The anti-CD6 antibody itolizumab provides clinical benefit without lymphopenia in rheumatoid arthritis patients: results from a 6-month, open-label Phase I clinical trial.

Itolizumab is a humanized anti-CD6 monoclonal antibody (mAb) that has previously shown encouraging results, in terms of safety and positive clinical effects, in a 6-week monotherapy clinical trial conducted in rheumatoid arthritis (RA) patients. The current Phase I study evaluated the safety and clinical response for a longer treatment of 12 itolizumab intravenous doses in subjects with active RA despite previous disease-modifying anti-rheumatic drug (DMARD) therapy. Twenty-one subjects were enrolled into four dosage groups (0·1, 0·2, 0·4 and 0·8 mg/kg). Efficacy end-points including American College of Rheumatology (ACR)20, ACR50 and ACR70 response rates and disease activity score in 28 joints (DAS28) were monitored at baseline and at specific time-points during a 10-week follow-up period. Itolizumab was well tolerated up to the highest tested dose. No related serious adverse events were reported and most adverse events were mild. Remarkably, itolizumab treatment did not produce lymphopenia and, therefore, was not associated with infections. All patients achieved a clinical response (ACR20) at least once during the study. Eleven subjects (55%) achieved at least a 20% improvement in ACR just 1 week after the first itolizumab administration. The clinical response was observed from the beginning of the treatment and was sustained during 24 weeks. The efficacy profile of this 12-week treatment was similar to that of the previous study (6-week treatment). These results reinforce the safety profile of itolizumab and provide further evidence on the clinical benefit from the use of this anti-CD6 mAb in RA patients.

Avaliação ecocardiográfica do átrio esquerdo de cães sadios por meio do modo-M convencional e do modo bidimensional / Echocardiographic evaluation of the left atrium of healthy dogs using the conventional M-mode and the bidimensional mode

Avaliaram-se o átrio esquerdo (AE) utilizando-se o método bidimensional (2-B) (corte transverso) e a relação átrio esquerdo:aorta (AE:Ao), em um grupo de 40 cães adultos e sadios, entre um, cinco e sete anos de idade e com pesos corpóreos de 3,2kg a 38,3kg, e compararam-se esses valores aos do modo-M convencional. Observou-se diferença entre AE e Ao nos dois métodos e entre os seus respectivos índices. A correlação foi positiva alta entre peso e superfície corpórea e entre AE no modo 2-B (AEB) e AE no modo-M (AEM). Não se observou correlação entre os índices, nos dois métodos, com o peso e a superfície corpórea, isto é, os índices são independentes do peso ou da superfície corpórea. Concluiu-se que o AEB é maior do que o AEM, o índice médio para o AEB:AoB é de 1,379, e o intervalo de confiança de 1,337 a 1,422. O índice no método 2-B é, portanto, superior ao índice no modo-M.

The left atrium (LA) was evaluated through the bidimensional method (2-D) (short axis) and the relation left atrium:aorta (LA:Ao) in a group of 40 healthy adult dogs between 1.5 and 7 years of age and weights ranging from 3.2 to 38.3kg, and these values were compared to those in the conventional M-mode. Comparing the variable LA and Ao with the two methods and their respective indexes, significant statistical difference was observed (P<0,001), high positive correlation between the weight and LA-2D and LAM, between body surface and LA-2D and LAM. A difference between LA and Ao in both methods and these respective indicators were observed. The association was higly positive between weight and body surface area (BSA) and between M- mode LA (LAM) and 2-D mode LA (LA-2D). No correlation was observed between these indicators and weight and BSA, in both methods, so these indicators are weight and BSA-independent. Conclusions: LA-2D is bigger than LAM, the LA-2D:Ao-2D average index is 1,379 and the confidence interval is 1,337 to 1,422. The index in the 2-D method is, therefore, superior to the index in the M-mode.

