Enterobacter cloacae Infection After Surgical Treatment of Ankle Fractures, a Multicenter Observational Study.

BACKGROUND: Infection is one of the challenging complications after open reduction and internal fixation for ankle fractures. Previously published case series conclude that Staphylococcus aureus is the most frequent causative microorganism. An unexpected increase in Enterobacter cloacae infections after this surgery was observed in a preliminary analysis of data at the promoting center of the study. In traumatology, its incidence has been reported in chronic osteomyelitis, prosthetic infections, septic osteoarthritis, open fractures in children and adults, and fractures other than the ankle. Because of this unexpected finding, we decided to perform this study to analyze the demographic and microbiological variables of acute osteosynthesis infection after ankle fracture and determine the distinctive features of the patients with E cloacae infection. METHODS: We performed a retrospective multicenter study including 4 university hospitals. All patients diagnosed with acute osteosynthesis infection after ankle fracture fixation between January 2015 and December 2018 were included. We analyzed demographic data, type of fracture, surgical technique, and microorganisms responsible for the infection. We performed a descriptive statistical analysis of the variables. Univariate and multivariate regression analysis were performed to compare patients with E cloacae infection to patients with infection caused by other microorganisms. RESULTS: A total of 65 patients were included. A predominance of polymicrobial infections (24.62%), followed by infections caused by S aureus (23.07%) and E cloacae (23.07%) was observed. When E cloacae isolated in polymicrobial infections were added, the incidence of E cloacae as a causative microorganism increased to 32.3%. Patients with E cloacae infection were older (64/53, P = .008) and had a higher requirement of negative-pressure therapy after surgical debridement (71%/40%, P = .017). CONCLUSION: A high incidence of E cloacae infections was observed. Patients with E cloacae infection were generally older and required a higher use of negative-pressure therapy after debridement. LEVEL OF EVIDENCE: Level V, mechanism-based reasoning.

Hyperamylasaemia and gastrointestinal bleeding as the first manifestation of jejunal ectopic páncreas / Hiperamilasemia y hemorragia digestiva como primera manifestación de páncreas ectópico yeyunal

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Evaluation of hydrophobic chitosan-based particulate formulations of porcine reproductive and respiratory syndrome virus vaccine candidate T cell antigens.

PRRS control is hampered by the inadequacies of existing vaccines to combat the extreme diversity of circulating viruses. Since immune clearance of PRRSV infection may not be dependent on the development of neutralising antibodies and the identification of broadly-neutralising antibody epitopes have proven elusive, we hypothesised that conserved T cell antigens represent potential candidates for development of a novel PRRS vaccine. Previously we had identified the M and NSP5 proteins as well-conserved targets of polyfunctional CD8 and CD4 T cells. To assess their vaccine potential, peptides representing M and NSP5 were encapsulated in hydrophobically-modified chitosan particles adjuvanted by incorporation of a synthetic multi-TLR2/TLR7 agonist and coated with a model B cell PRRSV antigen. For comparison, empty particles and adjuvanted particles encapsulating inactivated PRRSV-1 were prepared. Vaccination with the particulate formulations induced antigen-specific antibody responses, which were most pronounced following booster immunisation. M and NSP5-specific CD4, but not CD8, T cell IFN-γ reactivity was measurable following the booster immunisation in a proportion of animals vaccinated with peptide-loaded particles. Upon challenge, CD4 and CD8 T cell reactivity was detected in all groups, with the greatest responses being detected in the peptide vaccinated group but with limited evidence of an enhanced control of viraemia. Analysis of the lungs during the resolution of infection showed significant M/NSP5 specific IFN-γ responses from CD8 rather than CD4 T cells. Vaccine primed CD8 T cell responses may therefore be required for protection and future work should focus on enhancing the cross-presentation of M/NSP5 to CD8 T cells.

Efficiency of RAFT-synthesized PDMAEMA in gene transfer to the retina.

