Automedicación analgésica en pacientes que acuden al servicio de odontología del Hospital General Dr. Luis Razetti, Barinas Estado Barinas, Venezuela / Analgesic self-medication on patients attending General Hospital Dr. Luis Razetti's dental care service in Barinas state Barinas, Venezuela

La automedicación consiste en el uso de medicamentos por decisión propia o consejo no cualificado. La automedicación con fármacos analgésicos puede retrasar el diagnóstico, prolongar la enfermedad y llevar al uso inadecuado de estos medicamentos. En la población general esta conducta es ampliamente investigada; sin embargo, la información es escasa en pacientes odontológicos. El objetivo fue analizar las características de la automedicación analgésica en pacientes que acuden al Servicio de Odontología del Hospital General Dr. Luis Razetti. Barinas estado Barinas, Venezuela. Se realizó una investigación descriptiva de diseño transversal, en la que se aplicó un cuestionario a pacientes que acudieron al servicio durante los meses septiembre y octubre del año 2015. El análisis de los resultados reveló 84,8% de pacientes automedicados, predominio del género femenino (65,3%) y del nivel de instrucción secundario (55,8%); el principal motivo de consulta fue el dolor dental (43,2%). Los analgésicos más utilizados fueron acetaminofén (45,3%) e ibuprofeno (42,1%), la motivación más frecuente fue el consejo de amigos y familiares (57,9%) y el 38,9% de los pacientes considera la intolerancia gastrointestinal como efecto adverso potencial de los analgésicos. El nivel de instrucción se relacionó significativamente con el conocimiento sobre automedicación y la dosis del analgésico (p<0,05); también hubo asociación entre el tipo de analgésico y la dosis referida (p<0,05). Se concluye que la automedicación analgésica es frecuente en pacientes que solicitan atención odontológica, por tanto es importante que el personal odontológico esté informado sobre las características de esta práctica y las consecuencias negativas que puede ocasionar.

Self-medication is defined as the use of medicines on one's own decision, without a doctor's prescription. Self-medication can cause analgesic misuse it may also delay the illnesses diagnosis and prolong them. This behavior is widely investigated in the general population, however, the information is limited in dental patients. This investigation was primarily focused in the analysis of aspects related to self-medication using analgesics on patients attending General hospital Dr. Luis Razetti's dental care service in Barinas, state Barinas, Venezuela. A cross-sectional descriptive study was done by means of a questionnaire applied to dental service patients on September and October 2015. Results analysis revealed that 84, 8% of patients were self-medicated, with predominance of females (65,3%) with secondary education level (55,8%). As well, dental pain was found as the main reason for the consultation (43,2%). Most commonly analgesics were Acetaminophen (45, 3%) and Ibuprofen (42,1%). Main motivations came from friends or relatives advice (57,9%). Moreover, 38, 9% of the patients consider the gastrointestinal intolerance as a potential adverse effect of analgesics. The level of education was significantly related to the knowledge about self-medication and its dose (p<0, 05); there was also an association between the type of analgesic and the referred dose (p<0, 05). It is concluded that analgesic self-medication is frequent in patients requiring dental care attention, therefore, it is important that dental staff is informed about the characteristics of this practice and its negative consequences.

Novel inverted triple grease-gap isolation chamber for electrophysiological and calcium release studies in skeletal muscle fibers.

A novel inverted triple grease-gap chamber for electrophysiological studies and photometric detection of calcium release in skeletal muscle fibers is described. The chamber allows the construction of grease seals displaying high electrical resistance and mechanical stability. The fiber mounting procedure is fast, simple and not skill demanding, and the preparation is highly stable and reliable. Electrophysiological and photometric data are presented to illustrate the chamber performance.

Surveillance of bacterial pathogens associated with acute diarrhea in Lima, Peru.

