Self-contamination following removal of two personal protective equipment suits: a randomized, controlled, crossover simulation trial.

BACKGROUND: Healthcare personnel are often at high risk of contamination when participating in airway management and other aerosol-generating procedures. AIM: To explore the differences in self-contamination after removal of gown and coverall personal protective equipment (PPE) using an ultraviolet-fluorescent solution. METHODS: This prospective, randomized, controlled crossover trial was set in a third-level university health centre in Buenos Aires, Argentina between August and October 2020. The study included 60 anaesthesia personnel volunteers, and no participants were excluded from the study. A two-period/two-intervention design was chosen; each intervention comprised audio-guided placement of PPE, full-body spraying of fluorescent solution, audio-guided removal of PPE, and self-contamination assessment through ultraviolet light scanning. The primary outcome was the mean within-participant difference (any traces) between PPE suits. Statistical significance was tested using t-tests for paired data. The allocation ratio was 25/35 (gown followed by coverall/coverall followed by gown). FINDINGS: Self-contamination after removal of coveralls was greater than that after removal of gowns, with a mean within-participant difference of 11.45 traces (95% confidence interval 8.26-14.635; P<0.001). Significant differences were found for the number of self-contaminated body zones, small fluorescent traces and large fluorescent traces. Removal of a gown was associated with a markedly lower risk of self-contamination. CONCLUSIONS: Quick one-step removal of a gown and gloves may reduce self-contamination in the arm/hand area. Fluorescent solutions can help to identify self-contamination and compare outcomes between available PPE suits. Repeated training sessions and enhanced knowledge on self-contamination following removal of PPE are paramount. CLINICAL TRIAL REGISTRATION NUMBER: NCT04763304 (on ClinicalTrials.gov).

Shock mixto en paciente con infarto agudo de miocardio: intervenciones enfermeras / Mixed shock in patients with acute myocardial infarction: Nursing interventions

El tratamiento del shock cardiogénico incluye el uso de terapias de asistencia circulatoria cuando el tratamiento médico ha sido insuficiente y pueden ser un puente a decisión ya que conceden tiempo para evaluar la situación del paciente y tener en cuenta las diferentes opciones terapéuticas existentes. El objetivo de este artículo es desarrollar un plan de cuidados óptimo e individualizado utilizando la taxonomía NANDA-NOC-NIC. Observación clínica Se realizó una valoración enfermera según las necesidades de Virginia Henderson donde destacaron 2 necesidades alteradas: respiración y circulación, ya que la paciente precisó de ventilación mecánica invasiva (VMI) y requirió soporte de asistencia circulatoria mecánica. Intervenciones De acuerdo con las necesidades destacadas, se priorizaron 5 diagnósticos según la taxonomía NANDA utilizando el modelo de Análisis de Resultado del Estado Actual (AREA): riesgo de disminución del gasto cardíaco, deterioro de la ventilación espontánea, deterioro de la integridad tisular, riesgo del síndrome de desuso, riesgo de infección y riesgo de hipotermia. Discusión y conclusiones Los criterios de resultados evidenciaron una evolución favorable pasadas 96h. El desarrollo del lenguaje estandarizado NANDA-NOC-NIC nos permitió organizar el plan de cuidados enfermero. (AU)

Introduction and objectives We present a clinical case of a 40-year-old woman diagnosed with acute myocardial infarction (AMI) in Killip I who was admitted to our hospital. She experienced complications in the haemodynamic lab and in the operating room, including cardiogenic and anaphylactic shock requiring ventricular assist support. Conservative management support with inotropes and vasopressors in cardiogenic shock has been shown to be insufficient in many patients to maintain adequate perfusion and prevent irreversible multiple organ dysfunction syndrome. For this reason, short-term mechanical circulatory support systems are increasing substantially. The objective of this article is to develop optimal and individualised care plans using the NANDA, NOC, NIC taxonomies. Clinical observation An evaluation based on Virginia Hendersońs basic needs was made, and two altered needs stood out: breathing and circulation. The patient required mechanical ventilation and mechanical circulatory support. Interventions In relation to the highlighted needs, six diagnoses were prioritized according to the NANDA taxonomy using the Análisis de Resultado del Estado Actual (AREA) (Outcome-Present State Test (OPT)) model: risk of decreased cardiac output, impaired spontaneous ventilation, impaired tissue integrity, risk of disuse syndrome, risk of infection and risk of hypothermia. Discussion and conclusions Outcome criteria scores showed a favourable evolution after 96h. The development of a standardized NANDA-NOC-NIC language allowed us to organize the nursing care plan. (AU)

Mixed shock in patients with acute myocardial infarction: Nursing interventions.

