Comparison between transdermal nitroglycerin and sildenafil citrate in intrauterine growth restriction: effects on uterine, umbilical and fetal middle cerebral artery pulsatility indices.

OBJECTIVES: To evaluate the effects of transdermal nitroglycerin (GTN) and sildenafil citrate on Doppler velocity waveforms of the uterine (UtA), umbilical (UA) and fetal middle cerebral (MCA) arteries in pregnancies with intrauterine growth restriction (IUGR). METHODS: This was a prospective study of 35 singleton pregnancies (gestational age, 24-31 weeks) with IUGR and abnormal UtA and UA Doppler waveforms. We compared maternal arterial blood pressure and Z-scores of the pulsatility index (PI) of UtA, UA and fetal MCA before and after application of a transdermal GTN patch (average dose, 0.4 mg/h), oral sildenafil citrate (50 mg) or placebo. Statistical analysis was performed by ANOVA for paired samples. RESULTS: There was a significant decrease in UtA-PI after application of GTN (21.0%) and sildenafil citrate (20.4%). A significant reduction in UA-PI was also observed for both GTN (19.1%) and sildenafil citrate (18.2%). There was no difference in UtA- and UA-PI when the GTN and sildenafil groups were compared. No changes in Doppler velocimetry were observed in the placebo group and no significant change in MCA-PI was observed in any group. Maternal arterial blood pressure decreased with administration of both GTN and sildenafil citrate in those with pre-eclampsia. CONCLUSION: The use of transdermal GTN or sildenafil citrate in pregnancies with IUGR is associated with a significant reduction in both UtA and UA Doppler PI, as well as maternal arterial blood pressure. Neither drug affected the MCA-PI. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Blastocele fluid from in vitro- and in vivo-produced equine embryos contains nuclear DNA.

Normal mammalian early embryonic development involves apoptosis of blastomeres as a remodeling process during differentiation, starting at the blastocyst stage. Genomic DNA has been recently detected in the blastocele fluid of human embryos and has been amplified by real-time polymerase chain reaction (PCR) to diagnose the sex of in vitro-produced human embryos. This new approach varies from conventional preimplantation genetic diagnosis in that no cells are extracted from the embryo and only the blastocele fluid is aspirated and used as a DNA sample for diagnosis. In the present work, we investigated whether the blastocele fluid of equine preimplantation embryos contains nuclear DNA and whether this DNA could be used to diagnose the sex of the embryos by conventional PCR, using specific primers that target the TSPY and AMEL equine genes. The sex of 11 of 13 in vivo-produced embryos and of four of five in vitro-produced embryos was successfully diagnosed. The PCR amplification product was analyzed using genetic sequencing reporting that the DNA present in blastocele fluid was genomic. Additionally, after polyacrylamide gel electrophoresis and silver staining, the blastocele fluid from three different embryos produced a ladder pattern characteristic of DNA fragmented during apoptosis. Therefore, the results presented in this work report that blastocele fluid from in vivo- and in vitro-produced equine embryos contains nuclear DNA which is probably originated by apoptosis of embryonic cells, and this DNA could be used to diagnose the sex of preimlpantation embryos by conventional PCR.

Composition, yield, and functionality of reduced-fat Oaxaca cheese: effects of using skim milk or a dry milk protein concentrate.

The effect of adding either skim milk or a commercial dry milk protein concentrate (MPC) to whole milk on the composition, yield, and functional properties of Mexican Oaxaca cheese were investigated. Five batches of Oaxaca cheeses were produced. One batch (the control) was produced from whole milk containing 3.5% fat and 9% nonfat solids (SNF). Two batches were produced from milk standardized with skim milk to 2.7 and 1.8% fat, maintaining the SNF content at 9%. In the other 2 batches, an MPC (40% protein content) was used to standardize the milk to a SNF content of 10 and 11%, maintaining the milk fat content at 3.5%. The use of either skim milk or MPC caused a significant decrease in the fat percentage in cheese. The use of skim milk or MPC showed a nonsignificant tendency to lower total solids and fat recoveries in cheese. Actual, dry matter, and moisture-adjusted cheese yields significantly decreased with skim milk addition, but increased with MPC addition. However, normalized yields adjusted to milk fat and protein reference levels did not show significant differences between treatments. Considering skim milk-added and control cheeses, actual yield increased with cheese milk fat content at a rate of 1.34 kg/kg of fat (R=0.88). In addition, cheese milk fat and SNF:fat ratio proved to be strong individual predictors of cheese moisture-adjusted yield (r(2) ≈ 0.90). Taking into account the results obtained from control and MPC-added cheeses, a 2.0-kg cheese yield increase rate per kg of milk MPC protein was observed (R=0.89), with TS and SNF being the strongest predictors for moisture adjusted yield (r(2) ≈ 0.77). Reduced-fat Oaxaca cheese functionality differed from that of controls. In unmelted reduced-fat cheeses, hardness and springiness increased. In melted reduced-fat cheeses, meltability and free oil increased, but stretchability decreased. These changes were related to differences in cheese composition, mainly fat in dry matter and calcium in SNF.