Gene therapy has long been heralded as the new hope to evolve from symptomatic care of genetic pathologies to a full cure. Recent successes in using gene therapy for treating several ocular and haematopoietic pathologies have shown the great potential of this approach that, in the early days, relied on the use of viral vectors, which were considered by many to be undesirable for human treatment. Therefore, there is considerable interest and effort in developing non-viral vectors, with efficiency close to that of viral vectors. The aim of this study was to develop suitable non-viral carriers for gene therapy to treat pathologies affecting the retina. In this study poly(2-(N,N-dimethylamino)ethyl methacrylate), PDMAEMA was synthesized by reversible addition-fragmentation chain transfer (RAFT) and the in vitro cytocompatibility and transfection efficiency of a range of polymer:DNA ratios evaluated using a retinal cell line; in vivo biocompatibility was evaluated by ocular injection in C57BL/6 mice. The results showed that through RAFT, it is possible to produce a defined-size polymer that is compatible with cell viability in vitro and capable of efficiently directing gene expression in a polymer-DNA ratio-dependent manner. When injected into the eyes of mice, these vectors induced a transient, mild inflammation, characteristic of the implantation of medical devices. These results form the basis of future studies where RAFT-synthesized PDMAEMA will be used to deliver gene expression systems to the retina of mouse models of retinal pathologies. Copyright © 2014 John Wiley & Sons, Ltd.

Virus replicon particles expressing porcine reproductive and respiratory syndrome virus proteins elicit immune priming but do not confer protection from viremia in pigs.

Porcine reproductive and respiratory syndrome virus (PRRSV) is the causative agent of one of the most devastating and economically significant viral disease of pigs worldwide. The vaccines currently available on the market elicit only limited protection. Recombinant vesicular stomatitis virus (VSV) replicon particles (VRP) have been used successfully to induce protection against influenza A virus (IAV) in chickens and bluetongue virus in sheep. In this study, VSV VRP expressing the PRRSV envelope proteins GP5, M, GP4, GP3, GP2 and the nucleocapsid protein N, individually or in combination, were generated and evaluated as a potential vector vaccine against PRRSV infection. High level expression of the recombinant PRRSV proteins was demonstrated in cell culture. However, none of the PRRSV antigens expressed from VRP, with the exception of the N protein, did induce any detectable antibody response in pigs before challenge infection with PRRSV. After challenge however, the antibody responses against GP5, GP4 and GP3 appeared in average 2 weeks earlier than in pigs vaccinated with the empty control VRP. No reduction of viremia was observed in the vaccinated group compared with the control group. When pigs were co-vaccinated with VRP expressing IAV antigens and VRP expressing PRRSV glycoproteins, only antibody responses to the IAV antigens were detectable. These data show that the VSV replicon vector can induce immune responses to heterologous proteins in pigs, but that the PRRSV envelope proteins expressed from VSV VRP are poorly immunogenic. Nevertheless, they prime the immune system for significantly earlier B-cell responses following PRRSV challenge infection.

Correlation between permanent tooth eruption pattern and the predominance of the motor function laterality

OBJECTIVES: To asses whether dental eruption order can play a role in the early diagnosis of crossed laterality. STUDY DESIGN: Dental eruption pattern along with eye, ear, hand and foot lateralism were examined on 131 children between 6 to 8 years old from public schools from a multietnic population area of Barcelona city. Statistic methods (Statgraphics Plus 5.1 program) were used to evaluate data recollected. RESULTS: Only foot and dentition lateralities behave as independent variables regarding hand laterality. So dental eruption laterality (along with the foot one) would be one of the parameters more related to hand laterality given that dentition variable relationship is greater that the foot one. This suggests that tooth eruption could be more clinically relevant. Crossed laterality hand-foot is significantly more predominant in men (13%) than in women (1,6%). Meanwhile, the relationship between hand and dentition didn't show any influence of sex. CONCLUSIONS: Dental eruption order, can be used as a good parameter in the determination of the patient's laterality

Oculomicosis: una infección subestimada en Venezuela / Ocular mycosis: an underestimated infection in Venezuela

