[A socio-anthropological survey to support communication on Covid-19 in West Africa]. / Une enquête socio-anthropologique à l'appui de la communication sur le Covid-19 En Afrique de l'Ouest.

The population's adherence to preventive measures is crucial for the success of the fight against the Covid-19 epidemic, whether it is a question of respecting barrier gestures or vaccination. We conducted a socio-anthropological survey in five countries of the Economic Community of West African States (Burkina Faso, Cape Verde, Côte d'Ivoire, Guinea Bissau, and Sierra Leone) on the representations of Covid-19 that may influence this adherence. Our results showed that raising the awareness of barrier gestures was extremely well-received by the population and is perfectly understood, but that a substantial part of the population denies the presence of Covid-19 in their country, that the transmission of SARS-CoV2 by asymptomatic persons is mostly ignored, that the risk factors of severe forms of the disease are insufficiently known and that a majority of the respondents fear contracting Covid-19 when visiting a health center. The "infodemia" circulating on social networks does not seem to contribute to the various misconceptions we have highlighted, which are the product of the interviewees' observations and interpretation. We propose a reorientation of communication about Covid-19 based on the results of our survey.

Valor de la duración del intervalo QRS para predecir la toxicidad por ropivacaína. Implicaciones en la práctica de la anestesia regional en Cirugía Mayor Ambulatoria / Value of QRS interval duration to predict ropivacaine toxicity. Implications in the practice of regional anesthesia in Major Ambulatory Surgery

Objetivo: La anestesia regional es ampliamente utilizada en Cirugía Mayor Ambulatoria (CMA), asociando innumerables ventajas y un mejor control del dolor postoperatorio. La ropivacaína surgió como una alternativa menos tóxica a la bupivacaína, sin embargo, se han descrito casos de arritmias o parada cardiorrespiratoria tras su administración. Las alteraciones electrocardiográficas en la intoxicación por anestésicos locales afectan a la conducción ventricular, prolongando el intervalo QRS del ECG. Nuestro objetivo fue evaluar si la prolongación del intervalo QRS se correlaciona con niveles elevados en sangre de ropivacaína, lo que podría alertar al clínico de una intoxicación grave. Material y métodos: El estudio se realizó en 4 cerdos minipig premedicados con ketamina intramuscular (20 mg/kg) que fueron anestesiados con tiopental sódico (5 mg/kg) y sevoflurano. Tras la instrumentalización y monitorización continua del ECG se administraron 5 mg/kg de ropivacaína intravenosa. Se realizaron determinaciones analíticas y mediciones de parámetros electrocardiográficos basales y a los 5, 15 y 30 minutos. Se evaluó la correlación entre los niveles plasmáticos de ropivacaína y la duración del intervalo QRS. Análisis estadístico: test de correlación de Spearman. Significación estadística: p < 0,05. Resultados: La ropivacaína indujo un aumento significativo del intervalo QRS a los 5, 15 y 30 minutos. Los intervalos PR, QT y QTc también aumentaron. El porcentaje de aumento máximo del QRS fue de un 51 % a los 5 minutos. Se observó una correlación positiva entre la duración del intervalo QRS y los niveles de ropivacaína, r = 0,8 (p < 0,0001). Conclusión: Nuestro modelo experimental ha permitido relacionar la duración del intervalo QRS con los niveles sanguíneos de ropivacaína. Su ensanchamiento instantáneo puede ser un marcador útil para detectar casos de intoxicación sistémica por ropivacaína, muy utilizada en anestesia regional en CMA (AU)

Objective: Regional anaesthesia is widely used in ambulatory surgery (AS) and is associated with numerous benefits and a better control of postoperative pain. Ropivacaine emerged as a less toxic alternative to bupivacaine, however, cases of arrhythmias or cardiorespiratory arrest have been reported following accidental administration. Electrocardiographic alterations in local anaesthetic intoxication affect ventricular conduction by prolonging the QRS interval of the EKG. Our aim was to assess whether QRS interval prolongation correlates with elevated blood levels of ropivacaine, which could alert the clinician to the presence of severe intoxication. Material and methods: The study was performed in 4 minipig pigs premedicated with intramuscular ketamine (20 mg/kg) and anaesthetized with sodium thiopental (5 mg/kg) and sevoflurane. After instrumentation and continuous ECG monitoring, 5 mg/kg of intravenous ropivacaine was administered. Analytical blood gas samples determinations and measurements of electrocardiographic parameters were performed at baseline and at 5, 15 and 30 minutes. Correla tion between plasmatic levels of ropivacaine and QRS interval duration was assessed. Statistical analysis: Spearman correlation test. Statistical significance: p < 0.05. Results: Ropivacaine induced a significant increase in the QRS interval at 5, 15 and 30 minutes. The PR, QT and QTc intervals also increased. The percentage of maximum QRS increase was 51 % at 5 minutes. A positive correlation was observed between QRS interval duration and ropivacaine levels, correlation coefficient r = 0.8 (p < 0.0001). Conclusion: our experimental model has allowed us to relate QRS interval duration to ropivacaine blood levels. Its instantaneous widening could be a useful marker to detect cases of systemic intoxication by ropivacaine, widely used in regional anesthesia in AS (AU)

