Can COVID-19 pandemic worsen previous neurological/psychiatric diseases?

Introduction: The SARS-CoV-2 pandemic has been affecting the world since January 2020. Although its pathogenesis is primarily directed to the respiratory tract, other organs may be affected, including the nervous system. It has also been shown that the social context (confinement, lack of treatment) has affected neurological patients during this period. The aim of the study it was to assess the subjective worsening of neurological/psychiatric diseases in the context of the SARS-Cov-2 pandemic. Methods: Three groups of neurological/psychiatric patients were included: Patients who had symptomatic COVID-19 (n = 89), patients who had asymptomatic COVID-19 (n = 40), and a control group (n = 47), consisting of neurological/psychiatric patients without a history of SARS-Cov-2 infection. Results: 30.7% of the included individuals considered that their basal pathology had worsened during the study period. This feeling was significantly more frequent (P = 0.01) in patients with symptomatic COVID-19 (39.3%) than in patients of the other 2 groups (21.8%). Worsening was not related to the severity of COVID-19. The neurological conditions that significantly worsened after COVID-19, comparing symptomatic COVID-19 with the other 2 groups, were demyelinating and degenerative diseases. Conclusions: These results confirmed the impact of the SARS-Cov-2 pandemic on patients with neurological/psychiatric diseases. Confinement, lack of medical care, and the threat of diagnosis are surely contributing factors. Although the finding of a higher frequency of worsening in symptomatic COVID-19 patients may be related to greater anxiety/depression in this group of patients, we cannot exclude the role of direct affectation of the nervous system by the virus or damage due to neuroinflammation.

Introducción: La pandemia por SARS-CoV-2 afecta al mundo desde enero de 2020. Aunque su patogenia se dirige principalmente a las vías respiratorias, otros órganos pueden verse afectados, incluido el sistema nervioso. También se ha demostrado que el contexto social (confinamiento, falta de tratamiento) ha afectado a los pacientes neurológicos durante este periodo. El objetivo del estudio fue evaluar el empeoramiento subjetivo de enfermedades neurológicas/psiquiátricas en el contexto de la pandemia por SARS-Cov-2. Métodos: Se incluyeron tres grupos de pacientes neurológicos/psiquiátricos: pacientes que tenían COVID-19 sintomático (n = 89), pacientes que tenían COVID-19 asintomático (n = 40) y un grupo control (n = 47), formado por pacientes neurológicos/psiquiátricos sin antecedentes de infección por SARS-Cov-2. Resultados: El 30,7% de los individuos incluidos consideró que su patología basal había empeorado durante el período de estudio. Este sentimiento fue significativamente más frecuente (p = 0,01) en pacientes con COVID-19 sintomático (39,3%) que en pacientes de los otros 2 grupos (21,8%). El empeoramiento no estuvo relacionado con la gravedad de COVID-19. Las condiciones neurológicas que empeoraron significativamente después de la COVID-19, comparando la COVID-19 sintomática con los otros 2 grupos, fueron las enfermedades desmielinizantes y degenerativas. Conclusiones: estos resultados confirmaron el impacto de la pandemia del SARS-Cov-2 en pacientes con enfermedades neurológicas/psiquiátricas. El encierro, la falta de atención médica y la amenaza del diagnóstico son seguramente factores contribuyentes. Aunque el hallazgo de una mayor frecuencia de empeoramiento en pacientes sintomáticos de COVID-19 puede estar relacionado con una mayor ansiedad/depresión en este grupo de pacientes, no podemos excluir el papel de la afectación directa del sistema nervioso por el virus o el daño por neuroinflamación.

Impact of markers of endothelial injury and hypercoagulability on systemic lupus erythematosus.

