Isolation of two bioactive diterpenic acids from Copaifera glycycarpa oleoresin by high-speed counter-current chromatography.

INTRODUCTION: Phytochemical and biological studies carried out on Copaifera species showed that their oleoresins and isolated compounds have various biological activities. OBJECTIVE: The aims of this work were (i) to analyse the Copaifera oleoresin by gas chromatography-mass spectrometry, (ii) to isolate the diterpenic acids from this oleoresin by high-speed countercurrent chromatography (HSCCC) and (iii) to determine the rhodamine 6G Pdr5p activity of these acids. METHODOLOGY: HSCCC was used for the preparative separation of the diterpenes. Spectroscopic methods were used to establish their identity. RESULTS: The gas chromatogram of the oleoresin showed approximately 30 compounds. The two major ones, kaur-16-en-18-oic and polyalthic acids, were isolated in high purity. Kaur-16-en-18-oic acid exhibited the highest rodomine 6G Pdr5p activity among the tested compounds. CONCLUSION: HSCCC was shown to be a quick and effective tool in the isolation and purification of diterpenes from Copaifera oleoresin. This is the first report on the use of HSCCC for the fractionation of an oleoresin from Copaifera and the isolation of diterpenes therein.

Del trabajo en equipo a la colaboración entre equipos. Un avance en la atención a pacientes al final de la vida / No disponible

No disponible

Papel de la auxiliar de enfermería en las unidades domiciliarias de Cuidados Paliativos / No disponible

No disponible

Atención domiciliaria al paciente urémico terminal no susceptible de diálisis / Home-based care to end-stage uremic patients non susceptible for dialysis

No disponible

No disponible

Nucleophilicity toward ketenes: rate constants for addition of amines to aryl ketenes in acetonitrile solution.

Second-order rate constants (k(Nu)) have been measured for the addition of amines to ketenes 4-6 in acetonitrile solution by the laser flash photolysis technique. These ketenes are formed from a photochemical Wolff rearrangement of diazoketones 1-3, respectively. For all diazoketones studied, the presence of amines as nucleophiles in the reaction medium results in the formation of an intermediate that later converts to the amide. The rate of formation of these intermediates is linearly dependent on amine concentration. Various classes of amines, such as primary, secondary, and tertiary, aromatic, and aliphatic, have been used to investigate the ketene reactivity, and rate constants in the range 10(4)-10(9) M(-1) s(-1) have been measured. Reaction rates are dependent upon steric effects in both the ketene and the nucleophile, which is consistent with a reaction mechanism involving nucleophilic attack at Calpha in the molecular plane of the ketene. On the basis of these data, a set of N(+) parameters for the reaction of amines with ketenes was determined.

Normal values for serum, ultrafilterable and intraerythrocytic magnesium in children.

Serum magnesium (MgS), levels were determined in 137 children age range 2 months to 16 years. Ultrafilterable magnesium (MgU) and intraerythrocytic magnesium (MgI) concentrations were determined in 37 of these children. MgS was 0.83 +/- 0.1 mmol/L (range 0.66-1.36 mmol/L), with no differences between sexes. Children under 2 years had higher MgS levels (0.92 +/- 0.13 mmol/L) than children over 2 years (0.81 +/- 0.08 mmol/L; p < .001). Mean MgU was 0.60 +/- 0.07 mmol/L (range 0.50-0.87 mmol/L), with no differences between sexes. Mean MgI in children was 2.58 +/- 0.33 mmol/L (range 2.06-3.6 mmol/L), with no differences between sexes. MgS correlated with MgU, age, theoretical growth rate, and serum calcium, phosphorus and alkaline phosphatase; MgU correlated with MgI, age, theoretical growth rate, and serum phosphorus. MgS concentration was higher in children under 2 years than in children over 2 years. In healthy children, MgS concentration correlated with MgU, and MgU correlated with MgI, but MgS and MgI showed no correlation.

[Quality of antihypertensive drug prescription in a health area]. / Calidad de la prescripción de fármacos antihipertensivos en un área de salud.

