Knight by force and wounded, protecting without a shield: A meta-ethnography of men's experiences after an involuntary pregnancy loss.

OBJECTIVE: To synthesize the available body of qualitative research regarding the experiences of men after an involuntary pregnancy loss. DESIGN: Noblit and Hare's interpretive meta-ethnography of 13 original qualitative articles was carried out. RESULTS: After reciprocal and refutational translations, the lines of argument synthesis were developed, together with the metaphor "Knight by force and wounded, protecting without a shield." This metaphor symbolizes the experience of men after an involuntary pregnancy loss. CERQual assessment showed that the results are a (highly) reasonable representation of the phenomenon of interest. CONCLUSIONS: The men attempted to cope with the loss of fatherhood and suffering, while managing the lack of social recognition and social expectations of masculinity in terms of their behaviour and expression of suffering. They tended to be strong, although they did not always have the necessary support or knowledge. IMPLICATIONS FOR PRACTICE: Comprehensive and individualized care that includes the man is required. This requires the theoretical-practical training of nurses and midwives, and the provision of tools that help the emotional management of emotionally demanding care.

The size, number, and distribution of nerve endings around and within the human epiglottis, focusing on tracheal intubation maneuvers.

The aim of this study was to examine the distribution of nerve endings in the mucosa, submucosa, and cartilage of the epiglottis and the vallecula area and to quantify them. The findings could inform the choice of laryngoscope blades for intubation procedures. Fourteen neck slices from seven unembalmed, cryopreserved human cadavers were analyzed. The slices were stained, and cross and longitudinal sections were obtained from each. The nerve endings and cartilage were identified. The primary metrics recorded were the number, area, and circumference of nerve endings located in the mucosa and submucosa of the pharyngeal and laryngeal sides of the epiglottis, epiglottis cartilage, and epiglottic vallecula zone. The length and thickness of the epiglottis and cartilage were also measured. The elastic cartilage of the epiglottis was primarily continuous; however, it contained several fragments. It was covered with dense collagen fibers and surrounded by adipose cells from the pharyngeal and laryngeal submucosa. Nerve endings were found within the submucosa of pharyngeal and laryngeal epiglottis and epiglottic vallecula. There were significantly more nerve endings on the posterior surface of the epiglottis than on the anterior surface. The epiglottic cartilage was twice the length of the epiglottis. The study demonstrated that the distribution of nerve endings in the epiglottis differed significantly between the posterior and anterior sides; there were considerably more in the former. The findings have implications for tracheal intubation and laryngoscope blade selection and design.

Lurasidone for the treatment of schizophrenia in adult and paediatric populations.

Schizophrenia is a common debilitating disorder characterized by significant impairments in how reality is perceived, combined with behavioural changes. In this review, we describe the lurasidone development programme for adult and paediatric patients. Both the pharmacokinetic and pharmacodynamic characteristics of lurasidone are revisited. In addition, pivotal clinical studies conducted on both adults and children are summarized. Several clinical cases, which demonstrate the role of lurasidone in real-world practice, are also presented. Current clinical guidelines recommend lurasidone as the first-line treatment in the acute and long-term management of schizophrenia in both adult and paediatric populations.

Evaluación de la adecuación al protocolo de profilaxis antibiótica en histerectomías. Estudio de cohortes prospectivo / Evaluation of compliance with the antibiotic prophylaxis protocol in hysterectomy. Prospective cohort study

