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Purpose: A substantial increase in the prescription of immediate release fentanyl (IRF) outside hospitals was observed in previous studies between 2012 and 2017, however it remains unknown the extent of immediate release fentanyl use disorders (IRFUD). This study aimed to estimate the incidence and risk factors of IRFUD, such us abuse and dependence, in Spain during this period. Methods: Retrospective cohort study performed in a Spanish electronic primary care healthcare records database (BIFAP). The incidence rate of IRFUD was calculated by dividing the number of incident cases by the total patient-years (p-y) of exposure. Demographic data, lifestyle, cancer diagnosis, comorbidities and concomitant medication were described and analyzed overall and in patients developing IRFUD using Cox regression models. Effect of the type of treatment (continuous/discontinuous) and duration were also evaluated. Results: The incidence of IRFUD in the 12,267 patients analyzed was 1.8 cases per 100 p-y of exposure. Baseline analysis showed higher frequencies of IRFUD for smokers, patients with a history of substance abuse, non-oncology indication and diagnosis of depression and anxiety, respect to non-IRFUD patients. Patients aged ≥ 80 were less likely to develop IRFUD abuse/dependence. Significant differences were for concomitant use of other treatments with potential for dependence and abuse, such as benzodiazepines. The risk of IRFUD increased with treatment duration, being the highest for treatments lasting 180 days and longer. Conclusion: Incidence of IRFUD is difficult to contrast due to the lack of similar studies. It could be considered not too higher outside hospitals but possible in cancer and non-cancer patients... (AU)
En estudios previos se ha observado un aumento considerable en la prescripción de fentanilo de liberación inmediata en el ámbito extrahospitalario entre 2012 y 2017. Sin embargo, aún se desconoce la magnitud de dependencia y abuso derivada de su uso. Este estudio tiene como objetivo estimar la incidencia y los factores de riesgo de los trastornos derivados del uso de fentanilo de liberación inmediata en España, tales como el abuso y la dependencia durante este período. Métodos: Estudio de cohortes retrospectivo realizado en España en la base de datos de historias clínicas electrónicas de atención primaria (BIFAP). La tasa incidencia de trastornos por el uso de fentanilo, se calculó dividiendo el número de casos incidentes entre el total de personas-año de exposición. Se analizaron datos demográficos, estilo de vida, diagnóstico de cáncer, comorbilidades y medicación concomitante. Para el análisis se utilizaron modelos de regresión de Cox. También se evaluó el efecto del tipo de tratamiento (continuo/discontinuo) y la duración de tratamiento. Resultados:La incidencia de trastornos por el uso de fentanilo en los 12,267 pacientes analizados fue de 1.8 casos por 100 personas-año de exposición. Se observó una frecuencia más elevada en aquellos pacientes que al inicio del tratamiento eran fumadores, pacientes con antecedentes de abuso de sustancias, con indicaciones no oncológicas y en pacientes con diagnóstico de depresión y ansiedad en comparación con los pacientes que no desarrollaron el evento. Los pacientes mayores de 80 años presentaron menos probabilidades de desarrollar estos trastornos. Se observaron diferencias significativas en el uso concomitante con otros tratamientos con potencial de desarrollar dependencia y abuso, como las benzodiacepinas. El riesgo aumentó con la duración del tratamiento, siendo más elevado para aquellos tratamientos que duraban 180 días o más... (AU)
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Humanos , Neoplasias/diagnóstico , Estilo de Vida , Fentanilo , Trastornos Relacionados con Sustancias , Mal Uso de Medicamentos de Venta con Receta , EspañaRESUMEN