OBJECTIVE: To find the compliance with previously established criteria on the quality of prescription of medication for hypertension. DESIGN: Retrospective and concurrent evaluation study of scientific and technical quality, with processing data, using as data source the clinical history. SETTING: Primary care teams in a Madrid Health Area. PARTICIPANTS: 873 clinical histories of hyper-intense patients in treatment with diuretics, beta-blockers, ACE inhibitors and/or calcium antagonists were chosen through systematic probabilistic sampling with a randomised start. MEASUREMENTS AND MAIN RESULTS: Data on age, sex, recording of treatment, linked pathologies and situations conditioning the choice of medicine were gathered. Information on the defined use criteria of the various pharmacological groups was also collected. 1145 drugs were used on 873 patients. Most common were the thiazide diuretics (36%), followed by ACE inhibitors (34.4%), calcium antagonists (21%) and beta-blockers (8.6%). 72% of the patients were undergoing one single therapy. 89.7% of the cases (95% CI, 87.43-91.59) had the treatment correctly recorded in the clinical record. Of the 721 hyperintense patients over 59 years old, 70.3% (95% CI, 66.81-73.60) fitted the defined criterion for use of diuretics. 48.7% fitted the ACE inhibitor criteria defined (CI, 43.71-53.78); 85.7% the beta-blocker criteria (CI, 76.85-91.69); and 58.7% the calcium antagonist criteria (95% CI, 52.17-64.9). CONCLUSIONS: The fit of the use of diuretics with the defined quality criterion is acceptable, while in the cases of ACE inhibitors and calcium antagonists the quality of prescription could be improved, while the use of beta-blockers is minimal.

Calidad de la prescripción de fármacos antihipertensivos en un área de salud / Quality of the prescription of hypertension medication in a health area

Objetivo. Conocer el grado de cumplimiento de unos criterios de calidad de prescripción de fármacos antihipertensivos previamente establecidos. Diseño. Estudio de evaluación de la calidad científico-técnica, retrospectivo y concurrente, con datos de proceso, utilizando como fuente de datos la historia clínica. Emplazamiento. Equipos de atención primaria de un área de salud de Madrid. Participantes. Se seleccionaron mediante muestreo probabilístico sistemático con inicio aleatorio 873 historias clínicas de pacientes hipertensos en tratamiento con diuréticos, bloqueadores beta, IECA y/o antagonistas del calcio. Mediciones y resultados principales. Se recogieron datos relativos a edad, sexo, registro del tratamiento, patologías y situaciones asociadas que condicionan la selección del antihipertensivo, así como información respecto a los criterios de utilización definidos de los diferentes grupos farmacológicos. Se utilizaron 1.145 fármacos en 873 pacientes. Los diuréticos tiazídicos fueron los fármacos más utilizados(36 por ciento), seguidos de IECA (34,4 por ciento), antagonistas del calcio (21 por ciento) y bloqueadores beta (8,6 por ciento). Un 72 por ciento de los pacientes estaban en monoterapia. En el 89,7 por ciento (IC del 95 por ciento, 87,43-91,59) de los casos figuraba correctamente registrado el tratamiento en la historia clínica. De los 721 pacientes hipertensos mayores de 59 años un 70,3 por ciento (IC del 95 por ciento, 66,81-73,60) se adecuaba al criterio de utilización de diuréticos definido. La adecuación a los criterios definidos de IECA fue del 48,7 por ciento (IC del 95 por ciento, 43,71-53,78), de bloqueadores beta de un 85,7 por ciento (IC del 95 por ciento, 76,85-91,69) y de antagonistas del calcio del 58,7 por ciento (IC del 95 por ciento, 52,17-64,9). Conclusiones. La adecuación de la utilización de diuréticos al criterio de calidad definido es aceptable, mientras que en el caso de IECA y antagonistas del calcio la calidad de prescripción es mejorable, siendo mínima la utilización de bloqueadores beta (AU)

Surfactant treatment for acute respiratory distress syndrome.

