Neuromyelitis optica spectrum disorders relapses and seasonal influence in an equatorial country cohort. / Recaídas del trastorno de espectro de la neuromielitis óptica e influencia estacional en una cohorte de un país ecuatorial.

INTRODUCTION: Information about seasonal distribution of Neuromyelitis optica spectrum disorders (NMOSD) attacks, particularly in tropical countries, has rarely been described and the reported data are diverse. OBJECTIVE: To evaluate influence of seasonal variation in NMOSD relapses in an equatorial country. PATIENTS AND METHODS: Exploratory observational, retrospective ecological study in a cohort of patients with NMOSD followed from January 2008 to December 2019. Data of demographic, clinical information, characteristics of relapses and seasonal temporal variation were recorded. Also, the annual, monthly and intra-annual seasonal variation of relapses was quantified. A negative binomial regression was used to estimate the associations between the number of relapses and climatic and temporal variables. RESULTS: One hundred thirteen patients were included, most of them were female (89.38%), with a mean age at NMOSD diagnosis was 44.97 (±13.98) and the median of relapses per patient were 2 relapses (IQR 1-3). The patients presented 237 relapses, most of these in AQP4 seropositive patients (87.76%) and longitudinal extensive myelitis was the most frequent type of relapse (53.59%). According to the temporal variation, relapses were more common in the second rainy season (28.69%) during November and December. However, there weren't significant differences in the number of relapses between seasons and climatic variables in the multivariable model. CONCLUSION: The number of NMOSD relapses in this equatorial country cohort did not exhibit any significant associations with climatic variations, including changes in rainy or dry seasons.

TITLE: Recaídas del trastorno de espectro de la neuromielitis óptica e influencia estacional en una cohorte de un país ecuatorial.Introducción. La evidencia sobre la distribución estacional de las recaídas del trastorno del espectro de la neuromielitis óptica (NMOSD), especialmente en países tropicales, es limitada y diversa. Objetivo. Evaluar la influencia de las variaciones estacionales en las recaídas del NMOSD en un país localizado sobre la línea ecuatorial. Pacientes y métodos. Se llevó a cabo un estudio ecológico, con información retrospectiva de una cohorte de pacientes con NMOSD atendida entre enero de 2003 y diciembre de 2020 en Medellín, Colombia. Se recolectaron datos demográficos y clínicos de los pacientes, así como información sobre variables estacionales y climáticas. Se calculó la frecuencia de recaídas por estación, mes y año, y se realizó una regresión binomial negativa para evaluar la asociación entre el número de recaídas, y las variables estacionales y climáticas. Resultados. Se incluyó a 113 pacientes, de los cuales el 89,38% eran mujeres, con una edad media en el momento del diagnóstico de NMOSD de 44,97 (±13,98) años y una mediana de tres recaídas (rango intercuartílico: 1-2). Se registraron 237 recaídas, la mayoría en pacientes seropositivos para anticuerpos antiacuaporina 4 (87,76%) y con mielitis longitudinal extensa como la presentación clínica más común (53,59%). Las recaídas se presentaron con mayor frecuencia durante la segunda temporada lluviosa (28,69%; n = 68), y en los meses de noviembre y diciembre. Sin embargo, en la regresión binomial negativa no se observó una asociación significativa entre el número de recaídas y las variables climáticas y estacionales, los meses y los años. Conclusión. Las variables climáticas y los patrones estacionales no muestran una asociación significativa con cambios en el número de recaídas del NMOSD en pacientes residentes en un país localizado sobre la línea ecuatorial.

Ultrasound-Assisted Extraction of Phenolic Compounds from Adenaria floribunda Stem: Economic Assessment.

Adenaria floribunda is a native species found in tropical regions of South America used as a traditional medicine. Ultrasound-assisted extraction (UAE) is an extraction process known to increase the extraction yield, reduce extraction times, and use low temperatures. This study aims to obtain water-based extracts from A. floribunda stems using UAE, hot water extraction (HWE), and Soxhlet extraction and perform an economic analysis. The global extraction yield (GEY) and total phenolic compounds (TPC) of extracts ranged from 5.24% to 10.48% and from 1.9 ± 0.44 mg GAE g-1 DW to 6.38 ± 0.28 mg GAE g-1, respectively. Gallic acid, catechin, and ferulic acid were identified in the extract using HPLC-UV. Results indicate that Soxhlet extraction has the best performance regarding GEY and TPC. However, after performing an economic assessment, the cost of manufacturing (COM) of Soxhlet extraction (US$ 5.8 flask-1) was higher than the UAE (US$ 3.86 flask-1) and HWE (US$ 3.92 flask-1). The sensitivity results showed that obtaining extracts from A. floribunda by UAE and HWE is economically feasible when the selling price is above US$ 4 flask-1. Soxhlet extraction is a feasible technique when the selling price is above US$ 7 flask-1.