INTRODUCTION AND OBJECTIVES: We present a clinical case of a 40-year-old woman diagnosed with acute myocardial infarction (AMI) in Killip I who was admitted to our hospital. She experienced complications in the haemodynamic lab and in the operating room, including cardiogenic and anaphylactic shock requiring ventricular assist support. Conservative management support with inotropes and vasopressors in cardiogenic shock has been shown to be insufficient in many patients to maintain adequate perfusion and prevent irreversible multiple organ dysfunction syndrome. For this reason, short-term mechanical circulatory support systems are increasing substantially. The objective of this article is to develop optimal and individualised care plans using the NANDA, NOC, NIC taxonomies. CLINICAL OBSERVATION: An evaluation based on Virginia Henderson's basic needs was made, and two altered needs stood out: breathing and circulation. The patient required mechanical ventilation and mechanical circulatory support. INTERVENTIONS: In relation to the highlighted needs, six diagnoses were prioritized according to the NANDA taxonomy using the Análisis de Resultado del Estado Actual (AREA) (Outcome-Present State Test (OPT)) model: risk of decreased cardiac output, impaired spontaneous ventilation, impaired tissue integrity, risk of disuse syndrome, risk of infection and risk of hypothermia. DISCUSSION AND CONCLUSIONS: Outcome criteria scores showed a favourable evolution after 96 h. The development of a standardized NANDA-NOC-NIC language allowed us to organize the nursing care plan.

Mixed shock in patients with acute myocardial infarction: Nursing interventions. / Shock mixto en paciente con infarto agudo de miocardio: intervenciones enfermeras.

INTRODUCTION AND OBJECTIVES: We present a clinical case of a 40-year-old woman diagnosed with acute myocardial infarction (AMI) in Killip I who was admitted to our hospital. She experienced complications in the haemodynamic lab and in the operating room, including cardiogenic and anaphylactic shock requiring ventricular assist support. Conservative management support with inotropes and vasopressors in cardiogenic shock has been shown to be insufficient in many patients to maintain adequate perfusion and prevent irreversible multiple organ dysfunction syndrome. For this reason, short-term mechanical circulatory support systems are increasing substantially. The objective of this article is to develop optimal and individualised care plans using the NANDA, NOC, NIC taxonomies. CLINICAL OBSERVATION: An evaluation based on Virginia Hendersons basic needs was made, and two altered needs stood out: breathing and circulation. The patient required mechanical ventilation and mechanical circulatory support. INTERVENTIONS: In relation to the highlighted needs, six diagnoses were prioritized according to the NANDA taxonomy using the Análisis de Resultado del Estado Actual (AREA) (Outcome-Present State Test (OPT)) model: risk of decreased cardiac output, impaired spontaneous ventilation, impaired tissue integrity, risk of disuse syndrome, risk of infection and risk of hypothermia. DISCUSSION AND CONCLUSIONS: Outcome criteria scores showed a favourable evolution after 96h. The development of a standardized NANDA-NOC-NIC language allowed us to organize the nursing care plan.

Metabolism of Schizosaccharomyces pombe under reduced osmotic stress conditions afforded by fed-batch alcoholic fermentation of white grape must.