OBJECTIVES: A study was conducted in Lima, Peru, from January to April 1995, to determine the bacterial pathogens associated with acute diarrhea in adults, their susceptibility to common antimicrobials, the risk factors involved in cholera transmission, and the best clinical predictors of cholera. METHODS: A random sample of adult patients with acute diarrhea was studied. Epidemiologic and clinical data and risk factors to acquire diarrheal diseases were evaluated. Identification of bacteria and susceptibility to antimicrobials were determined. RESULTS: The study included 336 patients. Vibrio cholerae O1 (52.7%), Shigella spp. (4. 8%), and Salmonella spp (2.7%) were the pathogens most commonly isolated. No resistance to antimicrobials was observed. Patients with cholera had less access to municipal water (P = 0.0018) and were less likely to have homes connected to a sewage system (P = 0. 0003) or to have indoor toilet facilities (P = 0.0001) than those without cholera. Liquid stools (odds ratio [OR] = 16.51; confidence interval [CI] = 13.71-19.02; P = 0.003), severe dehydration (OR = 2. 48; CI = 1.57-3.38; P = 0.0083), generalized cramps (OR = 4.63; CI = 3.10-6.17, P < 0.0001), and washerwoman's hands (OR = 2.45; CI = 1. 55-3.34; P = 0.017) were the best clinical predictors of cholera in this setting. CONCLUSIONS: Cholera is still prevalent in Lima, and people living in environments with low sanitary conditions are especially at risk. Clinical signs of severe dehydration and liquid stools were the best predictors of cholera.

Inverted double-gap isolation chamber for high-resolution calcium fluorimetry in skeletal muscle fibers.

Here we describe an improved inverted double-grease-gap isolation chamber that allows the formation of grease seals of high mechanical stability and high electrical resistance. We also provide a detailed description of the procedure used to mount the muscle fibers onto the apparatus. The new chamber permits the electrophysiological study of muscle fibers using an inverted microscope and high-resolution objectives, thus complying with the requirements of modern fluorescence confocal detection methods. The simplicity and reliability of the mounting procedure make this chamber preferable over other gap isolation chambers currently used for simultaneous electrophysiological and optical studies of calcium release. Experimental results obtained from amphibian muscle fibers are presented to illustrate the performance of the chamber when using global fluorescence detection, confocal spot detection, and laser confocal scanning imaging.

Involvement of methionine residues in the fast inactivation mechanism of the sodium current from toad skeletal muscle fibers.

The role of methionine residues on the fast inactivation of the sodium channel from toad skeletal muscle fibers was studied with the mild oxidant chloramine-T (CT). Isolated segments of fibers were voltage clamped in a triple Vaseline gap chamber. Sodium current was isolated by replacing potassium ions by tetramethylammonium ions in the external and internal solutions. Externally applied chloramine-CT was found to render noninactivating a large fraction of sodium channels and to slow down the fast inactivation mechanism of the remainder fraction of inactivatable channels. The action of CT appeared to proceed first by slowing and then removing the fast inactivation mechanism. The voltage dependence of the steady-state inactivation of the inactivatable CT-treated currents was shifted +10 mV. CT also had a blocking effect on the sodium current, but was without effect on the activation mechanism. The effects of CT were time and concentration dependent and irreversible. The use of high CT concentrations and/or long exposure times was found to be deleterious to the fiber. This side effect precluded the complete removal of fast inactivation. The effects of CT on the fast inactivation of the sodium current can be explained assuming that at least two methionine residues are critically involved in the mechanism underlying this process.

Action of protein kinase A activators on the caudal neuromuscular junction of toad tadpoles, recorded on synaptic spots.

Miniature end-plate currents (MEPCS), from synaptic spots on the caudal muscles of Bufo marinus tadpoles, were analyzed in both pre- and postsynaptic domains, when protein kinase A (PKA) activity modificators were used. Sp-cAMPS diasteromer induced an increase in MEPC frequency, which was completely reversed by Rp-cAMPS. However, changes in the decay time of MEPCS were not detected. Dibutyryl-cAMP produced a similar presynaptic action, but its postsynaptic action was similar to butyrate. Presynaptic effect of forskolin (FSK), if any, is masked by the increase of MEPC frequency produced by dimethylsulfoxide (DMSO), the solvent used.

