ABSTRACT
OBJECTIVE: To analyze the possible in vitro effect of the cytokine RANKL and bacteria involved in apical periodontitis on the differentiation of macrophages into osteoclasts. MATERIAL AND METHODS: Bacteria were isolated (mainly E. faecium and E. faecalis) from the root canal of fifty patients with apical periodontitis, the possible effect of these bacteria on the phagocytic activity of the monocyte cell line THP-1 was analyzed by flow cytometry. Furthermore, the effect of these bacteria (alone or in combination with the cytokine RANKL) on the differentiation of THP-1 macrophages into osteoclasts was analyzed through the expression of the receptor RANK and the tartrate-resistant acid phosphatase TRAP. Finally, the release of different cytokines (IL-1ß, TNF-α, IL-6, IL-8, IL-10, and IL-12p70) by THP-1 cells induced to differentiate into osteoclasts was also analyzed. RESULTS: We observed a significant proportion of THP-1 cells were able to internalize E. faecium and E. faecalis. Furthermore, these bacteria were able to induce (alone or in combination with RANKL) a significant expression of RANK by THP-1 macrophages; accordingly, E. faecium and E. faecalis induced very significant levels of TRAP in these cells. Finally, during the differentiation of THP-1 macrophages induced by RANKL or bacteria, a significant release of the pro-inflammatory cytokines IL-6 and TNF-α was observed. CONCLUSIONS AND CLINICAL RELEVANCE: Our data suggest that the causative agents of apical periodontitis can induce the differentiation of osteoclasts as well as the release of pro-inflammatory cytokines, phenomena that may have an important role in the bone damage observed in this condition.
Subject(s)
Osteoclasts , Periapical Periodontitis , Humans , Tumor Necrosis Factor-alpha/metabolism , Interleukin-6/metabolism , Macrophages , Cell Differentiation , Cytokines/metabolism , Periapical Periodontitis/microbiology , Bacteria , RANK Ligand/metabolismABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Metacarpal Bones/abnormalities , Metacarpal Bones , Erythema/complications , Erythema/etiology , Necrosis/complications , Necrosis , Adrenal Cortex Hormones/therapeutic use , Metacarpal Bones/physiopathology , Metacarpal Bones/surgery , Hand/pathology , Hand , Osteotomy/instrumentation , Osteotomy/methods , Arthroplasty/methods , ArthroplastyABSTRACT
La elección del fármaco adecuado en el tratamiento del trastorno por déficit de atención e hiperactividad (TDAH) debe basarse en la característica individuales del paciente. El tamaño de efecto de los fármacos no estimulantes es menor que el de los estimulantes, pero esta diferencia se minimiza en estudios de larga duración y en pacientes naïve. Se debe considerar su uso en el caso de comorbilidades como el trastorno por tics, el trastorno ansioso depresivo o en el abuso de sustancias. Dentro del grupo de fármacos no estimulantes, la atomoxetiva en el único aprobado en España para esta indicación, con un inicio de acción que puede tardar varias semanas. Su mecanismo de acción se basa en el bloqueo de la recaptación de noradrenalida. La clonidina, el bupropión y los antidepresivos tricíclicos están disponibles par su uso pero no cuentan con indicación para el TDAH. Próximamente contaremos con nuevos recursos terapéuticos en este grupo, con la aprobación de uso de la guanfacina de liberación prolongada (AU)
Choosing the right drug in the treatment of ADHD should be based on individual patient characteristics. The effect size of the non-stimulant drug is less than the stimulant, but this difference is minimized in long-term studies or in naive patients. Its use should be considered in the case of comorbidities such as tic disorder, depressive anxiety disorder or substance abuse. Within the group of non-stimulant drugs, atomoxetine is the only approved for this indication in Spain, with its onset of action may take several weeks. Its mechanism of action in based on blocking the reuptake of norepinephrine. Clonidine, bupropion and tricyclic antidepressants are available for use but not indicated for ADHD. Coming soon will have new therapeutic resources in this group, with the approval of use of guanfacine extended release (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Attention Deficit Disorder with Hyperactivity/drug therapy , Atomoxetine Hydrochloride/therapeutic use , Antidepressive Agents/pharmacology , Adrenergic alpha-Agonists/pharmacology , Central Nervous System Stimulants/adverse effects , Amphetamines/adverse effects , Methylphenidate/adverse effectsABSTRACT