En las últimas décadas hemos asistido a una evolución en la medicina que obliga a una reflexión ética más cuidadosa y a una organización e institucionalización de los procesos de toma de decisiones que puedan resultar controvertidos. Los Comités de Ética Asistencial se constituyen para analizar y asesorar en la resolución de los conflictos éticos que se producen durante la práctica clínica asistencial y garantizar que los pacientes estén informados y puedan tomar las decisiones referentes a su salud, de acuerdo con su libre y propia voluntad. El objetivo de los Comités de Ética de la Investigación es la protección y el respeto de las personas participantes en estudios de investigación. En ambos casos, juegan un papel importante en la protección de los derechos, la equidad y la dignidad de la personas. Un marco normativo adecuado permite dar respuesta a los nuevos retos científicos y garantiza la protección de los ciudadanos en el ámbito de la salud. Sin embargo, la extensa red de comités locales, autonómicos y estatales en España, puede comprometer la eficiencia en la gestión administrativa de los procedimientos de evaluación y en la resolución de conflictos y dar lugar a duplicidades o incoherencias en los mismos. En este artículo se realiza una revisión y descripción de los diferentes comités de ética asistencial y de la investigación en España y se analizan aspectos relevantes en relación a su organización, regulación y ámbito de actuación
Recent decades have witnessed major advances in medical science that require a careful ethical reflection, organization and institutionalization of controversial decision-making processes. The Healthcare Ethics Committees (HECs) are independent interdisciplinary bodies to provide support in ethical dilemmas in healthcare settings, ensuring that patients are informed about their treatments and procedures and make their own decisions. The Institutional Review Boards (IRBs) are focus on the rights and welfare of the potential participants in the research. Nevertheless both HECs and IRBs play an important role in promoting respect and protection of dignity and human right in an attempt to achieve health equity and social justice. The regulation of HECs and IRBs provides an appropriate framework to address new scientific challenges in the field of health. Nevertheless the large number of local, regional and national HECs and IRBs in Spain might compromise the efficiency in the assessment procedures leading to duplication of reports and inconsistent opinions. In this article a review and description of the different HECs and IRBs in Spain is performed and relevant issues related to their organization, regulation and functions are also analyzed
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Humanos , Comités de Ética en Investigación/organización & administración , Comité Farmacéutico y Terapéutico/organización & administración , Bioética , EspañaRESUMEN
Achillea millefolium L. is a plant widely used in traditional medicine. Nowadays, there is a growing concern about the study of its bioactive properties in order to develop food and nutraceutical formulations. Supercritical anti-solvent fractionation (SAF) of an A. millefollium extract was carried out to improve its antioxidant and anti-inflammatory activities. A selective precipitation of phenolic compounds was achieved in the precipitation vessel fractions, which presented an antioxidant activity twice than original extract, especially when fractionation was carried out at 10â¯MPa. The main phenolic components identified in this fraction were luteolin-7-O-glucoside, 3,5-dicaffeoylquinic acid, 6-hidroxyluteolin-7-O-glucoside and apigenin-7-O-glucoside. However, separator fractions presented higher anti-inflammatory activity than precipitation vessel ones, particularly at 15â¯MPa. This fact could be related to separator fractions enrichment in anti-inflammatory compounds, mainly camphor, artemisia ketone and borneol. Therefore, SAF produced a concentration of antioxidant and anti-inflammatory compounds that could be used as high-added valued ingredients.