Diaphragm pacing in a pediatric patient with Acquired Central Hypoventilation syndrome. / Marcapasos diafragmático en paciente pediátrico con síndrome de Hipoventilación Central Adquirido.

INTRODUCTION: Diaphragmatic pacemaker is a device that reduces or eliminates the need of mechanical ventilation in patients with chronic respiratory failure who keep the phrenic nerve-diaphragm axis intact, as long as they do not present intrinsic lung disease. Although its implantation has been practiced for deca des, its use is not widespread and to date, there is little published literature about it, mostly related to high spinal cord injury and congenital central hypoventilation syndrome. OBJECTIVE: To describe an experience of diaphragmatic pacemaker implantation in a pediatric patient with acquired cen tral hypoventilation syndrome. CLINICAL CASE: Female patient with central hypoventilation syndrome secondary to ischemic brainstem lesion as a result of ventriculoperitoneal shunt malfunction. For this reason, for 5 years she was supported by inpatient mechanical ventilation. At 7 years of age, a diaphragmatic pacemaker was implanted by thoracoscopic surgery, which allowed, after a period of rehabilitation and respiratory conditioning, mechanical ventilation withdrawal, and hospital dischar ge. CONCLUSIONS: Diaphragmatic pacemaker is a feasible, potentially safe, and cost-effective option for decreasing or eliminating mechanical ventilation dependence and improve life quality in patients with acquired central hypoventilation syndrome.

Marcapasos diafragmático en paciente pediátrico con síndrome de Hipoventilación Central Adquirido / Diaphragm pacing in a pediatric patient with Acquired Central Hypoventilation syndrome

Resumen: Introducción: El marcapasos diafragmático permite reducir o eliminar la necesidad de ventilación mecánica en pacientes con insuficiencia respiratoria crónica que conservan el eje nervio frénico-diafragma in tacto, siempre que no presenten enfermedad pulmonar intrínseca. Aunque su implantación ha sido practicada por décadas, su uso no está ampliamente difundido, y existe poca literatura pu blicada al respecto, la mayoría relacionada con lesión medular alta y síndrome de hipoventilación central congénito. Objetivo: Describir una experiencia de implantación de marcapasos diafragmático en paciente pediátrico con síndrome de hipoventilación central adquirido. Caso Clínico: Pa ciente femenino con síndrome de hipoventilación central secundario a lesión isquémica de tronco cerebral como resultado de disfunción de válvula de derivación ventrículo peritoneal, motivo por el cual durante 5 años se mantuvo con asistencia de ventilación mecánica intrahospitalaria. A los 7 años de edad se implantó marcapasos diafragmático mediante cirugía toracoscópica, lo que per mitió posterior a un periodo de rehabilitación y acondicionamiento respiratorio el destete de la ventilación mecánica y el egreso hospitalario. Conclusiones: El marcapasos diafragmático es una opción factible, potencialmente segura y costo efectiva para disminuir o eliminar la dependencia de ventilación mecánica y mejorar la calidad de vida en pacientes con síndrome de hipoventilación central adquirido.

Abstract: Introduction: Diaphragmatic pacemaker is a device that reduces or eliminates the need of mechanical ventilation in patients with chronic respiratory failure who keep the phrenic nerve-diaphragm axis intact, as long as they do not present intrinsic lung disease. Although its implantation has been practiced for deca des, its use is not widespread and to date, there is little published literature about it, mostly related to high spinal cord injury and congenital central hypoventilation syndrome. Objective: To describe an experience of diaphragmatic pacemaker implantation in a pediatric patient with acquired cen tral hypoventilation syndrome. Clinical Case: Female patient with central hypoventilation syndrome secondary to ischemic brainstem lesion as a result of ventriculoperitoneal shunt malfunction. For this reason, for 5 years she was supported by inpatient mechanical ventilation. At 7 years of age, a diaphragmatic pacemaker was implanted by thoracoscopic surgery, which allowed, after a period of rehabilitation and respiratory conditioning, mechanical ventilation withdrawal, and hospital dischar ge. Conclusions: Diaphragmatic pacemaker is a feasible, potentially safe, and cost-effective option for decreasing or eliminating mechanical ventilation dependence and improve life quality in patients with acquired central hypoventilation syndrome.