El TDAH es el trastorno del neurodesarrollo más frecuente en la infancia. Los estudios han demostrado que el tratamiento más efectivo es aquel que tiene un enfoque multimodal con la implicación de la familia profesores y orientadores escolares. La terapia cognitivo-conductual (indicada como tratamiento inicial de este trastorno) y el entrenamiento para padres han demostrado tener efectos positivos en el control de la sintomatología de TDAH y los problemas de conducta. El TDAH conduce a graves dificultades en el control del tiempo, en la planificación y organización, en la persistencia ante la realización y finalización de un tarea, en el seguimiento de las normas, en la automotivación, en la memoria de trabajo y en otra funciones que si no se abordan de forma adecuada conducirán al alumno con TDAH al fracaso escolar. Por ello, el abordaje en el entorno escolar se convierte en algo prioritario en este tipo de pacientes. Este trabajo resume las principales técnicas conductuales y de abordaje en el entorno escolar aplicables al tratamiento global del TDAH (AU)
ADHD is the most frequency neurodevelopmental disorder during the childhood and adolescent. Studies have shown that the most effective treatment is a multimodal approach with the involvement of the family, teachers and counselors. Cognitive behavioral therapy (indicated as initial treatment of this disorder) and parthent training have shown positive affects in controlling the symptoms of ADHD and conduct problems. ADHD leads to serius difficulties in the control of time, planing and organization, persistence to the implementrion and completion of a task, in following the rules, motivation, working memory and other functions, if it is not addressed properly will lead the student with ADHD enviroment becomes a priority in these approach and techniques in the scholl invironment applicable to the overall treatment of ADHD (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Attention Deficit Disorder with Hyperactivity/therapy , Cognitive Behavioral Therapy , FamilyABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Azygos Vein/physiopathology , Aneurysm/complications , Respiratory Insufficiency/complications , Radiography, ThoracicABSTRACT
Presentamos el caso de un varón de 52 años, con antecedentes de cólicos renoureterales que había consultado por un episodio de similares características, acompañado de fiebre y elevaciones de la GGT y de la fosfatasa alcalina. Una ecografía abdominal mostró hepatoesplenomegalia y un material ecogénico en el eje esplenoportal, sugerente de trombosis. La TAC abdominal demostró trombosis de la vena mesentérica inferior, continuándose por la vena esplénica hasta el origen proximal de la vena porta. También se observaron numerosos divertículos. Se sospechó que el paciente presentaba una diverticulitis aguda complicada con trombosis vascular, por lo que se decidió la realización de cirugía, que confirmó la existencia de diverticulitis sin perforación ni abscesos, flebitis con pileflebitis de la arteria mesentérica inferior hasta su unión con la vena esplénica, con salida de pus al seccionar la vena. Se realizó ligadura de la vena mesentérica inferior e intervención de Hartman con ligadura del muñón rectal y colostomía. Además se indicó tratamiento antibiótico de amplio espectro y anticogulación, siendo la evolución favorable. Posteriormente comentamos algunos aspectos etiológicos, clínicos, diagnósticos y terapéuticos de esta infrecuente complicación de la diverticulitis
A case of a 52 year-old-male, with past medical history of renoureteral crisis and recurrent episodes of abdominal pain, is presented. The patient presented to the Emergency Department with abdominal pain (similar to previous episodes), fever and abnormal liver function test (marked elevation of gammaglutamyltranspeptidase and alkaline phosphatase). An abdominal ultrasound was performed showing hepatomegaly, and enlarged spleen and an echogenic material that suggested a thrombosis. A CT scan confirmed the thrombosis of the inferior mesenteric vein extending up to the splenic vein and the portal vein. It also showed a large number of diverticulum. Surgery was performed in order to rule out an acute diverticulitis. A phylephlebitis, infective suppurative thrombosis of the portal vein and its branches (inferior mesenteric vein and splenic vein) was found due to an acute diverticulitis with neither perforation nor abscess. A ligature of the inferior mesenteric vein and a Hartmann procedure with resection of the diseased colon, and end colostomy and creation of a rectal stump, were performed. A favourable outcome was obtained with antibiotics and anticoagulation. Some aspects of the aetiology, symptoms, diagnosis and treatment of this unusual complication of diverticulitis are also presented