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Achillea/química , Antiinflamatorios/análisis , Antioxidantes/análisis , Extractos Vegetales/química , Solventes , Apigenina/análisis , Fraccionamiento Químico , Flavonas/análisis , Ácido Gálico/análisis , Glucósidos/análisis , Humanos , Fenoles/análisis , Ácido Quínico/análogos & derivados , Ácido Quínico/análisis , Células THP-1/efectos de los fármacosRESUMEN
Infrared and Raman spectra of mono (13)C fully deuterated acetylene, (13)C(12)CD2, have been recorded and analysed to obtain detailed information on the C-D stretching fundamentals and associated combination, overtone, and hot bands. Infrared spectra were recorded at an instrumental resolution ranging between 0.006 and 0.01 cm(-1) in the region 1800-7800 cm(-1). Sixty new bands involving the ν1 and ν3 C-D stretching modes also associated with the ν4 and ν5 bending vibrations have been observed and analysed. In total, 5881 transitions have been assigned in the investigated spectral region. In addition, the Q branch of the ν1 fundamental was recorded using inverse Raman spectroscopy, with an instrumental resolution of about 0.003 cm(-1). The transitions relative to each stretching mode, i.e., the fundamental band, its first overtone, and associated hot and combination bands involving bending states with υ4 + υ5 up to 2 were fitted simultaneously. The usual Hamiltonian appropriate to a linear molecule, including vibration and rotation l-type and the Darling-Dennison interaction between υ4 = 2 and υ5 = 2 levels associated with the stretching states, was adopted for the analysis. The standard deviation for each global fit is ≤0.0004 cm(-1), of the same order of magnitude of the measurement precision. Slightly improved parameters for the bending and the ν2 manifold have been also determined. Precise values of spectroscopic parameters deperturbed from the resonance interactions have been obtained. They provide quantitative information on the anharmonic character of the potential energy surface, which can be useful, in addition to those reported in the literature, for the determination of a general anharmonic force field for the molecule. Finally, the obtained values of the Darling-Dennison constants can be valuable for understanding energy flows between independent vibrations.
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No disponible
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Humanos , Hipertensión/tratamiento farmacológico , Antihipertensivos/uso terapéutico , 50303 , Evaluación de Resultados de Intervenciones TerapéuticasRESUMEN
We propose new values for the V-V collisional energy transfer rate constant of (14)N2 (X(1)Σg(+)) at different temperatures in collisions between molecules in the v = 1 and v = 0 vibrational states. The values were obtained experimentally by means of a time-resolved double resonance pump-probe stimulated Raman setup in which the stimulated Raman technique was used for both the pump and the probe stage. The main feature of the experiment is the fact that population pumping is done with rotational (and thus spin) selectivity, that is, only molecules belonging to the ortho spin variety of (14)N2 are promoted to v = 1. The probe stage is then used to monitor the decay of this ortho rotational population placed in v = 1 and the emergence of a para population in that same vibrational level. Since the only possible mechanism for the arrival of para population to v = 1 is collisional V-V energy transfer, the evolution of the ortho/para ratio in v = 1 is used to quantify the rate constant of the process. The measurements were conducted at 77, 136, 226 and 300 K. The 300 K value had been measured and calculated before by other authors, but a spread larger than an order of magnitude existed between their results. Our proposed value is more precise than previous ones and lies near the mid-point of that interval. The low-temperature values of the rate constant are reported here for the first time. The availability of data at several temperatures has allowed us to unequivocally determine the existence of a strong negative temperature dependence of the rate constant between 77 and 300 K that exhibits a linear behavior in a Landau-Teller plot in this temperature interval.
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Air quality is a major issue for humans owing to the fact that the content of particles in the atmosphere has multiple implications for life quality, ecosystem dynamics and environment. Scientists are therefore particularly interested in discovering the origin of airborne particles. A new method has been developed to model the relationship between the emission surface and the total amount of airborne particles at a given distance, employing olive pollen and olive groves as examples. A third-degree polynomial relationship between the air particles at a particular point and the distance from the source was observed, signifying that the nearest area to a point is not that which is most correlated with its air features. This work allows the origin of airborne particles to be discovered and could be implemented in different disciplines related to atmospheric aerosol, thus providing a new approach with which to discover the dynamics of airborne particles.