OBJETIVO: Las infecciones relacionadas con la asistencia sanitaria (IRAS) son un problema de salud pública, siendo las infecciones de localización quirúrgica (ILQ) las más frecuentes a nivel hospitalario. El objetivo de este estudio fue evaluar el efecto de la adecuación de la profilaxis antibiótica en la incidencia de infección quirúrgica en pacientes histerectomizadas. MATERIAL Y MÉTODOS: Se realizó un estudio de cohortes prospectivo entre octubre de 2009 y diciembre de 2018. Se estudió la incidencia de ILQ durante los primeros 30 días tras la cirugía. Se evaluó el grado de adecuación de la profilaxis antibiótica en histerectomía y el efecto de su inadecuación en la incidencia de infección con el riesgo relativo (RR) ajustado mediante un modelo de regresión logística. RESULTADOS: Se estudiaron 1.025 intervenciones en 1.022 mujeres. La incidencia acumulada de ILQ fue del 2,1% (n=22) y la etiología más frecuente Escherichia coli (23,1%) y Proteus mirabilis (23,1%). La profilaxis antibiótica estaba indicada en 1.014 intervenciones (98,9%) administrándose en 1.009 de ellas (99,5%), con una adecuación general al protocolo del 92,5%. La causa principal de no cumplimiento fue el tiempo de inicio (40,9%), seguida por la elección del antibiótico (35,2%). El efecto de la inadecuación de la profilaxis sobre la incidencia de infección fue de RR=0,9; IC95% 0,2-3,9; p > 0,05. CONCLUSIONES: La adecuación de la profilaxis antibiótica fue muy alta, con una baja incidencia de infección quirúrgica. No se encontró asociación entre adecuación de la profilaxis e incidencia de infección en histerectomía. Se debe insistir en la mejora continua de la vigilancia epidemiológica en ginecología

OBJECTIVES: Health care-related infections are a public health problem, among them surgical site infection (SSI) are the most frequent in hospitals. The objetive of this study was to assess the effect of the compliance to antibiotic prophylaxis protocol on the incidence of surgical site infection in hysterectomized patients. MATERIAL AND METHODS: A prospective cohort study was carried out between October 2009 and December 2018. The incidence of SSI was studied after a maximum period of 30 days from the moment of surgery. The degree of adequacy of antibiotic prophylaxis in hysterectomy and the effect of its inadequacy on the incidence of infection was evaluated using relative risk (RR) adjusted with a logistic regression model. RESULTS: A total of 1,025 interventions were studied in 1,022 women. The cumulative incidence of SSI was 2,1% (n = 22). The most frequent etiology of infection was Escherichia coli (23.1%) and Proteus mirabilis (23.1%). Antibiotic prophylaxis was indicated in 1,014 interventions (98.9%) being administered in 1,009 of them (99.5%). The adherence to the protocol was 92,5%. The main cause of non-compliance was the time of onset (40.9%), followed by the choice of the antibiotic (35.2%). The effect of inadequate prophylaxis on the incidence of infection was RR = 0.9; 95% CI 0.2-3.9; p> 0.05. CONCLUSIONS: The adequacy of antibiotic prophylaxis was very high, with a low incidence of surgical site infection. No association was found between adequacy of prophylaxis and incidence of infection in hysterectomy. The continuous improvement of epidemiological surveillance in gynecology should be emphasized

Nueva técnica de reconstrucción postendodóncica: resina bulk-fill intraconducto vs postes de fibra de vidrio / New postendodontic reconstruction technique: bulk-fill intracanal resin vs glass fiber posts

Introducción: El uso de postes de fibra de vidrio es el método actual más utilizado para la reconstrucción postendodóncica. Sin embargo, su adhesión sigue siendo impredecible debido al control limitado de su técnica de cementación. Las resinas bulk-fill revelan valores de fuerza flexural similares a la dentina y su empleo en la reconstrucción postendodóncica podría ser una alternativa viable y conservadora. Objetivo: Comparar tres técnicas de reconstrucción postendodóncica al medir su resistencia a fuerzas de desalojo, clasificar el tipo de fractura y falla adhesiva, evaluar su costo y tiempo de trabajo. Material y métodos: Se realizan 18 muestras divididas en tres grupos: grupo 1: poste más cemento de un paso, grupo 2: poste más cemento de tres pasos y grupo 3: reconstrucción postendodóncica con resina bulk-fill. Resultados: En la evaluación de la fuerza al desalojo no se encontró diferencia estadísticamente significativa en los tres grupos. Respecto al comportamiento y falla adhesiva, se encontró una diferencia significativa p < 0.001, favoreciendo a los grupos 2 y 3, por su adhesión en la porción radicular. El tipo de fractura fue restaurable para los tres grupos. Respecto al tiempo y costo, fueron significativamente menores para el grupo 3. Conclusión: En nuestro estudio no existió diferencia significativa en la fuerza al desalojo en los tres grupos; sin embargo, la hubo en el comportamiento, falla adhesiva, costo y tiempo, favoreciendo mayormente al grupo 3. La técnica de reconstrucción con resina puede ser una técnica predecible, suficientemente resistente, conservadora, rápida y de menor costo

