Pie diabético en México: factores de riesgo para mortalidad posterior a una amputación mayor, a 5 años, en un hospital de salud pública de segundo nivel.

OBJETIVO: Investigar de manera retrospectiva a 5 años el porcentaje de mortalidad en los pacientes operados de amputación mayor por pie diabético e identificar los factores de riesgo asociados que aumentan la mortalidad en la población mexicana. MÉTODO: Estudio retrospectivo de pacientes sometidos a amputación mayor por pie diabético del 1 de enero al 31 de diciembre de 2009 en un hospital de segundo nivel. RESULTADOS: Se incluyeron en el protocolo de estudio 37 pacientes que cumplían los criterios de inclusión, y se encontró que 10 (27.03%) continuaban con vida y 27 (72.97%) habían fallecido. Los pacientes a quienes se realizó una amputación y tenían tres o más enfermedades concomitantes mostraron un riesgo 1.6 veces más alto de morir (p = 0.018). Cuanto mayor era la glucemia previa al momento de la amputación, mayor fue la probabilidad de muerte a 5 años (p = 0.015). CONCLUSIONES: En México hacen falta estudios con seguimiento prospectivo, de carácter multicéntrico, con una muestra heterogénea, que permitan tener un panorama nacional. OBJECTIVE: To investigate retrospectively at 5 years the mortality rate in postoperative patients of major amputation secondary to diabetic foot and to identify the associated risk factors that increase mortality in the Mexican population. METHOD: Retrospective study that included patients who underwent major amputation secondary to diabetic foot from January 1 to December 31, 2009 in a second-level hospital. RESULTS: 37 patients who met the inclusion criteria were included in the study protocol, finding that 10 patients (27.03%) were still alive and 27 patients (72.97%) had died. Observing In patients who undergo an amputation and have three or more comorbidities, they have a 1.6 times higher risk of dying (p = 0.018) and that the higher the glycemia prior to the amputation, the greater the probability of dying at 5 years (p = 0.015). CONCLUSIONS: Studies are needed in Mexico with prospective follow-up, multicenter in nature, with a heterogeneous sample, which allows us to have a National panorama.

Glutamate induced neonatal excitotoxicity modifies the expression level of EAAT1 (GLAST) and EAAT2 (GLT-1) proteins in various brain regions of the adult rat.

Glutamate-mediated excitatory synaptic signalling is primarily controlled by excitatory amino acid transporters (EAATs), such as EAAT1 and EAAT2, which are located mostly on astrocytes and, together, uptake more than 95 % of extracellular glutamate. Alterations in the functional expression levels of EAATs can lead to excessive extracellular glutamate accumulation, potentially triggering excitotoxicity and seizures, among other neurological disorders. Excitotoxicity induced in early developmental stages can lead to lasting changes in several neurotransmission systems, including the glutamatergic system, which could make the brain more susceptible to a second insult. In this study, the expression levels of EAAT1 (GLAST) and EAAT2 (GLT-1) proteins were assessed in the cerebral motor cortex (CMC), striatum, hippocampus and entorhinal cortex (EC) of male adult rats following the neonatal excitotoxic process triggered by monosodium glutamate (MSG)-treatment (4 g/kg of body weight at postnatal days 1,3,5 and 7, subcutaneously). Western blot analysis showed that neonatal MSG-treatment decreased EAAT1 expression levels in the CMC, striatum and hippocampus, while EAAT2 levels were increased in the striatum and EC and decreased in the CMC. Immunofluorescence staining confirmed the changes in EAAT1 and EAAT2 expression induced by neonatal MSG-treatment, which were accompanied by an increase in the glial fibrillary acidic protein (GFAP) immunofluorescence signalthat was particularly significant in the hippocampus. Our results show that a neonatal excitotoxic processes can induce lasting changes in the expression levels of EAAT1 and EAAT2 proteins and suggest that although astrogliosis occurs, glutamate uptake could be deficient, particularly in the CMC and hippocampus.

Etiology of acute gastroenteritis among children less than 5 years of age in Bucaramanga, Colombia: A case-control study.