Venezuela, debido a su localización geográfica, clima y situación social, tiene el perfil para que las enfermedades oculares de origen fúngico se presenten. Aunque, en el país, la incidencia y prevalencia de las oculomicosis no ha sido suficientemente documentada, la mayoría de los oftalmólogos han tenido que atenderla en su consulta tanto pública como privada. La queratitis micótica es la forma más frecuente de presentación oftalmológica de las infecciones de origen fúngico que puede tener complicaciones irreversibles, incluso ceguera monocular, especialmente para aquellas personas que viven en comunidades agrícolas de países en vías de desarrollo. La enfermedad es fácilmente desapercibida, y los diagnósticos tardíos son comunes. Este hecho, hace que aumente las probabilidades de secuelas severas y la necesidad de intervenciones quirúrgicas. Los hongos filamentosos son los microorganismos causantes más frecuentemente asociados con traumatismos oculares o al uso de lentes de contacto. El propósito de este estudio, es presentar una revisión clínico-epidemiológica actualizada que incluye estrategias de tratamiento y diagnóstico de un problema subestimado en Venezuela e incentivar futuros estudios epidemiológicos con el objetivo de conocer los factores de riesgo asociados y medidas preventivas necesarias a ser implementadas en la región.

Due to its climate, geographical and social situation, Venezuela has the profile for fungal ocular diseases. Even though the incidence and prevalence of this ocular morbidity is undetermined in our country, most of the ophthalmologist have encountered the disease yearly in public or private practice. Fungal keratitis is the most frequent form of presentation of ocular mycosis, it can lead to irreversible complications and even monocular blindness, especially for people living in the agricultural communities of the developing world. The disease is easily overlooked or missed, and delayed diagnosis is common. This fact increases the likelihood of severe sequelae and surgical interventions. Filamentous fungi are most frequently the causative organism for fungal keratitis associated with ocular trauma or contact lens wear. The purpose of this study is to present a clinical-epidemiological review-update, which includes diagnosis and treatment strategies of this underestimated disease in Venezuela, as well as to encourage future epidemiological studies to recognize risk factors and preventive treatment in our region.

Correlation between permanent tooth eruption pattern and the predominance of the motor function laterality.

OBJECTIVES: To asses whether dental eruption order can play a role in the early diagnosis of crossed laterality. STUDY DESIGN: Dental eruption pattern along with eye, ear, hand and foot lateralism were examined on 131 children between 6 to 8 years old from public schools from a multietnic population area of Barcelona city. Statistic methods (Statgraphics Plus 5.1 program) were used to evaluate data recollected. RESULTS: Only foot and dentition lateralities behave as independent variables regarding hand laterality. So dental eruption laterality (along with the foot one) would be one of the parameters more related to hand laterality given that dentition variable relationship is greater that the foot one. This suggests that tooth eruption could be more clinically relevant. Crossed laterality hand-foot is significantly more predominant in men (13%) than in women (1,6%). Meanwhile, the relationship between hand and dentition didn't show any influence of sex. CONCLUSIONS: Dental eruption order, can be used as a good parameter in the determination of the patient's laterality.

Prognosis and follow-up of 135 patients with ischemic colitis over a five-year period.

AIM: To study the prognosis (recurrence and mortality) of patients with ischemic colitis (IC). METHODS: This study was conducted in four Spanish hospitals, participants in the Ischemic Colitis in Spain study We analyzed prospectively 135 consecutive patients who met criteria for definitive or probable IC according to Brandt criteria, and follow up these patients during the next five years, retrospectively. Long-term results (recurrence and mortality) were evaluated retrospectively after a median interval of 62 mo (range 54-75 mo). RESULTS: Estimated IC recurrence rates were 2.9%, 5.1%, 8.1% and 9.7% at years 1, 2, 3 and 5 years, respectively. Five-year survival was 69% (93 of 135) and 24% (10 of 42 patients) died for causes related to the IC. Among these 10 patients, 8 died in their first episode at hospital (4 had gangrenous colitis and 4 fulminant colitis) and 2 due to recurrence. CONCLUSION: The five-year recurrence rate of IC was low. On the other hand, mortality during follow-up was high and was not associated with ischemic colitis.