Nefritis túbulo intersticial aislada en paciente con lupus eritematoso sistémico / No disponible

No disponible

Protein immunolocalization supports the presence of identical mechanisms of XY body formation in eutherians and marsupials.

The meiotic sex chromosomes of the American marsupials Monodelphis dimidiata and Didelphis albiventris were studied with electron microscopy (EM) and with immunofluorescence localization of meiotic proteins SYCP1 and SYCP3, and proteins essential for meiotic sex chromosome inactivation (MSCI), gamma-H2AX and BRCA1. The chromatin of the non-synaptic X and Y chromosomes contains gamma-H2AX, first as foci and then as homogeneous staining at late stages. The thick and split X and Y axes are labelled with BRCA1 except at one terminus. The bulgings of the axes contain SYCP1 as well as the inner side of the dense plate. The evenly spaced and highly packed chromatin fibres of the conjoined XY body in these species have the same behaviour and the same components (gamma-H2AX in the chromatin, BRCA1 in the axes) as in the XY body of eutherian species. These observations and recent data from the literature suggest that XY body formation is ancestral to the metatherian-eutherian divergence.

Homeopatía fundamentos científicos / Scientific bases of homeopathy

La homeopatía es un sistema terapéutico que consiste en administrar sustancias en dosis infinitesimales y que, en un sujeto sano, producirán los mismos síntomas que La enfermedad que vamos a tratar. Cada tratamiento exige una “individualización” meticulosa. La práctica de la homeopatia consiste en buscar los puntos de contacto existentes entre los síntomas que experimentalmente produce un remedio y los síntomas que presenta el enfermo. Em múltiples ensayos clínicos la homeopatia difiere del placebo, aunque su efecto no sea explicable por la medicina tradicional.

Homeopatía fundamentos científicos / Scientific bases of homeopathy

La homeopatía es un sistema terapéutico que consiste en administrar sustancias en dosis infinitesimales y que, en un sujeto sano, producirán los mismos síntomas que La enfermedad que vamos a tratar. Cada tratamiento exige una “individualización” meticulosa. La práctica de la homeopatia consiste en buscar los puntos de contacto existentes entre los síntomas que experimentalmente produce un remedio y los síntomas que presenta el enfermo. Em múltiples ensayos clínicos la homeopatia difiere del placebo, aunque su efecto no sea explicable por la medicina tradicional.

Comparison of dyspnea ratings during submaximal constant work exercise with incremental testing.

PURPOSE: The purpose of this study was to determine whether dyspnea ratings would be similar during submaximal (as used for training) and incremental (as used in testing) exercise at specific intensities in patients with chronic obstructive pulmonary disease (COPD). METHODS: We studied 20 patients with COPD. Age was 66 +/- 9 yr (mean +/- SD); FEV1 was 43 +/- 14% pred. At Visit 1 patients provided dyspnea ratings (0 to 10 scale) each minute during incremental exercise on the cycle ergometer. At Visit 2 patients rated dyspnea during production of submaximal exercise for 10 min at two intensities. RESULTS: Peak oxygen consumption (VO2) was 13.9 +/- 3.2 mL.kg-1.min-1. At visit 2 VO2 was stable, but dyspnea ratings increased slightly. Dyspnea ratings (2.0 +/- 1.2) during submaximal exercise were higher than during incremental exercise (1.1 +/- 0.7) at 55 +/- 8% of peak VO2 (P = 0.02) but were similar (4.3 +/- 1.5 vs 3.9 +/- 1.5) at 77 +/- 8% of peak VO2 (P = 0.40). CONCLUSIONS: In patients with COPD, dyspnea ratings were similar during steady state compared with equivalent levels of incremental exercise at a "high" intensity, but were slightly higher at the "low" exercise intensity. These data support the potential use of dyspnea ratings obtained during incremental exercise as a target for exercise training in patients with respiratory disease.

Clinical applications of cardiopulmonary exercise testing.

