Ultrasound-assisted green solvent extraction of high-added value compounds from microalgae Nannochloropsis spp.

The aim of this work was to investigate ultrasound (US)-assisted green solvent extraction of valuable compounds from the microalgae Nannochloropsis spp. Individual green solvents (water, ethanol (EtOH), dimethyl sulfoxide (DMSO)) and binary mixture of solvents (water-DMSO and water-EtOH) were used for the extraction procedures. Maximum total phenolic compounds yield (Yp ≈ 0.33) was obtained after US pre-treatment (W=400 W, 15 min), being almost 5-folds higher compared to that found for the untreated samples and aqueous extraction (Yp ≈ 0.06). The highest yield of total chlorophylls (Yc ≈ 0.043) was obtained after US (W=400 W, 7.5 min), being more than 9-folds higher than those obtained for the untreated samples and aqueous extraction (Yc ≈ 0.004). The recovery efficiency decreased as DMSO>EtOH>H2O. The optimal conditions to recover phenolic compounds and chlorophylls from microalgae were obtained after US pre-treatment (400 W, 5 min), binary mixtures of solvents (water-DMSO and water-EtOH) at 25-30%, and microalgae concentration of 10%.

Absceso piógeno del psoas secundario a espondilodiscitis postartrodesis lumbar. Revisión y comentario, a propósito de un caso / Piogenic abscess in the psoas muscle after lumbar spondylodiskitis postartrodesis. A case report, comentary and revision

Se presenta el caso de un paciente inmunocompetentesometido a artrodesis vertebral que sufre infección quirúrgicapor Staph. Aureus multisensible con evolución tórpiday múltiples recidivas locales pese antibioterapia e intervencionesquirúrgicas de drenaje.A los 3 meses de la artrodesis se retiró el material de fijación,y evoluciona a espondilodiscitis crónica con fístulacutánea lumbar. Aparece absceso del músculo psoas iliacoa los 5 años.Se establece el diagnóstico diferencial entre las entidadesresponsables de afectación del espacio retroperitoneal.Se analizan las imágenes evolutivas desde espondilodiscitisa absceso del psoas y la progresión hasta la resolución

We report a case of a immunocompromised patient withvertebral artrodesis that presented an infection by Staphylococcusaureus with torpid evolution and several local recidivain spite of antibiotic therapy and surgical drainage.After 3 months the artrodesis instrumental was extirpatedand the patient developed a chronic spondylodiskitisand cutaneous lumbar fistula. Appeared an abscess in thepsoas iliac musculature after 5 years.The differential diagnosis is established among the differententities responsible for the affectation of the retroperitonealcompartment.The evolutionary images are analyzed from the spondylodiskitisto psoas abscess and the progression until its resolution

['In vitro' activity of different antimicrobial agents on Gram-negative nonfermentative bacilli, excluding Pseudomonas aeruginosa and Acinetobacter spp]. / Actividad "in vitro" de diferentes antibacterianos sobre bacilos gram-negativos no fermentadores, excluidos Pseudomonas aeruginosa y Acinetobacter spp.

Gram-negative nonfermentative bacilli (NFB) are widely spread in the environment. Besides of difficulties for identification, they often have a marked multiresistance to antimicrobial agents, including those active against Pseudomonas aeruginosa. The objective of this study was to evaluate the 'in vitro' activity of different antimicrobial agents on 177 gram-negative nonfermentative bacilli isolates (excluding Pseudomonas aeruginosa and Acinetobacter spp.) isolated from clinical specimens. Minimum inhibitory concentrations (MIC) were determined according to the Mueller Hinton agar dilution method against the following antibacterial agents: ampicillin, piperacillin, piperacillin-tazobactam, sulbactam, cefoperazone, cefoperazone-sulbactam, ceftazidime, cefepime, aztreonam, imipenem, meropenem, colistin, gentamicin, amikacin, trimethoprim-sulfamethoxazole, chloramphenicol, erythromycin, rifampin, norfloxacin, ciprofloxacin and minocycline. Seven isolates: Sphingobacterium multivorum (2), Sphingobacteriumspiritivorum (1), Empedobacterbrevis (1), Weeksella virosa (1), Bergeyella zoohelcum (1) and Oligella urethralis (1), were tested for amoxicillin-clavulanic acid and ampicillin-sulbactam susceptibility, and susceptibility to cefoperazone or sulbactam was not determined. Multiresistance was generally found in Stenotrophomonas maltophilia, Burkholderia cepacia, Chryseobacterium spp., Myroides spp., Achromobacter xylosoxidans, and Ochrobactrum anthropi isolates. On the other hand, Pseudomonas stutzeri, Shewanella putrefaciens-algae, Sphingomonas paucimobilis, and Pseudomonas oryzihabitans, Bergeyella zoohelcum, Weeksella virosa and Oligella urethralis were widely susceptible to the antibacterial agents tested. As a result of the wide variation in antimicrobial susceptibility shown by different species, a test on susceptibility to different antibacterial agents is essential in order to select an adequate therapy. The marked multiresistance evidenced by some species, prompts the need to develop new antimicrobial agents active against this group of bacteria and to search for synergistic combinations.