We have explored the relationship between possible hemostatic changes and clinical manifestation of the systemic lupus erythematosus (SLE) as a function of greater or lesser disease activity according to Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) criteria. Endothelial injury and hypercoagulability were investigated in patients with SLE by measuring thrombomodulin (TM), D-dimer (DDi) and thrombin generation (TG) potential. A total of 90 participants were distributed into three groups: 1) women with SLE presenting with low disease activity (laSLE) (SLEDAI-2K ≤ 4), 2) women with SLE presenting with moderate to high disease activity (mhaSLE) (SLEDAI-2K > 4), and 3) a control group comprising healthy women. Levels of TM and DDi were higher both in the laSLE and mhaSLE groups compared to controls and in mhaSLE compared to the laSLE group. With respect to TG assay, lagtime and endogen thrombin potential, low concentrations of tissue factor provided the best results for discrimination among groups. Analysis of these data allow us to conclude that TM, DDi and TG are potentially useful markers for discriminating patients with very active from those with lower active disease. Higher SLE activity may cause endothelial injury, resulting in higher TG and consequently a hypercoagulability state underlying the picture of thrombosis common in this inflammatory disease.

Evaluation of potential biomarkers for the diagnosis and monitoring of Systemic Lupus Erythematosus using the Cytometric Beads Array (CBA).

BACKGROUND: Systemic Lupus Erythematosus (SLE) is an autoimmune, multisystemic disease. Currently diagnosis depends on complex criteria developed by the American College of Rheumatology. Moreover, the lack of specific biomarkers also challenges the diagnosis. METHODS: Inflammatory biomarkers such as IL-8, IP-10, MIG, MIP-1α and RANTES were measured in serum samples from SLE patients and subjects in control groups (patients with other autoimmune diseases and healthy individuals). Forty-six SLE patients (22 patients with low activity, SLEDAI-2 K ≤ 4, 24 patients with moderate/high activity, SLEDAI-2 K > 4), 42 patients with other autoimmune diseases (OAD group), and 8 healthy volunteers participated in this study. RESULTS: MIG (p < .001) and RANTES (p < .001) concentrations in SLE patients and healthy controls, and IP-10 concentrations in SLE patients with different disease activities (low activity, p < .01, moderate/high activity, p < .05) differed significantly. IL-8 (p < .001) and MIP-1α (p < .001) concentrations in SLE patients differed from those in patients from the OAD group. IL-8 (p < .05), IP-10 (p < .01), MIG (p < .05), MIP-1α (p < .001), and RANTES (p < .05) were correlated with SLE activity; their concentrations in SLE patients with low and moderate/high activity differed significantly. CONCLUSIONS: Given the findings of this study, one can envision the possibility of future use of some of these cytokines to assist in the screening of SLE patients, or even in monitoring disease activity.

First detection and characterization of Salmonella spp. in poultry and swine raised in backyard production systems in central Chile.

Little is known about Salmonella serovars circulating in backyard poultry and swine populations worldwide. Backyard production systems (BPS) that raise swine and/or poultry are distributed across Chile, but are more heavily concentrated in central Chile, where industrialized systems are in close contact with BPS. This study aims to detect and identify circulating Salmonella serovars in poultry and swine raised in BPS. Bacteriological Salmonella isolation was carried out for 1744 samples collected from 329 BPS in central Chile. Faecal samples were taken from swine, poultry, geese, ducks, turkeys and peacocks, as well as environmental faecal samples. Confirmation of Salmonella spp. was performed using invA-polymerase chain reaction (PCR). Identification of serovars was carried out using a molecular serotyping approach, where serogroups were confirmed by a multiplex PCR of Salmonella serogroup genes for five Salmonella O antigens (i.e., D, B, C1, C2-C3, and E1), along with two PCR amplifications, followed by sequencing of fliC and fljB genes. A total of 25 samples (1·4% of total samples) from 15 BPS (4·6 % of total sampled BPS) were found positive for Salmonella. Positive samples were found in poultry (chickens and ducks), swine and environmental sources. Molecular prediction of serovars on Salmonella isolated showed 52·0% of S. Typhimurium, 16·0% of S. Infantis, 16·0% S. Enteritidis, 8·0% S. Hadar, 4·0% S. Tennessee and 4·0% S. Kentucky. Poor biosecurity measures were found on sampled BPS, where a high percentage of mixed confinement systems (72·8%); and almost half of the sampled BPS with improper management of infected mortalities (e.g. selling the carcasses of infected animals for consumption). Number of birds other than chickens (P = 0·014; OR = 1·04; IC (95%) = 1·01-1·07), mixed productive objective (P = 0·030; OR = 5·35; IC (95%) = 1·24-27·59) and mixed animal replacement origin (P = 0017; OR = 5·19; IC (95%) = 1·35-20·47) were detected as risk factors for BPS positivity to Salmonella spp. This is the first evidence of serovars of Salmonella spp. circulating in BPS from central Chile. Detected serovars have been linked to human and animal clinical outbreaks worldwide and in Chile, highlighting the importance of BPS on the control and dissemination of Salmonella serovars potentially hazardous to public health.

