Multiple analysis of mitochondrial metabolism, autophagy and cell death.

In the perspective to evaluate the toxicity of drug candidates or the exploration of intracellular signaling pathways of cell stress response and pathophysiological conditions, we propose to evaluate cell death, autophagy, mitochondrial network and energetic metabolism by a series of optimized joint protocols for neonatal primary rat cardiomyocytes or H9c2 cardiac cell line in 96 well microtiter plates. We used Digitoxigenin and Digoxin, two cardiac glycosides, and Rapamycin as control drugs, for inhibition of oxidative stress-induced cell death and autophagy induction, respectively.

[Predictive factors of neurological complications in the period immediately after liver transplant: experiences in the Centro de Investigaciones Médico Quirúrgicas in Cuba]. / Factores predictivos de las complicaciones neurológicas en el postrasplante hepático inmediato: experiencia en el Centro de Investigaciones Médico Quirúrgicas de Cuba.

INTRODUCTION: Liver transplant (LT) is today a first choice procedure in a group of hepatic diseases in their acute and chronic terminal stages. It is not, however, a technique that is completely free of complications and those of a neurological nature constitute between 8 47% of those reported. AIMS. The purpose of this study is to present the immediate neurological complications (NC) found in our patients, as well as to determine the predictive factors and their relation to the mortality rate. PATIENTS AND METHODS: From the medical records of 26 patients who received LT at the CIMEQ (July 1999 December 2001), we collected a group of variables related to the donor, the surgical procedure and the post operative period and associated them to the occurrence of NC while these patients were in the ICU. RESULTS: NC were found in 16 patients (61.5%), the most frequent being encephalopathy (30.8%), tremor (26.9%), and convulsions (19.2%). No relation was found between the presence of NC and prior hepatic encephalopathy, the use of a suboptimal donor, nor did it represent a significant increase in the mortality rate. There was a significant relation with LT to recipients rated as grade C on the Child Pugh classification system, the presence of intraoperative hypotension (p= 0.0164) and primary dysfunction of the liver graft (p= 0.041). CONCLUSIONS: NC represented a significant cause of morbidity in the period following a liver transplant in our series, although they had no significant repercussion on the mortality rate. Their presence is related to variables concerning the recipient, the surgical procedure itself and the immediate post operative period.

Factores predictivos de las complicaciones neurológicas en el postrasplante hepático inmediato: experiencia en el Centro de Investigaciones Médico Quirúrgicas de Cuba / Predictive factors of neurological complications in the period immediately after liver transplant: experiences in the centro de investigaciones médico quirúrgicas in cuba

Introducción. El trasplante hepático (TH) es hoy en día un procedimiento de elección en un grupo de enfermedades hepáticas agudas y crónicas en estadio terminal. Sin embargo, no es una técnica exenta de complicaciones; las neurológicas se comunican entre el 8 y el 47 por ciento. Objetivos. Presentar las complicaciones neurológicas (CN) inmediatas encontradas en nuestros pacientes, así como determinar los factores predictivos y su relación con la mortalidad. Pacientes y métodos. De los expedientes clínicos de los 26 pacientes que fueron tributarios de TH en el CIMEQ (julio 1999-diciembre 2001), se recogió un grupo de variables relacionadas con el donante, el acto quirúrgico y el posoperatorio, y se relacionó con la presencia de CN durante su estancia en la UCI. Resultados. Encontramos CN en 16 pacientes (61,5 por ciento); las más frecuentes fueron la encefalopatía (30,8 por ciento), temblores (26,9 por ciento), y convulsiones (19,2 por ciento). No se encontró relación entre la presencia de CN, y encefalopatía hepática previa o con uso de donante subóptimo, ni representó un aumento significativo en la mortalidad. Existió una relación significativa con el TH a receptores grado C de la clasificación de Child-Pugh, la presencia de hipotensión intraoperatoria (p = 0,0164), y de disfunción primaria del injerto hepático (p = 0,041). Conclusiones. En nuestra serie, las CN representaron una morbilidad significativa en el postrasplante hepático, sin repercusión significativa en la mortalidad. Su presencia se relaciona con variables del receptor, del acto operatorio y del posoperatorio inmediato (AU)