Estudio radiológico para evaluar la difusión de dos volúmenes (10 vs. 20ml) de contraste radiopaco en el bloqueo de las ramas cutáneas de los nervios intercostales en la línea medio axilar (BRILMA) en un modelo experimental porcino / Radiological study to evaluate the spreading of two volumes (10 vs. 20ml) of radiological contrast in the block of cutaneous branches of intercostal nerves in medial axillary line (BRILMA) in a porcine experimental model

Objetivo: Los bloqueos interfasciales de la pared torácica se están desarrollando como alternativa a los bloqueos centrales en la cirugía de mama. Sin embargo, existen escasos estudios que hayan evaluado la extensión anatómica del anestésico local. Nuestro objetivo fue analizar, mediante fluoroscopia, la difusión de dos volúmenes (10 vs. 20ml) de contraste radiopaco (iopamidol) en el bloqueo del plano serrato-intercostal (BRILMA) en un modelo experimental porcino. Material y métodos: Se seleccionaron 10 cerdos de la raza Large-White a los que se realizó un bloqueo BRILMA ecoguiado bilateral, administrando 10 y 20ml de iopamidol en hemitórax izquierdo y derecho, respectivamente. La difusión del contraste se analizó por fluoroscopia. Se utilizó el test de correlación de Spearman para evaluar la relación entre el volumen administrado y la difusión radiológica. Se consideró significativo un valor de p<0,05. Resultados: Se realizaron 20 bloqueos, pudiéndose analizar 18. La administración de 10ml de contraste se asoció con una difusión media de 2,28±0,31 espacios (IC 95%: 2,01-2,54), mientras que la administración de 20ml mostró una difusión de 3±0,25 espacios (IC 95%: 2,81-3,18). Hubo una correlación significativa entre el volumen inyectado y la difusión del contraste (coeficiente de correlación de Spearman de 0,81; p=0,0001). Conclusión: Nuestros resultados demuestran una difusión dependiente del volumen en el bloqueo BRILMA, aunque sin guardar una relación 1:1. Duplicar el volumen ha incrementado en un 31% los segmentos bloqueados. Estos hallazgos, si se corroboran en la práctica clínica, permitirían un ajuste más preciso en el volumen de anestésico administrado

Objective: Interfascial blocks of the thoracic wall are being developed as an alternative to central blocks in breast surgery. However, there are few studies that have evaluated the anatomical extension of the local anaesthetic. The objective of this study was to analyse, using fluoroscopy, the spreading of two volumes (10 vs. 20ml) of radiological contrast in the serratus-intercostal plane block in an experimental pig model. Material: and methods Ten Large-White breed pigs were selected to have a bilateral ultrasound serratus-intercostal plane block performed, with the administering of 10ml and 20ml of iopamidol in the right and left hemithorax, respectively. The spreading of contrast was analysed by fluoroscopy. The Spearman test correlation was used to evaluate the relationship between the administered volume and radiological spreading. A value of P<.05 was considered significant. Results: Twenty anaesthetic blocks were performed, being able to analyse 18 of them. The administration of 10ml of contrast was associated with a mean spreading of 2.28±0.31 (95% CI; 2.01-2.54) intercostal spaces, while the administration of 20ml showed a spreading of 3±0.25 (95% CI; 2.81-3.18) intercostal spaces. There was a significant correlation between the injected volume and the spreading of the contrast (Spearman correlation coefficient of 0.81; P=.0001). Conclusion: The results showed a spreading of volume subject to the serratus-intercostal plane block, although not maintaining a 1:1 ratio. Doubling the volume increased the blocked segments by 31%. These findings, if corroborated in the clinical practice, would allow a more precise adjustment in the anaesthetic volume administered

Radiological study to evaluate the spreading of two volumes (10 vs. 20ml) of radiological contrast in the block of cutaneous branches of intercostal nerves in medial axillary line (BRILMA) in a porcine experimental model. / Estudio radiológico para evaluar la difusión de dos volúmenes (10 vs. 20ml) de contraste radiopaco en el bloqueo de las ramas cutáneas de los nervios intercostales en la línea medio axilar (BRILMA) en un modelo experimental porcino.