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Contaminantes Atmosféricos/análisis , Atmósfera/análisis , Monitoreo del Ambiente/métodos , Modelos Teóricos , Humanos , Olea , Polen , España , Análisis Espacio-TemporalRESUMEN
Objetivos: Describir la calidad ética y metodológica de los estudios posautorización de tipo observacional con medicamentos de uso humano promovidos por los Servicios de Farmacia Hospitalaria (SFH). Métodos: Se identificaron los estudios promovidos por los SFH registrados en la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) durante 2009-2011 y/o publicados en la revista Farmacia Hospitalaria en el mismo período. Se analizaron los aspectos éticos y metodológicos más relevantes. Con el fin de conocer las diferencias de los estudios promovidos por los SFH respecto a estudios realizados por otros promotores, se compararon con los estudios registrados durante 2003-2007. Resultados: Se registraron en la AEMPS 22 estudios promovidos por SFH, que comparados con aquellos realizados por promotores diferentes, mostraron un menor cumplimiento de los aspectos éticos recogidos en la normativa, así como resultados más discretos y estadísticamente significativos (p < 0,05), respecto a justificación del tamaño muestral (41,5% vs 80%) o ámbito internacional (0% vs 24%). Respecto a los estudios publicados en la revista Farmacia Hospitalaria (n = 52), ninguno fue registrado en la AEMPS. En comparación con los estudios registrados promovidos por SFH, presentaron menor calidad metodológica, en aspectos tales como presencia de grupo control (3,8% vs 27,3%) (p = 0,0072) o justificación del tamaño muestral (19,2% vs 42,8%) (p < 0,05). Conclusión: Existen aspectos administrativos, metodológicos y éticos de los estudios promovidos por los SFH que deben ser mejorados según la normativa. El registro en la AEMPS, parece tener un efecto positivo en el rigor científico y ético de los protocolos de investigación (AU)
Objectives: To describe the ethical and methodological quality of non-interventional post-authorization studies promoted by Hospital Pharmacy Departments (HPD). Methods: HPD promoted studies in the 2009-2011 period included in the Spanish Agency of Medicines and Medical Devices (AEMPS) registry and/or published in "Farmacia Hospitalaria" were identified. The most relevant ethical and methodological characteristics were analyzed. Studies promoted by HPD were also compared with studies not promoted by HPD. Results: Twenty two studies promoted by HPD, and registered in the AEMPS were identified. Within the registered studies HPD promoted studies had lower sample size estimation (41,5% vs 80%) and international scope (0% vs 24%) compared to non HPD promoted studies with significant differences (p < 0,05). None of the published studies in the journal Farmacia Hospitalaria have been registered in the AEMPS and had lower methodological quality than the registered studies promoted by HPD in characteristics such as presence of control group (3,8% vs 27,3%) (p = 0,0072) and the sample size estimation of (19,2% vs 42,8%) (p < 0,05). Conclusion: The management and the methodological and ethical characteristics of the studies promoted by HPD should be improved according to the regulation. The registration in the AEMPS might have a positive impact on the quality of these research protocols (AU)
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Humanos , Aprobación de Drogas/métodos , Drogas en Investigación/uso terapéutico , Ética Farmacéutica , Seguridad del Paciente/normas , Servicio de Farmacia en Hospital/organización & administración , Estudios Observacionales como AsuntoRESUMEN
Este artículo describe los procedimientos administrativos y requerimientos legales para llevar a cabo estudios observacionales con medicamentos de uso humano en España (AU)
This article describes the administrative and legal requirements to carry out non-interventional post-authorization studies in Spain (AU)
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Humanos , Drogas en Investigación/uso terapéutico , Medicamentos de Referencia , Aprobación de Drogas , Seguridad del Paciente/normas , Servicio de Farmacia en Hospital/organización & administraciónRESUMEN
OBJECTIVES: To describe the ethical and methodological quality of non-interventional post-authorization studies promoted by Hospital Pharmacy Departments (HPD). METHODS: HPD promoted studies in the 2009-2011 period included in the Spanish Agency of Medicines and Medical Devices (AEMPS) registry and/or published in "Farmacia Hospitalaria" were identified. The most relevant ethical and methodological characteristics were analyzed. Studies promoted by HPD were also compared with studies not promoted by HPD. RESULTS: Twenty two studies promoted by HPD, and registered in the AEMPS were identified. Within the registered studies HPD promoted studies had lower sample size estimation (41,5% vs 80%) and international scope (0% vs 24%) compared to non HPD promoted studies with significant differences (p < 0,05). None of the published studies in the journal Farmacia Hospitalaria have been registered in the AEMPS and had lower methodological quality than the registered studies promoted by HPD in characteristics such as presence of control group (3,8% vs 27,3%) (p = 0,0072) and the sample size estimation of (19,2% vs 42,8%) (p < 0,05). CONCLUSION: The management and the methodological and ethical characteristics of the studies promoted by HPD should be improved according to the regulation. The registration in the AEMPS might have a positive impact on the quality of these research protocols.