PLEX: the best first-line treatment in nmosd attacks experience at a single center in Colombia.

OBJECTIVE: Primary outcome was to evaluate complete improvement at six months after acute treatment in NMOSD relapses. METHODS: Retrospective observational cohort study of patients with diagnosis of NMOSD admitted for acute attacks. We performed an explanatory analysis using the univariate, bivariate and multivariate logistic regression approach. We compared survival curves using the Kaplan Meier analysis and estimated the median time for the main outcome. RESULTS: In the univariate analysis, basal EDSS score, AQP4-IgG positivity, PLEX as a first-line treatment (IVMP + PLEX), less systemic complications related to acute treatment and total attack history were independently associated with complete improvement at six months. After adjusting for confounding variables and using multivariate analysis by Cox Regression, positive AQ4-IgG (HR 0.04, 95% CI: 0.02-0.66) and IVMP + PLEX (HR 5.1, 95% CI: 3.9-66.4), were kept as independent factors associated to time to complete improvement. Time from admission to PLEX initiation and complete improvement at six months had a median of seven days (95% CI: 5.2-8.8). In secondary effects, there were no statistical differences between the groups. CONCLUSIONS: PLEX + IVMP is the treatment of choice for NMOSD relapses and should be initiated as early as possible.

A comparative and economic study of the extraction of oil from Baru (Dipteryx alata) seeds by supercritical CO2 with and without mechanical pressing.

The present study evaluated the effect of supercritical fluid extraction (SFE) assisted by cold pressing (SFEAP) on the overall yield, extraction kinetics, composition of baru seed oil and manufacturing cost (COM). The best extraction conditions were determined in extraction assays combining different pressures (150-350 bar) and temperatures (35 and 45 °C). The extraction yield by SFEAP (28.6 g oil/100 g baru seed) was approximately 31% higher than that obtained by SFE (21.9 g oil/100 g baru seed), according to the kinetic study with the best extraction conditions (350 bar and 45 °C). The extraction yield observed under this condition allowed us to obtain a lower COM for both techniques (SFE was US$ 118.32/kg baru oil and SFEAP was US$ 87.03/kg baru oil) compared to lower pressures and temperatures. The oil obtained under all extraction conditions was rich in unsaturated fatty acids and other bioactive compounds. The extraction of baru seed oil by SFEAP resulted in a higher yield and lower manufacturing cost than SFE.

Recent advances and comparisons of conventional and alternative extraction techniques of phenolic compounds.

Phenolic compounds are a group of secondary metabolites produced by plants under stressful conditions. Phenolic compounds play an important role in the prevention and treatment of certain illnesses and are exploited by the food and pharmaceutical industries. Conventional methods are commonly used as models to compare the efficiencies of alternative extraction methods. Among alternative extraction processes, microwave-assisted extraction (MAE), pressurized liquid extraction (PLE), supercritical fluid extraction (SFE) and ultrasonic-assisted extraction (UAE) are the most studied. These methods produce extracts rich in phenolic compounds using moderate temperatures, short extraction times, and solvents generally recognized as safe. The combination of extraction time and temperature plays a critical role in the stability of the compounds. Solvents of higher polarity enhance the extraction of phenolic compounds. The use of the ethanol-water mixture for MAE, PLE, and UAE is recommended. MAE and UAE involve shorter extraction times than do PLE and SFE. SFE requires a low average temperature (40 °C). MAE produces the highest total phenolic content [227.63 mg GAE/g dry basis (d.b.)], followed by PLE (173.65 mg GAE/g d.b.), UAE (92.99 mg GAE/g d.b.) and SFE (37 mg GAE/g d.b.). Extraction yields and recovery rates of the phenolic compounds can be enhanced by combining and integrating extraction methods.

Obtaining bixin from semi-defatted annatto seeds by a mechanical method and solvent extraction: Process integration and economic evaluation.

