Characterization of selective antibacterial peptides by polarity index.

In the recent decades, antibacterial peptides have occupied a strategic position for pharmaceutical drug applications and became subject of intense research activities since they are used to strengthen the immune system of all living organisms by protecting them from pathogenic bacteria. This work proposes a simple and easy statistical/computational method through a peptide polarity index measure by which an antibacterial peptide subgroup can be efficiently identified, that is, characterized by a high toxicity to bacterial membranes but presents a low toxicity to mammal cells. These peptides also have the feature not to adopt to an alpha-helicoidal structure in aqueous solution. The double-blind test carried out to the whole Antimicrobial Peptide Database (November 2011) showed an accuracy of 90% applying the polarity index method for the identification of such antibacterial peptide groups.

[Clinical and epidemiological characteristics of severe poisoning in an adult population admitted to an intensive care unit]. / Características clínicas y epidemiológicas de intoxicaciones graves en una población adulta que ingresa a una unidad de cuidados intensivos.

OBJECTIVE: To describe the clinical and epidemiological features of severe acute poisonings in an adult population. DESIGN: Retrospective analysis of clinical cases. PATIENTS AND METHODS: Analysis of the clinical charts, risk factors and main outcomes of 55 acute poisoned patients admitted to an intensive care unit (ICU). RESULTS: Of the 55 clinical charts reviewed, female prevailed over male gender with a relation of 1.5:1, the average age was 32 years (16-83 years), the major etiologic factor for the acute poisonings were drugs in 35 cases (64%), and home or work chemicals in 20 cases (36%). The mechanisms of intoxication/poisoning were: attempted or successful suicide in 51 cases (93%), accidental poisoning in three cases (5%), and iatrogenic in one case (2%). Precipitating factors were major depressive disorder in 29 cases (53%), dysthymic disorder in 12 cases (22%) and adjustment disorder with depressive mood or impulsive act in nine cases (16%). Associated feature comorbid conditions were: homosexuality, schizophrenia, drug addiction, AIDS, other chronic diseases, and previous suicide attempts. Outcomes were 33 (60%) patients discharged from the ICU without sequela, seven (13%) with permanent severe sequela and 15 (27%) deaths. CONCLUSIONS: There was a high rate of suicides related with depressive disorders in a predominantly female population. Drug products were used more frequently than home or work chemicals. Although advanced life support and antidotal treatments were available, mortality was high. Areas where injury prevention efforts might have an influence on adult poisoning morbidity and mortality include management of depression as well suitable control of drugs and chemicals.

[Acute fatty liver of pregnancy complicated by pancreatitis]. / Hígado graso agudo del embarazo complicado con pancreatitis.

A woman with acute fatty liver of pregnancy developed fulminant hepatic failure after delivery, a time when spontaneous recovery was expected. Pancreatitis and multiple organ failure was documented and intensive treatment in a critical care unit was needed to support organ function. She underwent plasmapheresis due to extreme hyperbilirubinemia and coma. She recovered completely.

[Acute non-calculous cholecystitis at a multidisciplinary intensive care unit]. / Colecistitis aguda acalculosa en una unidad de cuidados intensivos multidisciplinaria.

OBJECTIVE: To describe three cases of acute acalculous cholecystitis (AAC) in critically ill patients. PATIENTS AND METHODS: Admission charts of critically ill patients who required advanced life support in the intensive care unit and fulfilled three or more of the following ultrasonographic or tomographic diagnostic criteria for AAC were reviewed: 1. Gallbladder wall thickness > 4 mm with an increase in its volume (vesicular hydrops), 2. Pericholecystic fluid, 3. Subserosal edema, 4. Sloughing of the mucosa, 5. Abscence of calculi. RESULTS: Three men that met the criteria for AAC were identified from a total of 490 admission charts. The median age was 49 years, the average APACHE II at admission was 17 points. The median time in the ICU before development of AAC was 24 days. All patients had leukocytosis. The three cases were resolved by percutaneous cholecystostomy and external biliary drainage. CONCLUSIONS: The incidence of AAC in our ICU is one s case per 160 admissions or 0.6%. Shock, use of vasopressor drugs, narcotics and mechanical ventilation with PEEP are frequent in patients who subsequently develop AAC. Percutaneous cholecystostomy with external biliary drainage constitutes a safe and definitive treatment when there is no gangrene of the gallbladder wall.