Objetivos: Describir la calidad ética y metodológica de los estudios posautorización de tipo observacional con medicamentos de uso humano promovidos por los Servicios de Farmacia Hospitalaria (SFH). Métodos: Se identificaron los estudios promovidos por los SFH registrados en la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) durante 2009-2011 y/o publicados en la revista Farmacia Hospitalaria en el mismo período. Se analizaron los aspectos éticos y metodológicos más relevantes. Con el fin de conocer las diferencias de los estudios promovidos por los SFH respecto a estudios realizados por otros promotores, se compararon con los estudios registrados durante 2003-2007. Resultados: Se registraron en la AEMPS 22 estudios promovidos por SFH, que comparados con aquellos realizados por promotores diferentes, mostraron un menor cumplimiento de los aspectos éticos recogidos en la normativa, así como resultados más discretos y estadísticamente significativos (p < 0,05), respecto a justificación del tamaño muestral (41,5% vs 80%) o ámbito internacional (0% vs 24%). Respecto a los estudios publicados en la revista Farmacia Hospitalaria (n = 52), ninguno fue registrado en la AEMPS. En comparación con los estudios registrados promovidos por SFH, presentaron menor calidad metodológica, en aspectos tales como presencia de grupo control (3,8% vs 27,3%) (p = 0,0072) o justificación del tamaño muestral (19,2% vs 42,8%) (p < 0,05). Conclusión: Existen aspectos administrativos, metodológicos y éticos de los estudios promovidos por los SFH que deben ser mejorados según la normativa. El registro en la AEMPS, parece tener un efecto positivo en el rigor científico y ético de los protocolos de investigación.
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Ensayos Clínicos como Asunto/ética , Ética en Investigación , Servicio de Farmacia en Hospital/ética , Servicio de Farmacia en Hospital/organización & administración , Sistema de Registros , Proyectos de Investigación , Tamaño de la Muestra , EspañaRESUMEN
This article describes the administrative and legal requirements to carry out non-interventional post-authorization studies in Spain.
Este artículo describe los procedimientos administrativos y requerimientos legales para llevar a cabo estudios observacionales con medicamentos de uso humano en España.
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Vigilancia de Productos Comercializados/normas , Aprobación de Drogas , Guías como Asunto , Humanos , Farmacoepidemiología , EspañaRESUMEN
OBJECTIVES: Evaluation of the surgical management, outcome and complications in patients with pertrochanteric fractures treated with PFNA nail. MATERIAL AND METHOD: A retrospective study was conducted on 200 patients treated consecutively between April 2010 and February 2012. Radiological assessments were performed before and after the surgery, and during the follow-up (fracture reduction, blade position, consolidation or collapse signs). A clinical evaluation was performed as regards walking capabilities. The results were compared with those of a previous study on 700 patients treated with gamma 3 and TFN nails. RESULTS: The blade position was centre-centre in 64% of patients, and decreased to 53% in the mechanical complications group. Tip-apex distance was less than 25mm in 91.5%. The average hospital stay was 9.17 days, with a mean post-surgery stay of 5.95 days. Complications (7.5%): 2 cut out (1%), one cut through (0.5%), 4 cases of helical blade sliding (2%), one failure in distal locking procedure (0.5%), 2 cases with painful fasciae latae (1%), one union delay (0.5%), 2 cases of non-union with hardware failure (1%), one case of intense bleeding related to distal locking of the nail (0.5%), and one case of avascular necrosis (0.5%). CONCLUSIONS: The PFNA helical blade system seems to reduce the incidence of cut out and cut through in osteoporotic bone. Blade position was one of the main parameters associated with mechanical complications.
