Association between human papillomavirus in men and their sexual partners and uterine cervical intraepithelial neoplasia.

OBJECTIVES: To determine whether the presence of human papillomavirus (HPV) in men is a risk factor in the development of intraepithelial cervical neoplasia in their sexual partners and to corroborate HPV frequency and type. MATERIALS AND METHODS: A case-control study was carried out in the city of Colima, Mexico, from October 2004 to September 2005. It included the male sexual partners of females presenting with intraepitheleal neoplasia and with negative cervical uterine cytology. The study was approved by the local ethics committee, and participants signed a letter of informed consent. Samples were taken from the penis with a cytobrush and were analyzed by polymerase chain reaction (PCR) with type-specific HPV consensus primers. Statistical analysis was carried out using averages, percentages, and chi-square test for association. RESULTS: Twenty-one patients and 40 controls were analyzed. Eight were excluded due to DNA degradation. Chi-square test was utilized to find association between risk factor (HPV in men) in men whose sexual partners were women with premalignant lesions and normal Papanicolaou test. There was no statistical significance; OR was 2.5, CI was 0.38-16.41, and P = 0.37 (Fisher's exact test). There was no significant difference between the two study groups. Four HPV-positive cases (19%) were obtained from the case group, and two HPV-positive cases (6%) were obtained from the control group. The six positive samples had low-grade virus. There was no association between HPV in men and the cervical intraepitheleal neoplasia of their sexual partners. CONCLUSIONS: In the present study, HPV in men was not found to be a risk factor in the development of cervical uterine lesions. The viruses that were found were low risk. The sample size employed was not large enough to be able to determine any differences between both study groups.

Comparison of combined spinal and general anesthesia block and combined epidural and general anesthesia block in laparoscopic cholecystectomy.

OBJECTIVE: Combined spinal and general anesthesia block (CSGAB) and combined epidural and general anesthesia block (CEGAB) in laparoscopic cholecystectomy were compared. MATERIAL AND METHODS: Forty patients were randomly selected (ASA physical status I-II) to receive sevoflurane plus 10 to 15 mg of bupivacaine weighed at 0.5% and 20 microg of fentanyl (CSGAB) or sevoflurane plus 150 mg of ropivacaine and 1 microg/kg of fentanyl (CEGAB). Blood pressure, heart rate, oxygen and carbon dioxide saturation, drug doses and sevoflurane MAC (minimum alveolar concentration) were evaluated during surgery. Anesthesia recovery time and pain intensity and duration were evaluated during the first two postoperative hours. Frequency of incisional or referred pain, dyspnea, headache, cramping, nausea and vomiting were evaluated 24 hours after surgery. Statistical analysis was carried out using the Chi-square test and Student t test. Relative risk, absolute risk reduction and number needed to treat (NNT) for adverse reactions were determined. RESULTS: Systolic and diastolic arterial pressures posterior to semi-Fowler's position were lower in the CSGAB group than in the CEGAB group. (94 +/- 16 vs. 110 +/- 18 mmHg; p < 0.01 and 59 +/- 8 vs. 69 +/- 12, mmHg; p < 0.01, respectively). Anesthesia recovery time (32 +/- 17 vs. 61 +/- 29 minutes; p < 0.01) and pain duration (26 +/- 42 vs. 83 +/- 46 minutes; p < 0.01) were shorter in the CSGAB group. NNT was 8 for postoperative pain, 8 for nausea, and 95 for vomiting. CONCLUSIONS: CSGAB was more efficacious for rapid anesthesia recovery and had a shorter post-operative pain duration than CEGAB.

[Frequency of intestinal helminthiasis and its association with iron deficiency and malnutrition in children from western Mexico]. / Frecuencia de helmintiasis intestinal y su asociación con deficiencia de hierro y desnutrición en niños de la región occidente de México.

OBJECTIVE: To determine intestinal helminthiasis frequency and its association with malnutrition and iron deficiency. MATERIAL AND METHODS: An analytical cross-over study was carried out on children in the municipality of Comala, Colima, Mexico. Coproparasitoscopic exams in series of three using the Kato-Katz technique were performed in all children. To evaluate the degree ofmalnutrition, the following anthropometric indices were determined: means and z-scores for weight/height, height/age, weight/age. Severe, moderate and minimal iron deficiency was considered when ferritin was: < or = 12 ng/ml, 12 to 18 ng/mL and 19 to 24 ng/mL, respectively. RESULTS: 243 children were studied with an average age of 65.3+/-8.7 months. 60.9% (n = 148) of the children showed a decrease in ferritin levels and 2.5% (n = 6) had anemia. 16% (n = 39) had trichuriasis, 6.9% (n = 17) ascariasis and 5.3% (n = 13) had both parasites. Trichiura infection was associated with declining health (OR 11.0, CI 3.9-30.8; p<0.001) and with iron deficiency, with cut-off points of <24 ng (OR 2.0, CI 1.0-3.9, p = 0.02) and <18 ng/ dL (OR 2.2, CI 1.2-4.2, p= 0.009). Ascaris infection was not associated with malnutrition or iron deficiency. CONCLUSIONS: Trichiura infection was associated with declining health and slight and moderate degrees of iron deficiency.