Introduction. Liver transplant (LT) is today a first choice procedure in a group of hepatic diseases in their acute and chronic terminal stages. It is not, however, a technique that is completely free of complications and those of a neurological nature constitute between 8-47% of those reported. Aims. The purpose of this study is to present the immediate neurological complications (NC) found in our patients, as well as to determine the predictive factors and their relation to the mortality rate. Patients and methods. From the medical records of 26 patients who received LT at the CIMEQ (July 1999-December 2001), we collected a group of variables related to the donor, the surgical procedure and the post-operative period and associated them to the occurrence of NC while these patients were in the ICU. Results. NC were found in 16 patients (61.5%), the most frequent being encephalopathy (30.8%), tremor (26.9%), and convulsions (19.2%). No relation was found between the presence of NC and prior hepatic encephalopathy, the use of a suboptimal donor, nor did it represent a significant increase in the mortality rate. There was a significant relation with LT to recipients rated as grade C on the Child-Pugh classification system, the presence of intraoperative hypotension (p= 0.0164) and primary dysfunction of the liver graft (p= 0.041). Conclusions. NC represented a significant cause of morbidity in the period following a liver transplant in our series, although they had no significant repercussion on the mortality rate. Their presence is related to variables concerning the recipient, the surgical procedure itself and the immediate post-operative period (AU)

[Monitorization of the jugular oxygen saturation and cerebral ischaemia in the neurocritical patient]. / Monitorización de la saturación yugular de oxígeno y la isquemia cerebral en el paciente neurocrítico.

INTRODUCTION: Catheterization of the jugular bulb is of great value in the study of cerebral metabolism, since it permits diagnosis of episodes of hypoxia and cerebral ischaemia. OBJECTIVES: To determine the frequency of the appearance of episodes of desaturation and cerebral ischaemia, whether these were simultaneous and their relation to the mortality in an intensive care unit (ICU). PATIENTS AND METHODS: We studied 21 neurocritical patients, recording the following data: age, sex, diagnosis and state at the time of discharge from the ICU (alive or dead). In the group of patients in whom the jugular bulb had been catheterised we also recorded: the side cannulated, complications, SyO2, cerebral lactate oxygen index and modified cerebral lactate oxygen. RESULTS: In 57% of the patients we catheterised the jugular bulb and in 50% of them at least one episode of desaturation was recorded, and cerebral ischaemia in 42%. Only one patient had simultaneous desaturation and cerebral ischaemia. Of the six patients in whom desaturation was detected, 5 died in the ICU (83.3%). The mortality of patients with ischaemia was only 40%. 40% of the patients with head injuries were monitored and 50% of the non monitored patients had head injuries. CONCLUSIONS: Episodes of desaturation are frequent in neurocritical patients and are associated with increased mortality. Recordings of lactate are not useful at present in the diagnosis of cerebral ischaemia.

Características clinico epidemiológicas de un grupo de donantes multiorgánicos utilizados para trasplante de órganos en Cuba / Epidemiological characteristics of a group of multi-organ donors used to transplant organs in Cuba

Introducción. En la trasplantología actual el donante de órganos es un eslabón fundamental. Objetivos. Determinar las características demográficas de los donantes utilizados en el programa de trasplante hepático en Cuba, las principales causas de muerte cerebral, aminas más utilizadas y patrón serológico, así como presentar los trasplantes realizados. Pacientes y métodos. Se revisaron los expedientes clínicos de los donantes reales procesados entre julio de 1999 y julio de 2000. Resultados. En el período de estudio se trabajó con 13 donantes reales de órganos: 9 varones (69,2 por ciento) y 4 mujeres (30,8 por ciento), distribuidos en los siguientes grupos de edades: 15-30 años: 3 casos (23 por ciento), 31-45 años: 4 casos (30,8 por ciento), 46-60 años: 5 casos (38,5 por ciento) y mayores de 60 años: 1 caso (7,7 por ciento). Se realizaron 42 trasplantes: 12 de hígado, incluyendo el primero en nuestro país hepatorrenal, 18 de riñón, 10 de córnea y 1 de corazón. Las causas de muerte fueron: traumatismo craneoencefálico: 10 (76,9 por ciento) y accidente vascular cerebral hemorrágico: 3 (23,1 por ciento). Sólo 3 casos (23,1 por ciento) no requirieron de apoyo con aminas vasoactivas, los otros 10 (76,9 por ciento) sí las utilizaron; las más empleadas fueron la dopamina y la epinefrina en 6 casos, respectivamente (46,1 por ciento). Respecto a los estudios serológicos, las inmunoglobulinas G para citomegalovirus fueron positivas en los 13 casos: Epstein Barr Virus 6 (46,1 por ciento), toxoplasma: 12 (92,3 por ciento), herpes virus I: 13, herpes virus II: 13. Conclusiones. El donante tipo fue un varón de entre 46 y 60 años con muerte cerebral por traumatismo craneoencefálico secundario a accidente de tráfico. En un alto porcentaje de los donantes es necesario el apoyo con aminas para lograr una estabilidad hemodinámica, y existe un alto porcentaje de positividad para los estudios serológicos microbiológicos (AU)