This work involves the application of physical separation methods to concentrate the pigment of semi-defatted annatto seeds, a noble vegetal biomass rich in bixin pigments. Semi-defatted annatto seeds are the residue produced after the extraction of the lipid fraction from annatto seeds using supercritical fluid extraction (SFE). Semi-defatted annatto seeds are use in this work due to three important reasons: i) previous lipid extraction is necessary to recovery the tocotrienol-rich oil present in the annatto seeds, ii) an initial removal of the oil via SFE process favors bixin separation and iii) the cost of raw material is null. Physical methods including i) the mechanical fractionation method and ii) an integrated process of mechanical fractionation method and low-pressure solvent extraction (LPSE) were studied. The integrated process was proposed for processing two different semi-defatted annatto materials denoted Batches 1 and 2. The cost of manufacture (COM) was calculated for two different production scales (5 and 50L) considering the integrated process vs. only the mechanical fractionation method. The integrated process showed a significantly higher COM than mechanical fractionation method. This work suggests that mechanical fractionation method is an adequate and low-cost process to obtain a rich-pigment product from semi-defatted annatto seeds.

Fast analysis of curcuminoids from turmeric (Curcuma longa L.) by high-performance liquid chromatography using a fused-core column.

The recent development of fused-core technology in HPLC columns is enabling faster and highly efficient separations. This technology was evaluated for the development of a fast method for the analysis of main curcuminoids (curcumin, demethoxycurcumin and bisdemethoxycurcumin) present in extracts of turmeric (Curcuma longa L.). A step-by-step strategy was used to optimize temperature (40-55 °C), flow rate (1.0-2.5 mL min(-1)), mobile phase composition and equilibration time (1-5 min). A gradient method was developed using acidified water and acetonitrile combined with high column temperature (55 °C) and flow rate (2.5 mL min(-1)). Optimized conditions provided a method for the separation of these three curcuminoids in approximately 1.3 min with a total analysis time (sample-to-sample) of 7 min, including the clean-up and the re-equilibration of the column. Evaluation of chromatographic performance revealed excellent intraday and interday reproducibility (>99%), resolution (>2.23), selectivity (>1.12), peak symmetry (1.24-1.42) while presenting low limits of detection (<0.40 mg L(-1)) and quantification (<1.34 mg L(-1)). The robustness of the method was calculated according to the concentration/dilution of the sample and the injection volume. Several combinations of methanol and ethanol with water as sample solvents were evaluated and the best chromatographic results and extraction rate were obtained using 100% methanol. Finally, the developed method was validated with different extracts of turmeric rhizome and products that use turmeric in their formulation.

Analgesic effect and side effects of celecoxib and meloxicam in canine hip osteoarthritis / Efectos analgésicos y secundarios de celecoxib y meloxicam en osteoartritis de cadera canina

Objective. To evaluate the pharmacological, clinical and toxicological effects of celecoxib and meloxicam for analgesia for 30 days in dogs with hip osteoarthritis. Materials and methods. Twenty-four patients were evaluated, 75% were females with an average age of 7.16 ± 2.06 years and twenty five percent were males with an average age of 7.83 ± 2.22 years. All patients had hip osteoarthritis and they were randomized into two groups; one group received oral celecoxib 5 mg/kg every 12 hours during one month and the second group received oral meloxicam 0.2 mg/kg every 24 hours during 1 month. The patients were evaluated for analgesia, and hematological, renal, liver, and coagulation tests on days 0, 10th and 30th after treatment initiation, and a gastric endoscopy on day 30. Statistical analysis was performed using a HSD Tukey test and c² with a 5% level of statistical significance. Results. Both drugs reduced articular pain according to the Melbourne scale during the 30 days of treatment (p≤0.05). Hematological, renal, hepatic and coagulation tests were normal in both treatment groups. All patients presented chronic gastritis on endoscopy on day 30th. Conclusions. Both drugs decreased pain at day 30th without causing alterations in hematological, renal, hepatic or coagulation tests after 30 days of treatment. However, both drugs induced chronic gastritis.

Objetivos. Evaluar el efecto farmacológico, clínico y toxicológico de celecoxib y meloxicam utilizados como analgésicos durante 30 días en caninos con osteoartritis de cadera. Materiales y métodos. Fueron evaluados 24 pacientes, 75% hembras, con edad de 7.16 ± 2.06 años, y el 25% machos; con edad de 7.83 ± 2.22 años, todos tenían osteoartritis de cadera, se asignaron aleatoriamente a dos grupos; un grupo recibió celecoxib 5 mg/kg oral cada 12 horas durante 1 mes y el segundo grupo recibió 0.2 mg/kg de meloxicam, oral cada 24 horas durante 1 mes. Todos fueron evaluados por grado de analgesia y pruebas renales, hepáticas y de coagulación al día 0, 10 y 30. Se realizó una endoscopía gástrica al día 30. Para el análisis estadístico se utilizó el test HSD Tukey y c², con nivel significancia del 5%. Resultados. Ambos tratamientos redujeron el dolor articular durante los 30 días, según la escala Melbourne (p≤0.05). Las variables hemáticas, renales, hepáticas y de coagulación estuvieron dentro de los valores normales sin diferencia. Todos presentaron gastritis crónica por endoscopia a los 30 días. Conclusiones. Ambos fármacos redujeron el dolor, ninguno tuvo efectos sobre la hematología, función renal, hepática y de coagulación a los 30 días; sin embargo, hubo gastritis crónica a los 30 días.