Frecuencia de helmintiasis intestinal y su asociación con deficiencia de hierro y desnutrición en niños de la región occidente de México / Frequency of intestinal helminthiasis and its association with iron deficiency and malnutrition in children from western Mexico

Objetivo: Determinar la frecuencia de helmintiasis intestinal y su asociación con desnutrición y deficiencia de hierro. Material y métodos: Se realizó un estudio transversal analítico en el municipio de Comala, Colima, México. A todos los niños, se les determinó coproparasitoscópico seriado de tres días con la técnica de Kato-Katz. Para evaluar el grado de desnutrición; se establecieron los siguientes índices antropométricos: mediana y puntajes Z para peso/ talla, talla/edad y peso/edad. Se consideró que había deficiencia de hierro severa, moderada o leve con ferritina ≤ 12 ng/ ml, de 12 a 18 ng/mL y de 19 a 24 ng/mL respectivamente. Resultados: Se estudiaron 243 niños con una edad promedio de 65.3 ± 8.7 meses. El 60.9 % (n = 148) y el 2.5 % (n = 6) de los niños presentaron disminución de la ferritina y anemia respectivamente. El 16 % (n = 39) mostró trichuriasis, el 6.9 % (n = 17) ascariasis y el 5.3 % (n = 13) ambas. La infección por Trichuris trichiura se asoció a desmedro (OR 11.0, IC 3.9-30.8; p < 0.001) y a deficiencia de hierro con puntos de corte de < 24 ng (OR 2.0, IC 1.0-3.9, p = 0.02) y < 18 ng/dL (OR 2.2, IC 1.2-4.2, p = 0.009). La infección por ascaris no se asoció con desnutrición o deficiencia de hierro. Conclusiones: La infección de T. trichiura se asoció con desmedro y deficiencia de hierro grado leve y moderado.

OBJECTIVE: To determine intestinal helminthiasis frequency and its association with malnutrition and iron deficiency. Material and METHODS: An analytical cross-over study was carried out on children in the municipality of Comala, Colima, Mexico. Coproparasitoscopic exams in series of three using the Kato-Katz technique were performed in all children. To evaluate the degree ofmalnutrition, the following anthropometric indices were determined: means and z-scores for weight/height, height/age, weight/age. Severe, moderate and minimal iron deficiency was considered when ferritin was: < or = 12 ng/ml, 12 to 18 ng/mL and 19 to 24 ng/mL, respectively. RESULTS: 243 children were studied with an average age of 65.3+/-8.7 months. 60.9% (n = 148) of the children showed a decrease in ferritin levels and 2.5% (n = 6) had anemia. 16% (n = 39) had trichuriasis, 6.9% (n = 17) ascariasis and 5.3% (n = 13) had both parasites. Trichiura infection was associated with declining health (OR 11.0, CI 3.9-30.8; p<0.001) and with iron deficiency, with cut-off points of <24 ng (OR 2.0, CI 1.0-3.9, p = 0.02) and <18 ng/ dL (OR 2.2, CI 1.2-4.2, p= 0.009). Ascaris infection was not associated with malnutrition or iron deficiency. CONCLUSIONS: Trichiura infection was associated with declining health and slight and moderate degrees of iron deficiency.

An alpha-lipoic acid-vitamin E mixture reduces post-embolism lipid peroxidation, cerebral infarction, and neurological deficit in rats.

Oxidative stress increases delayed neuronal death in the brain following ischemia. As a consequence, many attempts to reduce the damage resulting from cerebral ischemia under more highly oxidized conditions have focused on treatments aimed at maintaining the redox equilibrium of the local environment. This study demonstrates the synergistic effects of combining treatments with alpha-lipoic acid (LA) and vitamin E (VE) as an efficient measure to reduce the damage caused by cerebral ischemia. Two oral therapeutic protocols were examined: intensive treatment (100 mg/kg LA and 140 mg/kg VE for 7 days after ischemia) and prophylactic treatment (20 mg/kg LA and 50 mg/kg VE from 30 days before infarction up to the day of sacrifice). The prophylactic treatment reduced serum lipid peroxidation, and diminished brain infarct volume by approximately 50%. Furthermore, prophylactically treated rats showed a reduction in post-ischemia neurological scores. No significant differences were found in the intensively treated group. Our data indicate that pre-ischemia administration of the LA-VE antioxidant mixture reduced the volume of brain damaged and the functional consequences of embolic infarction. These findings suggest that prophylaxis with an LA-VE mixture may be valuable in reducing cerebral damage levels in patients with a high risk of stroke.