Performance of butanol separation from ABE mixtures by pervaporation using silicone-coated ionic liquid gel membranes.

This work aims at the separation of n-butanol from aqueous solutions by means of pervaporation using membranes based on gelled ionic liquids (IL). These membranes were mechanically stabilized with a double silicone coating using two polydimethylsiloxane (PDMS) films. The first step of the membrane preparation considered the formation of a gelled ionic liquid layer, which was formed using two different imidazolium-based ionic liquids: [omim][Tf2N] and [bmim][Tf2N], and two different phosphonium-based ionic liquids: [P6,6,6,14][Tf2N] and [P6,6,6,14][DCA]. The gelation procedure was carried out on a porous paper support using a low molecular weight gelator. The membranes obtained from this method were tested in pervaporation assays to separate butanol from model ABE (Acetone-Butanol-Ethanol) fermentation solutions. These assays were done in an experimental setup especially built for this purpose. The pervaporation performance of these ionic liquid-based membranes was compared to that obtained with a single PDMS layer membrane. From these experimental results, butanol/water selectivity for [P6,6,6,14][Tf2N]-based membranes reached a value equal to 892, which is 150 times higher than the value obtained for a single PDMS layer membrane. Simultaneously, for the same IL, the transmembrane fluxes (kg h-1 m-2) of butanol and water were 37% and 99.6% lower than the values obtained using a single PDMS layer membrane, respectively. The hydrophobic character of the selected ionic liquid and its relatively high values for the transport parameters can explain this experimental response.

Association between periodontitis and chronic kidney disease: Systematic review and meta-analysis.

A systematic review and meta-analysis were conducted to evaluate the association between periodontitis (PD) and chronic kidney disease (CKD) and to explore the potential influence of periodontal treatment in patients with CKD. Databases (PubMed, Web of Science, Science direct, Cochrane Database) were screened for relevant articles, focusing on the periodontal status of patients with CKD, published until December 2017. Five hundred and fifty-three articles were identified, and 37 fulfilled the inclusion criteria and were considered in this systematic review. Seventeen articles were included in the meta-analysis and 7 in the review focusing on the impact of periodontal treatment. Most of the identified studies indicated an increased incidence of PD in patients with CKD. Meta-analysis showed an association between CKD and PD, and strength of this association was increased when severe PD was considered (OR = 2.39 (1.70-3.36)). The association could be observed even after adjustment for major CKD risk factors or use of precise diagnosis criteria (OR = 2.26 for severe PD (1.69-3.01)). Analysis of cohort studies indicated an incident rate ratio (IRR) of 1.73. Periodontitis is associated with CKD after multivariable adjustment. Further studies are necessary to determine whether prevention or treatment of PD can reduce the incidence and/or severity of CKD.

Paracrine factors of human mesenchymal stem cells increase wound closure and reduce reactive oxygen species production in a traumatic brain injury in vitro model.

Traumatic brain injury (TBI) consists of a primary and a secondary insult characterized by a biochemical cascade that plays a crucial role in cell death in the brain. Despite the major improvements in the acute care of head injury victims, no effective strategies exist for preventing the secondary injury cascade. This lack of success might be due to that most treatments are aimed at targeting neuronal population, even if studies show that astrocytes play a key role after a brain damage. In this work, we propose a new model of in vitro traumatic brain-like injury and use paracrine factors released by human mesenchymal stem cells (hMSCs) as a neuroprotective strategy. Our results demonstrate that hMSC-conditioned medium increased wound closure and proliferation at 12 h and reduced superoxide production to control conditions. This was accompanied by changes in cell morphology and polarity index, as both parameters reflect the ability of cells to migrate toward the wound. These findings indicate that hMSC is an important regulator of oxidative stress production, enhances cells migration, and shall be considered as a useful neuroprotective approach for brain recovery following injury.

Procedimientos mínimamente invasivos en nefrourología y patología pelviana / Minimally invasive procedures in nephrourology and pelvic pathology

Future medicine tendency is executing minimum invasive procedures in areas such as diagnostic and therapeutic. Nephrourology is not the exception. Simple and complex techniques are analyzed and described at the Interventional Unit of Imaging Center, Hospital Clínico Universidad de Chile, with theoretic and practical basis approved by several national and international institutions.