BACKGROUND: Acute gastroenteritis (AGE) is a major cause of morbidity and mortality in children aged less than 5 years in low- and middle-income countries where limited access to potable water, poor sanitation, deficient hygiene, and food product contamination are prevalent. Research on the changing etiology of AGE and associated risk factors in Latin America, including Colombia, is essential to understand the epidemiology of these infections. The primary objectives of this study were to describe etiology of moderate to severe AGE in children less than 5 years of age from Bucaramanga, Colombia, a middle-income country in Latin American, and to identify the presence of emerging E. coli pathotypes. METHODOLOGY/PRINCIPAL FINDINGS: This was a prospective, matched for age, case-control study to assess the etiology of moderate to severe AGE in children less than 5 years of age in Bucaramanga, Colombia, South America. We tested for 24 pathogens using locally available diagnostic testing, including stool culture, polymerase chain reaction, microscopy and enzyme-linked immunoassay. Adjusted attributable fractions were calculated to assess the association between AGE and each pathogen in this study population. The study included 861 participants, 431 cases and 430 controls. Enteric pathogens were detected in 71% of cases and in 54% of controls (p = <0.001). Co-infection was identified in 28% of cases and in 14% of controls (p = <0.001). The adjusted attributable fraction showed that Norovirus GII explained 14% (95% CI: 10-18%) of AGE, followed by rotavirus 9.3% (6.4-12%), adenovirus 3% (1-4%), astrovirus 2.9% (0.6-5%), enterotoxigenic Escherichia coli (ETEC) 2.4% (0.4-4%), Cryptosporidium sp. 2% (0.5-4%), Campylobacter sp. 2% (0.2-4%), and Salmonella sp.1.9% (0.3 to 3.5%). Except for Cryptosporidium, all parasite infections were not associated with AGE. Three emergent diarrheagenic E. coli pathotypes were identified in cases (0.7%), including an enteroaggregative/enterotoxigenic E.coli (EAEC/ETEC), an enteroaggregative/enteropathogenic E.coli (EAEC/EPEC), and an emergent enteroinvasive E. coli with a rare O96:H19. No deaths were reported among cases or controls. CONCLUSIONS/SIGNIFICANCE: Norovirus and rotavirus explained the major proportion of moderate to severe AGE in this study. Higher proportion of infection in cases, in the form of single infections or co-infections, showed association with AGE. Three novel E. coli pathotypes were identified among cases in this geographic region.

Neuroprotective and Neurorestorative Effects of Epo and VEGF: Perspectives for New Therapeutic Approaches to Neurological Diseases.

BACKGROUND: Erythropoietin (Epo) and vascular endothelial growth factor (VEGF) are two vasoactive molecules with essential trophic effects for brain development. The expression and secretion of both molecules increase in response to neuronal damage and they exert protective and restorative effects, which may also be accompanied by adverse side effects. OBJECTIVE: We review the most relevant evidence on the neuroprotective and neurorestorative effects of Epo and VEGF in three of the most frequent neurological disorders, namely, stroke, epilepsy and Alzheimer's disease, to develop new therapeutic approaches. METHODS: Several original scientific manuscripts and reviews that have discussed the evidence in critical way, considering both the beneficial and adverse effects of Epo and VEGF in the selected neurological disorders, were analysed. In addition, throughout this review, we propose several considerations to take into account in the design of therapeutic approaches based on Epo and VEGF signalling. RESULTS: Although the three selected disorders are triggered by different mechanisms, they evolve through similar processes: excitotoxicity, oxidative stress, neuroinflammation, neuronal death, glial reactivity and vascular remodelling. Epo and VEGF exert neuroprotective and neurorestorative effects by acting on these processes due to their pleiotropism. In general, the evidence shows that both Epo and VEGF reduce neuronal death but that at the vascular level, their effects are contradictory. CONCLUSION: Because the Epo and VEGF signalling pathways are connected in several ways, we conclude that more experimental studies, primarily studies designed to thoroughly assess the functional interactions between Epo and VEGF in the brain under both physiological and pathophysiological conditions, are needed.

Increased protein expression of VEGF-A, VEGF-B, VEGF-C and their receptors in the temporal neocortex of pharmacoresistant temporal lobe epilepsy patients.