OBJECTIVE: Interfascial blocks of the thoracic wall are being developed as an alternative to central blocks in breast surgery. However, there are few studies that have evaluated the anatomical extension of the local anaesthetic. The objective of this study was to analyse, using fluoroscopy, the spreading of two volumes (10 vs. 20ml) of radiological contrast in the serratus-intercostal plane block in an experimental pig model. MATERIAL AND METHODS: Ten Large-White breed pigs were selected to have a bilateral ultrasound serratus-intercostal plane block performed, with the administering of 10ml and 20ml of iopamidol in the right and left hemithorax, respectively. The spreading of contrast was analysed by fluoroscopy. The Spearman test correlation was used to evaluate the relationship between the administered volume and radiological spreading. A value of P<.05 was considered significant. RESULTS: Twenty anaesthetic blocks were performed, being able to analyse 18 of them. The administration of 10ml of contrast was associated with a mean spreading of 2.28±0.31 (95% CI; 2.01-2.54) intercostal spaces, while the administration of 20ml showed a spreading of 3±0.25 (95% CI; 2.81-3.18) intercostal spaces. There was a significant correlation between the injected volume and the spreading of the contrast (Spearman correlation coefficient of 0.81; P=.0001). CONCLUSION: The results showed a spreading of volume subject to the serratus-intercostal plane block, although not maintaining a 1:1 ratio. Doubling the volume increased the blocked segments by 31%. These findings, if corroborated in the clinical practice, would allow a more precise adjustment in the anaesthetic volume administered.

Desarrollo de un modelo experimental para el estudio de la toxicidad cardiaca inducida por bupivacaína, implicaciones para la anestesia en Cirugía Ambulatoria / Development of an experimental model for the study of bupivacaine induced cardiotoxicity, implications for anesthesia in Ambulatory Surger

Objetivo: Recientemente existe un renovado interés por las técnicas locorregionales, asistiendo a una gran demanda tanto por los pacientes como por los equipos quirúrgicos, especialmente en la cirugía ambulatoria. La descripción de casos clínicos graves asociados a intoxicación por bupivacaína es un evento infrecuente, sin embargo, para mejorar nuestro conocimiento y prevenir la toxicidad de los anestésicos locales es necesario el desarrollo de modelos animales. Los efectos adversos cursan con alteraciones electrocardiográficas relacionadas especialmente con la conducción ventricular y con prolongación del intervalo QRS. Poder detectar una intoxicación grave por anestésicos locales antes de que ocurra un colapso cardiovascular tendría importantes consideraciones clínicas. Nuestro objetivo fue desarrollar un modelo no letal de intoxicación aguda por bupivacaína y correlacionar los niveles del fármaco con el complejo QRS como marcador instantáneo de una intoxicación grave por anestésicos locales. Material y métodos: Se estudiaron 8 cerdos large-White premedicados con ketamina, 20 mg/kg, y anestesiados con tiopental sódico (19 ± 8 mg/kg-1) como inductor y sevoflurano 1 CAM (2,6 %) para el mantenimiento anestésico. Se canalizaron la arteria y vena femoral para la monitorización invasiva, determinaciones analíticas y de niveles de bupivacaína. Al finalizar la instrumentalización, se administró bupivacaína en dosis de 4 mg/kg-1. Se realizaron determinaciones analíticas antes y al 1, 5, 10 y 30 minutos de administración del fármaco. Se evaluó la correlación entre los niveles de bupivacaína en sangre y el intervalo QRS. Se consideró significativo una p < 0,05. Análisis estadístico: Test de correlación de Spearman. Resultados: Ningún animal falleció como resultado de la experiencia. El porcentaje medio de aumento del QRS fue de 185 ± 60 ms. Hubo una correlación estadísticamente significativa entre la duración del intervalo QRS y los niveles plasmáticos de bupivacaína, coeficiente de correlación de Spearman: 0,80; p < 0,0001. Conclusión: Nuestro modelo ha permitido el estudio de uno de los aspectos más relevantes de toxicidad de la bupivacaína. El ensanchamiento del intervalo QRS se ha relacionado positivamente con los niveles de bupivacaína. La modificación instantánea de este parámetro puede ser un marcador clínico instantáneo de gran utilidad en la práctica clínica diaria

