Rectal pre-treatment with ozonized oxygen (O3) aggravates clinic status in septic rats treated with amoxicillin/clavulanate / El pretratamiento rectal con ozono (O3) empeora el estado clínico de ratas sépticas tratadas con amoxicilina/clavulánico

INTRODUCTION: Despite the advanced antibiotic therapies, sepsis continues being a clinical entity with high morbidity and mortality. The ozone/oxygen mixture (O3/O2) has been reported to exhibit positive effects on immunity. The aim of our study was to analyze whether (O3/O2) combined with amoxicillin/clavulanate has any influence on the morbidity and mortality of septic rats. METHODS: We used 48 Sprague-Dawley rats randomly allocated to 6 groups (n = 8): healthy (C), septic (I), healthy+ozone therapy (O3), septic+amoxicillin/clavulanate (AMC), septic+amoxicillin/clavulanate+ ozone therapy (AMC/O3 ) and septic + ozone therapy (I/O3 ). O3 /O2 was administered rectally at increasing O3 concentrations during 10 days prior to the onset of sepsis model (intraperitoneally injection of fecal material) or saline administration in healthy control rats. Later (post-inoculation), 3 days per week, O3 was also administered. Vital signs were recorded, and microbiological, hematological and histopathological studies were performed. RESULTS: The number of surviving animal/total was higher in AMC (8/8) than in AMC/O3 (4/8) p = 0.077. The percentage of surviving animals with pneumonia was higher in AMC/O3 than in AMC (100% vs 37.5%). In dead animals, AMC/O3 rats had a significantly higher percentage of lesions: Cardiac lesions, pulmonary hemorrhages and pleuritis (100%) and serositis/peritonitis (75%). Only Escherichia coli (2 different bio- types) was isolated from blood and/or peritoneal fluid from all infected groups. A significant decrease in the percentage of band neutrophils from the surviviors belonging to AMC/O3 vs AMC was observed (p < 0.05). CONCLUSION: Rectal pre-treatment with O3/O2 aggravates clinic status in septic rats treated with amoxi- cillin/clavulanate

INTRODUCCIÓN: A pesar de los avances en terapia antibiótica, la sepsis sigue siendo una entidad clínica con alta morbimortalidad. Se ha publicado que la mezcla ozono/oxígeno (O3/O2) presenta efectos beneficiosos sobre el sistema inmunológico. El objetivo de este estudio es analizar si (O3 /O2 ) combinado con amoxicilina/clavulánico tiene efectos en la morbimortalidad de ratas sépticas. MÉTODOS: Utilizamos 48 ratas Sprague-Dawley distribuidas aleatoriamente en 6 grupos (n = 8): sanas (C), sépticas (I), sanas+ozonoterapia (O3), sépticas+amoxicilina/clavulánico (AMC), sépticas+amoxicilina/ clavulánico + ozonoterapia (AMC/O3 ) y sépticas + ozonoterapia (I/O3 ). (O3 /O2 ) se administró por vía rectal a concentraciones crecientes de O3 los 10 días previos a la instauración del modelo de sepsis (inyección intraperitoneal de material fecal) o de la administración de solución salina, en las ratas control. Posteriormente (postinoculación) se continuó administrando (O3 /O2 ), 3 días por semana. Registramos los signos vitales y realizamos estudios microbiológicos, histopatológicos y hematológicos. RESULTADOS: El número de supervivientes/total fue mayor en AMC (8/8) que en AMC/O3 (4/8), p = 0,077. El porcentaje de supervivientes con neumonía fue mayor en AMC/O3 que en AMC (100% vs 37,5%). Entre los fallecidos, AMC/O3 tenía un porcentaje mayor de lesiones: cardiacas, hemorragias pulmonares y pleuritis (100%) y serositis/peritonitis (75%). A partir de la sangre y/o líquido peritoneal de los grupos infectados se aislaron exclusivamente Escherichia coli (2 biotipos diferentes). Observamos una disminución significativa en el porcentaje de neutrófilos en banda en las supervivientes pertenecientes a AMC/O3 vs AMC (p < 0,05). CONCLUSIÓN: El tratamiento rectal previo con (O3 /O2 ) agrava el estado clínico en ratas sépticas tratadas con amoxicilina/clavulánico

Rectal pre-treatment with ozonized oxygen (O3) aggravates clinic status in septic rats treated with amoxicillin/clavulanate.