Strains of Schizosaccharomyces pombe are being increasingly investigated with regards to their grape winemaking potential either in combination with the typical production yeast, Saccharomyces cerevisiae, or in monoseptic fermentations. Their ethanol tolerance and ability to degrade L-malic acid is oenologically convenient but contrasts with the comparatively high acetic acid and acetaldehyde formation potential which is considered undesirable, especially in white winemaking. The purpose of this work was to investigate the performance of a selected S. pombe strain in monoseptic femerntations of white grape must. Traditional batch fermentations were compared with an innovative and automated fed-batch fermentation technique were sugar concentrations are kept low during fermentations to decrease sugar induced osmotic stress. Because of its known effect on growth and ethanol tolerance, the effect of Mg was also tested. While Mg supplementation was not shown to significantly influence residual values of sugars, ethanol, glycerol, organic acids and acetaldehyde, the application of the fed-batch technique led to a fundamental change in yeast physiology. While glycerol values were only slightly reduced, the fed-batch approach allowed obtaining wines devoid of acetic acid whose levels were considerable in wines produced by the traditional batch technique (0.6 g/L). The work demonstrates that the acetic acid metabolism of S. pombe is associated to sugar induced osmotic stress such as for S. cerevisiae, too, and may be controlled by application of suitable fermentation techniques for winemaking.

Retrospective study of perampanel efficacy and tolerability in myoclonic seizures.

OBJECTIVES: Perampanel is an antiepileptic drug (AED) approved for add-on treatment of focal seizures (with or without generalization) and primary generalized tonic-clonic (GTC) seizures. Our objective was to explore the effectiveness and tolerability of adjunctive perampanel in patients with drug-resistant myoclonic seizures, after failure of other AEDs. MATERIALS AND METHODS: Retrospective, multicenter, observational study. Data were collected from individual patient clinical files and analysed using appropriate descriptive statistics and inferential analyses. RESULTS: Data are reported for 31 patients with mean age 36.4 years, who had an average epilepsy duration of 18 years, previously taken an average of 5.03 AEDs, and were taking an average of 2.4 AEDs on perampanel initiation. Patients exhibited myoclonic, GTC, absence, tonic and focal seizures, and most had associated cognitive decline and/or ataxia. Median time on perampanel was 6 months, most common dose was 6 mg, and overall retention rate was 84%. The responder rate for myoclonic seizures was defined via reduction of days with myoclonic seizures per month. At 6 months, 15 (48.4%) of the 31 patients were classed as myoclonic seizure responders, 10 (32.3%) were myoclonic seizure free, and 39% saw improvements in functional ability. Of 17 patients with GTC seizures at baseline, 9 (53%) were responders at 6 months, and 8 (47.1%) were seizure free. The most frequent side effects were psychiatric disorders, instability, dizziness and irritability, and mostly resolved with dose reduction. Five patients discontinued perampanel due to side effects. CONCLUSIONS: Perampanel caused clinically meaningful improvements in patients with drug-resistant myoclonic seizures. It was generally well tolerated, but psychiatric and neurological side effects sometimes required follow-up and dose reduction.

A broad spectrum of genomic changes in latinamerican patients with EXT1/EXT2-CDG.

Multiple osteochondromatosis (MO), or EXT1/EXT2-CDG, is an autosomal dominant O-linked glycosylation disorder characterized by the formation of multiple cartilage-capped tumors (osteochondromas). In contrast, solitary osteochondroma (SO) is a non-hereditary condition. EXT1 and EXT2, are tumor suppressor genes that encode glycosyltransferases involved in heparan sulfate elongation. We present the clinical and molecular analysis of 33 unrelated Latin American patients (27 MO and 6 SO). Sixty-three percent of all MO cases presented severe phenotype and two malignant transformations to chondrosarcoma (7%). We found the mutant allele in 78% of MO patients. Ten mutations were novel. The disease-causing mutations remained unknown in 22% of the MO patients and in all SO patients. No second mutational hit was detected in the DNA of the secondary chondrosarcoma from a patient who carried a nonsense EXT1 mutation. Neither EXT1 nor EXT2 protein could be detected in this sample. This is the first Latin American research program on EXT1/EXT2-CDG.

The Armc10/SVH gene: genome context, regulation of mitochondrial dynamics and protection against Aß-induced mitochondrial fragmentation.