Actividad "in vitro" de diferentes antibacterianos sobre bacilos gram-negativos no fermentadores, excluidos Pseudomonas aeruginosa y Acinetobacter spp / ‘In vitro' activity of different antimicrobial agents on gram-negative nonfermentative bacilli, excluding Pseudomonas aeruginosa and Acinetobacter spp

Los bacilos gram-negativos no fermentadores se encuentran ampliamente distribuidos en el medio ambiente. Además de causar dificultades en la identificación, a menudo presentan una marcada multirresistencia a los antimicrobianos incluyendo aquellos activos frente a Pseudomonas aeruginosa. El objetivo de este trabajo fue evaluar la actividad "in vitro" de diferentes antimicrobianos sobre 177 aislamientos de bacilos gram-negativos no fermentadores (excluidos Pseudomonas aeruginosa y Acinetobacter spp.) provenientes de especimenes clínicos. Las concentraciones inhibitorias mínimas (CIM) se determinaron por el método de dilución en agar Mueller Hinton frente a los siguientes antibacterianos: ampicilina, piperacilina, piperacilina-tazobactama, sulbactama, cefoperazona, cefoperazona-sulbactama, ceftazidima, cefepima, aztreonam, imipenem, meropenem, colistina, gentamicina, amicacina, trimetoprima-sulfametoxazol (TMS), cloranfenicol, eritromicina, rifampicina, norfloxacina, ciprofloxacina y minociclina. Sobre siete aislamientos: Sphingobacterium multivorum (2), Sphingobacterium spiritivorum (1), Empedobacter brevis (1), Weeksella virosa (1), Bergeyella zoohelcum (1) y Oligella urethralis (1) se ensayó la sensibilidad a amoxicilina-ácido clavulánico y ampicilina-sulbactama y no se determinó la actividad de cefoperazona ni de sulbactama. La multirresistencia fue comúnmente observada en los aislamientos de Stenotrophomonas maltophilia, Burkholderia cepacia, Chryseobacterium spp., Myroides spp., Achromobacter xylosoxidans y Ochrobactrum anthropi. En cambio, Pseudomonas stutzeri, Shewanella putrefaciens-algae, Sphingomonas paucimobilis, Pseudomonas oryzihabitans, Bergeyella zoohelcum, Weeksella virosa y Oligella urethralis, fueron ampliamente sensibles a los antibacterianos ensayados. Debido a la gran variabilidad observada en la sensibilidad a los antimicrobianos en las distintas especies, se hace imprescindible realizar la prueba de sensibilidad a los antibacterianos a fin de abordar la elección correcta del mismo. Debido a la marcada multirresistencia de algunas especies, surge la necesidad del desarrollo de nuevos agentes antimicrobianos que posean actividad sobre este grupo de bacterias, así como tambien la búsqueda de combinaciones sinérgicas.