The vascular endothelial growth factor (VEGF) system has been shown to play a crucial role in several neuropathological processes. Temporal lobe epilepsy (TLE) is the most common focal epilepsy type in adult humans. We assessed the protein expression levels of VEGF-A, VEGF-B, and VEGF-C, their specific receptors VEGFR-2 and -3, their accessory receptors neuropilins 1 and 2, and PI3 and Akt kinases, in temporal neocortex from pharmacoresistant TLE (PR-TLE) patients and control subjects by western blotting. All proteins were found to be significantly overexpressed in samples of PR-TLE patients, indicating that the VEGF system contributes to PR-TLE pathogenesis and should be further studied.

Interactions Between Epilepsy and Plasticity.

Undoubtedly, one of the most interesting topics in the field of neuroscience is the ability of the central nervous system to respond to different stimuli (normal or pathological) by modifying its structure and function, either transiently or permanently, by generating neural cells and new connections in a process known as neuroplasticity. According to the large amount of evidence reported in the literature, many stimuli, such as environmental pressures, changes in the internal dynamic steady state of the organism and even injuries or illnesses (e.g., epilepsy) may induce neuroplasticity. Epilepsy and neuroplasticity seem to be closely related, as the two processes could positively affect one another. Thus, in this review, we analysed some neuroplastic changes triggered in the hippocampus in response to seizure-induced neuronal damage and how these changes could lead to the establishment of temporal lobe epilepsy, the most common type of focal human epilepsy.

Case-Control Pilot Study on Acute Diarrheal Disease in a Geographically Defined Pediatric Population in a Middle Income Country.

INTRODUCTION: Acute diarrheal disease (ADD) is a common cause of morbidity and mortality in children under 5 years of age. Understanding of the etiology of ADD is lacking in most low and middle income countries because reference laboratories detect limited number of pathogens. The objective of this study was to determine the feasibility to conduct a comprehensive case-control study to survey diarrheal pathogens among children with and without moderate-to-severe ADD. MATERIALS AND METHODS: Microbiology and molecular-based techniques were used to detect viral, bacterial, and parasitic enteropathogens. The study was conducted in Bucaramanga, Colombia, after Institutional Review Board approval was obtained. RESULTS: Ninety children less than 5 years of age were recruited after a written informed consent was obtained from parents or guardians. Forty-five subjects served as cases with ADD and 45 as controls. Thirty-six subjects out of 90 (40.0%) were positive for at least one enteropathogen, that is, 20 (44.4%) cases and 16 (35.5%) controls. CONCLUSIONS: The three most common enteric pathogens were enteroaggregative E. coli (10.0%), Norovirus (6.7%), and Salmonella spp. (5.6%). The E. coli pathogens were 18.8% of all infections making them the most frequent pathogens. Half of ADD cases were negative for any pathogens.

Glutamate Neonatal Excitotoxicity Modifies VEGF-A, VEGF-B, VEGFR-1 and VEGFR-2 Protein Expression Profiles During Postnatal Development of the Cerebral Cortex and Hippocampus of Male Rats.

Vascular endothelial growth factor (VEGF) exerts both neuroprotective and proinflammatory effects in the brain, depending on the VEGF (A-E) and VEGF receptor (VEGFR1-3) types involved. Neonatal monosodium glutamate (MSG) treatment triggers an excitotoxic degenerative process associated with several neuropathological conditions, and VEGF messenger RNA (mRNA) expression is increased at postnatal day (PD) 14 in rat hippocampus (Hp) following the treatment. The aim of this work was to establish the changes in immunoreactivity to VEGF-A, VEGF-B, VEGFR-1 and VEGFR-2 proteins induced by neonatal MSG treatment (4 g/kg, subcutaneous, at PD1, 3, 5 and 7) in the cerebral motor cortex (CMC) and Hp. Samples collected from PD2 to PD60 from control and MSG-treated male Wistar rats were assessed by western blotting for each protein. Considering that immunoreactivity measured by western blotting is related to the protein expression level, we found that each protein in each cerebral region has a specific expression profile throughout the studied ages, and all profiles were differentially modified by MSG. Specifically, neonatal MSG treatment significantly increased the immunoreactivity to the following: (1) VEGF-A at PD8-PD10 in the CMC and at PD6-PD8 in the Hp; (2) VEGF-B at PD2, PD6 and PD10 in the CMC and at PD8-PD9 in the Hp; and (3) VEGFR-2 at PD6-PD8 in the CMC and at PD21-PD60 in the Hp. Also, MSG significantly reduced the immunoreactivity to the following: (1) VEGF-B at PD8-PD9 and PD45-PD60 in the CMC; and (2) VEGFR-1 at PD4-PD6 and PD14-PD21 in the CMC and at PD4, PD9-PD10 and PD60 in the Hp. Our results indicate that VEGF-mediated signalling is involved in the excitotoxic process triggered by neonatal MSG treatment and should be further characterized.