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Clavos Ortopédicos , Fijación Intramedular de Fracturas/instrumentación , Fracturas de Cadera/cirugía , Anciano , Anciano de 80 o más Años , Clavos Ortopédicos/efectos adversos , Femenino , Fijación Intramedular de Fracturas/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios RetrospectivosRESUMEN
Objetivos. Evaluación del manejo quirúrgico, evolución y complicaciones de pacientes afectados por fractura pertrocantérea de cadera tratados mediante enclavado PFNA. Material y método. Revisión retrospectiva de 200 pacientes intervenidos entre abril de 2010 y febrero de 2012 de forma consecutiva. Se realiza evaluación radiográfica preoperatoria, postoperatoria y durante el seguimiento (reducción de la fractura, posición de la espiral, consolidación o signos de colapso). La evaluación clínica se realizó en función de la autonomía para la marcha. Se comparan los resultados obtenidos con estudio previo, sobre muestra de 700 pacientes y enclavado gamma 3 y TFN. Resultados. La posición de la espiral es centro-centro en el 64% de los pacientes, que disminuye al 53% en el grupo de las complicaciones mecánicas, siendo la distancia punta-vértice menor a 25 mm en el 91,5% de los casos. La estancia hospitalaria media se sitúa en 9,17 días con una estancia media postintervención de 5,95 días. Las complicaciones (7,5%) fueron: 2 casos de cut out (1%), uno de cut through (0,5%), 4 casos de efecto telescopaje (2%), un fallo en el encerrojado distal (0,5%), 2 casos de molestias en la fascia lata (1%), un retardo en la consolidación (0,5%), 2 seudoartrosis que condicionaron la rotura del dispositivo (1%), un caso de sangrado relativo al clavo (0,5%) y un caso de necrosis avascular (0,5%). Conclusiones. El sistema de espiral cefálica PFNA parece reducir la incidencia de cut out y cut through en el hueso osteoporótico. La posición de la espiral supone uno de los principales parámetros relacionados con las complicaciones mecánicas (AU)
Objectives. Evaluation of the surgical management, outcome and complications in patients with pertrochanteric fractures treated with PFNA nail. Material and method. A retrospective study was conducted on 200 patients treated consecutively between April 2010 and February 2012. Radiological assessments were performed before and after the surgery, and during the follow-up (fracture reduction, blade position, consolidation or collapse signs). A clinical evaluation was performed as regards walking capabilities. The results were compared with those of a previous study on 700 patients treated with gamma 3 and TFN nails. Results. The blade position was centre-centre in 64% of patients, and decreased to 53% in the mechanical complications group. Tip-apex distance was less than 25 mm in 91.5%. The average hospital stay was 9.17 days, with a mean post-surgery stay of 5.95 days. Complications (7.5%): 2 cut out (1%), one cut through (0.5%), 4 cases of helical blade sliding (2%), one failure in distal locking procedure (0.5%), 2 cases with painful fasciae latae (1%), one union delay (0.5%), 2 cases of non-union with hardware failure (1%), one case of intense bleeding related to distal locking of the nail (0.5%), and one case of avascular necrosis (0.5%). Conclusions. The PFNA helical blade system seems to reduce the incidence of cut out and cut through in osteoporotic bone. Blade position was one of the main parameters associated with mechanical complications (AU)
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Fijación Interna de Fracturas/instrumentación , Fijación Interna de Fracturas/métodos , Fijación Interna de Fracturas , Fracturas del Fémur/complicaciones , Fracturas del Fémur , Mortalidad Hospitalaria/tendencias , Fijadores Internos/tendencias , Fracturas del Fémur/fisiopatología , Fracturas del Fémur/cirugía , Estudios Retrospectivos , Cuidados Posoperatorios/métodos , Seudoartrosis/complicaciones , Complicaciones Intraoperatorias/diagnósticoRESUMEN