Subject(s)
Male , Middle Aged , Humans , Phlebitis/complications , Phlebitis/diagnosis , Diverticulitis/complications , Tomography, Emission-Computed/methods , Ampicillin/therapeutic use , Gentamicins/therapeutic use , Metronidazole/therapeutic use , Phlebitis/physiopathology , Phlebitis , Fever/diagnosis , Fever/etiology , Abdomen , Venous Thrombosis/complications , Portal Vein/pathology , Portal Vein/surgery , Hypertension, Portal/complications , Hypertension, Portal/diagnosisABSTRACT
No disponible
No disponible
Subject(s)
Female , Adult , Humans , Bacteremia/diagnosis , Bacteremia/therapy , Pantoea/isolation & purification , Cross Infection/complications , Cross Infection/diagnosis , Cross Infection/etiology , Protein Deficiency/diagnosis , Vancomycin/therapeutic use , Ceftazidime/therapeutic use , Ciprofloxacin/therapeutic use , Cross Infection/therapy , Bacteremia/complications , Pantoea/pathogenicity , Protein Deficiency/complications , Cross Infection/transmission , Enterococcus faecalis/isolation & purification , Enterococcus faecalis/pathogenicity , Protein Deficiency/pathology , Protein Deficiency/physiopathologyABSTRACT
A case of a 52 year-old-male, with past medical history of renoureteral crisis and recurrent episodes of abdominal pain, is presented. The patient presented to the Emergency Department with abdominal pain (similar to previous episodes), fever and abnormal liver function test (marked elevation of gammaglutamyltranspeptidase and alkaline phosphatase). An abdominal ultrasound was performed showing hepatomegaly, and enlarged spleen and an echogenic material that suggested a thrombosis. A CT scan confirmed the thrombosis of the inferior mesenteric vein extending up to the splenic vein and the portal vein. It also showed a large number of diverticulum. Surgery was performed in order to rule out an acute diverticulitis. A phylephlebitis, infective suppurative thrombosis of the portal vein and its branches (inferior mesenteric vein and splenic vein) was found due to an acute diverticulitis with neither perforation nor abscess. A ligature of the inferior mesenteric vein and a Hartmann procedure with resection of the diseased colon, and end colostomy and creation of a rectal stump, were performed. A favourable outcome was obtained with antibiotics and anticoagulation. Some aspects of the aetiology, symptoms, diagnosis and treatment of this unusual complication of diverticulitis are also presented.
Subject(s)
Diverticulitis/complications , Phlebitis/etiology , Portal Vein , Sigmoid Diseases/complications , Humans , Male , Middle Aged , Sepsis/etiology , Thrombosis/etiologyABSTRACT
No disponible
Subject(s)
Male , Middle Aged , Humans , Arthritis, Infectious/diagnosis , Osteomyelitis/diagnosis , Spondylarthritis/diagnosis , Streptococcal Infections/diagnosis , Streptococcus agalactiae , Arthritis, Infectious/complications , Osteomyelitis/complications , Spondylarthritis/complications , Streptococcal Infections/complicationsABSTRACT
La disgregación de los comprimidos es un paso previo fundamental para la liberación del principio activo, pudiendo influir en su biodisponibilidad y efecto terapéutico. Los disgregantes constituyen un componente de gran importancia en la formulación de comprimidos, pero son tan variados los mecanismos por los que ejercen su acción, que no siempre es fácil la elección del disgregante idóneo. Dentro de los distintos mecanismos de disgregación propuestos por diversos autores, destacan el hinchamiento de las partículas de disgregantes y la porosidad o red capilar porosa. En este trabajo se revisan los diferentes mecanismos de acción de los disgregantes así como los factores susceptibles de influir en el proceso de disgregación