Type-Specific Identification of Genital Human Papillomavirus Infection in Women with Cytological Abnormality.

OBJECTIVES: To estimate the frequency of human papillomavirus (HPV) infection and the genotype distribution of HPV among women with a Pap smear showing atypical squamous cells of undetermined significance (ASC-US) attending the Program for the Detection and Control of Cervical Cancer in Bogotá, Colombia. STUDY DESIGN: Cervical samples from 200 women with an ASC-US Pap smear were analyzed for the presence of HPV DNA and genotype distribution using a commercial molecular technique (Linear Array®; Roche Molecular Systems, USA). RESULTS: HPV infection was found in 140 women (70%). High-risk HPV types were present in 46.4% of the samples; 16.4% showed a low-risk HPV type, and 37.1% showed both. Of the positive samples, 42.9% were infected with a single viral genotype, whereas 57.1% exhibited multiple HPV infections. The most common HPV genotypes were HPV 16, 53, and 52 with a prevalence of 26.4, 16.4, and 13.6%, respectively. CONCLUSION: The epidemiological characterization of HPV infections described in this study might guide actions for epidemiological surveillance to strengthen the program in Bogotá and to develop appropriate HPV vaccination programs.

Proyecto: Creación de una Unidad de Desintoxicación / Project: Creation of a Detoxification Unit

Las adicciones constituyen un problema de salud en el mundo actual. El aumento del consumo de alcohol y el abuso de drogas registrados en los últimos años, incrementaron las consultas en los Servicios de Emergencias de los Hospitales Públicos, tanto por cuadros agudos, intoxicación o abstinencia, como por efectos secundarios de las sustancias. Confluyen en su génesis factores psicológicos, culturales y sanitarios. La situación constituye un problema sanitario de alto costo personal, social y económico. La complejidad del problema, su desconocimiento, las valoraciones peyorativas, los prejuicios y las estigmatizaciones de los aspectos relacionados con el consumo exigen una mirada multidisciplinaria e intersectorial que permita comprender la difícil realidad y proponer el adecuado manejo de técnicas y metodologías, elementos esenciales para lograr intervenciones superadoras de la cuestión

Addictions are a problem in the actual world. The rise in drugs and alcohol abuse in later years have increased consultations in emergency services for intoxications or abstinence as well as for secondary effects to substances abuse. In their genesis coincide psichological, sanitary and cultural factors. This situation constitutes a sanitary problem of high personal social and echonomic level. The complexity of the problem, its lack of knowledge, prjeudices and stigmatizations of many aspects relationed to drug consume demand a multidisciplinary look that allows to undertsand the difficult reality and to propose adequate handling of techniques and methodology which are essential to achieve adequate interventions

As adicções são um problema de saúde no mundo de hoje. O aumento do consumo de álcool e o abuso de drogas registrados nos últimos anos, acrescentaram as consultas nos Serviços de Pronto Socorro dos Hospitais Públicos, tanto por casos agudos, intoxicação ou abstinência, quanto por efeitos colaterais das substâncias. Convergem para gerá-los fatores psicológicos, culturais e de saúde. A situação constitui um problema de saúde pública de grande custo pessoal, social e econômico. A complexidade, o desconhecimento, as qualificações pejorativas, os preconceitos e as estigmatizações dos aspectos relacionados com o consumo exigem um olhar multidisciplinar e intersectorial para a compreensão da difícil realidade e para propor técnicas e metodologias adequadas, que são essenciais para alcançar intervenções superadoras da questão

NKCC1 and KCC2 protein expression is sexually dimorphic in the hippocampus and entorhinal cortex of neonatal rats.