Introduction: The use of fiberglass posts is the current method most used for post-endodontic reconstruction. However, its adhesion remains unpredictable due to the limited control of its cementing technique. Bulkfill resins reveal values of flexural strength similar to dentin and their use in post-endodontic reconstruction could be a viable and conservative alternative. Objective: Compare three post-endodontic reconstruction techniques by measuring their resistance to eviction forces, classifying the type of fracture and adhesive failure, evaluating their cost and time of work. Material and methods: 18 samples are divided into 3 groups: group 1: post plus cement of 1 step, group 2: post plus cement of 3 steps and group 3: post-endodontic reconstruction with bulk-fill resin. Results: In the evaluation of the force to the eviction, no statistically significant difference was found in the 3 groups. Regarding the behavior and adhesive failure, a significant difference was found p < 0.001, favoring groups 2 and 3, due to its adhesion in the root portion. The type of fracture was restorable for the 3 groups. Regarding time and cost, they were significantly lower for group 3. Conclusion: In our study there was no significant difference in the force to the eviction in the three groups, however there was in the behavior, adhesive failure, cost and time, favoring mainly the group 3. The technique of reconstruction with resin can be a predictable technique, Sufficiently resistant, conservative, fast and of lower cost (AU)

Experience of a Portuguese Center: Effectiveness of Direct-Acting Antiviral Therapy for Hepatitis C.

INTRODUCTION: In late 2014, Portugal implemented a national program for the treatment of patients with chronic hepatitis C with directacting antiviral agents. This program has made Portugal one of the first European countries to implement a structured measure of treatment to eliminate this serious public health problem. The aim of this study was to assess the effectiveness of direct-acting antiviral therapy in the treatment of patients with chronic hepatitis C virus infection. MATERIAL AND METHODS: A retrospective observational study was conducted at Centro Hospitalar de Lisboa Ocidental on the national online platform from December 2014 until February 2017 and included patients with hepatitis C virus infection who underwent treatment. The primary endpoint was sustained virologic response at least 12 weeks post treatment. Data was analyzed with the SPSS 17.0 program. RESULTS: During the study period, 820 patients completed therapy and achieved sufficient follow-up time to assess sustained virologic response with an overall response rate of 97.2% (n = 797) and a response rate of 98.0%, 99.5%, 90.9%, 95.1% and 94.2% for genotypes 1a, 1b, 2, 3 and 4, respectively. Data suggested that advanced fibrosis (F3/F4), human immunodeficiency virus co-infection and treatment failure with interferon and ribavirin were not negatively related with sustained virologic response in our population. Most patients (80.1%) completed treatment with ledipasvir/sofosbuvir ± ribavirin. The most common adverse events were fatigue and insomnia followed by headache and weight loss. DISCUSSION: Patients predominantly had genotype 1 infection which correlates with HCV distribution in Europe, but we found a major proportion in genotype 4 which can be explained by immigration from African countries. Our patients' ages ranging from 22 to 90 years, reflected a new approach with no upper age limit. Direct-acting antivirals regimens resulted in remarkably high SVR rates compared to interferon-based regimens, which were consistent with clinical trials data. CONCLUSION: Our data showed that direct-acting antiviral-based regimens are safe and have a high success rate in the treatment of patients with hepatitis C virus infection in a real-world setting.