Matrilineage differentiation of the genus Tetragonisca using mitochondrial DNA markers and the polymerase chain reaction-restriction fragment length polymorphism technique.

The Meliponinae are important pollinators of plant species, and one of the most managed species is Tetragonisca angustula. Initially, two subspecies were identified in T. angustula: T. angustula angustula and T. angustula fiebrigi. Subsequently, T. a. fiebrigi was considered a species, based on the coloration of its mesepisternum. The objective of the present study was to obtain genetic markers that could differentiate the two species by amplifying regions of mitochondrial DNA and conducting polymerase chain reaction-restriction fragment length polymorphism analysis. Worker bees were collected in three Brazilian states: Paraná (Maringá, Altônia, and Foz do Iguaçu), São Paulo (Dracena, São Carlos, and Santa Cruz do Rio Pardo), and Rondônia (Ariquemes). Ten pairs of insect heterologous primers were tested and four were used (primer pair 1, ND2 and COI; primer pair 2, COI; primer pair 8, 16S and 12S; and primer pair 9, COII). For the restriction analysis, 13 enzymes were tested: EcoRI, EcoRV, HindIII, HinfI, RsaI, PstI, XbaI, HaeIII, ClaI, XhoI, BglII, PvuII, and ScaI. Markers were obtained (primer pair 8 cleaved with EcoRV and XbaI and primer pair 9 cleaved with HaeIII, RsaI, and XbaI) that enabled matrilineage identification in the nests studied, which confirmed that hybridization could occur between both Tetragonisca species. The beginning of speciation was probably recent, and secondary contact has resulted in crosses between T. angustula females and T. fiebrigi males. Because of this hybridization, it would be appropriate to consider them as two subspecies of T. angustula.

MRJP microsatellite markers in Africanized Apis mellifera colonies selected on the basis of royal jelly production.

It is important to select the best honeybees that produce royal jelly to identify important molecular markers, such as major royal jelly proteins (MRJPs), and hence contribute to the development of new breeding strategies to improve the production of this substance. Therefore, this study focused on evaluating the genetic variability of mrjp3, mrjp5, and mrjp8 and associated allele maintenance during the process of selective reproduction in Africanized Apis mellifera individuals, which were chosen based on royal jelly production. The three loci analyzed were polymorphic, and produced a total of 16 alleles, with 4 new alleles, which were identified at mrjp5. The effective number of alleles at mrjp3 was 3.81. The observed average heterozygosity was 0.4905, indicating a high degree of genetic variability at these loci. The elevated FIS values for mrjp3, mrjp5, and mrjp8 (0.4188, 0.1077, and 0.2847, respectively) indicate an excess of homozygotes. The selection of Africanized A. mellifera queens for royal jelly production has maintained the mrjp3 C, D, and E alleles; although, the C allele occurred at a low frequency. The heterozygosity and FIS values show that the genetic variability of the queens is decreasing at the analyzed loci, generating an excess of homozygotes. However, the large numbers of drones that fertilize the queens make it difficult to develop homozygotes at mrjp3. Mating through instrumental insemination using the drones of known genotypes is required to increase the efficiency of Africanized A. mellifera-breeding programs, and to improve the quality and efficiency of commercial royal jelly apiaries.

Antimicrobial synergism against different lineages of methicillin-resistant Staphylococcus aureus carrying SCCmec IV.