Seizure susceptibility appears to be greater in males than females during the early developmental stages of the brain when the gamma-aminobutyric acid (GABA), acting through its GABA-A receptor, predominantly produces neuronal depolarization. GABA-mediated excitation has been observed when the NKCC1 (chloride importer) expression level is higher than KCC2 (chloride exporter). In this study, the relative protein expression of NKCC1 and KCC2 over ß-actin was evaluated in the hippocampus and entorhinal cortex of male and female rats during postnatal days (PND) 1, 3, 5, 7, 9, 11, 13 and 15 using Western blotting assays. For both cerebral regions in the females, the NKCC1/ß-actin expression ratio was constant during all evaluated ages, whereas the KCC2/ß-actin expression ratio increased gradually until reaching a maximal level at PND9 that was nearly three- and ten-fold higher in the hippocampus and entorhinal cortex, respectively, compared with the initial level. In males, the NKCC1/ß-actin expression ratio was constant during the first week, peaking almost three-fold higher than the initial level at PND9 in the hippocampus and at PND11 in the entorhinal cortex and then returning to the initial values at PND13, whereas the KCC2/ß-actin expression ratio increased gradually to reach a maximal and steady level at PND5, which were nearly two- and four-fold higher in the hippocampus and entorhinal cortex, respectively, compared with the intial level. In conclusion, the NKCC1/ß-actin and KCC2/ß-actin expression ratios displayed a specific expression profile for each gender and cerebral region, which could be related with the differences in seizure susceptibility observed between genders.

Mitochondrial response to oxidative and nitrosative stress in early stages of diabetes.

Diabetes mellitus (DM) is associated with increased production of reactive oxygen and nitrogen species; consequently, an increase in lipid peroxidation and a decrease in antioxidants resulting in mitochondrial dysfunction. Using a rat model of DM induced by streptozotocin, we show the opposite: an increase in NO levels, S-nitrosylation, aconitase activity, and total glutathione and a decrease in lipid peroxidation at early stages of diabetes. These data imply that the decrease in lipid peroxidation is a vital early response to hyperglycemia to prevent escalation of ROS generation in mitochondria. These results also suggest a need for novel therapeutic targets to prevent the neurological consequences of diabetes.

Estrategias para la implementación y reporte de los puntos de corte CLSI vigentes y pruebas fenotípicas confirmatorias para BLEE y carbapenemasas en bacilos Gram negativos en laboratorios clínicos de Colombia / Strategies for implementation and reporting of current CLSI Breakpoints and phenotypic confirmatory tests for ESBLs and carbapenemases in Gram-negative bacilli in Colombian clinical laboratories

En 2010, el Instituto Americano de Estándares Clínicos y de Laboratorio (CLSI) inició un proceso de revisión y actualización de los puntos de corte para microdilución y disco difusión para cefalosporinas (cefazolina, cefotaxima, ceftriaxona, ceftizoxima, ceftazidima), monobactámicos (aztreonam) y carbapenémicos (imipenem, meropenem, ertapenem, doripenem). Los cambios se basaron en modelos PK/PD que buscan predecir la respuesta clínica con el uso exclusivo de la concentración inhibitoria mínima (CIM) y esquemas específicos de dosificación de forma independiente al mecanismo de resistencia expresado. Este nuevo paradigma eliminaría la necesidad de realizar pruebas fenotípicas para beta-lactamasas de espectro extendido (BLEE) y carbapenemasas para tomar decisiones terapéuticas y permitiría utilizarlas únicamente para fines epidemiológicos. Sin embargo, ante las limitaciones de las metodologías actuales para pruebas de susceptibilidad en Colombia, el desconocimiento de estos cambios y la alarma epidemiológica por la aparición de nuevas ß-lactamasas en el país, se hace necesario generar recomendaciones para los laboratorios clínicos, con el fi n de unifi car los criterios para la realización e informe de los antibiogramas en bacilos Gram negativos, incluyendo la implementación de los puntos de corte actuales y la aplicación de las pruebas fenotípicas para la detección de BLEE y carbapenemasas.