[Desensitization of the nicotinic acetylcholine receptor]. / La desensibilizacion del receptor nicotinico para la acetilcolina.

In biological membranes, ionic channels act speeding up ion movements. Each ionic channel is excited by a specific stimulus (i.e. electric, mechanical, chemical, etc.). Chemically activated ionic channels (CAIC), such as the nicotinic acetylcholine receptor (nAChR), suffer desensitization when the receptor site is still occupied by the agonist molecule. The desensitized CAIC is a non functional channel state regarded as a particular case of receptors rundown. CAIC desensitization only involve reduced activity and not their membrane elimination. Desensitization is important to control synaptic transmission and the development of the nervous system. In this review we discuss results related to its production, modulation and some aspects associated to models that consider it. Finally, an approach combining molecular biology and electrophysiology techniques to understand desensitization and its importance in biological systems is presented.

[Pulmonary alveolar microlithiasis in two siblings]. / Microlitiasis alveolar pulmonar en dos hermanos.

The study of two brothers with pulmonary alveolar microlithiasis (MLA) a rare lung alteration with autosomic recessive character is presented. In one case the lung biopsy made the diagnosis by the identification of multiple calcospherites. The importance of the familiar study is stressed, as a sister with the same radiographic image was discovered this way. The literature is revised and the main data of MLA are presented; the radiologic images and histopathologic findings are commented.

The effects of aldehydes on the inward rectifier of skeletal muscle fibres from the toad Bufo marinus.

A comparative study of the effects of formaldehyde and glutaraldehyde on the inward rectification in skeletal muscle fibre of the toad Bufo marinus was made using two different techniques. In whole sartorius muscle fibres formaldehyde produced a transient increase in conductance, followed by a decrease while glutaraldehyde only produced the second effect, with a rather fast time course. In cut end single fibres both aldehydes produced only a reduction of conductance and eventually the abolition of the inward rectification. The blocking effect of glutaraldehyde was concentration and voltage dependent while formaldehyde only produced a concentration dependent blocking. The elimination of inward rectifying currents by aldehydes allowed an estimation of the time constants of activation by a subtraction method.

Inward rectification in muscle fibres of the toad Bufo marinus.

Inward rectification of the resting potassium conductance was studied in skeletal muscle fibres of the toad Bufo marinus. This conductance was shown to be blocked by Ba and Cs and located both in the surface membrane and the membranes of the tubular system. Some differences were found between the properties of this conductance channel in Bufo marinus and those reported for various species of Rana. The possible adaptative value of these differences is pointed out.

Congenital epidermoid cysts over the anterior fontanelle.

Epidermoid cysts over the anterior fontanelle were once regarded as rare and exclusive to blacks. The latest reports in the literature indicate a more widespread incidence. Only a few cases have been described in Europe. The authors report three cases of epidermoid cysts in this location occurring in Spaniards. Clinical, radiological, and surgical features are briefly discussed and pertinent literature is reviewed.

Genitales ambiguos en un paciente con mosaico 45, X/46, X i (Yq) / Ambiquous genitalia in a patient with a mosaic 45, X/46,X i (Yq).

Se presenta el caso de un paciente de 6 meses de edad con hipertrofia del clitoris, aplasia de labios menores y hernia inguinal izquierda. La laparatomia exploradora demostro utero y trompas rudimentarias, no se encontraron gonadas. En el estudio citogenetico la cromatina X resulto negativa y el cariotipo revelo un mosaico 45, X/46, X i(Yq). La anomalia se detecto mediante estudio de bandas C. Se comprueba que en ausencia de brazos cortos del cromosoma Y, no existe gonada masculina y que la diferenciacion de los organos genitales internos y externos es mas bien de tipo femenino.