Transcriptomic response of immune signalling pathways in intestinal epithelial cells exposed to lipopolysaccharides, Gram-negative bacteria or potentially probiotic microbes.

In order to understand the appropriate use of potentially probiotic Gram-positive microbes through their introduction in the gut microbiome, it is necessary to understand the influence of individual bacteria on the host-response system at a cellular level. In the present study, we have shown that lipopolysaccharides, flagellated Gram-negative bacteria, potentially probiotic Gram-positive bacteria and yeast interact differently with human intestinal epithelial cells with a custom-designed expression microarray evaluating 17 specific host-response pathways. Only lipopolysaccharides and flagellated Gram-negative bacteria induced inflammatory response, while a subset of Gram-positive microbes had anti-inflammatory potential. The main outcome from the study was the differential regulation of the central mitogen-activated protein kinase signalling pathway by these Gram-positive microbes versus commensal/pathogenic Gram-negative bacteria. The microarray was efficient to highlight the impact of individual bacteria on the response of intestinal epithelial cells, but quantitative real-time polymerase chain reaction validation demonstrated some underestimation for down-regulated genes by the microarray. This immune array will allow us to better understand the mechanisms underlying microbe-induced host immune responses.

Valoración de la Atención Continuada en un Centro de Salud Rural de la Comarca de la Vera en la provincia de Cáceres / Assessment of continuing care in a rural health centre in the Vera area of Caceres province, Spain

El objetivo fue determinar las características de la demanda asistencial en la atención continuada en una zona de salud rural de la Comarca de la Vera. Material y métodos. Estudio epidemiológico descriptivo y transversal, basado en la recogida de los datos que figuran en los libros de registro de cada una de las urgencias atendidas en el Centro de Salud de Villanueva de la Vera, desde el 1 de Enero de 2005 al 1 de Enero de 2006. Material y métodos. Se recogieron las siguientes variables: sexo, edad, hora, fecha, motivo de consulta, tipo de asistencia y derivación hospitalaria. Resultados. Se atendieron un total de 5.677 pacientes con una media de 473,08/mes y 15,6/día sin diferencia entre ambos sexos. Resultados. Un 93,1% se resolvieron en el centro de salud, mientras que un 6,8%, se derivaron al hospital de referencia siendo el primer motivo de traslado los problemas relacionados con el aparato locomotor. Resultados. La mayoría de la demanda corresponde a patologías no graves, por lo que nuestra labor asistencial, en los centros de atención primaria, debería estar enfocada hacia la educación para la salud influyendo positivamente en conocimientos, actitudes y conductas de la población. Conclusiones. El perfil de usuario que demanda atención continuada es el de una persona joven, trabajador activo que consulta por traumatismos y problemas respiratorios a la salida de sus centros de trabajo (AU)

The objective is to determine the characteristics of emergency care demand in the rural health area of Vera. Material and methods. A descriptive epidemiological, cross-sectional study, based on collecting the data contained in the records of each of the emergencies seen in the Villanueva Health Centre,Vera, from 1st January 2005 to 1st January 2006. We collected the following variables: gender, age, time, date, reason for consultation, and type of assistance and hospital referral. Results. A total of 5677 patients were seen, with an average of 15.6 per day (or 473/month) with no sex differences. Most, 93.1%, were resolved at the Health Centre, while 6.8%, were referred to Hospital, as the main cause was problems associated with musculoskeletal system movement. Results. Most of the demand is dealing with non-serious diseases, therefore care work in Primary Care Health Centres should be focused on health education impacting positively on knowledge, attitudes and behaviour of the population. Conclusions. The user profile that demand continuing care is that of a young person, active employee who complains of injuries and respiratory problems on leaving their workplaces (AU)

Nandrolone decanoate is a good alternative for the treatment of anemia in elderly male patients on hemodialysis.

OBJECTIVE: To assess the efficiency of nandrolone decanoate (ND) in the control of anemia in elderly male patients on hemodialysis (HD), and to determine its influence on nutritional parameters. DESIGN: A prospective 6-month study with randomization of patients on recombinant human erythropoietin (rHuEPO) therapy into two groups. Group A: rHuEPO was stopped before starting treatment with ND. Group E: rHuEPO was continued. SETTING: Renal unit, tertiary-care center. PATIENTS: 14 male patients in Group A and 19 patients, 12 males and 7 females, in Group E. INTERVENTIONS: In Group A rHuEPO was stopped and ND 200 mg/I.M. weekly was given over six months. RESULTS: The increase in hemoglobin and hematocrit levels was progressive with ND, and significant differences (p < 0.003) were evident after six months (9.6 +/- 1.0 vs 11.0 +/- 1.4 and 28.9 +/- 4.7 vs 33.0 +/- 4.7, respectively), which remained unmodified in Group E. Group A showed a significant increase in serum creatinine, total protein, transferrin and anthropometric parameters. These parameters remained stable and even presented a tendency to decrease in Group E. There was a significant rise in the concentration of triglycerides and a significant decrease in both HDL-cholesterol and apolipoprotein A-1 in Group A. However, lipoprotein (a) decreased significantly. No significant changes were detected in Group E. CONCLUSIONS: The use of ND would allow us an acceptable treatment of anemia as well as a better nutritional condition in elderly male patients on dialysis.