AIM: To evaluate the synergistic activity of antimicrobial drugs against lineages of methicillin-resistant Staphylococcus aureus (MRSA) carrying SCCmec IV. The biofilm production and related genes were also detected. METHODS AND RESULTS: Forty two MRSA isolates were tested for biofilm production and related genes. Biofilm/biomass susceptibility to gentamicin (G), linezolid (L), rifampicin (R) and vancomycin (V) was determined for six isolates from three lineages prevalent in Rio de Janeiro hospitals in concentrations ranging from 0·25 to 64 µg ml(-1). Biomass was evaluated by microtitre plate test and number of viable cells (CFU cm(-2)) and inspected by epifluorescence microscopy. All isolates presented the icaA and sasG genes, but only 38% were biofilm producers. There were 50 and 45% biomass reductions when concentrations ≥4 µg ml(-1) of R or L and ≥16 µg ml(-1) of G or V, respectively, were used. Synergism tests produced a 55% biomass reduction with R(2µgml-1) + G(16µgml-1), R(2µgml-1) + L(2µgml-1), R(2µgml-1) + V(4µgml-1), and L(2µgml-1) + V(4µgml-1). Number of viable cells was reduced from 2 to 3 logs with R(2µgml-1) + L(2µgml-1) and R(2µgml-1) + V(4µgml-1). CONCLUSIONS: Synergisms involving R plus L and R plus V caused important reductions in biofilm/biomass and the number of viable cells. Drug combinations should be considered in the chemotherapies of MRSA-SCCmec IV infections. SIGNIFICANCE AND IMPACT OF THE STUDY: Biofilms in MRSA infections restrict the clinical choice of antimicrobials. Thus, knowledge of the best options for monotherapy and drug synergisms could improve clinical results.

Nifedipine versus fenoterol in the management of preterm labor: a randomized, multicenter clinical study.

PURPOSE: To compare the efficacy of nifedipine and fenoterol in the management of threatened preterm labor (TPL). METHODS: A randomized and multicenter study assessing the tocolytic effect of nifedipine versus fenoterol in patients admitted to the participating maternity units with a diagnosis of TPL and a cost-savings study for economic assessment. For a power of 80% and an α error equal to 0.05, 132 consecutive patients were recruited during the study period; 66 patients were assigned to each group. A χ(2) analysis and a mean differences test were performed according to variable types and survival curves per intention-to-treat. RESULTS: Demographics were similar in both groups. The latency period was similar in both groups (26.7 vs. 25.6; p = 0.3). There were no differences in the results obtained. Nifedipine failed more frequently to obtain tocolysis when used as a first-line agent (80 vs. 90%, p = 0.0001). The group treated with fenoterol showed more drug adverse events (57.8 vs. 19.0%, p = 0.0001). The economic assessment did not evidence a significant difference in terms of cost savings between groups treated with either drug. CONCLUSION: The present study failed to demonstrate either clinical or economic superiority of any of the two drugs used in TPL management. The highest failure percentage of nifedipine when used as a first-line agent should encourage further research.

Evaluation of miltefosine for the treatment of dogs naturally infected with L. infantum (=L. chagasi) in Brazil.

Dogs naturally infected with Leishmania Infantum (=L. chagasi) were treated with miltefosine using different therapeutic regimens. The animals were evaluated for clinical evolution, biochemical parameters, parasite load (by real-time PCR), cytokine levels and humoral response. After treatment and during the following 24 months, there was progressive clinical improvement and complete recovery in 50% (7/14) of the treated animals. There was a decrease in the smear positivity of the bone marrow after treatment, and there was also a gradual and constant decrease in positive cultures at the end of the follow-up period. However, the PCR detection of parasite DNA remained positive. In general, all animals presented a significant increase in parasite load 6 months after treatment. The IFN-γ levels in all the groups tended to increase during follow-up period, regardless of the miltefosine dose administered. The IL-4 and IL-10 levels of the animals tended to decrease during follow-up, except after 300 days when only IL-10 increased. The serum antibodies identified antigens that ranged from 116 kDa to less than 29 kDa in the Western blot assay. Furthermore, 300 days after treatment, qualitative and quantitative differences in the antigen profiles were observed. Antigens of 97 and 46 kDa were the most intensely recognized. Higher levels of antigen-specific Leishmania IgG were detected before and 300 days after treatment in all groups. Taking together, the improvement in the clinical symptoms was not followed by parasitological clearance, suggesting that treatment with miltefosine is not recommended, especially in endemic areas like Brazil, where children are the major victims and dogs are involved in the maintenance of the parasite cycle.