Introdução: No final de 2014 foi implementado em Portugal um programa nacional para o tratamento de doentes com infecção crónica por vírus da hepatite C com recurso a antivíricos de acção directa. Este programa fez com que Portugal fosse um dos primeiros países europeus a implementar uma medida estruturante para a eliminação da hepatite C. Este estudo tem como objectivo a avaliação da efectividade dos antivíricos de acção directa no tratamento da hepatite C crónica. Material e Métodos: Estudo retrospectivo observacional dos doentes seguidos no Centro Hospitalar de Lisboa Ocidental, entre dezembro de 2014 e fevereiro de 2017. O objectivo primário do estudo é avaliar a resposta virológica sustentada a partir das 12 semanas pós tratamento. Analisámos os dados com o programa SPSS 17.0. Resultados: Durante o período do estudo 820 doentes completaram o tratamento e o tempo necessário para avaliação da resposta virológica sustentada. A resposta virológica sustentada global foi de 97.2% (n = 797), com taxas de resposta de 97,2%, 98,5%, 90,9%, 95,1% e 94,2% para os genótipos 1a, 1b, 2, 3 e 4, respectivamente. Os dados sugerem não haver relação entre a fibrose avançada (F3 / F4), a coinfecção pelo vírus da imunodeficiência humana e a falência do tratamento com interferão e ribavirina e uma menor resposta ao tratamento. A maioria dos doentes (80,1%) concluiu o tratamento com ledipasvir/sofosbuvir ± ribavirina. Os eventos adversos mais frequentes foram a fadiga e a insónia, seguida de dor de cabeça e perda de peso. Discussão: A população em estudo apresentou maior prevalência de infecção pelo genótipo 1, à semelhança dos restantes países Europeus, contudo a prevalência do genótipo 4 foi superior, reflectindo a imigração africana. A faixa etária (22 - 90 anos) dos doentes tratados reflecte uma nova abordagem sem limite superior de idade. A taxa de RVS obtida, muito superior à obtida com regimes baseados em interferão, foi consistente com os dados dos ensaios clínicos. Conclusão: Os dados encontrados demonstram que os regimes baseados em antivirais de acção directa, em contexto de vida real, são seguros e eficazes no tratamento de doentes com infecção por vírus da hepatite C.

Saccharomyces cerevisiae mutants affected in vacuole assembly or vacuolar H+-ATPase are hypersensitive to lead (Pb) toxicity.

Lead is an important environmental pollutant. The role of vacuole, in Pb detoxification, was studied using a vacuolar protein sorting mutant strain (vps16Δ), belonging to class C mutants. Cells disrupted in VPS16 gene, did not display a detectable vacuolar-like structure. Based on the loss of cell proliferation capacity, it was found that cells from vps16Δ mutant exhibited a hypersensitivity to Pb-induced toxicity, compared to wild type (WT) strain. The function of vacuolar H(+)-ATPase (V-ATPase), in Pb detoxification, was evaluated using mutants with structurally normal vacuoles but defective in subunits of catalytic (vma1Δ or vma2Δ) or membrane domain (vph1Δ or vma3Δ) of V-ATPase. All mutants tested, lacking a functional V-ATPase, displayed an increased susceptibility to Pb, comparatively to cells from WT strain. Modification of vacuolar morphology, in Pb-exposed cells, was visualized using a Vma2p-GFP strain. The treatment of yeast cells with Pb originated the fusion of the medium size vacuolar lobes into one enlarged vacuole. In conclusion, it was found that vacuole plays an important role in the detoxification of Pb in Saccharomyces cerevisiae; in addition, a functional V-ATPase was required for Pb compartmentalization.

Evaluation of the role of glutathione in the lead-induced toxicity in Saccharomyces cerevisiae.