Objective: Recently there has been an extraordinary advance in the techniques of regional anaesthesia, assisting to a great demand from the patients and the surgical team especially in day surgery. Reports of serious cardiac bupivacaine intoxication are fortunately unusual, however in order to improve our knowledge and prevention of local anaesthetic toxicity the development of animal models is needed. The adverse event comes along with important electrocardiographic alterations, especially those related to ventricular conduction such as the QRS interval widening. Detecting a severe intoxication with local anaesthetic before a cardiovascular collapse takes place involves important clinical considerations. We aimed to develop a non-lethal steady model of bupivacaine intoxication and correlate bupivacaine plasma levels with the QRS complex duration as an instantaneous marker of severe local anaesthetic intoxication. Material and methods: Eight mini-pigs were premedicated with ketamine and anesthetized with intravenous sodium thiopental 5 mg/kg. The anesthetic maintenance was performed with sevoflurane 1 CAM (2.6 %). Femoral artery and vein were canalized for invasive monitoring, analytical blood gas samples and bupivacaine levels determinations. After instrumentation and motorization, a bupivacaine bolus of 4 mg/kg-1 was administered. Electrocardiographic parameters were recorded and blood samples were taken before and 1, 5, 10 and 30 min after the drug administration. We correlated venous plasma concentration with the QRS widening observed. Statistical: Spearman rank correlation coefficient. A P-value < 0.05 was considered statistically significant. Results: No animal died as a result of the experience and hemodynamic data and blood gas analysis were maintained at physiological range. The mean maximal percent increase in QRS interval was 185 ± 60 ms. There was a statistically significant positive correlation between the QRS interval and bupivacaine plasmatic levels. (Correlation coefficient of r = 0,80 (p < 0,0001). Conclusions: This porcine model of bupivacaine intoxication has been steady, obtaining important electrocardiographic modifications and keeping alive all animals. The relevant QRS interval widening was positively correlated with bupivacaine plasmatic levels. The instantaneous modification of this electrocardiographic parameter could be a useful clinical marker of serious bupivacaine intoxication in a daily basis

Self-compression controlled by the chirp of the input pulse.

Self-compressed (SC) pulses have been achieved through the filamentation process in air without any additional dispersion compensation, using the input pulse chirp as the control parameter. For any studied input pulse energy (3-5 mJ), we have found two opposite sign input group-delay dispersion values for which SC pulses can be achieved systematically. In addition, we have observed that the energy coupled into the inner core of the filament is always of the order of 20% of the total input pulse energy, which opens the way to a scalable technique to obtain intense short pulses directly from the filamentation process.

Effects of prenatal protein malnutrition on the electrical cerebral activity during development.

Early protein restriction during the prenatal period has significant repercussions on the ontogeny and development of the central nervous system. The present study investigates whether early prenatal protein malnutrition could alter the electrical cerebral activity of the progeny. We used Sprague-Dawley female rats of 200 g randomly divided into three groups: a control group that received a diet with 25% of the protein content (lactalbumin), the experimental group, that received a diet with 6% of the protein content and the rehabilitated group that initially received a diet with 6% of the protein content, then switched to a diet with 25% of the protein content after the weaning period (P20D) up to 60 days of life (P60D). Reduction of the protein content from 25% to 6% of lactalbumin in the diet of pregnant rats produces impairment in the electrical cerebral activity in the progeny at P20D and at P60D. The power spectral analysis for each one of the electroencephalograms revealed that prenatal protein malnutrition in rats produced a significant reduction of the alpha (8-13 Hz) and the beta bands (13-30 Hz) and a significant increase of the theta (4-8 Hz), and delta bands (1-4 Hz), at two different stages of life (P20D and P60D). Similar results were obtained for the rehabilitated group. These results indicate that early malnutrition in life affects the ontogeny of the electrical cerebral activity. This insult probably disrupts the establishment of cortical neural circuits during the critical period of brain development. The rehabilitation period did not revert the impairment in the electrical cerebral activity produced by malnutrition. We used one-way ANOVA analysis, followed by Tukey test (*p<0.001).

Heterogeneity of smooth muscle cells in advanced human atherosclerotic plaques: intimal smooth muscle cells expressing a fibroblast surface protein are highly activated by platelet-released products.

BACKGROUND: In vascular disease, smooth muscle cells (SMC) undergo phenotypic modulation and may acquire properties resembling those of fibroblasts in tissue wound healing. AIMS: We aimed to show the differential expression of a fibroblast surface protein (FSP) by SMC in atherosclerotic lesions. RESULTS: In early human coronary atherosclerotic lesions the expression of FSP in the intima was absent. In contrast, 29 of 29 middle/advanced lesions contained intimal SMC expressing high levels of FSP. Fibroblast surface protein positive SMC were negative for desmin but expressed variable levels of alpha-SM actin, SM caldesmon, SM myosin heavy chain and vimentin. Explants from advanced atherosclerotic lesions yielded two main SMC subpopulations. SMC over-expressing FSP exhibited higher in vitro mitogenic response (premitotic DNA synthesis) to sera (2- to 8-fold) and platelet-released products (8- to 26-fold), especially from thrombin-activated platelets, than FSP-negative SMC. CONCLUSIONS: Our results suggest that the expression of FSP in SMC could indicate an activated phenotype, and the presence of highly positive FSP cells in the atherosclerotic lesions might be indicative of an increased SMC responsiveness to processes that locally generate thrombin and activate platelets.