Year-round resource defence and the evolution of male and female song in suboscine birds: social armaments are mutual ornaments.

The evolution of sexually monomorphic (i.e. mutual) ornamentation has attracted growing attention as a 'blind-spot' in evolutionary biology. The popular consensus is that female ornaments are subject to the same modes of sexual selection as males: intrasexual competition and mate choice. However, it remains unclear how these forces interact within and between sexes, or whether they fully capture selection on female traits. One possibility is that the 'armament-ornament' model - which proposes that traits used primarily in male-male contests are also co-opted by females as indicators of male quality - can be extended to explain signal evolution in both sexes. We examine this idea by testing the function of acoustic signals in two species of duetting antbirds. Behavioural observations and playback experiments suggest that male and female songs function primarily as armaments in competitive interactions. Removal experiments reveal that song is also a classic ornament used by unpaired males and females to advertise for mates. These results indicate that 'armament-ornament' processes may operate in reciprocal format, potentially explaining widespread mutual ornamentation in species with elevated intrasexual competition for resources. In addition, given that songs mediate competition between species outside the breeding season, our findings suggest that processes shaping monomorphic ornaments extend beyond the traditional definitions of sexual selection and are best understood in the broader framework of social selection.

Evaluación de la escala de BISAP en el pronóstico de la pancreatitis aguda / Assessment of a predictive score for complications and mortality among patients with acute pancreatitis

Background: It is important to stratify patients with acute pancreatitis according to their risk. Many staging systems for acute pancreatitis have been proposed, each with advantages and disadvantages. Aim: To evaluate the sensitivity, specificity, positive and negative predictive value of the BISAP system. Material and Methods: Retrospective crosses sectional study, which included all patients that presented with acute pancreatitis to a private hospital in Mexico City from 2003 to 2009. The variables needed to calculate BISAP and complications were obtained from the medical records. Results: The records of 345 patients with a mean aged of 52 years (57 percent males) were analyzed. Twelve percent had complications and 2.3 percent died. Patients with a BISAP score over three had a significantly higher mortality. The sensitivity, specificity and positive predictive value of a BISAP score over three for mortality were 12.5, 92.9 and 4 percent, respectively. Conclusions: Because of its high negative predictive value and specificity the BISAP system can be used to stratify patients who are at low risk for complications related to pancreatitis. If the patient has a score of 3 or higher it is necesary to use other scoring systems which are more sensitive and have a higher positive predictive value.

La pancreatitis aguda afecta aproximadamente a 200.000 personas por año en los Estados Unidos. Puede cursar de manera leve o de manera agresiva con una morbi-mortalidad alta. Es importante estratificar a los pacientes de manera temprana de acuerdo a su riesgo. Nosotros analizamos el sistema BISAP y determinamos su sensibilidad, especificidad, valor predictivo positivo y negativo en relación a morbi-mortalidad. Métodos: Realizamos un estudio transversal retrospectivo e incluimos a todos los pacientes con diagnóstico de pancreatitis aguda en un hospital privado de tercer nivel en la ciudad de México desde el 2003 a 2009. Se obtuvo la morbi-mortalidad y las variables necesarias para calcular el BISAP. Se estratificaron los pacientes. Se utilizó la prueba de Fisher para comparación de variables. Resultados: 345 pacientes fueron incluidos. Edad promedio de 51,8 años. La morbilidad fue de 11,6 por ciento y la mortalidad 2,3 por ciento. Conforme aumentaba el puntaje BISAP había una tendencia hacia más morbilidad. Dividimos la población en un grupo de BISAP bajo (< 3) y un grupo con BISAP alto (> = 3) y observamos una diferencia estadísticamente significativa en cuanto a la morbilidad de ambos grupos. El BISAP tiene una alta especificidad y valor predictivo negativo. Su sensibilidad y valor predictivo positivo son pobres. Conclusiones: Dado su alto valor predictivo negativo y especificidad el BISAP se puede utilizar para estratificar los pacientes que tienen un bajo riesgo de presentar pancreatitis aguda severa relacionada con morbilidad. Si el paciente examinado presenta un BISAP > = 3, creemos necesario utilizar otro sistema con más sensibilidad y valor predictivo positivo para el manejo.