Gram-negative nonfermentative bacilli (NFB) are widely spread in the environment. Besides of difficulties for identification, they often have a marked multiresistance to antimicrobial agents, including those active against Pseudomonas aeruginosa. The objective of this study was to evaluate the ‘in vitro' activity of different antimicrobial agents on 177 gram-negative nonfermentative bacilli isolates (excluding Pseudomonas aeruginosa and Acinetobacter spp.) isolated from clinical specimens. Minimum inhibitory concentrations (MIC) were determined according to the Mueller Hinton agar dilution method against the following antibacterial agents: ampicillin, piperacillin, piperacillin-tazobactam, sulbactam, cefoperazone, cefoperazone-sulbactam, ceftazidime, cefepime, aztreonam, imipenem, meropenem, colistin, gentamicin, amikacin, trimethoprim-sulfamethoxazole, chloramphenicol, erythromycin, rifampin, norfloxacin, ciprofloxacin and minocycline. Seven isolates: Sphingobacterium multivorum (2 ), Sphingobacterium spiritivorum (1), Empedobacter brevis (1), Weeksella virosa (1), Bergeyella zoohelcum (1) and Oligella urethralis (1), were tested for amoxicillin-clavulanic acid and ampicillin-sulbactam susceptibility, and susceptibility to cefoperazone or sulbactam was not determined. Multiresistance was generally found in Stenotrophomonas maltophilia, Burkholderia cepacia, Chryseobacterium spp., Myroides spp., Achromobacter xylosoxidans, and Ochrobactrum anthropi isolates. On the other hand, Pseudomonas stutzeri, Shewanella putrefaciens-algae, Sphingomonas paucimobilis, and Pseudomonas oryzihabitans, Bergeyella zoohelcum, Weeksella virosa and Oligella urethralis were widely susceptible to the antibacterial agents tested. As a result of the wide variation in antimicrobial susceptibility shown by different species, a test on susceptibility to different antibacterial agents is essential in order to select an adequate therapy. The marked multiresistance evidenced by some species, prompts the need to develop new antimicrobial agents active against this group of bacteria and to search for synergistic combinations.

Actividad [quot ]in vitro[quot ] de diferentes antibacterianos sobre bacilos gram-negativos no fermentadores, excluidos Pseudomonas aeruginosa y Acinetobacter spp. / [In vitro activity of different antimicrobial agents on Gram-negative nonfermentative bacilli, excluding Pseudomonas aeruginosa and Acinetobacter spp.]

Gram-negative nonfermentative bacilli (NFB) are widely spread in the environment. Besides of difficulties for identification, they often have a marked multiresistance to antimicrobial agents, including those active against Pseudomonas aeruginosa. The objective of this study was to evaluate the in vitro activity of different antimicrobial agents on 177 gram-negative nonfermentative bacilli isolates (excluding Pseudomonas aeruginosa and Acinetobacter spp.) isolated from clinical specimens. Minimum inhibitory concentrations (MIC) were determined according to the Mueller Hinton agar dilution method against the following antibacterial agents: ampicillin, piperacillin, piperacillin-tazobactam, sulbactam, cefoperazone, cefoperazone-sulbactam, ceftazidime, cefepime, aztreonam, imipenem, meropenem, colistin, gentamicin, amikacin, trimethoprim-sulfamethoxazole, chloramphenicol, erythromycin, rifampin, norfloxacin, ciprofloxacin and minocycline. Seven isolates: Sphingobacterium multivorum (2), Sphingobacteriumspiritivorum (1), Empedobacterbrevis (1), Weeksella virosa (1), Bergeyella zoohelcum (1) and Oligella urethralis (1), were tested for amoxicillin-clavulanic acid and ampicillin-sulbactam susceptibility, and susceptibility to cefoperazone or sulbactam was not determined. Multiresistance was generally found in Stenotrophomonas maltophilia, Burkholderia cepacia, Chryseobacterium spp., Myroides spp., Achromobacter xylosoxidans, and Ochrobactrum anthropi isolates. On the other hand, Pseudomonas stutzeri, Shewanella putrefaciens-algae, Sphingomonas paucimobilis, and Pseudomonas oryzihabitans, Bergeyella zoohelcum, Weeksella virosa and Oligella urethralis were widely susceptible to the antibacterial agents tested. As a result of the wide variation in antimicrobial susceptibility shown by different species, a test on susceptibility to different antibacterial agents is essential in order to select an adequate therapy. The marked multiresistance evidenced by some species, prompts the need to develop new antimicrobial agents active against this group of bacteria and to search for synergistic combinations.

Characterization of coloured compounds obtained by enzymatic extraction of bakery products.