Mitochondrial function and dynamics are essential for neurotransmission, neural function and neuronal viability. Recently, we showed that the eutherian-specific Armcx gene cluster (Armcx1-6 genes), located in the X chromosome, encodes for a new family of proteins that localise to mitochondria, regulating mitochondrial trafficking. The Armcx gene cluster evolved by retrotransposition of the Armc10 gene mRNA, which is present in all vertebrates and is considered to be the ancestor gene. Here we investigate the genomic organisation, mitochondrial functions and putative neuroprotective role of the Armc10 ancestor gene. The genomic context of the Armc10 locus shows considerable syntenic conservation among vertebrates, and sequence comparisons and CHIP-data suggest the presence of at least three conserved enhancers. We also show that the Armc10 protein localises to mitochondria and that it is highly expressed in the brain. Furthermore, we show that Armc10 levels regulate mitochondrial trafficking in neurons, but not mitochondrial aggregation, by controlling the number of moving mitochondria. We further demonstrate that the Armc10 protein interacts with the KIF5/Miro1-2/Trak2 trafficking complex. Finally, we show that overexpression of Armc10 in neurons prevents Aß-induced mitochondrial fission and neuronal death. Our data suggest both conserved and differential roles of the Armc10/Armcx gene family in regulating mitochondrial dynamics in neurons, and underscore a protective effect of the Armc10 gene against Aß-induced toxicity. Overall, our findings support a further degree of regulation of mitochondrial dynamics in the brain of more evolved mammals.

The autism and schizophrenia associated gene CYFIP1 is critical for the maintenance of dendritic complexity and the stabilization of mature spines.

Copy number variation (CNV) at the 15q11.2 region has been identified as a significant risk locus for neurological and neuropsychiatric conditions such as schizophrenia (SCZ) and autism spectrum disorder (ASD). However, the individual roles for genes at this locus in nervous system development, function and connectivity remain poorly understood. Haploinsufficiency of one gene in this region, Cyfip1, may provide a model for 15q11.2 CNV-associated neuropsychiatric phenotypes. Here we show that altering CYFIP1 expression levels in neurons both in vitro and in vivo influences dendritic complexity, spine morphology, spine actin dynamics and synaptic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor lateral diffusion. CYFIP1 is highly enriched at synapses and its overexpression in vitro leads to increased dendritic complexity. Neurons derived from Cyfip1 heterozygous animals on the other hand, possess reduced dendritic complexity, increased mobile F-actin and enhanced GluA2-containing AMPA receptor mobility at synapses. Interestingly, Cyfip1 overexpression or haploinsufficiency increased immature spine number, whereas activity-dependent changes in spine volume were occluded in Cyfip1 haploinsufficient neurons. In vivo, Cyfip1 heterozygous animals exhibited deficits in dendritic complexity as well as an altered ratio of immature-to-mature spines in hippocampal CA1 neurons. In summary, we provide evidence that dysregulation of CYFIP1 expression levels leads to pathological changes in CNS maturation and neuronal connectivity, both of which may contribute to the development of the neurological symptoms seen in ASD and SCZ.

IMRT: preliminary results in a series of advanced head-and-neck cancer patients

PURPOSE: To determine retrospectively 2-3 year local and regional control (LRC), free-of-disease survival (FDS) and overall survival (OS), as well as summarized toxicities in a group of 31 advanced head-and-neck cancer patients, treated at our institution between 2004 and 2011 with definitive IMRT low-dose concomitant boost, the majority of them with concurrent chemotherapy based on cisplatin. The results are also shown in the sub-group of nasopharyngeal cancer patients (NPC: 15 cases). PATIENTS AND METHODS: Radiological basal and contrasted CT series, MR-CT or PET/CT fused images in the setup position with immobilization mask were registered in simulation therapy patients. Planed doses were: 70 Gy in primary tumor and positive nodes >1 cm; 63 Gy in high-risk areas of microscopic diseases +10 mm safety margin; and 56 Gy in low risk of diseases regional lymph nodes. Treatment was delivered using a Varian 2100 Clinac with sliding windows IMRT. Spinal cord doses were limited to a strict maximum of 45 Gy, and optimization aimed for mean doses in parotid glands below 26 Gy, especially in the contralateral parotid gland. Online DRR-portal X-ray comparison images were taken every day with a deviation module tolerance ≤3 mm. RESULTS: The mean follow-up since IMRT was 34 months (interval: 8-89; median 31 months). Median follow-up in living patients was 22 months. The 2-year rate for global LRC was 64 %, for FDS 61 % and OS 77 %. For the NPC group after 2 years, LRC was 73 %, FDS 73 % and OS 93 %. The 3-year rates were similar. Seven patients died as a consequence of local and/or regional progression (mean time 10 months). Relapses were observed in eight patients (26 %), but only seven could be confirmed by biopsy (22.6 %; mean time to relapse: 8.6 months). Global acute mucositis was 61 % and chronic mucositis was shown in six cases which developed xerostomia (19 %) in the first control after IMRT, but 1 year later it was reduced to only four patients, two Grade 2 and two Grade 1. CONCLUSIONS: No excessive, unwarranted toxicities were observed using concomitant low doses boost in IMRT. High rates of compliance to concurrent chemotherapy were achieved. Late xerostomia associated with this regime decreased 1 year after conclusion of treatment. The implementation of IMRT requires advances in imaging for better tumor delineation; otherwise the physician loses the advantage of dose modulation or faces a risk of geographical miss (AU)

