Dabigatran: Experience in standard clinical practice. / Dabigatrán: experiencia en la práctica clínica habitual.

INTRODUCTION AND OBJECTIVES: Dabigatran is an anticoagulant drug and a direct thrombin inhibitor and has been approved for the prevention of ischaemic stroke secondary to nonvalvularauricular auricular fibrillation. The aim of this study was to determine the efficacy of dabigatran in clinical practice for preventing cerebral ischaemic events associated with nonvalvularauricular auricular fibrillation, as well as its tolerance and safety profile. MATERIAL AND METHODS: A descriptive and retrospective study was conducted, which included all patients who started anticoagulant treatment with dabigatran between November 2011 and September 2012. Follow-up was performed from the start of treatment until June 2013. The incidence of ischaemic events of cerebral, cardiac and peripheral origin was recorded, as was the onset of adverse effects and haemorrhagic complications, whose location and severity were determined. RESULTS: We analysed 316 patients, with a mean age of 76.46±8.37 years, of whom 53.5% were men. Two patients (0.55/100 patient-years) presented ischaemic stroke (including one amaurosis fugax). Eight (2.18/100 patient-years) patients had an adverse ischaemic event, whose origin was cardiac in 5 (1.36/100 patient-years) cases and peripheral in 3 (0.81/100 patient-years). Forty (10.91/100 patient-years) patients had a haemorrhagic complication: 32 minor (8.73/100 patient-years) and 8 major (2.18/100 patient-years) haemorrhages. CONCLUSIONS: Dabigatran is effective in standard clinical practice in preventing stroke and has a safety profile similar to that reported in the clinical trials.

[Obtention of monoclonal antibodies against human secretory IgA]. / Obtención de anticuerpos monoclonales contra IgA secretora humana.

In order to determine the IgA levels in secretions, the authors engaged themselves to obtain monoclonal antibodies against this immunoglobulin and to show their possible utilization in the development of quantitation methods. 6 monoclonal antibodies were obtained: one against the secretory component (SC) and five against the heavy-chain (HC) of IgA. IgA purified from human colostrum was used as immunogen (HC). The immunoglobulin isotypes (IgG2a and IgG1) were determined in 2 monoclonal antibodies, one against SC and the other against HC. Polyacrylamide gel electrophoresis was performed in the presence of sodium dodecyl sulphate and b-mercapto-ethanol. Immunotransference was also carried out to determine their specificity. Secretory IgA was detected in saliva specimens. The anti-SC monoclonal antibody obtained in-the laboratory of the "Pedro Kourí" Institute of Tropical Medicine (IPK) was compared with a commercial one (Sigma Chemical Co.), and a similar behaviour was observed. The monoclonal antibody against SC (IPK) was used to detect IgA specific to LPS ogawa in persons vaccinated with an attenuated strain of Vibrio cholerae. Marked differences were found between the levels before and after immunization. The anti-HC monoclonal antibody was utilized to make an ELISA-like simulated system. The detection limit was 9.89 ng/mL.

Iodine-induced sialadenitis: report of 4 cases and review of the literature.

Sialadenitis after administration of iodine compounds is rare. In this paper we report 4 hemodialysis patients who suffered from this rare manifestation of iodism and review the literature.

Causes of graft bruits other than of renal arterial stenosis.

Hypertension and bruit over the graft are commonly associated to renal arterial stenosis in transplant patients. However, these findings can have other origins, too. In the present work we report on two patients in whom remote arteriovenous fistulas were the cause of a spurious bruit heard over the kidney allograft.