Melanoidins, the brown-colored polymers formed through Maillard type reaction in several heat-treated foods, represent a significant part of our diet, with an average intake of grams per day. Most of the studies on the physiological effects of these compounds have been performed using the water soluble melanoidin fractions. But dietary melanoidins formed on the surface of bakery products are poorly soluble in water as well as in organic solvents. In this work, an enzymatic solubilization procedure was developed on a gluten-glucose model system and it was applied to bread and biscuits. The soluble material obtained was tested for its antioxidant activity, for its effect on phase-I and phase-II xenobiotic enzymes and for potential cytotoxic effects. Soluble melanoidins from model system and biscuits exhibit a strong antioxidant activity and do not show any cytotoxicity on Caco-2 cells. Melanoidins extracted from biscuits was able to inhibit the activity of Phase I (NADPH-cytochrome-c reductase) and Phase II (Glutathione-S-transferase) enzymes, whereas the low molecular weight melanoidins isolated from gluten-glucose model system inhibit the activity of NADPH-cytochrome-c reductase.

[Improving care for victims of domestic violence. Impact of a priority intervention]. / Mejora de la atención prestada a víctimas de violencia doméstica. Impacto de una intervención priorizada.

OBJECTIVE: To evaluate the impact of a priority intervention in the care given to women who are victims of domestic violence and their children. DESIGN: Non-randomised intervention study. SETTING: Urban health centre. PATIENTS: Women and children living at a reception centre for families suffering domestic violence and who had clinical records opened at the health centre. Pre-intervention group (December 1997-July 1999): 36 women, 70 children. Post-intervention group (August 1999-June 2000): 35 women and 41 children.Interventions. Allocation to a single family doctor and paediatrician. Elimination of bureaucratic obstacles and prioritised care. Social/family assessment by the social worker. Preferential inclusion in programmes: Women: family planning, hepatitis B vaccination, pregnancy control, early diagnosis of breast cancer (women > 50), same for cervical cancer. Children: child health (< 5) (priority activities: psychomotor development and somatometry) and vaccinations. This intervention started in August 1999. MEASUREMENTS AND MAIN RESULTS: Measurement of the impact of the intervention: bivariant analysis through Chi2 test for qualitative variables and Student's t test and U Mann-Whitney test for quantitative variables (alpha 0.05) in the pre- and post-intervention groups. Statistically significant differences in participation were detected between the pre- and post-intervention groups in the following activities: number of visits to programmes (0.49, SD 0.95; 1.01, SD 1.24, respectively), social and family assessment (83%/100%), family planning (14%/51.4%), hepatitis B vaccination (19%/48.7%), early cervical cancer diagnosis (0/25.7%), child health (33.4%/70%), vaccinations (26.34%/64%), somametric assessment (25%/100%) and psychomotor development assessment (41.6%/94%). CONCLUSIONS: Prioritised intervention in families that are victims of domestic violence improves their participation in preventive activities.

Mejora de la atención prestada a víctimas de violencia doméstica. Impacto de una intervención priorizada / Improving care for victims of domestic violence. Impact of a priority intervention

Objetivo. Evaluar el impacto de una intervención priorizada en la atención prestada a mujeres víctimas de violencia doméstica y sus hijos. Diseño. Estudio de intervención no aleatorizado. Emplazamiento. Centro de salud urbano. Pacientes. Mujeres y niños residentes en un centro de acogida para familias víctimas de violencia doméstica, con historia clínica abierta en el centro de salud. Grupo preintervención (diciembre 1997-julio 1999): 36 mujeres y 70 niños. Grupo postintervención (agosto 1999-junio 2000): 35 mujeres y 41 niños. Intervenciones. Asignación a un único médico de familia y pediatra. Eliminación de trabas burocráticas y asistencia priorizada. Valoración sociofamiliar realizada por trabajadora social. Inclusión preferente en programas. Mujeres: planificación familiar, vacunación hepatitis B, control de embarazo, diagnóstico precoz de cáncer de mama (mujeres > 50 años), diagnóstico precoz de cáncer de cérvix. Niños: salud infantil (< 5 años) (actividades priorizadas: desarrollo psicomotor y somatometría) y vacunas. Se realiza esta intervención desde agosto de 1999. Mediciones y resultados principales. Medida del impacto de la intervención: análisis bivariante mediante jicuadrado en variables cualitativas y t de Student y U de Mann-Whitney en cuantitativas (alfa, 0,05) en los grupos pre y postintervención. Se detectan diferencias estadísticamente significativas en la participación entre los grupos pre y postintervención en las siguientes actividades: número de visitas a programas (0,49; DE, 0,95; frente a 1,01; DE, 1,24), valoración sociofamiliar (83 por ciento frente a 100 por ciento), planificación familiar (14 por ciento frente a 51,4 por ciento), vacunación de hepatitis B (19 por ciento frente a 48,7 por ciento), diagnóstico precoz de cáncer de cérvix (0 frente a 25,7 por ciento), salud infantil (33,4 por ciento frente a 70 por ciento), vacunas (26,34 por ciento frente a 64 por ciento), valoración somatometría (25 por ciento frente a 100 por ciento) y del desarrollo psicomotor (41,6 por ciento frente a 94 por ciento). Conclusiones. La intervención priorizada en familias víctimas de violencia doméstica mejora su participación en actividades preventivas. (AU)