Avaliação ecocardiográfica do átrio esquerdo de cães sadios por meio do modo-M convencional e do modo bidimensional / Echocardiographic evaluation of the left atrium of healthy dogs using the conventional M-mode and the bidimensional mode

Avaliaram-se o átrio esquerdo (AE) utilizando-se o método bidimensional (2-B) (corte transverso) e a relação átrio esquerdo:aorta (AE:Ao), em um grupo de 40 cães adultos e sadios, entre um, cinco e sete anos de idade e com pesos corpóreos de 3,2kg a 38,3kg, e compararam-se esses valores aos do modo-M convencional. Observou-se diferença entre AE e Ao nos dois métodos e entre os seus respectivos índices. A correlação foi positiva alta entre peso e superfície corpórea e entre AE no modo 2-B (AEB) e AE no modo-M (AEM). Não se observou correlação entre os índices, nos dois métodos, com o peso e a superfície corpórea, isto é, os índices são independentes do peso ou da superfície corpórea. Concluiu-se que o AEB é maior do que o AEM, o índice médio para o AEB:AoB é de 1,379, e o intervalo de confiança de 1,337 a 1,422. O índice no método 2-B é, portanto, superior ao índice no modo-M.(AU)

The left atrium (LA) was evaluated through the bidimensional method (2-D) (short axis) and the relation left atrium:aorta (LA:Ao) in a group of 40 healthy adult dogs between 1.5 and 7 years of age and weights ranging from 3.2 to 38.3kg, and these values were compared to those in the conventional M-mode. Comparing the variable LA and Ao with the two methods and their respective indexes, significant statistical difference was observed (P<0,001), high positive correlation between the weight and LA-2D and LAM, between body surface and LA-2D and LAM. A difference between LA and Ao in both methods and these respective indicators were observed. The association was higly positive between weight and body surface area (BSA) and between M- mode LA (LAM) and 2-D mode LA (LA-2D). No correlation was observed between these indicators and weight and BSA, in both methods, so these indicators are weight and BSA-independent. Conclusions: LA-2D is bigger than LAM, the LA-2D:Ao-2D average index is 1,379 and the confidence interval is 1,337 to 1,422. The index in the 2-D method is, therefore, superior to the index in the M-mode.(AU)

Using of WHO guidelines for the management of severe malnutrition to cases of marasmus and kwashiorkor in a Colombia children's hospital.

BACKGROUND: In 2007, the Hospital Infantil Los Ángeles (HILA) in Colombia implemented a slightly-modified version of the WHO guidelines for the diagnosis and management of malnutrition during childhood. OBJECTIVE: To evaluate the efficacy of the WHO-HILA protocol in children hospitalized with severe, chronic marasmus and kwashiorkor malnutrition (MS-KWK) in 2007 and 2008. MATERIAL AND METHODS: In this descriptive retrospective study the records of 100 children hospitalized with MSKWK were initially evaluated. Of these, 30 fulfilled the inclusion criteria: children of both sexes with a primary diagnosis of MS-KWK. Patients with any chronic disease liable to cause malnutrition were excluded. Anthropometric parameters, clinical signs and biochemical indicators of malnutrition were assessed upon admission and again at discharge following application of the WHO guidelines. Univariate analysis was performed for each study variable; serum hemoglobin and albumin levels on admission and at discharge were compared, and data were subjected to bivariate analysis. RESULTS: Marasmus was diagnosed in 23.3% of children, kwashiorkor in 73.3% and marasmic kwashiorkor in 3.3%. The major clinical findings were: edema (70%), emaciation (40%), "flag sign" hair (42.86%), low serum albumin (93%) and anemia (80%). Thirteen children following the WHO-HILA protocol showed a significant nutritional status improvement (p<0.05), whereas no improvement was noted in the 17 children not treated according to the protocol. CONCLUSIONS: Application of the WHO-HILA protocol was associated with reduced morbimortality in children with marasmus-kwashiorkor malnutrition. Implementation of this protocol should therefore be considered in all children´s hospitals in countries where this disease is prevalent.

Comparison of single-reflection near-infrared and attenuated total reflection mid-infrared spectroscopies to identify and monitor hydrocarbons spilled in the marine environment.