INTRODUCTION: Despite the advanced antibiotic therapies, sepsis continues being a clinical entity with high morbidity and mortality. The ozone/oxygen mixture (O3/O2) has been reported to exhibit positive effects on immunity. The aim of our study was to analyze whether (O3/O2) combined with amoxicillin/clavulanate has any influence on the morbidity and mortality of septic rats. METHODS: We used 48 Sprague-Dawley rats randomly allocated to 6 groups (n=8): healthy (C), septic (I), healthy+ozone therapy (O3), septic+amoxicillin/clavulanate (AMC), septic+amoxicillin/clavulanate+ozone therapy (AMC/O3) and septic+ozone therapy (I/O3). O3/O2 was administered rectally at increasing O3 concentrations during 10 days prior to the onset of sepsis model (intraperitoneally injection of fecal material) or saline administration in healthy control rats. Later (post-inoculation), 3 days per week, O3 was also administered. Vital signs were recorded, and microbiological, hematological and histopathological studies were performed. RESULTS: The number of surviving animal/total was higher in AMC (8/8) than in AMC/O3 (4/8) p=0.077. The percentage of surviving animals with pneumonia was higher in AMC/O3 than in AMC (100% vs 37.5%). In dead animals, AMC/O3 rats had a significantly higher percentage of lesions: Cardiac lesions, pulmonary hemorrhages and pleuritis (100%) and serositis/peritonitis (75%). Only Escherichia coli (2 different biotypes) was isolated from blood and/or peritoneal fluid from all infected groups. A significant decrease in the percentage of band neutrophils from the surviviors belonging to AMC/O3vs AMC was observed (p<0.05). CONCLUSION: Rectal pre-treatment with O3/O2 aggravates clinic status in septic rats treated with amoxicillin/clavulanate.

Primary frontal hyperhidrosis successfully treated with low doses of botulinum toxin A as a useful alternative to surgical treatment.

Frontal hyperhidrosis appears to be a special and rare form of focal hyperhidrosis. These patients may suffer greatly from the condition so an efficient treatment is highly demanded. Surgical treatment may solve this problem permanently, but the possibility of serious complications and low satisfactory results makes it less advisable than in other types of hyperhidrosis where surgery has shown great benefits. We report a case of primary frontal hyperhidrosis in a young man who refused surgery and was treated with low doses of botulinum toxin type A injected into the forehead. The patient noted a high level of satisfaction, with the abolishment of sweating and a long effect that was maintained for up to 10 months without any complications. In conclusion, we consider that low doses of botulinum toxin A is a well tolerated, safe and very effective treatment for primary frontal hyperhidrosis and it should be offered as an alternative to patients who suffer from this disorder.

Erythropoietin in cancer treatment: considerations about Henke's article.

The concurrent use of erythropoietin beta (EPO)and radiotherapy in head and neck cancer patients has been reported by Henke et al (Lancet 2003;362:1255-60) to correct anemia and impair cancer control. Due to the potential impact in daily clinical practice of this information a systematic critical review of the mentioned article was performed. Authors selected 10 arguments to question the contents regarding methodological and statistical aspects of the trial, and added 14 comments of controversy in more basic scientific concepts mentioned in the text as published. The panel including epidemiologist and radiation oncologists with expertise in clinical research concluded with 5 additional remarks recommending caution in interpretation of these results in terms of changes in daily practice of anemic patients support, and advising not to use EPO at experimental doses or after reaching physiological concentrations of hemoglobin.

Erythropoietin in cancer treatment: considerations about Henke's article

The concurrent use of erythropoietin beta (EPO) and radiotherapy in head and neck cancer patients has been reported by Henke et al (Lancet 2003; 362:1255-60) to correct anemia and impair cancer control. Due to the potential impact in daily clinical practice of this information a systematic critical review of the mentioned article was performed. Authors selected 10 arguments to question the contents regarding methodological and statistical aspects of the trial, and added 14 comments of controversy in more basic scientific concepts mentioned in the text as published. The panel including epidemiologist and radiation oncologists with expertise in clinical research concluded with 5 additional remarks recommending caution in interpretation of these results in terms of changes in daily practice of anemic patients support and advising not to use EPO at experimental doses or after reaching physiological concentrations of hemoglobin

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