Plexopatía braquial bilateral aguda tras una cirugía abdominal que imita al síndrome del ‘hombre en el barril’ / Acute bilateral brachial plexopathy after abdominal surgery mimicking a man-in-the barrel syndrome

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Natural killer cell subpopulations in putative resistant individuals and patients with active Mycobacterium tuberculosis infection.

Herein, we intended to perform flow-cytometric analyses of peripheral blood NK-cell subsets in patients with active tuberculosis (TB) and those putative resistant subjects displaying positive tuberculin skin test (TST+) and compared with TST- healthy controls. Our findings demonstrated distinct phenotypic features in TST+ as compared with TB. While lower values of NK-cells with increased frequency of CD3-CD16+ CD56- and CD3-CD16-CD56+ subsets besides lower frequency of CD3-CD16+ CD56+ NK-cells was observed in TST+, unaltered levels of NK-cells with increased levels of CD3-CD16+ CD56- NK-cells with lower frequency of CD3-CD16+ CD56+ NK-cells was found in TB. Additional analysis highlighted a shift towards increased levels of CD3-CD16-/+CD56bright NK-cells as the hallmark of TST+, whereas unaltered frequency was observed in TB. Increased levels of CD3+CD56+ cells were observed in both TST+ and TB. Further focusing on the monocyte/NK-cell network, we have reported that enhanced frequency of CD14+ CD16+ monocytes particularly observed in TST+. Outstanding were the distinct correlation profiles observed between CD3-CD16-CD56+ NK-cells and CD3+ CD56+ cells CD14+ CD16+ monocytes for TST+ and TB. These data suggested that high levels of CD3-CD16-CD56+ NK-cells aside CD14+ CD16+ monocytes as well as non-concurrent increment of CD3+ CD56+ cells, may be involved in protective mechanisms in putative tuberculosis-resistant individuals. On the other hand, the basal levels of macrophage-like monocytes despite its positive correlation with increased levels of CD3+ CD56+ cells may count for the lack of the protective immunity in patients with active tuberculosis. Further studies focusing on the cytokine profiling of peripheral blood innate immunity cells before and after chemotherapeutic treatment are currently under evaluation.

[Epidural spinal abscesses. Review of a clinical serie]. / Abscesos espinales epidurales. Revisión de una serie clínica.

INTRODUCTION: The spinal abscess is an infrequent infectious complication whose diagnosis is often delayed, therefore bringing about significant morbidity and death rates. In the last years, its incidence has raised progressively. The objective of this work is to present the clinical features of a series of spinal abscesses. METHOD: The clinical histories of all patients diagnosed of spinal cord abscess were evaluated retrospectively. RESULTS: We obtained seven cases, with a 5/2 male/female proportion, all subjects being over 50 years old. Incidence was 0.58/10,000 admissions per year. All patients debuted with local pains, but only 6/7 (90%) had fever. Focal neurological signs appeared in all patients within the first 0-5 day-period; they were weakness (86%) and sensitive alterations (43%). The most frequent germ was Staphylococcus aureus ( 5 0%). Diabetes mellitus existed in 5/7 cases (71.5%). Four patients were treated by surgery; three of them (75%) had flaccid motor deficit as sequel and the other died. Medical treatment alone was maintained in 3/7 (43%); two experienced partial improvement without recovery of the motor functions and another died. CONCLUSIONS: Spinal epidural abscess is a rare, although serious, disease. For this reason, we should maintain a high level of suspicion when a patient has spinal or radicular pain associated with systemic symptoms such as fever or deterioration in the general state of health, especially in patients >50 years under weakening situations.