Bioequivalence study of 2 orodispersible formulations of ondansetron 8 mg in healthy volunteers.

This study was designed to compare the rate and extent of absorption of 2 oral formulations of ondansetron (CAS 99614-02-5) 8 mg orodispersible tablets in healthy volunteers. 22 subjects were administered ondansetron orodispersible tablets of test and reference formulation in a single-dose, 2-period, 2-sequence, fasting, open-label, crossover and randomised study. Plasma concentrations were determined by LC/MS/MS. Log-transformed AUCs and Cmax values were tested for bioequivalence based on the ratios of the geometric means (test/reference). Tmax was analysed nonparametrically. The 90% confidence intervals of the geometric mean values for the test/reference ratios for AUC0-t and Cmax were within the bioequivalence acceptance range of 80-125%. According to the European Guideline [1] it may be therefore concluded that test formulation of ondansetron 8 mg orodispersible tablet is bioequivalent to the reference formulation.

Intestinal parasitic infections in hosted Saharawi children.

Literatures on intestinal parasitic infections in Saharawi children were scarce and distributed in non parasitological journals. This was the first article that specifically highlighted on the prevalence of these infections in 270 Saharawi children aged from 6 to 12 years hosted in Spain. Six different intestinal parasites were identified in this study and 78, 46, 40, 24, 13 and 5 were positive for Giardia lamblia (29%), Entamoeba coli (17%), Blastocystis hominis (15%), Endolimax nana (9%), Hymenolepis nana (5%) and Enterobius vermicularis (2%), respectively. Mixed intestinal parasitic infections were seen in 12 (4.4%) studied children. Six (2.2%) double infections for G. lamblia and B. hominis were seen in these children while in four (1.5%) had G. lamblia and H. nana. Triple intestinal parasitic infections of G. lamblia, B. hominis and H. nana were observed in two (0.7%) of the children studied. In the other hand, about 14.8% of the studied children had a mild anaemia and 15.5 and 16.6% had iron deficiency and eosinophilia, respectively.

Intestinal parasitic infections in hosted Saharawi children

Literatures on intestinal parasitic infections in Saharawi children were scarce and distributed in non parasitological journals. This was the first article that specifically highlighted on the prevalence of these infections in 270 Saharawi children aged from 6 to 12 years hosted in Spain. Six different intestinal parasites were identified in this study and 78, 46, 40, 24, 13 and 5 were positive for Giardia lamblia (29%), Entamoeba coli (17%), Blastocystis hominis (15%), Endolimax nana (9%), Hymenolepis nana (5%) and Enterobius vermicularis (2%), respectively. Mixed intestinal parasitic infections were seen in 12 (4.4%) studied children. Six (2.2%) double infections for G. lamblia and B. hominis were seen in these children while in four (1.5%) had G. lamblia and H. nana. Triple intestinal parasitic infections of G. lamblia, B. hominis and H. nana were observed in two (0.7%) of the children studied. In the other hand, about 14.8% of the studied children had a mild anaemia and 15.5 and 16.6% had iron deficiency and eosinophilia, respectively.

Effectiveness of chondroitin sulphate in patients with concomitant knee osteoarthritis and psoriasis: a randomized, double-blind, placebo-controlled study.