Survival of renal transplantation patients older than 60 years: a single-center experience.

BACKGROUND: Elderly patients are the fastest growing population requiring renal replacement therapy. It has been stated that renal transplantation may be the best treatment option for these patients. However, it has been observed that older patients have a higher mortality rate than those who are younger. Yet the factors that determine post-transplantation outcomes in this population remain poorly defined. The aims of this study were to evaluate the graft and patient survival in kidney transplant recipients who are older than 60 years of age to identify relevant predictive factors. METHODS: In this population-based retrospective cohort study of 201 kidney transplantations performed in elderly patients from January 2002 throughout June 2009, we estimated the 1-,3-,and 5-year patients and graft survival rates. We also evaluated the complications and the predictors of poor outcomes. Survival times were analyzed using the Kaplan-Meier method and survival differences assessed with Mantel-Cox log rank-test. We performed a Cox proportional hazards regression models to evaluate the impact of baseline and treatment characteristics on patient and graft survival. RESULTS: Graft and patient survival rates at 1, 3, and 5 years were 76.4%, 71.3%, and 54.3%, and 78.2%, 73.8%, and 56.4%, respectively. Graft survival rates censored for patient death with a functioning graft were 93.1, 92.1, and 89%. Patient survival rates differed between diabetic and nondiabetic subjects at 1, 3 and 5 years (69.5% versus 83.6%; 59.8% versus 72.3%; 43.6% versus 65.7%; P = .008). On multivariate analysis, the factors associated with patients survival were diabetes mellitus (hazard ratio [HR] 2.058, 95% confidence interval [CI] 1.173-3.611, P = .012) and the 1-month serum creatinine value was > 1.6 mg/dL (HR 2.108 for each point increase, 95% CI 1.521-2.921, P = .000). Furthermore, there was an insignificant trend forward an association between active or past smoker and lower patient survival (HR 1.689, 95% CI 0.937-3.043, P = .08). The main causes of graft loss were patient death (79.5%). acute rejection (6.8%), and chronic allograft nephropathy (5.5%). CONCLUSION: Renal transplantation can be performed safely and with acceptable outcomes in elderly patients after appropriate clinical evaluation. The grafts show excellent survival albeit that deaths with a functional graft continue to be an important issue.

Preservation solutions for liver transplantation in adults: celsior versus custodiol: a systematic review and meta-analysis with an indirect comparison of randomized trials.

BACKGROUND: The University of Wisconsin (UW) solution has been recognized as the gold standard for liver preservation; however, it possesses some limitations, and other solutions exist for organ preservation. The aim of this study was to compare the liver functions of transplanted grafts that had been stored in Celsior and Custodiol solutions. METHODS: We searched the MEDLINE, EMBASE, LILACS, Cochrane Central Register of Controlled Trials, and SCIELO databases. We included randomized and quasi-randomized, controlled trials that compared the efficacy and safety of Celsior and Custodiol with UW solution for liver preservation in adults. The factors that were considered for analysis were their impacts on primary dysfunction (primary nonfunction and initial poor function), ischemic-type biliary lesions, and patient and graft survival rates. Because of the lack of direct evidence, an indirect comparison of Celsior and Custodiol was calculated. RESULTS: We identified 3 randomized controlled trials and 1 quasi-randomized, controlled trial to pool in a meta-analysis of Celsior versus UW solutions. The number of episodes of primary dysfunction was lower in the Celsior group (7.4%) than in the UW group (9.8%), but the difference was not significant (relative risk [RR], 0.68; 95% confidence interval [CI], 0.22-1.97). Two randomized controlled trials compared Custodiol and Wisconsin solutions were identified. The number of episodes of primary dysfunction was also lower in the Custodiol group (3.0%) compared with the Wisconsin group (8.4%), but the difference was not significant (RR, 0.36; 95% CI, 0.08-1.70). An indirect comparison using data from the main analysis revealed no difference between the Celsior and Custodiol solutions (RR, 1.88; 95% CI, 0.57-6.16). CONCLUSION: The Celsior and Custodiol solutions performed similarly to UW solution as preservation solutions in liver transplantation clinical settings.