Monitorización de la saturación yugular de oxígenoy la isquemia cerebral en el paciente neurocrítico / Monitorization of the jugular oxygen saturation jugular and cerebral ischaemia in the neurocritical patient

Introducción. La cateterización del golfo yugular es de gran valor en el estudio del metabolismo cerebral ya que nos permite el diagnóstico de episodios de hipoxia e isquemia cerebral. Objetivos. Determinar la frecuencia de aparición de episodios de desaturación e isquemia cerebral, su simultaneidad, así como su relación con la mortalidad en la Unidad de Cuidados Intensivos (UCI). Pacientes y métodos. Se estudiaron 21 pacientes neurocríticos, recogiendo los siguientes datos: edad, sexo, diagnóstico y estado en el momento del alta en la UCI (vivo o fallecido). Al grupo de pacientes a los que se les cateterizó golfo yugular se les tomó además: lado canulado, complicaciones, SyO2, índice cerebral lactato-oxígeno (ICLO) e índice cerebral lactato-oxígeno modificado (ICLO-M).Resultados. Al 57 por ciento de los pacientes se les canalizó golfo yugular, y en el 50 por ciento de ellos se detectó al menos un episodio de desaturación, e isquemia cerebral en el 42 por ciento; en sólo 1 paciente coincidió desaturación con isquemia cerebral. De los 6 pacientes en los que se detectó desaturación, 5 fallecieron en la UCI (83,3 por ciento). La mortalidad de pacientes con isquemia fue sólo del 40 por ciento. La mortalidad de los pacientes con diagnóstico de TCE que fueron monitorizados fue del 40 por ciento; y de los no monitorizados de un 50 por ciento. Conclusiones. Los episodios de desaturación son frecuentes en el paciente neurocrítico y se asocian a una mayor mortalidad. Las variables aisladas del lactato en el diagnóstico de isquemia cerebral no tienen utilidad actual (AU)

Dreams in obsessive-compulsive disorder: an analysis of semantic and emotional content compared to controls.

OBJECTIVE: We sought to investigate the content of the dreams of obsessive-compulsive outpatients in the light of the following postulate: if dreams play a role in the processing of information and mental storage of events of the day, the dream recollections of obsessive-compulsive disorder (OCD) patients should present evidence of diurnal obsessive or ritual themes. METHOD: On seven successive mornings, immediately after awakening in their home environment, 10 nondepressed OCD patients and 11 controls recorded their recollections of the night's dreams on an audiotape. After randomization of dreams, two judges were asked to carry out a blind evaluation of the emotional characteristics perceptible in these dreams and the presence of obsessive or ritual themes. RESULTS: 47 dreams were collected in the OCD group and 55 in the control group. No differences were found between the two groups regarding anxiety, sadness, the theme of failure, or the presence of obsessive or ritual themes. About 60% of OCD patients and 73% of the control group recounted dreams expressing anxiety, sadness, or failure. Most surprisingly, in the control group as well as in the OCD group, about one-third of subjects presented obsessive or ritual themes in their dreams. CONCLUSION: These data suggest that there is no evident link between diurnal mental activity and the morning recollection of nocturnal dreams regarding anxiety, failure, sadness, and obsessive-compulsive themes.