Synthesis of optically active 2-alkoxy-2H-pyran-3(6H)-ones. Their use as dienophiles in Diels-Alder cycloadditions.

Optically active 2-alkoxy-2H-pyran-3(6H)-ones (4a-d) were synthesized in one step by the tin(IV) chloride-promoted glycosylation and rearrangement of the 2-acetoxy-3,4-di-O-acetyl-D-xylal (3) prepared from D-xylose (1). The absolute configuration of the new stereocenter at C-2 was determined by chemical transformation of the dihydropyranones 4a and 4b into the known alkyl pentopyranosides (7a and 7b, respectively). Also, from (1)H NMR experiments using a chiral ytterbium shift reagent, the enantiomeric excesses for 4a (>86%) and 4b (>77%) were established. Enantiomerically pure 4c and 4d were obtained by reaction of 3 with chiral 2-octanol (R and S, respectively). Dihydropyranones 4a-d were employed as dienophiles in Diels-Alder cycloadditions with 2,3-dimethylbutadiene and butadiene. Under thermal conditions, only moderate yields (approximately 50%) of cycloadducts 9a-c and 10a were respectively obtained with good diastereofacial selectivity (>80%). Optimized Lewis acid promoted cycloadditions led to 9a-d and 10a,c in higher yields (approximately 80%) and with higher diastereoselectivities (>94%). The major products were formed by approach of the dienes from the less hindered face of the dihydropyranones, and the minor products (such as 11a) were formed by addition from the opposite side. Furthermore, cycloadduct 9a was stable in an alkaline solution, whereas 11a underwent epimerization under the same conditions.

Cu, Pt, and Pd complexes of the 3-deoxy-1,2-bis(thiosemicarbazone) derived from D-glucose.

3-Deoxy-D-erythro-hexos-2-ulose bis(thiosemicarbazone) (1) acts as a tetradentate ligand of the N2S2 type which forms stable coordination complexes with metal(II) cations. The Cu(II), Pt(II), and Pd(II) chelates (2, 4, and 6, respectively) of 1 were synthesized and characterized by elemental analysis and NMR spectroscopy. The NMR spectra of the Pt complex (4) showed the coupling of H-1 and C-1, C-2 of the bis(thiosemicarbazone) with 195Pt (33.7% naturally occurring), which supports the structure proposed for the chelate. The complexes 2, 4, and 6 were acetylated to give the corresponding tri-O-acetyl derivatives 3, 5, and 7. Elimination of Cu(II) from 3 with hydrogen sulfide afforded 8, the tri-O-acetyl derivative of 1. Preliminary studies have shown antiviral activity of chelates 2, 4, and 6 against poliovirus type 1.

Synthesis of furanose derivatives of 3-deoxy-D-erythro-2-hexulosonic acid and their 3-bromo and 3-deuterio analogs.

Methanolysis of 2,4,6-tri-O-benzoyl-2,3-dibromo-3-deoxy-D-altrono-1,5-lactone gave methyl 3-bromo-3-deoxy-2,4,6-tri-O-benzoyl-alpha-D-ribo-hex-2-ulofuranosonat e (3) and the anomeric mixture of the analogous 4,6-di-O-benzoyl derivative, having HO-2 free. Compound 3 was subjected to debromination with tributyltin hydride and tributyltin deuteride in the presence of 2,2'-azo-bisisobutyronitrile affording, respectively, the corresponding derivatives of 3-deoxy-D-erythro-2-hexulosonic acid and its 3-deuterio analog. The structure of the products and intermediates was established by spectroscopic methods and chemical transformations.

The glycosyl-aldonolactone approach for the synthesis of beta-D-Galf-(1-->3)-D-Manp and 3-deoxy-beta-D-xylo-hexofuranosyl-(1-->3)-D-Manp.