The modeling of the shape of H(2)O lines perturbed by N(2) (and air) using the Keilson-Storer (KS) kernel for collision-induced velocity changes is revisited with classical molecular dynamics simulations (CMDS). The latter have been performed for a large number of molecules starting from intermolecular-potential surfaces. Contrary to the assumption made in a previous study [H. Tran, D. Bermejo, J.-L. Domenech, P. Joubert, R. R. Gamache, and J.-M. Hartmann, J. Quant. Spectrosc. Radiat. Transf. 108, 126 (2007)], the results of these CMDS show that the velocity-orientation and -modulus changes statistically occur at the same time scale. This validates the use of a single memory parameter in the Keilson-Storer kernel to describe both the velocity-orientation and -modulus changes. The CMDS results also show that velocity- and rotational state-changing collisions are statistically partially correlated. A partially correlated speed-dependent Keilson-Storer model has thus been used to describe the line-shape. For this, the velocity changes KS kernel parameters have been directly determined from CMDS, while the speed-dependent broadening and shifting coefficients have been calculated with a semi-classical approach. Comparisons between calculated spectra and measurements of several lines of H(2)O broadened by N(2) (and air) in the ν(3) and 2ν(1) + ν(2) + ν(3) bands for a wide range of pressure show very satisfactory agreement. The evolution of non-Voigt effects from Doppler to collisional regimes is also presented and discussed.
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El Síndrome de Tousseau se considera un síndrome paraneoplásico caracterizado por distintos eventos trombóticos, tanto rteriales como venosos, que pueden originarse tras el desarrollo de una enfermedad neoplásica o como signo premonitorio de la existencia de un cáncer oculto. La presencia de sucesos trombóticos idiopáticos nos debe alertar de la posible sospecha neoplásica. Una serie de pruebas diagnósticas son recomendables en estas circunstancias, tales como marcadores tumorales y ecografía abdomino-pélvica. Este síndrome conlleva un mal pronóstico en la evolución del proceso neoplásico, especialmente en los casos de trombosis arterial. A pesar de su relevancia clínica, alta incidencia de nuevas neoplasias y su pronóstico nefasto, esta patología sigue siendo bastante desconocida. En esta revisión se analiza su fisiopatología, las medidas terapéuticas antitrombóticas y modelos predictivos de riesgo, enfatizando la necesidad de nuevos estudios de investigación para una mayor comprensión de este síndrome (AU)
Tousseau Syndrome is regarded as a paraneoplasic syndrome characterized by thrombotic events, both arterial and venous occlusions, which can be originated after the development of a neoplasic disease or as a premonitory sign of the existence of a hidden cancer. The presence of thrombotic idiopathic events must warn us about the possible neoplasic suspect. A series of diagnostical studies are advisable in these circumstances, such tumoral markers and abdomino-pelvical ultrasound scan. This syndrome involves a bad prognosis in the evolution of the neoplasic process, especially in cases of arterial thrombosis. In spite of its clinical relevance, high incidence of new neoplasias and an ill-fated prognosis, this pathology continues to be unknown enough. In this revision its fisiopathology, the therapeutic antithrombotic treatment, and the risk predictive models are discussed, emphasizing the necessity of new research studies for a bigger understanding of this syndrome (AU)
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Humanos , Síndromes Paraneoplásicos/diagnóstico , Trombosis/epidemiología , Biomarcadores de Tumor/análisis , Neoplasias Primarias Desconocidas/patología , Inhibidores de la Angiogénesis/uso terapéuticoRESUMEN
We report the first experimental observation of homonuclear propensity in collisional relaxation of a polyatomic molecule. A pump-probe stimulated Raman setup is used to pump population to a single rotational level of the v(2) = 1 vibrationally excited state in (13)C(12)CD(2) and then monitor the redistribution of the rotational population that has taken place after a fixed delay. The Q-branch of the 2ν(2)-ν(2) band shows a pattern of intensity alternation between the even and the odd rotational components, with the greater intensities always corresponding to the rotational levels with the same parity as the one where all the population was initially deposited. The effect can be explained by the existence of a propensity rule that favors collisional relaxation between rovibrational levels of the same parity.