OBJECTIVE: The aim of the trial was to assess the efficacy of chondroitin sulphate (CS) on symptomatic knee osteoarthritis (OA) associated to psoriasis. METHODS: In this randomized, double-blind, placebo (PBO)-controlled clinical trial 129 patients with symptomatic knee OA and concomitant psoriasis were randomized into two groups receiving 800 mg daily of CS or PBO for 3 months. The primary efficacy outcome for knee OA was the Huskisson's visual analogue scale (VAS) and for psoriasis was the Psoriasis Area and Severity Index (PASI). Additionally, other secondary efficacy criteria for both conditions were assessed. RESULTS: After 3 months of treatment, CS was more effective than PBO, relieving pain VAS (CS -26.9+/-24.8 vs PBO -14.23+/-20.8mm, P<0.01), decreasing the Lequesne index (CS -4.8+/-3.4 vs PBO -3.3+/-3.5, P<0.05) and reducing the number of patients using acetaminophen as rescue medication (CS 43% vs PBO 64%, P<0.05). Regarding PASI, Overall Lesion Severity Scale and Physician's Global Assessment of Change no statistically significant changes were detected in front of PBO. However, CS improved plantar psoriasis compared to PBO (CS 87% vs PBO 27%, P<0.05). Quality of life improved significantly in CS-treated patients according to the Short Form-36 health survey and the Dermatology Life Quality Index (DLQI). CS tolerability was excellent. Adverse events were infrequent and evenly distributed among groups. The incidence of psoriatic flares did not increase after treatments. CONCLUSIONS: This study confirms the efficacy and safety of CS as a symptomatic slow-acting drug in patients with knee OA and shows that CS improves plantar psoriasis. The use of CS could represent a special benefit in patients with both pathologies since non-steroidal anti-inflammatory drugs have been reported to induce or exacerbate psoriasis.

Double-blind, randomized, placebo-controlled Phase I Clinical Trial of the therapeutical antituberculous vaccine RUTI.

A Phase I interventional Clinical Trial was performed with a potential tuberculosis vaccine, based on detoxified cellular fragments of M. tuberculosis, named RUTI. The objective was to evaluate the safety profile and T-cell immune responses over a 6-month period following subcutaneous inoculation. The double-blind, randomized and placebo-controlled trial was conducted in healthy volunteers, all recruited at one site. RUTI, at each of the four tested doses, starting from 5microg and going up to 200microg, and placebo were inoculated to groups of 4 and 2 volunteers respectively, consecutively. RUTI appeared to be well tolerated as judged by local and systemic clinical evaluation, though vaccine dose dependent local adverse reactions were recorded. T-cell responses of blood lymphocytes to PPD and a number of antigen subunits were elevated, when compared with controls subjects. These results support the feasibility of future evaluation, to be targeted at subjects with latent tuberculosis infection (LTBI).

Evaluation of the triangular fibrocartilage in cadaveric wrists by means of arthrography, magnetic resonance (MR) imaging, and MR arthrography.

PURPOSE: To evaluate the diagnostic accuracy of arthrography, magnetic resonance (MR) imaging, and MR arthrography in the detection and localization of defects of the triangular fibrocartilage (TFC) in cadaveric wrists, using arthroscopy as a reference standard. MATERIAL AND METHODS: Twenty-four specimen wrists were evaluated. The different imaging modalities were blinded to reviewers and were interpreted independently. A classification of TFC defects was used for the evaluation of images in the different imaging modalities, thus permitting a more uniform correlation. Two cases were excluded from the MR imaging study because of poor image quality. Contingency tables with the chi-square test and Fisher's exact test were used for statistical analysis. RESULTS: Defects of the TFC were identified in 17 of the 24 specimen wrists by means of arthroscopy, and 16 defects were observed when arthrography was carried out. With MR imaging 14 defects of the TFC were detected in the 22 specimen wrists evaluated, and with MR arthrography 16 defects were observed. Most defects were central or combined (two or more defects). In comparison to arthroscopy, the accepted diagnostic gold standard, the following results were found for arthrography in the detection of TFC defects: sensitivity 95%, specificity 100%, and accuracy 95% (P<0.0005); for MR imaging: sensitivity 86%, specificity 85%, and accuracy 70% (P<0.002); and for MR arthrography: sensitivity 100%, specificity 85%, and accuracy 95% (P<0.0005). CONCLUSION: The results of the study seem to indicate that both arthrography and MR arthrography have high accuracy, and either would be useful for evaluation of the TFC. The combined approach using both techniques would have a very high accuracy equivalent to that resulting from arthroscopy.