The effect of intracellular reduced glutathione (GSH) in the lead stress response of Saccharomyces cerevisiae was investigated. Yeast cells exposed to Pb, for 3 h, lost the cell proliferation capacity (viability) and decreased intracellular GSH level. The Pb-induced loss of cell viability was compared among yeast cells deficient in GSH1 (∆gsh1) or GSH2 (∆gsh2) genes and wild-type (WT) cells. When exposed to Pb, ∆gsh1 and ∆gsh2 cells did not display an increased loss of viability, compared with WT cells. However, the depletion of cellular thiols, including GSH, by treatment of WT cells with iodoacetamide (an alkylating agent, which binds covalently to thiol group), increased the loss of viability in Pb-treated cells. In contrast, GSH enrichment, due to the incubation of WT cells with amino acids mixture constituting GSH (L-glutamic acid, L-cysteine and glycine), reduced the Pb-induced loss of proliferation capacity. The obtained results suggest that intracellular GSH is involved in the defence against the Pb-induced toxicity; however, at physiological concentration, GSH seems not to be sufficient to prevent the Pb-induced loss of cell viability.

Influence of preinfarction angina on the release kinetics of endothelial progenitor cells and cytokines during the week after infarction.

BACKGROUND: Preinfarction angina, a possible form of ischaemic preconditioning, improves the prognosis in patients who experience a major ischaemic event; though the associated pathophysiology is not yet fully understood. The aim of this study was to determine the possible involvement of endothelial progenitor cells (EPC), the vascular endothelial growth factor (VEGF) and the hepatocyte growth factor (HGF) in the development of preinfarction angina. METHODS AND RESULTS: We studied 41 patients (60·5 ± 12 years; 34% women) and 14 healthy controls; 43·9% of the patients had preinfarction angina. No differences were found in the baseline characteristics of the two groups. Although the EPC, VEGF and HGF were raised as compared with the control group, no significant differences were found according to the presence or absence of preinfarction angina in the levels of EPC (baseline, P = 0·25; day 3, P = 0·11; day 7, P = 0·32), VEGF (baseline, P = 0·96; day 3, P = 0·06; day 7, P = 0·57) or HGF (baseline, P = 0·18; day 3, P = 1; day 7, P = 0·86). An association was seen in the patients who had preinfarction angina between the EPC levels at baseline and on days 3 and 7 and the HGF on admission with the time from the angina to the STEMI (ß = -0·070; ß = -0·066; ß = -0·081; ß = -80·16; P < 0·05), showing a reduction in the level of EPC cells for each hour passed since the event. CONCLUSIONS: No differences were found in the release kinetics of EPC, VEGF or HGF after a first infarction according to whether the patients had angina during the week before the infarction.

The Malaga schizophrenia case-register (RESMA): overview of methodology and patient cohort.

BACKGROUND: Little information has become available after psychiatric reforms regarding outcomes of persons with schizophrenia and related disorders cared for in community-based mental health facilities. AIMS: The aim of this study was to determine the consequences of psychiatric services in the users of mental health services in Malaga. METHOD: We describe the cohort and methods involved in the Schizophrenia Case Register (RESMA) in Malaga, Spain. All cases (n = 1,022) were users of public mental health services provided in the catchment area over one year. The majority were male (65%), single (68%), living with their original family (50%), with primary education (41%) and living on disability benefits (52%). RESULTS: Concerning use of services, the majority had out-patient contacts (89%). RESULT: s show a substantial overlap in the use of different services during the study period. CONCLUSION: The Malaga Schizophrenia Case Register provides sociodemographic, clinical and service use information for a large sample of patients with schizophrenia or related disorders. Results obtained from the cohort studied will be instrumental for the follow-up and evaluation of the mental health care reform.

Construction of an immunotoxin by linking a monoclonal antibody against the human epidermal growth factor receptor and a hemolytic toxin.

Hybrid molecules obtained through conjugation of monoclonal antibodies and toxins constitute an approach under exploration to generate potential agents for the treatment of cancer and other diseases. A frequently employed toxic component in the construction of such immunotoxins is ricin, a plant toxin which inhibits protein synthesis at ribosomal level and so requires to be internalized by the cell. A hemolytic toxin isolated from the sea anemone Stichodactyla helianthus, which is active at the cell membrane level, was linked through a disulfide bond to the anti-epidermal growth factor receptor monoclonal antibody ior egf/r3. The resulting immunotoxin did not exhibit hemolytic activity except under reducing conditions. It was toxic for H125 cells that express the human epidermal growth factor receptor, but non-toxic for U1906 cells that do not express this receptor.