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Trypanosoma cruzi, the causative agent of Chagas' disease, may sabotage humoral response by affecting B cells at the different stages of its development. The present review highlights the contributions of our laboratory in understanding how T. cruzi hinders B-cell generation and B-cell expansion limiting host defence and favouring its chronic establishment. We discuss how homoeostatic mechanisms can be triggered to control exacerbated B-cell proliferation that favour T. cruzi infection by eliminating parasite-specific B cells. Specific targeting of evasion mechanisms displayed in T. cruzi infection, as in vivo Fas/FasL blockade or Gal-3 expression inhibition, allowed us to modulate B-cell responses enhancing the anti-parasite humoral immune response. A comprehensive understanding of the biology of the B cell in health and disease is strictly required to devise immunointervention strategies aimed at enhancing protective immune responses during infections.
Asunto(s)
Subgrupos de Linfocitos B/inmunología , Subgrupos de Linfocitos B/patología , Enfermedad de Chagas/inmunología , Enfermedad de Chagas/parasitología , Trypanosoma cruzi/crecimiento & desarrollo , Trypanosoma cruzi/inmunología , Animales , Subgrupos de Linfocitos B/parasitología , Diferenciación Celular/inmunología , Enfermedad de Chagas/patología , HumanosRESUMEN
An analysis of the nu(17)-nu(4) difference bands near 800 cm(-1) of two isotopic species, (10)B(2)H(6) and (11)B(2)H(6), of diborane has been carried out using infrared spectra recorded with a resolution of ca. 0.003 cm(-1). In addition, the nu(17) band of (10)B(2)H(6) has been recorded and assigned. Since this band in (11)B(2)H(6) had already been studied (R. L. Sams, T. A. Blake, S. W. Sharpe, J.-M. Flaud, and W. J. Lafferty, J. Mol. Spectrosc. 191, 331-342 (1998)), it was possible to derive precise energy levels and Hamiltonian constants for the 4(1) vibrational states of both isotopic species. Copyright 2000 Academic Press.
RESUMEN
In this study we report the first measurements of the pressure-induced lineshift coefficients due to Ar, He, O(2), and N(2) for 22 rovibrational lines from P(53) to R(53), belonging to the 2nu(3) band of (16)O(12)C(32)S at 4100 cm(-1). The lineshift results were obtained from the simultaneous record of the pressure-broadened and pure low-pressure OCS lines, using a tunable difference-frequency laser spectrometer. For four lines of the 2nu(3) band we also report Ar-, He-, O(2)-, and N(2)-broadening coefficients by fitting Voigt and Rautian profiles to the measured shapes of these lines. The broadening and shift coefficients are compared to the results of theoretical calculations based on the semiclassical Robert-Bonamy formalism and two different isotropic and anisotropic intermolecular potentials. For OCS-Ar we also consider the Smith-Giraud-Cooper model including all orders of the interaction within the peaking approximation. In all cases, the calculated broadening coefficients are in reasonable agreement with the experimental data. By considering adjustable parameters for the vibrational dependence of the isotropic potential, the general trends of the lineshifts with J can be roughly predicted, except at low J values where an asymmetry behavior for P and R branches is generally observed. Copyright 2000 Academic Press.