Estudio comparativo de diversos métodos de inducción de aterogénesis experimental en el pollo / Comparative study of several induction methods of experimental atherogenesis in the chicken

Dada la importancia de la arteriosclerosis y sus consecuencias clínicas en las sociedades desarrolladas (primera causa de muerte en Europa y EEUU) resulta interesante disponer de modelos animales en los que reproducir la enfermedad de cara a la investigación básica y aplicada en esta materia. El pollo reproduce espontáneamente y de forma inducida estos procesos, además de otras ventajas como su fácil disponibilidad, precio o similitud de las lesiones con el hombre. El objetivo de este trabajo era estandarizar los métodos de inducción de la aterogénesis en este biomodelo aviar, de cara a plantearnos ensayos con diversos principios activos, para conseguir la regresión de las lesiones arterioscleróticas. En base a las experiencias realizadas, se llega a la conclusión que, para conseguir resultados uniformes mediante el uso del biomodelo de arteriosclerosis del pollo, resulta más conveniente el uso de colesterol puro añadido a una dieta estándar que la mezcla a base de huevo. Por otro lado, debe utilizarse un vehículo como el aceite de palma líquido para facilitar la absorción del colesterol a nivel digestivo, y suministrar la mezcla ad libitum (AU)

Atherosclerosis and its consequences continue to be the major cause of death in Europe and the United Status. Animals have been used as experimental models in atherosclerosis-related research since the turn of the past century. The chicken is a good animal model and offers economic and technical advantages over mammalian models. Furthermore, it is able to develop spontaneous and induced atherosclerosis, and there is no essential difference between vascular lesions seen in chickens as a result of cholesterol diet and that of atherosclerosis observed in man. In this work, we examine several induction methods of atherogenesis in the chicken experimental model. It may be concluded that adding cholesterol to an standard diet gives better results, than using an egg-based diet. Palm oil results an excellent mean of increasing the digestive absortion of cholesterol. The atherogenic diet must be administered ad libitum (AU)

Uso del pollo como biomodelo experimental en arteriosclerosis / Use of the chicken as experimental biomodel in atherosclerosis

En este artículo se describen los principales trabajos que justifican el interés del pollo en el estudio de la arteriosclerosis. Se comentan estudios de arteriosclerosis espontánea y arteriosclerosis experimental o inducida, así como los modelos mutantes. Se detallan los más importantes métodos experimentales aplicados, diferenciando los estudios en animales intactos, con y sin denudación, los estudios en arterias aisladas, los llevados a cabo e cultivos celulares y los que emplean la aféresis (AU)

Tratamiento de la hipertensión esencial / The arterial hipertension treatment

Se revisa la hipertensión arterial (HTA) y su tratamiento. Inicialmente se definen el concepto de HTA y los factores de riesgo que condicionan su tratamiento. A continuación se describen las medidas no farmacológicas para el tratamiento de la HTA. Posteriormente se revisan los hipotensores clásicos junto con las últimas novedades terapéuticas (antagonistas de los receptores de angiotensina II). Se plantea el algoritmo del tratamiento establecido por The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI), y cuáles son los fármacos que deben escogerse en presencia de enfermedades concomitantes. Por último se repasa el tratamiento de las urgencias y emergencias hipertensivas (AU)

A review of vinorelbine in the treatment of breast cancer.

As combinations and sequences of anthracyclines and taxanes increasingly become standard adjuvant treatment for early breast cancer, a major need for new treatment options for metastatic breast cancer will arise. Vinorelbine is highly active in the treatment of metastatic breast cancer, both as a single agent and in combination regimens. Furthermore, it is well tolerated, with a low incidence of subjective toxicities. It is anticipated, therefore, that vinorelbine will become increasingly utilized for treating metastatic breast cancer due to its favorable safety profile, good tolerability, and promising results in combination with other chemotherapy agents. Combinations with trastuzumab and newer molecular targeting agents are being explored. Doublets or triplets of vinorelbine with drugs other than anthracyclines and taxanes could be considered in the next generation of adjuvant and neoadjuvant trials, where it is anticipated that anthracycline/taxane combinations are likely to replace anthracycline/cyclophosphamide combinations as the mainstay of adjuvant treatment.