[The prevalence of clotting disorders in a series of cases of thrombosis of the cerebral venous sinuses]. / Prevalencia de los trastornos de la coagulación en una serie de trombosis de senos venosos cerebrales.

INTRODUCTION: Cerebral venous sinus thrombosis (CVSTs) constitutes an infrequent location of the venous thrombotic disease. It is caused by diverse factors, although up to 35% of the CVSTs can remain without aetiologic diagnosis. Coagulation disorders have been involved in up to 75% of the CVSTs. AIM. To describe the prevalence of coagulation disorders in a consecutive series of CVSTs. PATIENTS AND METHODS: We performed a retrospective revision of the clinical history of all patients with CVST admitted in our service between January, 1st 1995 and December, 31st 2005. The thrombophilic study was carried out a posteriori in whatever individual who lacked it. RESULTS: We studied twenty-one cases (7 men and 14 women), within an age range of 16-69 years old (corresponding to an average of 35,4 +/- 14,4 years old). The thrombophilic study was carried out in eighteen patients. Five (27,7%) presented some hereditary coagulation disorder; in four of them, a hormonal cause coexisted. CONCLUSION: Recent advances in the diagnostic procedures for the detection of thrombophilias and hereditary prothrombotic mutations have enabled the specialists to be more precise in the aetiologic diagnosis of suspected CVST. Even so, the apparent cause for a high percentage of patients with CVST has not been found yet.

Prevalencia de los trastornos de la coagulación en una serie de trombosis de senos venosos cerebrales / The prevalence of clotting disorders in a series of cases of thrombosis of the cerebral venous sinuses

La trombosis de senos venosos cerebrales (TSVC) constituye una localización infrecuente de la enfermedadvenosa trombótica. En su aparición están implicados diversos factores, aunque hasta un 35% de las TSVC puedequedar sin diagnóstico etiológico. Los trastornos de coagulación se han implicado hasta en un 75% de las TSVC. Objetivo.Describir la prevalencia de los trastornos de la coagulación en una serie de TSVC consecutivas. Pacientes y métodos. Se realizó una revisión retrospectiva de todas las historias clínicas de los pacientes ingresados con una TSVC en el Servicio de Neurologíadel Hospital Universitario de Gran Canaria Doctor Negrín, entre el 1 de enero de 1995 y el 31 de diciembre de 2005. En todos los casos en los que no se hubiese realizado estudio de trombofilia se hizo a posteriori. Resultados. Se estudiaron 21 casos (7 varones y 14 mujeres), entre 16 y 69 años (edad media de 35,4 ± 14,4 años). Se realizaron 18 estudios de trombofilia.Se halló algún trastorno de la coagulación hereditario en cinco (27,7%), y en cuatro de ellos existía una causa hormonal.Conclusión. La mejora en los métodos diagnósticos para la detección de trombofilias y mutaciones protrombóticas hereditarias ha permitido aumentar la precisión en el diagnóstico etiológico de las TSVC. Aun así, un porcentaje elevado de pacientes con TSVC sigue sin tener una causa aparente para ésta

Cerebral venous sinus thrombosis (CVSTs) constitutes an infrequent location of the venous thromboticdisease. It is caused by diverse factors, although up to 35% of the CVSTs can remain without aetiologic diagnosis. Coagulation disorders have been involved in up to 75% of the CVSTs. Aim. To describe the prevalence of coagulation disorders in a consecutive series of CVSTs. Patients and methods.We performed a retrospective revision of the clinical history of all patientswith CVST admitted in our service between January, 1st 1995 and December, 31st 2005. The thrombophilic study was carried out a posteriori in whatever individual who lacked it. Results. We studied twenty-one cases (7 men and 14 women), within an age range of 16-69 years old (corresponding to an average of 35,4 ± 14,4 years old). The thrombophilic study was carried outin eighteen patients. Five (27,7%) presented some hereditary coagulation disorder; in four of them, a hormonal cause coexisted. Conclusion. Recent advances in the diagnostic procedures for the detection of thrombophilias and hereditary prothrombotic mutations have enabled the specialists to be more precise in the aetiologic diagnosis of suspected CVST. Evenso, the apparent cause for a high percentage of patients with CVST has not been found yet

Acute and chronic toxicological studies of Dimorphandra mollis in experimental animals.