In 2010, the Clinical and Laboratory Standards Institute (CLSI) began a process to revise and update the breakpoints for broth microdilution and disk diffusion for cephalosporins (Cefazolin, Cefotaxime, Ceftriaxone, Ceftazidime), monobactams (Aztreonam) and carbapenems (Imipenem, Meropenem, Ertapenem and Doripenem). The changes made were based on PK/PD models that attempt to predict clinical outcomes using minimum inhibitory concentration (MIC) and specific dosage regimens, regardless of the resistance mechanism expressed by the organism. The new breakpoints would eliminate the need to perform screening and confirmatory testing for ESBLs and carbapenemases for treatment decisions, and thus they would be used only for infection control purposes. Nevertheless, there are limitations to current methods in Colombia, a lack of knowledge regarding the recent changes and epidemiologic alarm over new B-lactamases spreading in our country. Therefore it was necessary to formulate and issue recommendations for clinical laboratories, with the aim of standardizing the criteria for reports on antibiograms in Gram-negative bacilli, including the current CLSI breakpoints and applying phenotypic confirmatory testing to detect ESBLs and Carbapenemases.

Receptor to glutamate NMDA-type: the functional diversity of the nr1 isoforms and pharmacological properties.

Glutamic acid (Glu) is the major excitatory neurotransmitter in the central nervous system, and interacts with two classes of receptor: metabotropic and ionotropic receptors. Ionotropic receptors are divided according to the affinity of their specific agonists: Nmethyl- D-aspartate (NMDA), amino acid-3-hydroxy-5-methyl-4-isoxazole acid (AMPA) and kainic acid (KA). NMDA receptors (NMDA-R) are macromolecular structures that are formed by different combinations of subunits: NMDAR1 (NR1), NMDAR2 (NR2) and NMDAR3 (NR3). The study of this receptor has aroused great interest, partly due to its role in synaptic plasticity but mainly because of its permeability to the Ca(2+) ion. This review examines the molecular composition of NMDA-R and the variants of NR1 subunit editing in association with NR2 subunit dimers, which form the main components of this receptor. Their composition, structure, function and distinct temporal and spatial expression patterns demonstrate the versatility and diversity of functionally different isoforms of NR1 subunits and the various pharmacological properties of the NR2 subunit. Finally, the involvement of NMDA-R in the excitotoxicity phenomenon, as well as, its expression changes under these conditions as neuronal response are also discussed.

Respiratory capacity of the Kluyveromyces marxianus yeast isolated from the mezcal process during oxidative stress.

During the mezcal fermentation process, yeasts are affected by several stresses that can affect their fermentation capability. These stresses, such as thermal shock, ethanol, osmotic and growth inhibitors are common during fermentation. Cells have improved metabolic systems and they express stress response genes in order to decrease the damage caused during the stress, but to the best of our knowledge, there are no published works exploring the effect of oxidants and prooxidants, such as H2O2 and menadione, during growth. In this article, we describe the behavior of Kluyveromyces marxianus isolated from spontaneous mezcal fermentation during oxidative stress, and compared it with that of Saccharomyces cerevisiae strains that were also obtained from mezcal, using the W303-1A strain as a reference. S. cerevisiae strains showed greater viability after oxidative stress compared with K. marxianus strains. However, when the yeast strains were grown in the presence of oxidants in the media, K. marxianus exhibited a greater ability to grow in menadione than it did in H2O2. Moreover, when K. marxianus SLP1 was grown in a minibioreactor, its behavior when exposed to menadione was different from its behavior with H2O2. The yeast maintained the ability to consume dissolved oxygen during the 4 h subsequent to the addition of menadione, and then stopped respiration. When exposed to H2O2, the yeast stopped consuming oxygen for the following 8 h, but began to consume oxygen when stressors were no longer applied. In conclusion, yeast isolated from spontaneous mezcal fermentation was able to resist oxidative stress for a long period of time.

Hypolipidemic Activity of Eryngium carlinae on Streptozotocin-Induced Diabetic Rats.

Diabetes mellitus (DM) is a significant risk factor for the development of cardiovascular complications. This study was undertaken to investigate the effect of chronic administration of ethanolic extract of Eryngium carlinae on glucose, creatinine, uric acid, total cholesterol, and triglycerides levels in serum of streptozotocin- (STZ-) induced diabetic rats. Triglycerides, total cholesterol, and uric acid levels increased in serum from diabetic rats. The treatment with E. carlinae prevented these changes. The administration of E. carlinae extract reduced the levels of creatinine, uric acid, total cholesterol, and triglycerides. Thus administration of E. carlinae is able to reduce hyperlipidemia related to the cardiovascular risk in diabetes mellitus.