Perfil neuroepidemiológico en la zona centro del departamento de Caldas (Colombia), años 2004-2005 / Neuroepidemiology profile center zone of department of Caldas (Colombia), years 2004-2005

Introducción. La enfermedad neurológica (EN) es un reto para la comunidad médica; es la causante en un alto grado de la mortalidad, la discapacidad y el deterioro en la calidad de vida del paciente y su familia. Objetivo. Determinar la prevalencia de EN en la población del departamento de Caldas (Colombia): migraña, enfermedad cerebrovascular, enfermedades extrapiramidales, neuropatía periférica, epilepsia, demencia e insomnio. Este último es innovador pues en los estudios colombianos publicados no se conoce su prevalencia con la metodología de la Organización Mundial de la Salud (OMS). Pacientes y métodos. Estudio poblacional, descriptivo, de corte transversal. Se usó el protocolo neuroepidemiológico desarrollado por la OMS y modificado para Colombia. El neurólogo evaluó los casos sospechosos de padecer EN. La información se procesó en el paquete estadístico Epi Info 6.04d. Resultados. De 787 encuestados, 360 fueron sospechosos de EN con criterios de remisión al neurólogo. Se evaluó como control a 20 sujetos no sospechosos. La prevalencia global de EN para la comunidad estudiada, sin incluir el insomnio, fue del 13,4%, mientras que considerando el insomnio fue del 60,4%. Las enfermedades en orden de prevalencia fueron por 1.000 habitantes: insomnio 468 (IC 95%: 433,4-504,4), migraña 278 (IC 95%: 246,3-310,2), demencias (en mayores de 50 años) 51 (IC 95%: 15,8-87,0), neuropatía periférica 48 (IC: 32,7-63,4), enfermedades extrapiramidales 25 (IC 95%: 13,8-37,0), epilepsia 24 (IC 95%: 12,8-35,5) y enfermedad cerebrovascular 10 (IC 95%: 2,5-17,8). Conclusiones. Estos resultados muestran una alta prevalencia de la migraña en nuestra comunidad. De igual manera, la neuropatía periférica, la enfermedad extrapiramidal y la epilepsia fueron más frecuentes que en investigaciones previas. La demencia y la enfermedad cerebrovascular presentaron una prevalencia similar a la descrita. El insomnio mostró una alta prevalencia, pero por la imposibilidad de comparación con otros estudios locales, queda abierta la necesidad de confirmar estos hallazgos

Introduction. The neurological disease (ND) is a challenge for the medical community, cause of a high degree of morbility, mortality, deterioration in the quality of life of the patient and its family. Aim. To determine the prevalence of ND in the population of the department of Caldas (Colombia): migraine, movement disorders, cerebrovascular diseases, peripheral neuropathy, epilepsy, dementia and insomnia. This last one is innovating aspect in the published Colombian studies has not considered and therefore its prevalence with World Health Organization (WHO) methodology is not known. Patients and methods. This is a population, descriptive study, of cross section. The neuroepidemiological protocol developed by the WHO, modified for Colombia was used. The suspicious cases to suffer ND were evaluated by the neurologist. The information was processed in the statistical package Epi Info 6.04d. Results. Of 787 interviews, 360 were suspicious of ND; additionally 20 non suspicious subjects were evaluated like controls. The global prevalence of ND, excluding insomnia was 13.4%, while including insomnia was 60.4%. The prevalence diseases in sequence (by 1,000 inhabitants) were: insomnia 468 (CI 95%: 433.4-504.4), migraine 278 (CI 95%: 246.3-310.2), dementia (in older 50 years) 51 (CI 95%: 15.8-87), peripheral neuropathy 48 (CI 95%: 32.7-63.4), movement disorders 25 (CI 95%: 13.8-37.0), epilepsy 24 (CI 95%: 12.8-35.5) and cerebrovascular disease 10 (CI 95%: 2.5-17.8). Conclusions. These results show high prevalence of migraine in our community. Also, the peripheral neuropathy, movement disorders and epilepsy were more frequent than in previous investigations. Dementia and stroke presented prevalence similar to the reported one. The insomnia showed very high prevalence, but by the non possibility of comparison with other local studies, it is need conduced others studies to confirm these findings

[Neuroepidemiology profile of the central zone of the department of Caldas (Colombia), years 2004-2005]. / Perfil neuroepidemiológico en la zona centro del departamento de Caldas (Colombia), años 2004-2005.