Dimorphandra mollis Benth. (Caesalpiniaceae), known as "faveira" or "fava d'anta" is a common plant in central Brazilian cerrado that is used mainly as a vasoprotector. Its main marker is rutin. The present study aimed to evaluate the security of Dimorphandra mollis dry extract in rodents. The extract presented a rutin content of 76+/-3%. Acute and chronic (180 days) toxicity was evaluated after per os administration. In acute toxicity, 3500 and 5000 mg/kg doses presented reversible effects. In chronic toxicity, 1000 and 2000 mg/kg doses did not provoke significant changes in body weight of the animals and in water and food consumption. Behavioral reversible changes and in blood count parameters (hemoglobin, hematocrit and red cells decrease and platelets increase in male in rats) were observed only in 2000 mg/kg dose. In biochemical evaluation, the results varied a lot considering doses and sex, without a linear profile. Some parameters showed a significant difference but without a clinical correlation. In histopathological examination, lung hemorrhage was observed in 2000 mg/kg dose. In conclusion, the study suggest that the extract is safe in a 1000 mg/kg dose, whereas for 2000 mg/kg dose further studies are needed. In long-term use, caution is required.

Age-related changes in cortical bone mass: data from a German female cohort.

To describe data from digital radiogrammetry (DXR) in an unselected German female cohort over a wide age range. Using a retrospective study design we analyzed radiographs of the hand from 540 German women (aged 5-96 years) using an automated assessment of cortical thickness, metacarpal index (MCI), and estimated cortical bone mineral density (DXR-BMD) on digitized radiographs. Both hands were radiographed in 97 women. In this group DXR-BMD and cortical thickness were significantly higher in the right metacarpals while there was no significant difference in MCI. To study the association with age we differentiated young (<20 years), middle-aged (20-45 years), and an older patients (>45 years). In young women all parameters increased significantly with age in a linear fashion (r=0.8 for DXR-BMD, r=0.7 for MCI). In those aged 25-45 years DXR-BMD and MCI were highest (peak bone mass). In women aged 45 or older all parameters decreased with age in an almost linear fashion with an annual change ranging from 0.7% to 0.9%. Our results for an unselected German female cohort indicate that DXR is a reliable, widely available osteodensitometric technique based on the refinement of conventional radiogrammetry. These findings are comparable to those from other studies and represent a valid resource for clinical application and for comparisons with other ethnic groups.

Pulmonary tuberculosis: evaluation of interferon-gamma levels as an immunological healing marker based on the response to the Bacillus Calmette-Guerin.

Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis whose interaction with the host may lead to a cell-mediated protective immune response. The presence of interferon gamma (IFN-gamma) is related to this response. With the purpose of understanding the immunological mechanisms involved in this protection, the lymphoproliferative response, IFN-gamma and other cytokines like interleukin (IL-5, IL-10), and tumor necrosis factor alpha (TNF-alpha) were evaluated before and after the use of anti-TB drugs on 30 patients with active TB disease, 24 healthy household contacts of active TB patients, with positive purified protein derivative (PPD) skin tests (induration > 10 mm), and 34 asymptomatic individuals with negative PPD skin test results (induration < 5 mm). The positive lymphoproliferative response among peripheral blood mononuclear cells of patients showed high levels of IFN-gamma, TNF-alpha, and IL-10. No significant levels of IL-5 were detected. After treatment with rifampicina, isoniazida, and pirazinamida, only the levels of IFN-gamma increased significantly (p < 0.01). These results highlight the need for further evaluation of IFN-gamma production as a healing prognostic of patients treated.