A novel locus for autosomal dominant cone-rod dystrophy maps to chromosome 10q.

Here we report recruitment of a three-generation Romani (Gypsy) family with autosomal dominant cone-rod dystrophy (adCORD). Involvement of known adCORD genes was excluded by microsatellite (STR) genotyping and linkage analysis. Subsequently, two independent total-genome scans using STR markers and single-nucleotide polymorphisms (SNPs) were performed. Haplotype analysis revealed a single 6.7-Mb novel locus between markers D10S1757 and D10S1782 linked to the disease phenotype on chromosome 10q26. Linkage analysis gave a maximum LOD score of 3.31 for five fully informative STR markers within the linked interval corresponding to the expected maximum in the family. Multipoint linkage analysis of SNP genotypes yielded a maximum parametric linkage score of 2.71 with markers located in the same chromosomal interval. There is no previously mapped CORD locus in this interval, and therefore the data reported here is novel and likely to identify a new gene that may eventually contribute to new knowledge on the pathogenesis of this condition. Sequencing of several candidate genes within the mapped interval led to negative findings in terms of the underlying molecular pathogenesis of the disease in the family. Analysis by comparative genomic hybridization excluded large chromosomal aberrations as causative of adCORD in the pedigree.

Adaptación cultural y validación al español de la escala COMFORTS de satisfacción de las mujeres con los cuidados en el parto y puerperio / Cultural adaptation and validation of the Spanish version of the COMFORTS scale of women’s satisfaction in delivery and the postnatal period

Objetivo: determinar la validez y fiabilidad de una versión adaptada culturalmente al entorno español de la Care in Obstetrics: measure for testing satisfaction (COMFORTS), una escala de medida de la satisfacción con los cuidados en el parto y el puerperio. Material y método: estudio observacional de validación realizado en una muestra de 500 puérperas con parto vaginal normal, feto único en presentación cefálica y sin factores de riesgo durante la gestación, atendidas en el servicio de Obstetricia del Hospital Universitario Puerta de Hierro de Majadahonda (Madrid). Se realizó la adaptación de la escala COMFORTS por el método de traducción-retrotraducción; estudio de validez de contenido mediante entrevistas a expertos y puérperas; consistencia interna mediante el coeficiente alfa de Cronbach; y validez de constructor mediante análisis factorial exploratorio de componentes principales. Resultados: la escala modificada y adaptada al español consta de 40 ítems agrupados en cuatro dimensiones: "Cuidados durante el periodo de parto" (13 ítems), "Cuidados en el puerperio" (11 ítems), "Cuidados del recién nacido" (10 ítems) y "Logística y entorno" (6 ítems). La muestra estuvo compuesta por 486 encuestas válidas (tasa de respuesta del 97,2%). El análisis de validez de contenido demostró que la escala adaptada es conceptualmente equivalente a la escala original. La consistencia interna fue de 0,95 para la escala total. El análisis factorial exploratorio para el modelo propuesto mostró cuatro dimensiones o factores que explicaban el 56,63% de la varianza. Conclusiones: la escala COMFORTS en versión española es una escala válida y fiable para medir la satisfacción de las mujeres con los cuidados en el parto y en el puerperio (AU)

Objective: To determine the validity and reliability of a Care in Obstetrics: measure for testing satisfaction (COMFORTS) version that has been culturally adapted to the Spanish setting. This scale measures satisfaction during delivery and the postnatal period. Material and method: Observational validation study performed on a sample of 500 women with a normal vaginal delivery, with a single foetus in cephalic presentation and without risk factors during pregnancy, treated at the department of Obstetrics of the Hospital Universitario Puerta de Hierro in Majadahonda (Madrid). The COMFORTS scale was adapted using the back-translation method, content validity study by interviewing experts and postpartum women, internal consistency was assessed using the Cronbach's alpha coefficient, and construct validity was assessed through principal components factor analysis. Results: The modified and adapted scale to Spanish consists of 40 items grouped into four dimensions: "Nursing care during labor/delivery" (13 items), "Care in the puerperium" (11 items), "Newborn care" (10 items) and "Logistics and environment" (6 items). The sample consisted of 486 valid questionnaires (response rate 97.2%). Content validity analysis showed that the modified scale is conceptually equivalent to the original scale. Internal consistency was 0.95 for the total scale. Exploratory factor analysis for the proposed model showed four dimensions or factors that explained 56.63% of the variance. Conclusions: The Spanish version of the COMFORTS scale is a valid and reliable scale to measure women’s satisfaction with the care during labour/delivery and postpartum periods (AU)