INTRODUCTION: The neurological disease (ND) is a challenge for the medical community, cause of a high degree of morbility, mortality, deterioration in the quality of life of the patient and its family. AIM. To determine the prevalence of ND in the population of the department of Caldas (Colombia): migraine, movement disorders, cerebrovascular diseases, peripheral neuropathy, epilepsy, dementia and insomnia. This last one is innovating aspect in the published Colombian studies has not considered and therefore its prevalence with World Health Organization (WHO) methodology is not known. PATIENTS AND METHODS: This is a population, descriptive study, of cross section. The neuroepidemiological protocol developed by the WHO, modified for Colombia was used. The suspicious cases to suffer ND were evaluated by the neurologist. The information was processed in the statistical package Epi Info 6.04d. RESULTS: Of 787 interviews, 360 were suspicious of ND; additionally 20 non suspicious subjects were evaluated like controls. The global prevalence of ND, excluding insomnia was 13.4%, while including insomnia was 60.4%. The prevalence diseases in sequence (by 1,000 inhabitants) were: insomnia 468 (CI 95%: 433.4-504.4), migraine 278 (CI 95%: 246.3-310.2), dementia (in older 50 years) 51 (CI 95%: 15.8-87), peripheral neuropathy 48 (CI 95%: 32.7-63.4), movement disorders 25 (CI 95%: 13.8-37.0), epilepsy 24 (CI 95%: 12.8-35.5) and cerebrovascular disease 10 (CI 95%: 2.5-17.8). CONCLUSIONS: These results show high prevalence of migraine in our community. Also, the peripheral neuropathy, movement disorders and epilepsy were more frequent than in previous investigations. Dementia and stroke presented prevalence similar to the reported one. The insomnia showed very high prevalence, but by the non possibility of comparison with other local studies, it is need conduced others studies to confirm these findings.

Influence of exogenous insulin on C-peptide levels in subjects with type 2 diabetes.

AIM: The aim of this study was to determine whether the influence of insulin therapy on fasting and stimulated C-peptide levels in type 2 diabetic subjects is due to plasma glucose reduction or a direct effect of exogenous insulin. METHODS: Plasma glucose and serum C-peptide levels were determined before and after IV injection of 1mg glucagon on three separate days in 21 type 2 diabetic subjects. Day 1: without pharmacological treatment and fasting plasma glucose > 11.1 mmol/L; day 2: fasting plasma glucose 4.4-7.8 mmol/L, 1h after withdrawing intravenous regular insulin infusion; day 3: fasting plasma glucose 4.4-7.8 mmol/L with bed-time NPH insulin. RESULTS: Fasting and glucagon stimulated C-peptide levels were higher on day 1 than days 2 and 3. Fasting, but not stimulated C-peptide levels, were lower on day 3 than day 2. These differences were not appeared when the percentage of C-peptide increment or the C-peptide/glucose ratio were compared in the three days. CONCLUSIONS: Blood glucose reduction instead of exogenous insulin is responsible for the C-peptide decrease during insulin therapy in type 2 diabetic subjects.

Incidentaloma suprarrenal como forma de presentación de feocromocitoma familiar / Adrenal incidentaloma as initial presentation of familial pheohromocytoma

Los feocromocitomas son tumores productores de catecolaminas derivados de la médula suprarrenal. Suelen ser clínicamente sintomáticos produciendo hipertensión arterial crónica o en crisis, así como sintomatología adicional generalmente paroxística (taquicardia, sudación y nerviosismo) y que se produce por una brusca liberación de catecolaminas al torrente sanguíneo (crisis adrenérgica). Por ello, los feocromocitomas raramente se diagnostican de forma casual al realizar alguna prueba de imagen de la cavidad abdominal, siendo su presentación como "incidentaloma" suprarrenal relativamente baja. En familias afectadas de síndromes hereditarios con presencia de feocromocitomas (MEN2A y enfermedad de Von Hippel-Lindau, fundamentalmente), aún es más raro el hallazgo casual, puesto que el cribado periódico de los sujetos genéticamente afectados está encaminado a su detección. Presentamos un caso de feocromocitoma hallado casualmente en una paciente asintomática, con antecedentes de tumor suprarrenal en madre y hermano, en la que nunca se había sospechado la posibilidad de un feocromocitoma familiar. La elevación de las concentraciones de catecolaminas y metanefrinas en orina, así como una captación patológica de la glándula suprarrenal izquierda en la gammagrafía con MIBG, indicaron su existencia. Una vez confirmado el feocromocitoma tras la exéresis quirúrgica y obtenida la información de que los tumores suprarrenales de los familiares correspondieron también a feocromocitomas, se pensó en la posibilidad de que se tratara de un síndrome MEN2A o una enfermedad de Von Hippel-Lindau. Ambos se descartaron ante la ausencia de mutaciones en los genes responsables correspondientes (AU)