[Health problems and factors determining the number of on-demand visits of over-users of a health centre]. / Problemas de salud y factores determinantes del número de visitas a demanda en pacientes hiperutilizadores de un centro de salud.

OBJECTIVES: To describe the social and demographic characteristics and health problems of over-users of a health centre and to determine the number of attendances requested on demand at the general medical clinic. DESIGN: Retrospective and descriptive. Multivariate analysis: multiple linear regression. SETTING: Urban health centre. PATIENTS: Patients who requested a consultation at the health centre on at least nine occasions in 1999 (N = 7852). Random sample of 386 patients (alpha 0.05, 95% accuracy). MEASUREMENTS AND MAIN RESULTS: Dependent variable: number of on-demand consultations requested in 1999. INDEPENDENT VARIABLES: age, family size, area of residence, active or pensioner, inclusion in programmes, health problems (CIAP-2), number of drugs on repeat prescription (Anatomical Classification), short-term time off work. 57% of over-users were women (CI, 52.9-62.7%); mean age 55 (SD 18.5); family size 2.7 members (SD 1.457); 58.8% pensioners. Mean number of appointments 15 (SD 6.7). Mean habitual consumption of 1.58 medicines (SD 2.46). Inclusion in programmes: 37.7% hypertension, 16% diabetes, 17% dyslipaemia, 16% nursing clinic. Most prevalent pathologies: cardio-circulatory (43.8%), endocrino-metabolic (32%), traumatology (26.7%) and mental health (21%). The regression model included the variables of age, number of medicines and having had short-term time off. CONCLUSIONS: Over-users of our health centre are middle-aged women with chronic physical health problems and with mental health problems. The number of attendances is related to age and administrative requirements: medication and sick notes.

Problemas de salud y factores determinantes del número de visitas a demanda en pacientes hiperutilizadores de un centro de salud / Health problems and factors determining the number of on-demand attendances of over-users of a health centre

Objetivos. Describir las características sociodemográficas y problemas de salud que presentan los pacientes hiperconsultadores de un centro de salud y determinar los factores que explican el número de visitas solicitadas en consulta demanda del médico de familia. Diseño. Descriptivo, retrospectivo. Análisis multivariante: regresión lineal múltiple. Emplazamiento. Centro de salud urbano. Pacientes. Pacientes que han solicitado cita para consulta demanda en el centro de salud en al menos nueve ocasiones durante 1999 (n = 7.852). Muestra aleatoria de 386 pacientes (alfa, 0,05; precisión, 95 por ciento).Mediciones y resultados principales. Variable dependiente: número de consultas demanda solicitadas en 1999. Variables independientes: edad, tamaño familiar, zona residencia, activo o pensionista, inclusión en programas, problemas de salud (CIAP-2), número de fármacos en prescripción repetida (clasificación anatómica), incapacidad laboral temporal (IT). Los hiperconsultadores son un 57,8 por ciento (IC, 52,9-62,7 por ciento) mujeres; edad media, 55 años (DE, 18,5); tamaño familiar, 2,7 miembros (DE, 1,457); 58,8 por ciento pensionistas; número medio de citas, 15 (DE, 6,7); consumo medio, 1,58 (DE, 2,46) fármacos de forma habitual; inclusión en programas: 37,7 por ciento, hipertensión; 16 por ciento, diabetes; 17 por ciento, dislipemia; 16 por ciento, consulta de enfermería. Patologías más prevalentes: cardiocirculatorias (43,8 por ciento), endocrinometabólicas (32 por ciento), traumatológicas (26,7 por ciento) y salud mental (21 por ciento). El modelo de regresión incluye las variables edad, número de fármacos y haber estado en IT. Conclusiones. Los hiperconsultadores de nuestro centro de salud son mujeres de edad media con problemas de salud física de evolución crónica y problemas de salud mental. El número de visitas está relacionado con la edad y las necesidades administrativas: medicación y bajas (AU)