Calidad de vida de los pacientes con colostomía e ileostomía a corto y medio plazo / Quality of life of patients with short and mid-term colostomy and ileostomy

Objetivo: conocer la calidad de vida percibida a corto y medio plazo de los pacientes enterostomizados (colostomías o ileostomías). Material y método: estudio de cohorte prospectivo con enterostomizados del Hospital Universitario Puerta de Hierro (Madrid). Variables: calidad de vida, sociodemográficas y clínicas. Instrumentos: cumplimentaron el SF-36 y Stoma-QOL (mientras conservaron el estoma) en el preoperatorio, a los 15 días del alta, a los tres y seis meses de la cirugía.Análisis: análisis descriptivo. Variaciones de las puntuaciones de la calidad de vida desde la visita inicial a la final. Resultados: 44 pacientes ostomizados; 68% hombres, con edad media 66años, y 32% mujeres, con edad media 59 años, el 73% casados; 48% jubilados/incapacidad; 57% con estudios medios/superiores; 57% de cirugíaprogramada; 75% padecían cáncer colorrectal; 52% fueron colostomías.Hubo 25% cierre precoz, 36% ostomía temporal y 39% permanente.Los cambios en las puntuaciones globales a lo largo de los cuatro tiempos fueron significativos en el área funcional del SF-36. También resultaron significativos los cambios en las puntuaciones globales del Stoma-QOL al comparar los valores a los 15 días del alta-3 meses de la cirugía.Conclusiones: la percepción de calidad de vida es peor los tres primeros meses de la cirugía, que mejora y se mantiene entre los tres y seis meses posteriores. La percepción de calidad de vida fue mejor en los más jóvenes y en los sujetos con estudios medios o superiores. Los pacientescon estomas permanentes valoraron mejor su percepción de calidad de vida en el área emocional (AU)

Objective: to determine the short- and mid-term quality of life perceived by enterostomized patients (colostomies or ileostomies).Material and method: prospective cohort study with enterostomized patients of the Puerta del Hierro University Hospital (Madrid). Variables: Quality of life, sociodemographic and clinical variables. Instruments:Subjects completed the SF-36 and Stoma-QOL (while they still were stomatized)in the preoperative phase, at 15 days after discharge, and at 3and 6 months after surgery. Analysis: Descriptive analysis. Variations ofquality of life scores between the first visit and the final visit.Results: 44 ostomized patients. 68% men, mean age 66 years, and 32%women, mean age 59 years. 73% were married, 48% were retired/disabled,57% had intermediate/higher studies. 57% had a programmedsurgery. 75% had colorectal cancer. 52% were colostomies. 25% hadearly closure, 36% had a temporary ostomy and 39% had a permanentostomy. Changes in the overall scores over the four points in time assessed were significant in the functional area of the SF-36. The changes in theoverall scores of the Stoma-QOL were also significant when comparingvalues at 15 days after discharge-3 months after surgery.Conclusions: perceived quality of life is worse in the first three monthsafter surgery, and then improves and remains stable between the thirdand sixth month. Perceived quality of life was better in young people and in subjects with intermediate or higher studies. Patients with permanentstomas assessed their perceived quality of life in the emotionaldomain more positively (AU)

Clinical patterns and outcomes of ischaemic colitis: results of the Working Group for the Study of Ischaemic Colitis in Spain (CIE study).