Absorbed fractions in a voxel-based phantom calculated with the MCNP-4B code.

A new approach for calculating internal dose estimates was developed through the use of a more realistic computational model of the human body. The present technique shows the capability to build a patient-specific phantom with tomography data (a voxel-based phantom) for the simulation of radiation transport and energy deposition using Monte Carlo methods such as in the MCNP-4B code. MCNP-4B absorbed fractions for photons in the mathematical phantom of Snyder et al. agreed well with reference values. Results obtained through radiation transport simulation in the voxel-based phantom, in general, agreed well with reference values. Considerable discrepancies, however, were found in some cases due to two major causes: differences in the organ masses between the phantoms and the occurrence of organ overlap in the voxel-based phantom, which is not considered in the mathematical phantom.

Curvatura cervical: estudio cefalométrico en posición de reposo clínico postural / Cervical curvature: a cephalometric analysis in a position of clinical rest

Background: Alterations in the head position and in cervical curvature are associated with mandibular dysfunction, an increased vertical occlusal dimension, upper airways obstruction and bad postural behaviors at work among other conditions. Aim: To perform a cephalometric analysis in young adults. Subjects and methods: Lateral cervical X-ray examinations were performed in 46 university students (26 female) aged 19 years old as a mean. Cephalometric landmarks and planes reported by Sollow & Tallgren, determined by investigators, were used for radiographic analysis. Results: The combined error of the method did not exceed 0.9­ for any studied variable. Mean craniocervical angulations were 102­ for OPT-SNL, 109­ for CVT-SNL, 94.8­ for craneum-C2 and 105 for SN-vertical. There were significant sex differences in craniocervical angulations and these were abnormal in two thirds of subjects studies. The Forward Head Position is characterized by a cervical compensation with head inclination. This abnormal postural position showed a dolichofacial growth and an alteration of hyoid angle. Conclusions: The craniocervical position appeared to be related to a vertical craniofacial growth pattern

Comparative study of transfer factor and acyclovir in the treatment of herpes zoster.

Reactivation of varicella herpes virus (VHV), latent in individuals who have previously suffered varicella, gives rise to herpes zoster and in some cases leads to a sequela of post herpetic neuritis with severe pain which is refractory to analgesics. Many different antiviral agents have been tried without achieving satisfactory results. Of all the antiviral agents employed, acyclovir has been the most successful in reducing post herpetic pain. However acyclovir has not been as reliable as interferon alpha (IFN-alpha). We have previously looked into the use of transfer factor (TF) as a modulator of the immune system, specifically with respect to its effectiveness in the treatment of herpes zoster. In this work findings from a comparative clinical evaluation are presented. A double blind clinical trial of TF vs acyclovir was carried out in which 28 patients, presenting acute stage herpes zoster, were randomly assigned to either treatment group. Treatment was administered for seven days and the patients were subsequently submitted to daily clinical observation for an additional 14 days. An analogue visual scale was implemented in order to record pain and thereby served as the clinical parameter for scoring results. The group treated with TF was found to have a more favorable clinical course, P < or = 0.015. Laboratory tests to assess the immune profile of the patients were performed two days prior and 14 days after initial treatment. The results of these tests showed an increase in IFN-gamma levels, augmentation in the CD4+ cell population but not the percentage of T rosettes in the TF treated group. These parameters were however insignificantly modified in patients receiving acyclovir. Although TF treated patients showed an increase in CD4+ counts these cells remained below the levels for healthy individuals. The fact that IFN-gamma levels as well as the counts for CD4+ cells rose in the TF treated group and not in the acyclovir one is very significant and confirms the immunomodulating properties of TF.