Bovine SLC11A1 3' UTR SSCP genotype evaluated by a macrophage in vitro killing assay employing a Brucella abortus strain.

The 3' untranslated region (3' UTR) of the bovine natural resistance-associated macrophage gene (NRAMP1 or SLC11A1) was genotyped in Colombian Creole Blanco Orejinegro (BON) (Bos taurus) (n = 140) and Zebu Brahman (Bos indicus) (Z) (n = 20) cattle and their crosses (BON x Zebu Brahman [B x Z] [n = 10]; Zebu Brahman x BON [Z x B] [n = 10]), and in animals from a Holstein x BON (H x B) (n = 10) cross. Direct sequencing and single-strand conformation polymorphism analysis (SSCP) helped in detecting the polymorphic behaviour. The association between resistance to brucellosis infection and SSCP genotype was evaluated using a macrophage in vitro killing assay employing a virulent Brucella abortus strain. The 3' UTR (GT) repeated polymorphism was gentoyped and its association with resistance to brucellosis was evaluated. When all breeds were grouped, a high frequency in the homozygote GT(12) (AA genotype) (0.823) and a very low frequency in the homozygote GT(10) (BB genotype) (0.047) were detected. The BON (0.963), Z x B (0.60) and H x B (1.00) cattle showed high GT(12) allele frequencies, unlike that seen for the B x Z and Zebu cattle (0.3002 and 0.218, respectively). The GT(10) allele was only found in the Zebu cattle (0.391). A significant association (p < 0.001) was found between the B. abortus macrophage in vitro killing assay phenotypes and the bovine SLC11A1 3' UTR genotypes, which suggests that the A allele may be associated with resistance. Because only nine animals had the BB genotype, the results require some confirmation in more extensive populations.

[Epidemiology of cerebrovascular diseases in Sabaneta, Colombia (1992-1993)]. / Epidemiología de las enfermedades cerebrovasculares en Sabaneta, Colombia (1992-1993).

INTRODUCTION AND OBJECTIVES: In Columbia the epidemiology of cerebrovascular illness (ECV) is unknown. For this reason a study was made to determine the prevalence, incidence and annual mortality, and to identify the different types of ECV and the demographic characteristics of the population. MATERIAL AND METHODS: In the urban area of Sabaneta, Columbia 13,588 door to door interviews were carried out among the inhabitants. A cutoff study carried out between April and June 1992 showed the prevalence of ECV. One year follow-up of persons without ECV between June 1992 and June 1993, enabled the incidence and annual mortality to be evaluated. A structured interview was used to identify the demographic characteristics of the population and classify people as healthy or as possibly having ECV. The latter were examined by neurologists to confirm or rule out the presence of ECV and to determine the type of ECV involved. Of the total urban population, 76.9% agreed to participate in the study. During the follow-up year, 8.4% were lost trace of. RESULTS AND CONCLUSIONS: The prevalence of ECV was 559.3/ 100,000 inhabitants, increasing with age (15). In the 15-40 year old group, the incidence of ECV was 44 times higher in women than in men. The annual incidence rate was 88.9/100,000 inhabitants: thromboembolic disease was the most frequent. Of a total of 87 cases of ECV, 12 (13.98%) died of various causes during the year in which they were being observed. The annual mortality rate for ECV was 16.2/100,000 inhabitants, all being primary cases.

Adiaspiromycosis in the Franklin's ground squirrel, Spermophilus franklini, and pika, Ochotona princeps, from Alberta, Canada.

Pulmonary adiaspiromycosis due to Emmonsia crescens was diagnosed in three of six Franklin's ground squirrels (Spermophilus franklini) captured in Rochester, central Alberts, Canada in the summer of 1971, and in one of 240 pikas (Ochotona princeps) collected in southwestern Alberta in 1969. Granulomas measuring 0.5 to 1 mm in diameter were found in both lungs. These granulomas contained adiaspores measuring 60 to 400 mum in diameter. The disease was not found in six Franklin's ground squirrels collected in 1964, nor in 10 white-footed mice (Peromyscus maniculatus), one porcupine (Erethizon dorsatum), and 270 snowshoe hares (Lepus americanus) from the Rochester area. Lungs from an additional 17 hares from Alaska and 25 from New Brunswick and 96 pikas from Colorado were also examined but no adiaspores were found.