BACKGROUND: There is a lack of prospective studies evaluating the natural history of colonic ischaemia (CI). We performed such a study to evaluate the clinical presentation, outcome, and mortality as well as clinical variables associated with poor prognosis. METHODS: An open, prospective, and multicentre study was conducted in 24 Spanish hospitals serving a population of 3.5 million people. The study included only patients who met criteria for definitive or probable CI. A website (www.colitisisquemica.org) provided logistical support. RESULTS: A total of 364 patients met criteria for inclusion. CI was suspected clinically in only 24.2% of cases. The distribution of clinical patterns was as follows: reversible colopathy (26.1%), transient colitis (43.7%), gangrenous colitis (9.9%), fulminant pancolitis (2.5%), and chronic segmental colitis (17.9%). A total of 47 patients (12.9%) had an unfavorable outcome as defined by mortality and/or the need for surgery. Multivariate analysis identified the following signs as independent risk factors for an unfavorable outcome: abdominal pain without rectal bleeding [odds ratio (OR) 3.9; 95% confidence interval (CI) = 1.6-9.3], non-bloody diarrhoea (OR 10; 95% CI = 3.7-27.4), and peritoneal signs (OR 7.3; 95% CI = 2.7-19.6). Unfavorable outcomes also were more frequent in isolated right colon ischaemia (IRCI) compared with non-IRCI (40.9 vs. 10.3%, respectively; p < 0.0001). The overall mortality rate was 7.7%. CONCLUSIONS: The clinical presentation of CI is very heterogeneous, perhaps explaining why clinical suspicion of this disease is so low. The presence of IRCI, and occurrence of peritoneal signs or onset of CI as severe abdominal pain without bleeding, should alert the physician to a potentially unfavorable course.

Expression of estrogen receptor subtypes and neuronal nitric oxide synthase in neutrophils from women and men: regulation by estrogen.

OBJECTIVES: (a) To identify the subtype of estrogen receptor (ER) expressed in neutrophils from premenopausal women and in neutrophils from men under different estrogen conditions and (b) to analyze the association between the modifications in the expression of ER subtypes and neuronal nitric oxide synthase (nNOS) expression induced by estrogen. METHODS: Neutrophils were isolated from pre-menopausal women during different stages of the menstrual cycle and from ten men for in vitro estrogen incubations. RESULTS: Neutrophils from premenopausal women expressed both ERalpha and ERbeta subtypes which were increased in the ovulatory phase of the menstrual cycle. Neutrophils derived from men also expressed ERalpha and ERbeta but only ERalpha expression was enhanced by in vitro incubation with 17beta-estradiol (10(-8) mol/l). In vitro incubation of neutrophils from women with 17beta-estradiol enhanced expression of both ER-alpha and ER-beta subtypes. nNOS protein was overexpressed in neutrophils from premenopausal women during the ovulatory phase. 17beta-Estradiol (10(-8) mol/l) also increased nNOS protein expression in neutrophils derived from men. Mithramycin A (10(-6) mol/l) and curcumin (10(-6) mol/l), prevented the upregulation of nNOS and ERalpha in neutrophils derived from men, suggesting the involvement of AP-1 and Sp-1 transcription factors. CONCLUSIONS: Although the in vivo levels of circulating estrogen concentrations seem to be associated with overexpression of both ERalpha and ERbeta in neutrophils from premenopausal women, which was further confirmed by the in vitro experiments with neutrophils from women, in vitro incubation of neutrophils from men with 17beta-estradiol only increased ERalpha protein expression which was associated with enhanced expression of nNOS protein.

Autoinjerto de conjuntiva y mitomicina C como tratamiento combinado para el pterigión / Conjunctival autograft mitomivina C combined for the treatment of pterygia