The capability of single-reflection near-IR (NIR) spectroscopy to differentiate, characterize and monitor the fate of a set of hydrocarbons spilled in the marine environment was compared with that of multiple-reflection horizontal attenuated total reflection mid-IR (ATR-MIR) spectroscopy. Multivariate pattern recognition techniques [principal component analysis (PCA), multivariate polynomial regression, cluster analysis and potential curves] were applied to unravel the major trends of the weathering processes of four generic types of crude oils and two heavy fuel oils spilled under controlled conditions for almost 4 months. A chemical interpretation of the NIR spectra related the weathering processes and the PCA loadings, which had not already been done in the literature. Weathering for both light and heavy products was characterized by a contrast among the linear aliphatic structures (more volatile and easy to degrade) and the branched and aromatic structures (more recalcitrant). Potential curves were applied to model each product and determine objectively whether unknown samples could be classified correctly. Polynomial regression on the PCA scores was employed to evaluate the time elapsed from the oil spillage to its sampling; this represents a new approach to assess the age of a hydrocarbon lump. In general, NIR spectroscopy yielded good results when light crude oils were studied, whereas ATR-MIR spectroscopy led to satisfactory results for both light and heavy products.

Niveles de exposición a arsénico en agua de bebida y riesgo relativo de cáncer de piel, en Máximo Paz, Santa Fe, Argentina. Período 2001-2005

El Arsénico en el agua de bebida es un importante problema ambiental en amplias zonas de Argentina. El cáncer, especialmente de piel, es uno de los riesgos asociados con el consume crónico de agua con elevados tenores de arsénico. Los valores máximos recomendados por la Organización Mundial de la Salud son de 0.010mg/l. La Ley Provincial Nº 11.220 de 1995 obliga a todos los servicios de agua potable a suministrar agua de bebida con concentraciones de arsénico de 0.050 mg/l (Límite Recomendado) o menores, aunque las normas en vigencia admiten plazos para alcanzar condiciones normales de operación y el límite recomendado, período durante el cual debe el prestador cumplir con el "límite obligatorio" de 0.100 mg/l. Estos valores pueden significar riesgos para la salud de las poblaciones expuestas. Se evalúa el riego relativo para desarrollar cáncer de piel en la población rural de Máximo Paz

Niveles de exposición a arsénico en agua de bebida y riesgo relativo de cáncer de piel, en Máximo Paz, Santa Fe, Argentina. Período 2001-2005

El Arsénico en el agua de bebida es un importante problema ambiental en amplias zonas de Argentina. El cáncer, especialmente de piel, es uno de los riesgos asociados con el consume crónico de agua con elevados tenores de arsénico. Los valores máximos recomendados por la Organización Mundial de la Salud son de 0.010mg/l. La Ley Provincial Nº 11.220 de 1995 obliga a todos los servicios de agua potable a suministrar agua de bebida con concentraciones de arsénico de 0.050 mg/l (Límite Recomendado) o menores, aunque las normas en vigencia admiten plazos para alcanzar condiciones normales de operación y el límite recomendado, período durante el cual debe el prestador cumplir con el "límite obligatorio" de 0.100 mg/l. Estos valores pueden significar riesgos para la salud de las poblaciones expuestas. Se evalúa el riego relativo para desarrollar cáncer de piel en la población rural de Máximo Paz

[Esophagitis associated with use of alendronate in 5 postmenopausic patients]. / Esofagitis asociada con el uso de alendronato en 5 pacientes posmenopáusicas.

The bisphosphonate, alendronate sodium (e.g. Fosamax) is a bone resorption inhibitor used to treat postmenopausal osteoporotic women and osseous Paget's disease. Esophagitis is one of the adverse effects (AE) associated to its use. Five (5) patients with alendronate-associated esophagitis assisted in the Gastroenterologic Center, Rosario, Argentina, between October 1996 and December 1999 are described. The aim is to correlate the clinical, endoscopic and histopathological findings in 5 women (ages 57-71) complaining for upper digestive symptoms (dysphagia, epigastralgia, retrosternal pain.). All had osteoporosis treated with alendronate 10 mg/day and received detailed instructions about how to take the medication. The time from the beginning of alendronate intake and the appearance of the symptoms was elapsed 30, 35, 67, 85 and 90 days. The esophagitis was graded according to the Savary-Miller Classification. The videoscopy disclosed esophagitis of III and IV grades. Three patients had also antral and antroduodenal lesions, one of them associated to Helicobacter Pylori. Anatomopathologic findings confirm esophagitis and esophagic ulceration. Some authors claim that bisphosphonates as a new class of gastrotoxic drugs with AE similar to aspirin. Even when it is administrated according to the instructions of the manufacturers it should be used with caution. Our contribution emphasize the importance of this AE and suggest measures to diminish or suppress them, and take into consideration those patients who are taking aspirin. With alendronate, as well as with other potentially corrosive agents, is very important to take in mind the measures to prevent AE.