[Epidemiological characteristics of a group of multi organ donors used to transplant organs in Cuba]. / Características clinicoepidemiológicas de un grupo de donantes multiorgánicos utilizados para trasplante de órganos en Cuba.

INTRODUCTION: For current transplants, the organ donor is a basic factor. OBJECTIVES: To determine the demographic characteristics of the donors used in the Cuban liver transplant programme, the main causes of brain death, most widely used amines and serology pattern. To report the transplants carried out. PATIENTS AND METHODS: We reviewed the clinical histories of the actual donors processed between July 1999 and July 2000. RESULTS: During the period studied 13 actual donors were used: 9 men (69.2%) and 4 women (30.8%) distributed in the following age groups: 15 30 years: 3 cases (23%); 31 45 years : 4 cases (30.8%); 46 60 years: 5 cases (38.5%), and over 60 years: 1 case (7.7%). We did 42 transplants: 12 liver, including the first hepato renal in Cuba, 18 kidney, 10 cornea, and 1 heart. The causes of death were: head injury: 10 (76.9%), and hemorrhagic cerebral vascular accident: 3 (23.1%). Only 3 cases (23.1%) did not require the use of vasoactive amines. These were used in the other 10 (76.9%). The most commonly used were dopamine and epinephrine, in 6 cases each (46.1%). In the serological studies for immunoglobulin G for cytomegalovirus all 13 were positive, Epstein Barr virus 6 (46.1%), toxoplasma 12 (92.3%), herpes virus 1: 13, herpes virus 11: 13. CONCLUSIONS: The typical donor was a man aged 46 60 years with brain death due to head injury following a road traffic accident. A large proportion of donors required the use of amines to maintain hemodynamic stability. There was a large proportion of patients who were found on microbiological serology studies to test positive.

Influence of the dielectric property on microwave oven heating patterns: application to food materials.

Patterns of power absorption in a microwave oven for a range of dielectric properties of relevance to food processing were investigated. The governing Maxwell's equations with boundary conditions and a TE10 excitation were solved using a finite element method. Food properties were varied from values at their frozen state to values at high temperatures, as would be typical in a thawing process. For low-loss materials such as frozen foods, the high quality factor makes the heating significantly higher only when the size and shape of the load permit a dielectric cavity resonance in the load. Otherwise, the heating pattern will follow the modal electric field pattern of the oven. For moderate loss materials, the patterns will come from the modes of the dielectric cavity. The bandwidths of these modes are larger than the low-loss situation and their overlap results in a heating pattern that is somewhat more uniform. For high-loss materials, the concept of modes is no longer useful as the very large number of modes strongly overlap. The rapidly decaying field and power loss in the high-loss material can probably be characterized as an exponential decay.

[Antidepressive agents in non-depressive disorders]. / Les antidépresseurs en dehors de la dépression.

The evaluation of effect of psychotropic medications required clarification of operating diagnostic and of scales sensitive to change. In a second time, these allowed to demonstrate that some antidepressant agents act on pure obsessive-compulsive disorder and on pure panic disorder, i.e. without associated depression. These antidepressants below to different chemical families, but their common action is to act on two main synaptic transmissions: the noradrenergic and the serotoninergic paths.

[Fluvoxamine. Study of treatment effect on a group of 189 hospitalized patients with depression]. / Fluvoxamine. Etude de l'effet du traitement sur un groupe de 189 déprimés hospitalisés.

The study of a sample of 189 inpatients with the diagnostic of Major Depressive Disorder (DSM III-R) treated with fluvoxamine showed: a good compromise efficacy/tolerance in 75% of cases; an interruption of treatment in 25% of cases, schematically divided in early gastric intolerance and in late resistance. 2.5% of manic switches have been observed and contribued, with this pattern of good results, to confirm the major antidepressant activity and good tolerance of fluvoxamine.

[Fluvoxamine. Study of the relation between posology and plasma levels in a group of 80 hospitalized patients with depression]. / Fluvoxamine. Etude de la relation posologies-taux plasmatiques sur un groupe de 80 déprimés hospitalisés.

The study of the relationship between 198 plasmatic fluvoxamine dosages and posology has been done on a sample of 80 inpatients. It shows that plasmatic levels increase proportionally with posology p.o. In contrast, plasmatic levels seem to be independent from weight and age of inpatients.