Comparar porcentajes de recurrencia entre la técnica de autoinjerto de conjuntiva y la combinación de las misma con mitomicina C intraoperatoria para el tratamiento del pterigión. Ensayo clínico controlado de una muestra seleccionada de casos, conformada por un total de 64 pacientes (65 ojos) que acudieron a la consulta de oftalmología del Hospital "Domingo Luciani". El seguimiento fue realizado por 8 meses. Los casos fueron seleccionados por azar simple para conformar dos grupos; 34 ojos se les practicó la técnica de autoinjerto y a 31 ojos autoinjerto + mitomicina C 0.02 por ciento intraoperatoria. Los porcentajes de recurrencia con la técnica de autoinjerto + mitomicina fueron de 3.3 por ciento y 3.6 por ciento a los seis meses y ocho meses respectivamente, mientras que en el grupo control fueron de 6.2 por ciento y 6.7 por ciento a los 6 y 8 meses respectivamente. Sin embargo, estas diferencias resultaron estadísticamente no significativas. No se observaron complicaciones postoperatorias graves relacionadas al uso de mitomicina C. El autoinjerto de conjuntiva demostró una vez más ser una técnica segura y eficaz, aunque en el trabajo no se registraron complicaciones relacionadas a uso de la mitomicina C seguimientos a largo plazo y estudios multicéntricos son necesarios para poder determinar la eficacia y seguridad de este medicamento combinado con el autoinjerto como tratamiento para el pterigión en nuestro medio

Efecto del triflusal sobre la agregación y secreción de las plaquetas humanas: papel del óxido nítrico / Effect of Triflusal on Human Platelet Aggregation and Secretion: Role of Nitric Oxide

Introducción y objetivos. Recientes estudios in vitro realizados en nuestro laboratorio demostraron que el triflusal reduce la agregación plaquetaria mediante la estimulación de la producción de óxido nítrico (NO) por los neutrófilos. El objetivo de este trabajo fue evaluar si el tratamiento in vivo con triflusal también aumenta la capacidad de los neutrófilos de generar NO analizando el papel del NO liberado por los neutrófilos sobre la agregación y secreción plaquetaria. Métodos. El estudio se realizó en 12 voluntarios sanos de 32 ñ 6 años a los que se administró triflusal (600 mg/día) durante 5 días, extrayéndoles plaquetas y neutrófilos antes y después del tratamiento y midiéndoles su capacidad de producir NO, el porcentaje de agregación de sus plaquetas frente a ADP y la capacidad de liberar factor transformante del crecimiento (TGF- ). Resultados. Tras el tratamiento con triflusal se obtuvieron los siguientes resultados: a) aumento de la producción de NO en los neutrófilos; b) potenciación de la inhibición de la agregación plaquetaria en presencia de neutrófilos, efecto que se revertía al incubar los neutrófilos con un antagonista de L-arginina, L-NAME, y c) la presencia de neutrófilos redujo la liberación del TGF- por las plaquetas determinado como medida de secreción plaquetaria, por un mecanismo independiente del NO. Conclusiones. Nuestro estudio demuestra que el tratamiento con triflusal (600 mg/día/5 días) estimula la producción de NO por los neutrófilos. Tras el tratamiento con triflusal los neutrófilos inhiben la agregación y la secreción de las plaquetas. El efecto antiagregante plaquetario demostrado por los neutrófilos fue dependiente del NO, pero no así la inhibición de la desgranulación plaquetaria (AU)

Conocimiento, actitudes y prácticas sobre las drogas entre los estudiantes de medicina de la UASD

Se realizó un estudio prospectivo, longitudinal y descriptivo para determinar los conocimientos, actitudes y prácticas sobre las drogas entre los estudiantes del departamento de Medicina de la Facultad de Ciencias de la Salud de la Universidad Autónoma de Santo Domingo, República Dominicana. En esta investigación se establecen las relaciones de conocimientos, actitudes y prácticas con algunas variables socio-demográficas y socio-económicas, en una muestra no selectiva de 214 alunos investigados durante el período enero-agosto de 1989. Los estudiantes con edades comprendidas entre 20 y 30 años representaron el 100%; los de 20 a 22 años (37.7%) fueron los más frecuentes; los del sexo femenino representaron el 60.2%; los solteros 87.0%; y los católicos 66.4%. Los de procedencia urbana 56.51%; ingreso familiar de $ 1,500.00 y con un conocimiento relativo en cuanto a drogas. Además de una actitud bien definida a fin de lograr erradicar la dependencia y con una práctica que se corresponde con la de toda sociedad, que es la posibilidad de caer en esta lamentable situación