types while the magnetic liquid was added in the culture media in low concentrations (ml/l). The germination test showed a positive influence of the magnetic liquid, the cell division test revealed an increased mitotic index, callus accumulation rate is enhanced while the fluorescence spectra showed maxima shift for the samples in comparison to the controls.

[Cytogenetic changes induced by low-intensity microwaves in the species Triticum aestivum]. / Modificari citogenetice induse de microunde de mica intensitate la specia Triticum aestivum.

Seeds of Triticum aestivum having an uniform genophond have been exposed to a microwave flow, with a frequency of 9.75 GHz and a low intensity. The effects of microwaves at various doses on mitotic activity have been followed. Our results show that as compared to the controls different types of chromosomal aberrations appeared: delayed chromosomes, micronuclei, interchromosomal bridges, chromosomal fragments.

Validated assay for the quantification of anastrozole in human plasma by capillary gas chromatography-63Ni electron capture detection.

An assay was developed for the quantification of anastrozole [2,2'-[5-(1H-1,2,4-triazol-1-ymethyl)-1,3-phenylene]bis(2-++ +methylpropiononitrile)] in human plasma using liquid-liquid extraction. Anastrozole and an internal standard were chromatographed and detected by gas chromatography with electron capture detection, using a combination temperature-pressure program. The range of the assay is 3 to 100 ng/ml. Anastrozole was quantified by comparing its peak area to that of an internal standard. A cross-validation of this assay was also successfully performed between several laboratories.