OBJECTIVE: To determine prospectively the efficacy of surfactant in acute respiratory distress syndrome. STUDY DESIGN: Twenty patients, 1 month to 16 years of age, diagnosed with an acute pulmonary disease with severe hypoxaemia (PaO2/FiO2 < 100) (13 with systemic or pulmonary disease and seven with cardiac disease) were treated with one to six doses of 50-200 mg/kg of porcine surfactant administered directly into the trachea. The surfactant was considered to be effective when the PaO2/FiO2 improved by > 20%. RESULTS: After initial surfactant administration the PaO2/FiO2 increased significantly in patients with systemic or pulmonary disease from 68 to 111, and the oxygenation index (OI) diminished significantly from 36.9 to 27.1. The PaO2/FiO2 and OI did not improve in children with cardiac disease. The improvement of the patients who survived was greater than that of those who died. CONCLUSIONS: Surfactant moderately improves oxygenation in some children with severe acute respiratory distress syndrome secondary to pulmonary or systemic disease.

[Epidemiological study of fertility in adolescents in the Autonomous Community of Madrid]. / Estudio epidemiológico de la fecundidad en adolescentes en la Comunidad Autónoma de Madrid.

OBJECTIVE: The purpose of this study was to research the frequency and distribution of fertility in adolescence and, in looking at different environments within the Autonomous Community of Madrid (ACM), to evaluate the relationship of fertility rates to determined variables of a socio-economic, educational and demographic nature. DESIGN: An observational crossover study was carried out. SETTING: Autonomous Community of Madrid. PATIENTS AND OTHERS PARTICIPANTS: In this study, the specific rate of fertility in adolescents (SRFA) was calculated and the correlation between the SRFA and variables of a socioeconomic, educational and demographic nature were analysed by means of the multiple linear regression method. MEASUREMENTS AND MAIN RESULTS: We found important differences in the distribution of fertility within the ACM. There was also a positive correlation (p < 0.05) between the SRFA and those variables which expressed the percentages of illiteracy, industrial workers and with the synthetic youth index. A negative correlation (p < 0.05) was found for the percentages of graduates, professionals and technicians, managers and directors and with the synthetic ageing index. We found no correlation with the unemployment index. On applying the multivariant model, the variable that weighed most on fertility was the level of education, which was in our case measured by the percentage of illiteracy. CONCLUSIONS: We found an uneven spread of adolescents' fertility rates in the Autonomous Community of Madrid. The fertility rates were higher in those boroughs where there was more illiteracy.

[Diarrhea and enteral nutrition]. / Diarrea y nutrición enteral.

The present study is a review of what is understood by diarrhoea and the factors leading to its development in patients on enteral nutrition. An analysis is made of the factors related to the preparation, administration and the factors concerning the patient. It has been observed that there are important discrepancies in the evaluation of diarrhoea provoked by enteral diets. This is due to the different definitions of diarrhoea, the method used and exclusion criteria used by different authors.

[Updated study of enteral nutritional diets sold in Spain]. / Estudio actualizado de las dietas de nutrición enteral comercializadas en España.

Due to the large number of enteral nutrition diets on the market in Spain, it is difficult to collect together all the information on the subject. This study sets out the criteria recommended by the Hospital of Alabama and the University of Birmingham in the evaluation of the information furnished by the laboratories that prepare the enteral nutrition diets. The study includes a compendium of the data provided by these laboratories with a view to simplifying the electron of the preparations.

[Familial outbreak of Mycoplasma pneumoniae pneumonia]. / Brote familiar de neumonía por Mycoplasma pneumoniae.

Mycoplasma pneumoniae is a pathogen of the human species which causes primarily acute respiratory diseases including pneumonia. It is transmitted from person through the respiration, and results in small epidemics. Most infected persons only develop pharyngitis or tracheobronchitis, whereas pneumonia develops in 3-30% depending on the age and characteristics of the evaluated group. Mycoplasma pneumoniae is the causative organism of 20% of community acquired pneumonias in the general population; this proportion rises to 60% in closed groups and in individuals below age 20 years. Two cases of Mycoplasma pneumoniae pneumonia identified in a single family are reported, together with a case of tracheobronchitis most likely caused by the same organism. The clinical, diagnostic, therapeutic and preventive approaches to the mycoplasma infections are discussed, and also the therapeutic approach to be recommended, in primary care, to young patients with pneumonia.