Esofagitis asociada con el uso de alendronato en 5 pacientes posmenopáusicas / Esophagitis associated with use of alendronate in 5 postmenopausic patients

The biphosphonate, alendronate sodium (e.g. Fosamax) is a bone resorption inhibitor used to treat posmenopausal osteoporotic women and osseous Pagets disease. Esophaghitis is one of the adverse effects (AE) associated to its use. Five (5) patients with alendronate-associated esophagitis assisted in the Gastroenterologic Center, Rosario, Argentina, between October 1996 and December 1999 are described. The aim is to correlate the clinical, endoscopic and histopathological findings in 5 women (ages 57-71) complained for upper digestive symptoms (disphagia, epigastrialgia, retroesternal pain). All had osteoporosis treated with alendronate 10 mg/day and received detailed instructions about how to take the medication. The time from the beginning of alendronate intake and the appearence of the symptoms was elapsed 30, 35, 67, 85 and 90 days. The esophagitis was graded according to the Savary-Miller Classification. The videoscopy disclosed esophagitis of III and IV grades. Three patients has also antral and antroduodenal lesions, one of them associated to Helicobacter pylori. Anatomopathological findings confirm esophagitis and esophagic ulceration. Some authors claim that disphosphonates as a new class of gastrotoxic drugs with AE similar to aspirin. Even when it is administrated according to the instructions of the manufactures it should be used with caution. Our contribution emphazise the importance of this AE and suggest measures to diminish or suppres them, and take into consideration those patients who are taking aspirin. With alendronate, as well as with other potentially corrosive agents, is very important to take in mind the measures to prevent AE. (Au)

Esofagitis asociada con el uso de alendronato en 5 pacientes posmenopáusicas / Esophagitis associated with use of alendronate in 5 postmenopausic patients

The biphosphonate, alendronate sodium (e.g. Fosamax) is a bone resorption inhibitor used to treat posmenopausal osteoporotic women and osseous Paget's disease. Esophaghitis is one of the adverse effects (AE) associated to its use. Five (5) patients with alendronate-associated esophagitis assisted in the Gastroenterologic Center, Rosario, Argentina, between October 1996 and December 1999 are described. The aim is to correlate the clinical, endoscopic and histopathological findings in 5 women (ages 57-71) complained for upper digestive symptoms (disphagia, epigastrialgia, retroesternal pain). All had osteoporosis treated with alendronate 10 mg/day and received detailed instructions about how to take the medication. The time from the beginning of alendronate intake and the appearence of the symptoms was elapsed 30, 35, 67, 85 and 90 days. The esophagitis was graded according to the Savary-Miller Classification. The videoscopy disclosed esophagitis of III and IV grades. Three patients has also antral and antroduodenal lesions, one of them associated to Helicobacter pylori. Anatomopathological findings confirm esophagitis and esophagic ulceration. Some authors claim that disphosphonates as a new class of gastrotoxic drugs with AE similar to aspirin. Even when it is administrated according to the instructions of the manufactures it should be used with caution. Our contribution emphazise the importance of this AE and suggest measures to diminish or suppres them, and take into consideration those patients who are taking aspirin. With alendronate, as well as with other potentially corrosive agents, is very important to take in mind the measures to prevent AE.