Somatostatin and somatostatin receptor subtype gene expression in medullary thyroid carcinoma.

The possible existence of an autocrine/paracrine role for SRIF in normal and neoplastic thyroid parafollicular C cells has supported the use of SRIF analogues in the treatment of patients with medullary thyroid carcinoma (MTC). In this study, we have investigated the expression of SRIF by immunohistochemistry and RT-PCR, and the expression of SRIF receptor (SSTR) subtypes by RT-PCR, in a series of 14 MTCs. SRIF messenger RNA was detected in all cases, although immunoreactive cells were only identified in 8. SSTR messenger RNA was present in 12 out of the 14 tumors. Expression of more than 1 SSTR subtype was detected in 10 tumors. SSTR2, the subtype that preferentially binds to the SRIF analogue octreotide, was the subtype most frequently detected, whereas SSTR4 was not detected in any case. These results confirm the frequent expression of both SRIF and its receptors in MTC. The presence of different combinations of SSTR subtypes in a given patient may explain the variable clinical response to SRIF analogues and may promote the search for more selective drugs with different affinities to the various receptor subtypes.

Molecular diagnosis of von Hippel-Lindau disease in a kindred with a predominance of familial phaeochromocytoma.

OBJECTIVE: To study the presence of germline mutations in the von Hippel-Lindau gene (vhl) in a kindred with a predominance of familial phaeochromocytoma in order to confirm the diagnosis of von Hippel-Lindau disease (VHLD) as well as to identify asymptomatic members. DESIGN: DNA extracted from peripheral blood was amplified by the polymerase chain reaction using oligonucleotide primers corresponding to exon 3 of the vhl gene. Specific mutations in codon 238 were screened by restriction endonuclease digestion of PCR products with Msp I. The results were confirmed by DNA sequence analysis. PATIENTS: Two generations of a family consisting of 15 individuals were studied. RESULTS: A germline missense point mutation at codon 238 of the vhl gene (CGG-->TGG; Arg-->Trp) was detected in all patients with phaeochromocytoma and in only one of the asymptomatic family members. CONCLUSION: Mutational analysis of the vhl gene in patients with familial phaeochromocytoma may permit specific diagnosis of von Hippel-Lindau disease, and is a good method for the identification of asymptomatic individuals at risk of von Hippel-Lindau disease.

Sex-steroid hormone receptors in human medullary thyroid carcinoma.

Three complementary techniques were used to detect sex-steroid hormone receptors in tumor tissues from seven patients with medullary thyroid carcinoma: steroid binding analysis, enzyme immune assay, and immunohistochemistry. The presence of estrogen receptors was detected by steroid binding analysis in one of seven patients, although in very low concentrations (3.17 to 5.06 fmol/mg protein). These results were confirmed by enzyme immune assay (6.35 to 9.32 fmol/mg protein). Progesterone receptors were found in five of seven patients by steroid binding analysis (11.1 to 47.9 fmol/mg protein), and progesterone receptor results were confirmed by enzyme immune assay (8.1 to 34.1 fmol/mg protein). By immunohistochemistry, progesterone receptors were focally detected in all cases, whereas all tumors were negative for estrogen receptors. In summary, our results confirm the presence of sex-steroid hormone receptors, particularly progesterone receptors in medullary thyroid carcinoma. The presence of progesterone receptors in medullary thyroid carcinoma apparently does not require the continuous presence of estrogen receptors.

[Chagas disease: impact of Triatoma infestans control program in Alto del Carmen, Huasco Province, III Region Atacama, Chile]. / Enfermedad de Chagas: impacto del programa de control del Triatoma infestans en la comuna de Alto del Carmen, provincia de Huasco, III Region Atacama, Chile.