Violencia en el hogar: Atención sociosanitaria a niños residentes en una casa de acogida / Domestic violence. Socio-sanitary attention to children living in shelter houses

Objetivo: Ofertar a hijos de mujeres maltratadas residentes en una Casa de Acogida atención integral específica y priorizada a nivel preventivo, asistencial y rehabilitador.Diseño: Descriptivo retrospectivo.Ambito de estudio: Centro de salud urbano. Sujetos: Niños residentes en casa de acogida de mujeres maltratadas dependiente de la administración autonómica desde mayo 1997 a julio 1999 atendidos en el centro de salud en ese periodo de tiempo.Intervenciones: Protocolo de intervención específica: 1)captación a programas: vacunación, salud infantil 2) mejora de la accesibilidad eliminando trabas burocráticas 3) valoración- intervención individualizada por trabajadora social 4) atención médica a problemas físicos y psicológicos. Las variables evaluadas son la inclusión en programas, la realización de valoración sociofamiliar por la trabajadora social y los principales problemas de salud atendidos. Se realiza una valoración de resultados y propuestas de mejora por parte del equipo.Resultados: Se han atendido 38 mujeres y 70 niños con criterios de inclusión. La edad media de la madre es 32 años, teniendo en 9 casos menos de 25 años. El n° medio de hijos es 2. La edad media de los niños es 8,5 años, siendo en su mayoría de edad preescolar y escolar, existiendo 9 niños > 14 años. Se ha hecho un importante uso de servicios: 76 consultas de trabajadora social, 92 del médico de familia, . 54 del pediatra. La inclusión en programas es baja: 5 en salud infantil, 3 en vacunas. Se ha realizado valoración social en todos salvo en 4 casos (89 por ciento). La problemática detectada se resume en: patología infecciosa (28 consultas), traumatismos (3 casos), alteraciones de conducta alimentaria (3 casos) y abuso sexual infantil (1 caso). Se detecta una baja inclusión en programas, falta de registro de actuaciones, escaso tiempo de permanencia en la zona y necesidad de educación sanitaria de las madres. Se propone: asignar a un solo pediatra, facilitar accesibilidad, intervención educativa en alimentación y vacunas.Conclusiones: El uso de servicios sanitarios por parte de niños residentes en casas de acogida de mujeres maltratadas es alto, si bien es baja la inclusión en programas de salud y la participación en actividades preventivas (AU)

Activation of human monocyte chemiluminescence response by acylpoly(1,3)galactosides derived from Klebsiella pneumoniae.