A convenient synthesis of free beta-D-Galf-(1-->3)-D-Manp (8a) is reported. The disaccharide is present as external unit in the lipopeptidophosphoglycan (LPPG) of Trypanosoma cruzi and internally in the lipophosphoglycan (LPG) of Leishmania. Condensation of 2,5,6-tri-O-benzoyl-D-mannono-1,4-lactone (1) with 1,2,3,5,6-penta-O-benzoyl-D-galactofuranose, promoted by SnCl4, led to the beta-glycosyl-lactone, a key intermediate for disaccharide 8a, readily obtained by successive reduction of the lactone with diisoamylborane and debenzoylation. As in the LPG of Leishmania the HO-3 group of the galactofuranose is glycosylated by alpha-D-Galp, we also synthesized 3-deoxy-beta-D-xylo-hexofuranosyl-(1-->3)-D-Manp (8b) and p-nitrophenyl 3-deoxy-beta-D-xylo-hexofuranoside for studying the influence of HO-3 in the interaction with specific glycosidases. The disaccharide 8a, and its corresponding alditol, were good substrates for the beta-D-galactofuranosidase from Penicillium fellutanum, whereas the 3-deoxyglycosides were not hydrolyzed by the enzyme.

The response of smooth muscle cells to alpha-thrombin depends on its arterial origin: comparison among different species.

BACKGROUND: Thrombin plays a pivotal role in the pathogenesis of arterial thrombosis and exerts a wide spectrum of effects on the cells of vessel walls. METHODS: In this paper we focus on the direct role of thrombin as a mitogen for smooth muscle cells (SMCs) derived from different vessels from the vascular tree (coronary artery, aorta, carotid artery and pulmonary artery) of different species (human and pig). All cell populations examined responded mitogenically to alpha-thrombin, however the extent of this response was dependent on both vascular origin and the species from which vessels were derived. RESULTS: Thrombin (1-100 nmol L-1) induced DNA synthesis ranging from 1.5- to 4-fold baseline depending on cell type. Porcine coronary SMCs showed the highest response to thrombin (100 nmol L-1) in terms of protein and DNA synthesis (4.0 +/- 0.2-fold) and cell division (53.4 +/- 8.8%) among the tested cells. In these cells recombinant (r)-hirudin, a specific thrombin inhibitor, exhibited maximal effectiveness to block the mitogenic effect of thrombin. Human SMC response ([3H]-thymidine incorporation) to either sera or thrombin was lower than that of porcine cells. In contrast, c-fos mRNA levels induced by thrombin in human SMCs were higher than those induced in porcine cells. In human cells, thrombin elicited an overexpression of c-fos and a lower rate of [3H]-thymidine incorporation than in porcine cells. Insulin-like growth factor I but not insulin showed additive mitogenic effects with thrombin in human coronary SMCs. The response of these cells to thrombin from different sources was a function of thrombin specific activity. CONCLUSION: These results suggest that the cell system chosen to check thrombin mitogenicity not only determines thrombin quantitative effects but also may affect the effectiveness of an inhibitor to block its biological activity.

Monounsaturated and polyunsaturated n-6 fatty acid-enriched diets modify LDL oxidation and decrease human coronary smooth muscle cell DNA synthesis.

Proliferation of smooth muscle cells (SMCs) plays an important role in atherosclerotic lesion progression. The purpose of this investigation was to examine the effect of diets differing in fatty acid composition on human coronary SMC entry in the cell proliferation cycle. Twenty-four healthy men and women were placed on four consecutive diets lasting 5 weeks each: (1) saturated fatty acid (SFA)-rich diet with palm oil; (2) monounsaturated fatty acid (MUFA)-rich diet with olive oil; (3) polyunsaturated fatty acid (PUFA) n-6-rich diet with sunflower oil; and (4) PUFA n-3-rich diet (3.8 g/d). All diets supplied 35% of calories as fat. Compared with the SFA diet, all unsaturated diets reduced LDL cholesterol. Resistance of LDL to oxidative modification was significantly increased during the MUFA period (P < .05). Human coronary SMCs were cultured and induced by sera derived from the different groups. 3H-Thymidine incorporation into doubling DNA was significantly (P < .01) reduced during the MUFA and PUFA n-6 periods but not during the PUFA n-3 diet with respect to the SFA diet. This effect was more pronounced in women than in men. In conclusion, the MUFA-enriched diet reduced SMC DNA synthesis and LDL levels and protected LDL from oxidation. Therefore, these combined effects suggest that an oleic acid-rich Mediterranean diet could be better than PUFA (n-6)- or PUFA (n-3)-rich diets in the prevention of atherosclerosis.

Cross-cultural variations and changes in food-group intake among elderly women in Europe: results from the Survey in Europe on Nutrition and the Elderly a Concerted Action (SENECA).