Construction of an immunotoxin by linking a monoclonal antibody against the human epidermal growth factor receptor and a hemolytic toxin

Hybrid molecules obtained through conjugation of monoclonal antibodies and toxins constitute an approach under exploration to generate potential agents for the treatment of cancer and other diseases. A frequently employed toxic component in the construction of such immunotoxins is ricin, a plant toxin which inhibits protein synthesis at ribosomal level and so requires to be internalized by the cell. A hemolytic toxin isolated from the sea anemone Stichodactyla helianthus, which is active at the cell membrane level, was linked through a disulfide bond to the anti-epidermal growth factor receptor monoclonal antibody ior egf/r3. The resulting immunotoxin did not exhibit hemolytic activity except under reducing conditions. It was toxic for H125 cells that express the human epidermal growth factor receptor, but non-toxic for U1906 cells that do not express this receptor.

Mucosal and systemic adjuvant effects of cholera toxin and Cry1Ac protoxin on the specific antibody response to HIV-1 C4/V3 peptides are different and depend on the antigen co-administered.

Evidence from several sources support the assertion that cholera toxin (CT) is a potent immunogen and mucosal adjuvant; however there are also reports showing its lack of adjuvanticity against some antigens. Cry1Ac protoxin also exerts adjuvant effects in the antibody responses to proteins and polysaccharides but its adjuvanticity with regard to peptide vaccines had not been tested. To probe whether the adjuvant effects of these proteins varied depending on the antigen co-administered, we evaluated antipeptide antibody responses in serum and mucosal samples (vaginal, intestinal, and pulmonary) of mice that were immunized by intranasal or intraperitoneal routes with one of two distinct hybrid C4/V3 HIV peptides, either alone or with CT or Cry1Ac. The tested HIV 1 peptides differed in two aminoacids, T1SP10MN(A) was modified at the SP10 region by the substitution of the isoleucines 12 and 14 for cysteines and was called modified (m)T1SP10MN(A). Our data indicate that the adjuvant effects of CT and Cry1Ac are different. In addition they vary depending on the antigen co-administered and the number of antigen doses, because after three doses moderate adjuvant effects of CT and Cry1Ac on anti-peptide serum and mucosal antibody responses were observed only against the mT1SP10MN(A). In contrast, to attain significant adjuvant effects against the T1SP10MN, four doses were required. Interestingly we found that modification of the HIV peptide increases its immunogenicity without altering the principal neutralizing determinant (SP10).

Evaluación de la toxicidad por administración única del producto QT2B21 en ratas Sprague Dawley / Evaluation of toxicity by the sole administration of the QT2B21 product in Sprague Dawley rats

Se realizó un estudio de toxicidad aguda en ratas Sprague Dawley de ambos sexos mediante la administración oral única del producto QT2B21 obtenido a partir de la especie de helecho Nephrolepis cordifolia, para determinar su toxicidad. Fueron evaluados 3 niveles de dosis: 33,33, 133,32 y 533,28 mg/kg. Se determinaron algunos índices hematológicos sin encontrar efectos tóxicos atribuibles a la administración del producto. Se realizaron los estudios anatomopatológico (por inspección macroscópica) e histopatológico de los principales órganos. La inspección de estos no demostró alteraciones macroscópicas. Según el resultado del estudio histopatológico, sólo fueron observadas diferencias estadísticamente significativas en el porcentaje de peso relativo de los testículos en el grupo tratado con la dosis intermedia con respecto al grupo control. Este efecto no fue dependiente de la dosis. Se concluyó que la administración única por vía oral del producto QT2B21, no produjo alteraciones por toxicidad que pudieran ser atribuidas al mismo. Se consideró este producto como tolerable en ratas Sprague Dawley de ambos sexos en el rango de dosis desde 33,33 hasta 533,28 mg/kg de peso.