Monosodium glutamate neonatal treatment as a seizure and excitotoxic model.

Monosodium glutamate (MSG) subcutaneously administrated to neonatal rats induces several neurochemical alterations in the brain, which have been associated with an excitotoxic process triggered by an over activation of glutamate receptors; however there are few systematic studies about initial changes in intracerebroventricular (i.c.v.) Glu levels produced by MSG in the brain. Thus, to characterize these changes, rat pups were injected with a MSG solution at 1, 3, 5 and 7 postnatal days (PD), and i.c.v. Glu levels and hippocampal total content of related amino acids (Asp, Glu, Gln, Gly, Tau, Ala and GABA) were estimated before, immediately and after each injection. Behavioral and EEG responses were also monitored after MSG administrations. Significant rise in i.c.v. Glu levels were found, mainly in response to the first and second injection. Moreover, the total content of all amino acids evaluated also increased during the first hour after the first MSG administration but only Glu and GABA remained elevated after 24 h. These biochemical modifications were accompanied with behavioral alterations characterized by: screeching, tail stiffness, head nodding, emprosthotonic flexion episodes and generalized tonic-clonic convulsions, which were associated with electroencephalographic pattern alterations. Altered behavior found in animals treated with MSG suggests an initial seizure situation. Although four MSG administrations were used, the most relevant findings were observed after the first and second administrations at PD1 and PD3, suggesting that only two MSG injections could be sufficient to resemble a seizure and/or excitotoxic model.

Excitotoxic neonatal damage induced by monosodium glutamate reduces several GABAergic markers in the cerebral cortex and hippocampus in adulthood.

Monosodium glutamate (MSG) administered to neonatal rats during the first week of life induces a neurodegenerative process, which is represented by several neurochemical alterations of surviving neurons in the brain, where signalling mediated by GABA is essential for excitation threshold maintenance. GABA-positive cells, [(3)H]-GABA uptake, expression of mRNA for GABA transporters GAT-1 and GAT-3, and expression of mRNA and protein for two main GABA synthesizing enzymes, GAD(65) and GAD(67), were measured at postnatal day 60, after MSG neonatal treatment in two critical cerebral regions, cerebral cortex and hippocampus. GABA-positive cells, [(3)H]-GABA uptake, and mRNA for GAT-1, were significantly diminished in both cerebral regions. In the cerebral cortex, MSG neonatal treatment also decreased the mRNA for GAD(67) and protein for GAD(65) without significant changes in its corresponding protein and mRNA, respectively. Moreover in the hippocampus, mRNA and protein for GAD(65) were increased, whilst GAD(67) protein was elevated without significant changes in its mRNA. Clearly these results confirm the GABA cells loss after MSG neonatal treatment in both cerebral regions. As most of the GABAergic markers measured were reduced in the cerebral cortex, this region seems to be more sensitive than hippocampus, where interesting compensatory changes over GAD(65) and GAD(67) proteins were observed. However, it is possible that others neurotransmission systems are also compensating the GABA-positive cells loss in the cerebral cortex, and that elevations in two main forms of GAD in the hippocampus are not sufficient to maintain the neural excitation threshold for this region.

Experiencia en el tratamiento del cáncer gástrico en 30 años 1970-1999 / Experience in the treatment of the gastric cancer in 30 years 1970-1999

En el Servicio de Cirugía del Hospital Carlos Andrade Marín, se intervino quirúrgicamente a 1005 casos de cáncer gástrico. 103 casos (10.24 por ciento) de cáncer temprano y 902 (89.75 por ciento) de cáncer avanzado. Se dividió en 3 períodos de 10 años cada uno para el estudio y evaluación de la enfermedad. La relación hombre mujer es de 3 a 1. La edad promedio para los hombres es de 59.83 (R 25-87), para las mujeres 55, 11 años (R17-92). La lesión estuvo localizada más frecuentemente en el antro gástrico, sin embargo en el 2do y 3er período existe un ligero aumento en la porción media del estómago. La incidencia del cáncer temprano aumento notoriamente en el 2do y 3er período. El estadio III y IV de la enfermedad representó el 74.23 por ciento de los casos...