The stimulating activity of several preparations isolated from a membrane proteoglycan of a nonencapsulated smooth strain of Klebsiella pneumoniae (Kp-MPG) on the oxidative burst of human blood monocytes was assessed by luminol-enhanced chemiluminescence (CL). Five Kp derivatives were studied: a 34-kd acylpoly(1,3)galactoside (APG), obtained by drastic alkaline hydrolysis and purified by chromatography; an APG preparation subjected to acid hydrolysis that removed the core part and all fatty acids, leaving intact the galactose chain of APG (GC-APG); an APG preparation subjected to mild oxidation (ox APG); a preparation obtained by mild alkaline hydrolysis of Kp-MPG, containing additional ester-linked C14 and C16 fatty acids bound to the APG molecule (EFA-APG); and a polymer of the latter compound, APG pol. EFA-APG directly stimulated monocyte CL, whereas Kp-MPG, APG pol, and the whole bacterial cells had little or no activity. APG itself and ox APG induced a weaker response than EFA-APG. Polymyxin B sulfate completely inhibited the CL response to bacterial lipopolysaccharide (LPS) but not to EFA-APG. The stimulating action of EFA-APG on blood monocytes was dependent on the extracellular levels of both calcium and magnesium. Preincubation of monocytes with monoclonal antibody anti-Mac-1 directed against CD11b, the alpha chain of complement receptor type 3 (CR3; CD11b/CD18), strongly inhibited CL activation by EFA-APG and to a lesser extent CL activation by unopsonized zymosan and rough LPS. Altogether, these findings provide indirect evidence for the contribution of the CD11b/CD18 integrin in the functional interaction of EFA-APG with monocyte membranes. They demonstrate the role of fatty acids in the triggering of monocyte oxidative burst, while the polysaccharide chain itself does not contribute to induction of the CL response in this model. In keeping with the effects of EFA-APG and APG, we show that the monocyte CL response was triggered by bacterial LPS from the rough strain of Salmonella minnesota Re 595 and its lipid A, but not by LPS from smooth strains, again suggesting a critical role for the lipid moiety.

[Hemodynamic benefits of sequential atrioventricular pacing]. / Beneficio emodinamico della stimolazione sequenziale atrio-ventricolare.

The purpose of this study was to evaluate the hemodynamic benefits of atrioventricular (A-V) sequential pacing. 30 pts implanted with DDD pacemakers underwent M-mode, B-mode and Doppler echocardiography. In each patient, left ventricular (LV) stroke volume was assessed by measuring the time-velocity integral of mitral inflow in the following modes and rates: VOO at 70 ppm or at the minimum stimulation rate and at 120 ppm; DOO at the same rates with different A-V delay (100, 150, 200, 250 and, whenever possible, 300 msec). The increase in stroke volume obtained with dual chamber pacing at the optimal A-V delay was 45 +/- 25% at 75 ppm and 29 +/- 14% at 120 ppm (p less than 0.05 75 vs 120 ppm). This increase was significantly higher in pts with than in pts without LV hypertrophy (respectively: 51.9 +/- 20.4 vs 36.9 +/- 20.8% at 75 ppm, p less than 0.05 and 33 +/- 13.4 vs 25.4 +/- 14.5% at 120 ppm, p = 0.08). Concerning the A-V delay, we noted that at 75 ppm stroke volume was significantly higher in DOO than in VOO with any A-V delay ranging +/- 100 msec from the optimal one; at 120 ppm the hemodynamic benefit of DOO pacing was observed only when the programmed A-V delay was the optimal one or very near to it. In conclusion, atrio-ventricular sequential pacing allows a significant increase in LV stroke volume over single chamber ventricular pacing both at 75 and 120 ppm. Programming the optimal A-V delay is absolutely necessary to obtain this hemodynamic benefit at the higher stimulation rate.

Adenocarcinoma arising in an intrathoracic duplication cyst of foregut origin: a case report with review of the literature.

A 41-year-old man presented with an asymptomatic superior mediastinal mass. At thoracotomy, a duplication cyst of the foregut was found. Microscopic examination of the cyst revealed mucosal alterations ranging from dysplasia and in situ carcinoma to infiltrating colonic carcinoma. Although malignant change has been reported in intra-abdominal foregut cysts, this is the first reported instance of carcinoma arising in a mediastinal duplication cyst.

Trasplante renal. / Kidney transplantation

Se presentan los resultados de 15 pacientes trasplantados en el Hospital de Especialidades del CMO del Instituto Mexicano del Seguro Social. Con donador relacionado vivo y siguiendo la tecnica quirurgica de Harrison y Murray y con inmunodepresion en base de azathioprina con ciclos de ciclosfosfamida y metil-prednisolona. 14 de los 15 pacientes estan vivos con el trasplante de rinon, uno de ellos fallecio en el postrasplante a causa de neumonia por pseudomona. 10 de los 15 pacientes fueron compatibilidad "A", segun el sistema H.L.A., los otros 5 fueron compatibilidad "B". Las complicaciones fueron fundamentalmente: 5 casos con insuficiencia de rinon aguda normalizandose posteriormente. Tuvimos tambien 3 infecciones como linfocele, y no ha habido ni complicaciones angiologicas ni urologicas