To study cross-cultural variations and changes in intake of food groups in elderly Europeans, longitudinal data on food-group intake from Danish (n = 55), Dutch (n = 65), Swiss (n = 79), and Spanish (n = 46) female participants in the Survey in Europe on Nutrition and the Elderly a Concerted Action (SENECA) were compared. Participants were born between 1913 and 1918. Information on food intake was obtained with use of the same diet-history method at all sites and in both 1988-1989 and 1993. Actual food intake was coded according to the Eurocode system, the applicability of which for European multicenter studies was evaluated in this study. All participants, regardless of site, reported consumption of milk, grain products, and vegetables, and almost all ate meat, fats, and fruit. Fewer women ate eggs, fish, and sugar. The variations between the sites were in the food groups consumed and the types of foods within the groups. Spanish women appeared to have the most healthy food-intake pattern. They also had more changes in their dietary pattern than did women in the other countries. The Eurocode was adequate for describing the actual food intake of elderly women in four European towns. The coding for meat, however, was ambiguous and should be revised.

One-pot synthesis of beta-D-Galf(1-->4)[beta-D-Galp(1-->6)]-D-GlcNAc, a 'core' trisaccharide linked O-glycosidically in glycoproteins of Trypanosoma cruzi.

Tin(IV) chloride-promoted condensation of benzyl 2-acetamido-3-O-benzoyl-2-deoxy-alpha-D-glucopyranoside (4) with penta-O-benzoyl-beta-D-galactopyranose (6) gave the derivative of beta-D-Galp-(1-->6)-alpha-D-GlcNAc 7 in 80% yield. This was glycosylated with penta-O-benzoyl-alpha, beta-D-galactofuranose (5), employing the same catalyst, to afford the protected benzyl per-O-benzoyl-beta-D-Galf(1-->4)[beta-D-Galp(1-->6)]D-GlcNAc 10 in 41% yield. Alternatively, compound 10 was obtained directly in a one-pot reaction from 4, by sequential addition of 6 and 5 (34% yield). beta-Glycosidic linkages were diastereoselectively formed. De-O-benzoylation of 10, followed by heterogeneous catalytic transfer hydrogenolysis of the benzyl group afforded the free trisaccharide beta-D-Galf(1-->4)[beta-D-Galp(1-->6)]-D-GlcNAc (14) in 98% yield from 10. Sodium borohydride reduction of 14 gave the corresponding alditol, whose spectral data were identical to those reported for the alditol obtained from the 38-43 kDa cell-surface glycoprotein of Trypanosoma cruzi.

Synthesis and antitumor activity of anthracycline disaccharide glycosides containing daunosamine.

Daunosamine, as its 4-O-acetyl-3-N-trifluoroacetyl glycosyl chloride derivative (1b), has been coupled alpha-L-glycosidically to the 3- and 4-mono-O-acetyl derivatives of L-rhamnal to afford disaccharide glycal derivatives, whose conversion into the corresponding 2-deoxyglycosides by sequential alkoxyiodination-tributylstannane reduction has been evaluated. The sequence successfully demonstrated with the methyl glycosides was successfully extended with daunomycinone as the aglycon, providing a preparative route to 7-O-[3-O-(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)- 2,6-dideoxy-alpha-L-arabino-hexopyranosyl]daunomycinone hydrochloride (15), an analogue of natural anthracycline antibiotics containing daunosamine and a 2,6-dideoxy-L-hexose.

[Effect of nutrition on the functional capacity of a group of elderly Spaniards]. / Influencia de la nutrición en la capacidad funcional de un grupo de ancianos españoles.

The present study analyzes the influence of the nutritional status on the functional capability of 11 institutionalized elderly living in Madrid (Spain). Nutritional status was evaluated by dietetic, anthropometric, hematological and biochemical data and functional status was evaluated considering adiposity, strength in hands and legs bent and stretched and flexibility. The most important nutritional problems that conditional functional wastages are obesity, hypercholesterolemia and protein and micronutrient deficiency. The adverse influence of obesity and hypercholesterolemia on the functional capacity of the elderly is shown by the inverse relationship between flexibility and strength in hands and legs with the adiposity degree, with the thickness of skin folds and the cholesterolemia. In reference to the diet's influence, there are positive correlations between food intake and most of the nutrients with hand and legs strength, and there are statistical significances for proteins, iron, zinc, magnesium and pyridoxine, and also for vitamin C, niacin, thiamin, folic acid and vitamin E. For blood values, the mayor correlation exists between functional parameters and iron, ferritin and vitamin C levels. Our results contribute to confirm the influence of nutrition on the functional capacity of the influence of nutrition on the functional capacity of the elderly and manifest the necessity of improving the elderly's diet, to prevent micronutrient deficiency and also the necessity of increasing their physical activity. Both measures will mean an important help for sanitary and functional improvement of the elderly.