Evaluación de la toxicidad por administración única del producto QT2B21 en ratas Sprague Dawley / Evaluation of toxicity by the sole administration of the QT2B21 product in Sprague Dawley rats

Se realizó un estudio de toxicidad aguda en ratas Sprague Dawley de ambos sexos mediante la administración oral única del producto QT2B21 obtenido a partir de la especie de helecho Nephrolepis cordifolia, para determinar su toxicidad. Fueron evaluados 3 niveles de dosis: 33,33, 133,32 y 533,28 mg/kg. Se determinaron algunos índices hematológicos sin encontrar efectos tóxicos atribuibles a la administración del producto. Se realizaron los estudios anatomopatológico (por inspección macroscópica) e histopatológico de los principales órganos. La inspección de estos no demostró alteraciones macroscópicas. Según el resultado del estudio histopatológico, sólo fueron observadas diferencias estadísticamente significativas en el porcentaje de peso relativo de los testículos en el grupo tratado con la dosis intermedia con respecto al grupo control. Este efecto no fue dependiente de la dosis. Se concluyó que la administración única por vía oral del producto QT2B21, no produjo alteraciones por toxicidad que pudieran ser atribuidas al mismo. Se consideró este producto como tolerable en ratas Sprague Dawley de ambos sexos en el rango de dosis desde 33,33 hasta 533,28 mg/kg de peso.(AU)

Biodistribución y farmacocinética de Taninos de Pinus caribaea Morelet y Casuarina equisetifolia en ratones / Biodistribution and pharmacokinetics of tannins from Pinus caribaea Morelet and Casuarina equisetifolia in mice

Se estudió la biodistribución y la farmacocinética de taninos condensados purificados y marcados radioisotópicamente, extraídos a partir de la corteza de las especies forestales Pinus caribaea Morelet var caribaea y Casuarina equisetifolia previa administración por vía oral y endovenosa, con el empleo de ratones como biomodelo. Los taninos estudiados, con una alta capacidad antioxidante y diferenciados por la propiedad de formar complejos con proteínas, presentaron una rápida biodistribución hacia los diferentes órganos y tejidos, con manifestaciones de un importante acúmulo en el estómago e intestinos. Los taninos de ambas especies describen una biodistribución que se ajusta a un modelo bicompartimental de distribución. Se reportan los parámetros farmacocinéticos como tiempo de residencia medio, aclaramiento total, área bajo la curva, biodisponibilidad e instante de tiempo en que ocurre la máxima incorporación a partir de las curvas del aclaramiento sanguíneo

Biodistribución y farmacocinética de Taninos de Pinus caribaea Morelet y Casuarina equisetifolia en ratones / Biodistribution and pharmacokinetics of tannins from Pinus caribaea Morelet and Casuarina equisetifolia in mice

Se estudió la biodistribución y la farmacocinética de taninos condensados purificados y marcados radioisotópicamente, extraídos a partir de la corteza de las especies forestales Pinus caribaea Morelet var caribaea y Casuarina equisetifolia previa administración por vía oral y endovenosa, con el empleo de ratones como biomodelo. Los taninos estudiados, con una alta capacidad antioxidante y diferenciados por la propiedad de formar complejos con proteínas, presentaron una rápida biodistribución hacia los diferentes órganos y tejidos, con manifestaciones de un importante acúmulo en el estómago e intestinos. Los taninos de ambas especies describen una biodistribución que se ajusta a un modelo bicompartimental de distribución. Se reportan los parámetros farmacocinéticos como tiempo de residencia medio, aclaramiento total, área bajo la curva, biodisponibilidad e instante de tiempo en que ocurre la máxima incorporación a partir de las curvas del aclaramiento sanguíneo(AU)

Utilidad de la medición de permeabilidad alveolocapilar con TC99m-DTPA en el compromiso pulmonar de pacientes portadores del virus de inmunodeficiencia adquirida / Value of Tc99m-DTPA alveolar permeability in lung involvement detection of patients with HIV infection