The disintegration of tablets is a fundamentalprevious step for the liberation of the activeprinciple from the pharmaceutical dosage form,being able to influence in its bioavailability and therapeutic effect. The disgregantes constitute a component of great importance in the tablet formulation, but so the mechanisms are varied by which they exert his action, that not alwaysis easy the election of the suitable disintegrant. Within the different mechanisms of disintegration proposed by diverse authors, they emphasize the swelling of particles of disintegrants and the porosity or porous hair network. In this work the different mechanisms from action of the disgregantes as well as the factors susceptible are reviewed to influence in the disintegration process The disintegration of tablets is a fundamental previous step for the liberation of the active principle from the pharmaceutical dosage form, being able to influence in its bioavailability and therapeutic effect. The disgregantes constitute a component of great importance in the tablet formulation, but so the mechanisms are varied by which they exert his action, that not always is easy the election of the suitable disintegrant. Within the different mechanisms of disintegration proposed by diverse authors, they emphasize the swelling of particles of disintegrants and the porosity or porous hair network. In this work the different mechanisms from action of the disgregantes as well as the factors susceptible are reviewed to influence in the disintegration process
Subject(s)
Tablets/metabolism , Tablets/pharmacology , Tablets/pharmacokinetics , Biological Availability , Pharmaceutical Preparations/administration & dosage , Pharmaceutical Preparations/metabolism , Pharmaceutical Preparations/supply & distribution , Tablets/chemistry , Tablets/chemical synthesis , Tablets/supply & distribution , Tablets/standards , Pharmaceutical Preparations/chemical synthesis , Pharmaceutical Preparations/isolation & purification , Pharmaceutical Preparations/standardsSubject(s)
Arthritis, Infectious/diagnosis , Osteomyelitis/diagnosis , Spondylarthritis/diagnosis , Streptococcal Infections/diagnosis , Streptococcus agalactiae , Arthritis, Infectious/complications , Humans , Male , Middle Aged , Osteomyelitis/complications , Spondylarthritis/complications , Streptococcal Infections/complicationsSubject(s)
Atrial Fibrillation/complications , Splenic Infarction/etiology , Atrial Fibrillation/diagnosis , Cardiomyopathy, Dilated/complications , Echocardiography , Electrocardiography , Forced Expiratory Volume , Humans , Male , Middle Aged , Radiography, Abdominal , Splenectomy , Splenic Infarction/diagnosis , Splenic Infarction/diagnostic imaging , Splenic Infarction/surgery , Tomography, X-Ray ComputedSubject(s)
Carcinoma, Hepatocellular/complications , Chylous Ascites/etiology , Liver Neoplasms/complications , Aged , Aged, 80 and over , Carcinoma, Hepatocellular/diagnosis , Chylous Ascites/diet therapy , Chylous Ascites/drug therapy , Diuretics/therapeutic use , Hepatitis B, Chronic/complications , Hepatitis C, Chronic/complications , Humans , Liver Cirrhosis/etiology , Liver Neoplasms/diagnosis , Male , Parenteral Nutrition , Triglycerides/therapeutic useABSTRACT
La elaboración de la mayoría de las formas farmacéuticas, y concretamente los comprimidos, precisa una serie de operaciones básicas previas, entre las que se encuentra la pulverización o molienda, mediante la cual se consigue una reducción en el tamaño de partícula. Del proceso de molienda llevado a cabo va a depender tanto el tamaño como la distribución del tamaño de partícula obtenido y por tanto muchas de sus propiedades como fluidez, estabilidad, propiedades de cesión, etc. Además el proceso de molienda da lugar a importantes cambios en la reactividad del sólido, como la reactividad en medio líquido, que influye directamente sobre la solubilidad. En este trabajo se revisan diversos estudios que analizan la influencia del tamaño de partícula sobre las propiedades de compresión de diferentes materiales y las de los comprimidos obtenidos a partir de éstos (AU)
Subject(s)
Humans , Tablets/chemistry , Drug Stability , Drug Compounding/methods , Technology, Pharmaceutical/methodsABSTRACT
No disponible
Subject(s)
Middle Aged , Male , Humans , Splenectomy , Splenic Infarction , Tomography, X-Ray Computed , Radiography, Abdominal , Atrial Fibrillation , Echocardiography , Electrocardiography , Forced Expiratory Volume , Cardiomyopathy, DilatedSubject(s)
Hyponatremia/etiology , Hypopituitarism/diagnosis , Adrenal Insufficiency/etiology , Analgesics, Opioid/adverse effects , Colic/drug therapy , Confusion/chemically induced , Confusion/etiology , Disease Progression , Empty Sella Syndrome/diagnostic imaging , Empty Sella Syndrome/etiology , Female , Fluid Therapy/adverse effects , Humans , Hypopituitarism/complications , Hypothyroidism/etiology , Kidney Diseases/complications , Kidney Diseases/drug therapy , Meperidine/adverse effects , Middle Aged , RadiographyABSTRACT
No disponible