A control program of Triatoma infestans has been carried out in Alto del Carmen, an endemic chagasic rural county in the III Region, Chile. The program started in 1988 with an attack phase consisting in a masshouse spraying with residual insecticide, followed by an entomological surveillance phase with health education for community participation and vector detection in eventually reinfested houses. A yearly evaluation in 1992, 1993, 1994 and 1995 was carried out in order to determine the effectiveness of vector control activities. In 1992, 24.1% of dwellings was infested, whereas in 1993, 1994 and 1995 the infestation rates were 3.9%, 2.8% and 4.0% respectively. The similar infestation rates found in 1993, 1994 and 1995 suggest passive dispersion of triatomas from areas without surveillance. Additionally, in 1994, 110 (16.0%) out of 688 examined people resulted serologically positive. It is noteworthy that all of the children in the 0-4 year age group--born after the attack phase--resulted serologically negative. This fact may indicate the interruption of vectorial transmission of Chagas' disease in Alto del Carmen county. It is concluded that the control activities performed in the county constitute good strategies to the Nacional Program of Control of T. infestans, but for the success of such a program it is necessary to integrate the efforts of all endemic areas with an active community participation.

111In-octreotide and 99mTc(V)-dimercaptosuccinic acid studies in the imaging of recurrent medullary thyroid carcinoma.

Detection of recurrence from medullary thyroid carcinoma (MTC) remains a diagnostic problem, especially when increased serum tumour marker levels suggest recurrence and conventional imaging techniques are non-diagnostic. In this study, we performed 111In-octreotide and 99mTc(V)-dimercaptosuccinic acid (DMSA) scans in a series of eleven patients with MTC presenting with elevated serum tumour markers after surgery. 111In-octreotide whole body studies detected tumour in six of the eleven patients studied and detected nine tumoral localizations. 99mTc(V)-DMSA whole body studies detected tumour in five of the eleven patients studied and eight tumoral localizations. 111In-octreotide and 99mTc(V)-DMSA studies detected recurrence in all four patients with basal calcitonin levels above 1000 ng/l. We conclude that 111In-octreotide and 99mTc(V)-DMSA studies have limited sensitivity to detect recurrence in patients with MTC, although their sensitivity may improve with high serum calcitonin levels. These radionuclide imaging techniques should be employed when conventional imaging techniques are negative or inconclusive or, in the case of 111In-octreotide studies, should be employed when we went to investigate the presence of somatostatin receptors that provide the basis for treatment with somatostatin analogues.

Proliferative activity in C-cell hyperplasia and medullary thyroid carcinoma. Evaluation by PCNA immunohistochemistry and AgNORs staining.

C cell hyperplasia (CCH) is a preneoplastic lesion that precedes the development of medullary thyroid carcinoma (MTC) in familial cases. It has been hypothesized that CCH progressively acquires the neoplastic phenotype after presenting some genetic changes that involve oncogenes and tumor suppressor genes. The proliferative activity of nodular C cell hyperplasia (NCCH) and early MTC has been assessed by PCNA (Proliferating Cell Nuclear Antigen) immunohistochemistry and nucleolar organizer regions silver staining (AgNOR) in surgical specimens of seven patients with familial MTC. The ratios of PCNA-positive nuclei in NCCH (mean 1.2, range 0.2-4) were lower than in MTC (mean 2, range 1-7%). The AgNOR scores for NCCH (mean 1.53, range 1.10-1.90) were also lower than for MTC (mean 2.10, range 1.90-2.64). The results suggest that C cells progressively acquire a higher proliferative activity in agreement with the severity of the morphologic changes in the process of hyperplasia-neoplasia that leads to widely invasive MTC.

[Bartter's syndrome: variability and clinical course]. / Síndrome de Bartter: variabilidad clínica y evolutiva.

The clinical, hydroelectrolytical and hormonal features, as well as the treatment of 3 patients with Bartter's syndrome are analyzed. The patients consulted due to severe hypokalaemia with little clinical expression (paresthesiae, carpopedal spasms, polyuria, polydipsia and/or weakness). All had normal blood pressure, hypokalemia, hyperreninaemic hyperaldosteronism and a decrease in the fractional distal chloride reabsorption; hyperuricaemia was observed in two cases and hypomagnesemia in one. Treatment with oral potassium supplements and indomethacin managed to raise serum K to around the lower limit of the normal range. However, the tubular defect and hyperreninaemic hyperaldosteronism persisted. The urinary excretion of prostaglandin E2 was normal in both the patients in whom it was measured. Given the minimal clinical expression of hypokalemia despite the difficulty in correcting it, it is probable that this syndrome often remains unrecognized.