Pentoxifylline and oxygen consumption in severe sepsis--a preliminary report.

OBJECTIVE: To demonstrate that pentoxifylline (PTX) and not placebo improves oxygen consumption (VO2) in critically ill patients with severe sepsis. SETTING: Multidisciplinary intensive care unit in a university affiliated hospital. DESIGN: A randomized, double blinded clinical trial comparing 300 mg of PTX administered in a 120 min iv infusion with an identically looking placebo. PATIENTS: 13 patients (9 men and 4 women) average age 39 (24-62) years old received PTX, and 12 patients (5 men and 7 women) average age 38 (21-83) years old received placebo. All satisfied ACCP/SCCM criteria for severe sepsis. MEASUREMENTS AND INTERVENTIONS: Patients fulfilling criteria for severe sepsis was identified on admission, cardiac output, DO2 and VO2 were measured by thermodilution and standard oximetric technics after adequate volume replacement at baseline, 60 and 120 during infusion. F-test of analysis of variance was used to test hypothesis about differences of DO2 and VO2 by group, by time and for the interaction terms, a "p" value < 0.05 was considered significant. RESULTS: Evaluation of baseline measurements of both groups revealed no significant difference in any haemodynamic function or oxygen transport variables. The average VO2 difference (0-120 min) between groups was 21 mL/min.m2 and it was higher in the experimental group, however, this difference was non significant. CONCLUSION: We think that the trend in VO2 followed by the experimental group is clinically important. If this difference is sustained we will probably be able to demonstrate our hypothesis.

[Comparative treatment of acute optic neuritis with "boluses" of intravenous methylprednisolone or oral prednisone]. / Tratamiento comparativo de la neuritis óptica aguda con "bolos" de metilprednisolona endovenosa o prednisona oral.

Sixteen patients with acute optic neuritis were studied, and randomized into two groups of treatment. Group I was assigned to in hospital treatment with intravenous methylprednisolone 500 mg Q8 hours for 10 doses, followed by oral prednisone for two weeks and tapering doses thereafter. Group II was treated with oral prednisone one mg per kilogram of body weight for two weeks followed by tapering doses. All patients had examination of visual acuity, visual field at baseline and repeated on weeks two, four and sixteen. Two patients in group I were lost to follow up, and three patients (two in group I and one in group II) had previous established diagnosis of Multiple Sclerosis and the onset of acute optic neuritis was considered a recurrence of the disease. There was no statistical difference between the groups with regards to clinical outcome, visual acuity and visual field examination (p = 0.329) Fisher test.

[The somatostatin analog SMA (201-995) as adjuvant treatment in patients with external fistulae of the digestive system]. / El análogo de somatostatina SMS (201-995) como tratamiento adyuvante en pacientes con fístulas externas del aparato digestivo.

Six patients with gastrointestinal fistulae treated with a potent inhibitor of gastrointestinal hormones, the somatostatin analogue SMS 201-995 are reported. All patients had severe intraabdominal diseases and underwent a mean of 3.5 surgery procedures during their hospital stay. When the patients were analyzed individually a mean reduction of 42.5% (P < 0.050 of basal fistulae output was observed after treatment. In three patients the fistulae closed after seven and ten days of treatment with the analogue; the other three patients died after a protracted hospital stay which included multiple admissions to the Intensive Care Unit. When the output of all fistulae treated where analyzed together it showed a tendency to decrease, but it didn't reach statistical significance.