Esofagitis asociada con el uso de alendronato en 5 pacientes posmenopáusicas. / [Esophagitis associated with use of alendronate in 5 postmenopausic patients]

The bisphosphonate, alendronate sodium (e.g. Fosamax) is a bone resorption inhibitor used to treat postmenopausal osteoporotic women and osseous Pagets disease. Esophagitis is one of the adverse effects (AE) associated to its use. Five (5) patients with alendronate-associated esophagitis assisted in the Gastroenterologic Center, Rosario, Argentina, between October 1996 and December 1999 are described. The aim is to correlate the clinical, endoscopic and histopathological findings in 5 women (ages 57-71) complaining for upper digestive symptoms (dysphagia, epigastralgia, retrosternal pain.). All had osteoporosis treated with alendronate 10 mg/day and received detailed instructions about how to take the medication. The time from the beginning of alendronate intake and the appearance of the symptoms was elapsed 30, 35, 67, 85 and 90 days. The esophagitis was graded according to the Savary-Miller Classification. The videoscopy disclosed esophagitis of III and IV grades. Three patients had also antral and antroduodenal lesions, one of them associated to Helicobacter Pylori. Anatomopathologic findings confirm esophagitis and esophagic ulceration. Some authors claim that bisphosphonates as a new class of gastrotoxic drugs with AE similar to aspirin. Even when it is administrated according to the instructions of the manufacturers it should be used with caution. Our contribution emphasize the importance of this AE and suggest measures to diminish or suppress them, and take into consideration those patients who are taking aspirin. With alendronate, as well as with other potentially corrosive agents, is very important to take in mind the measures to prevent AE.

[Prions, infections and confusions in the "transmissible" spongiform encephalopathies. The other evidence-based science. III. Review]. / Priones, infecciones y confusiones en las encefalopatías espongiformes "trasmisibles". Ciencia basada en la otra evidencia III. Revisión.

There are some neurological disorders with a pathological hallmark called spongiosis which include Creutzfeld-Jakob disease and its new variant, the Gertsmann-Straussler-Scheinker Syndrome and the Fatal Familial Insomnia in humans; and Scrapie and Bovine Spongiform Encephalopathy, among others, in animals. The etiological agent has been considered either transmissible or hereditary or both. Curiously, this agent has no nucleic acids, is impossible to filter, is resistant to inactivation by chemical means, has not been cultured and is unobservable at electron microscopy. All of these facts have led to some researches to claim that these agents are similar to viruses appearing in computers. However, after almost fifty years of research, is still not possible to explain why and how such elements produce the diseases commented about. On the contrary, during these years have been possible to know that these entities called slow viral infections, transmissible amyloidosis, transmissible dementia, transmissible spongiform encephalopathies or prion diseases appear in individuals with genetical predispositions exposed to several worldwide immunological stressors. The possibility that prions are the consequence and not the cause of these diseases in animals and man is day by day more reliable, and supports the suggestion that a systematic intoxication due to pesticides as well as mycotoxin ingestion, produced mainly by different molds such as Aspergillus, Penicillium or Fusarium, seem to be the true etiology of these neurodegenerative disorders.

Determinación de hierro en el cuerpo humano: consideraciones generales y revisión de métodos analíticos / Determination of iron in human body: revision of the analytical methods

El objetivo primordial del presente trabajo es dar una visión general de las características que presenta el hierro en el cuerpo humano y hacer una recopilación de los métodos más recientemente propuestos para su determinación. Esta visión pretende ser una clasificación general de metodologías, ilustradas con ejemplos de casos propuestos por los investigadores actuales para que pueda servir de punto de arranque en un mayor estudio; algo que, creemos, es de la mayor importancia. Se hará así un exhautivo recorrido por lo publicado desde enero de 1983 hasta enero de 1990

Determinación de hierro en el cuerpo humano: consideraciones generales y revisión de métodos analíticos / Determination of iron in human body: revision of the analytical methods

El objetivo primordial del presente trabajo es dar una visión general de las características que presenta el hierro en el cuerpo humano y hacer una recopilación de los métodos más recientemente propuestos para su determinación. Esta visión pretende ser una clasificación general de metodologías, ilustradas con ejemplos de casos propuestos por los investigadores actuales para que pueda servir de punto de arranque en un mayor estudio; algo que, creemos, es de la mayor importancia. Se hará así un exhautivo recorrido por lo publicado desde enero de 1983 hasta enero de 1990