Se evaluó la utilidad de la medición de permeabilidad alveolocapilar con Tc99m -DTPA en pacientes VIH positivo con posible compromiso pulmonar e infección por pneumocystis carinii (PC) . Se incluyeron 20 pacientes con síntomas respiratorios y 4 con síntomas sistémicos usando como control a un grupo de 11 asintomáticos con similar valor de linfocitos CD, todos con suspensión de tabaco previa. Se realizaron radiografía de tórax, hemograma, esputo inducido y/o fibrobroncoscopía, obteniéndose confirmación de presencia o ausencia de PC en 16 pacientes sintomáticos y 3 asintomáticos. Para detección de PC la sensibilidad fue 78 por ciento, la especificidad 40 por ciento y la seguridad diagnóstica 58 por ciento. Para procesos inflamatorios pulmonares los valores fueron 85 por ciento, 60 por ciento y 79 por ciento, respectivamente. Cuatro de seis pacientes falsos positivos para PC tenían cuadros que explicaban la alteración del DTPA. Concluyendo, el DTPA es sensible pero poco específico para detectar infección pulmonar por PC, siendo superior para procesos inflamatorios

Coronografía precoz en el angor inestable / Early coronary arteriography in unstable angina

Con el objeto de evaluar los hallazgos angiográficos del estudio precoz (< 48 hrs del último dolor) en el angor inestable (AI) se analiza la coronariografía de 226 pacientes (p), 65 mujeres, de 62 ñ 13 años: 109 con angor de reciente comienzo (ARC), 77 con angor de reposo (AR) y 40 con angor progresivo (AP). La severidad de la enfermedad coronaria (EC) fue mayor en el AP que en el AR y mayor en éste que en ARC. Carecían de lesiones críticas el 37 por ciento de los ARC, el 22 por ciento de AR, y sólo el 15 por ciento del AP. La presencia de trombo/úlcera fue de 51 por ciento en AR, 33 por ciento en AP y sólo 24 por ciento en ARC; p < 0,01. Se estudian 105 p < 48 hrs; 36 por ciento carecían de lesiones críticas v/s 21 por ciento del estudio tardío (p < 0,05). El estudio precoz no se asoció a mayor severidad de la EC ni a la presencia de trombo/úlcera. El estudio precoz no se asoció a mayor incidencia de coronarias normales en el AR, pero sí en ARC (51 por ciento) y AP (50 por ciento), p < 0,005. Los cambios del ST-T no discriminan ausencia de lesiones críticas, EC severa ni presencia de trombo/úlcera. El estudio precoz no se asocia a mayor morbimortalidad hospitaaria (1 sólo paciente fallece) por lo que lo recomendamos en todos los pacientes con AR. En el ARC, en cambio, por la alta incidencia de coronarias normales y la poca severidad de la EC recomendamos un estudio no invasivo rápido para descartar EC. El AP suele consultar > 48 hrs

Actualización de los criterios del tratamiento de la deficiencia de hierro / Update on iron deficiency treatment criteria

La deficiencia de hierro constituye un problema de salud pública. Recientemente se han desarrollado nuevos protocolos para la profilaxis y tratamiento de esta carencia nutricional. Biología molecular del hierro orgánico. Se revisa la relación del hierro con importantes macromoléculas que captan, transportan y utilizan el hierro. Factores que determinan el estado nutricional relativo al hierro. El balance del hierro se ve influido por la pérdida crónica de sangre, los altos requerimentos de hierro en la lactancia, la adolescencia y el embarazo. Estrategias para la profilaxis y el tratamiento de la deficiencia de hierro. Se comenta la importancia de la determinación del receptor soluble de la transferrina; así como los programas para suplementar a los lactantes con leche fortificada con hierro o azúcar fortificada con la sal ferrosa de EDTA sódico, o bien tabletas de sulfato ferroso en protocolo de dosis bisemanal