Noninvasive measurement of metabolic and cardiorespiratory variables can be readily obtained using computerized systems as part of exercise testing of patients on a cycle ergometer or treadmill. The major indications for CPEX are: to assess exercise-related symptoms, especially dyspnea and chest pain; to measure exercise capacity including acceptability of patients with end-stage heart disease for cardiac transplantation; to evaluate for impairment/disability; to establish safety and guidelines for exercise training; and to assess response to specific therapy. As most patients with chronic cardiorespiratory disorders reduce their activities and consequently become deconditioned, CPEX should be considered as part of the initial evaluation. The results of CPEX should enable the physician to understand the reason(s) for the patient's exercise limitation and usually support the recommendation that the patient participate in a reconditioning or rehabilitation program. Should expired gases be measured as routine for all exercise tests? The use of CPEX depends on the clinical question. If the question is, "Does the patient have ischemic heart disease?", then a standard "cardiac stress test" is adequate. If the clinical question is, "Why is the individual limited in exercise ability?" or "Why is a patient breathless with activities?", then comprehensive CPEX is indicated. One important issue relating to CPEX is cost effectiveness. Do the results of CPEX justify the expense? There are little if any data to answer this question. However, if CPEX can establish a specific diagnosis, exclude significant heart disease, estimate work capacity, and/or provide guidelines for prescription of exercise intensity, this information may be invaluable to the individual patient and to the health-care provider. It is possible that CPEX may answer a specific clinical question and thereby actually eliminate the need and reduce the cost of additional expensive diagnostic tests. A prospective assessment of the cost effectiveness of CPEX will be important for select clinical problems.

The lack of association of marijuana and other recreational drugs with progression to AIDS in the San Francisco Men's Health Study.

We evaluated the associations of specific recreational drugs and alcohol with laboratory predictors of AIDS at entry into the San Francisco Men's Health Study (SFMHS) in 1984 and with the development of the acquired immunodeficiency syndrome (AIDS) during 6 years of follow-up. Marijuana use was associated with a decreased rate of progression to AIDS in the univariate analysis (RR = 0.7; P = 0.01). Marijuana use was more common among individuals with elevated HIV viral core protein antibody (p24Ab) titer (> 1:16) at baseline (P = 0.03); this finding suggests that marijuana users were healthier at baseline. When the data were adjusted for p24 Ab and other laboratory parameters, no association with progression to AIDS was observed for marijuana, suggesting that the observed univariate result was due to a difference in HIV-related disease at the time of enrollment. No statistically significant associations were observed for nitrites, methylene dioxyamphetamines, ethyl chloride, downers, cocaine, stimulants, narcotics, or psychedelic drugs. These data suggest no substantial association between use of these drugs and the development of AIDS among HIV-infected men.

A prospective study of the association of serum neopterin, beta 2-microglobulin, and hepatitis B surface antigenemia with death in infants and children with HIV-1 disease.

A high percentage of HIV-1-infected infants and children in Romania are coinfected with hepatitis B virus. Little information is available on the impact of concurrent hepatitis B infection on the course of HIV-1 infection. We conducted a prospective cohort study over 1 year in a group of 68 HIV-1-infected infants and children to determine whether hepatitis B surface antigenemia, neopterin, and beta 2-microglobulin (B2M) predicted death. Among the 44 hepatitis B surface antigen-positive (HBsAg+) subjects at enrollment, 13 (30%) died during 1 year of follow-up. In comparison, two of 24 (8%) HBsAg-negative subjects died (RR = 7.7; p = 0.05). Higher initial serum concentrations of neopterin and B2M were negatively associated with survival. After stratifying by baseline clinical evidence of HIV-related disease, survival was negatively associated with HBsAg+ status (p = 0.04) in 33 children in stage P-2, adjusting for age, serum neopterin, and serum B2M levels. The results of this study suggest that serum neopterin is a marker for severity of clinical illness and that HBsAg+ status increases the mortality rate among children with clinical evidence of HIV infection.

Association of immune activation with intravenous heroin use and methadone treatment in HIV-1 seropositive and seronegative subjects.

This study evaluated the effect of continued heroin use during methadone treatment on serum neopterin levels in 40 human immunodeficiency virus (HIV) type 1 seropositive (HIV+) and 70 seronegative (HIV-) intravenous drug users (IVDUs). Persistent drug use, determined by urinary evidence of opiates, was more common in HIV+ than in HIV- IVDUs (p = 0.01). Serum neopterin concentration, an indicator of increased probability of progression to AIDS, was elevated in HIV+ IVDUs, p < 0.0001 (mean 16.0 nmol/L) compared to that of HIV- IVDUs (mean 10.0 nmol/L) and in persistent IV drug users compared with abstainers, p < 0.0001. The effect of drug use and HIV status on serum neopterin was not explained by differences in methadone treatment, age, sex, or total years of i.v. drug use. Neopterin decreased in 25 IVDUs, regardless of HIV serostatus, treated with methadone for an average of 1.5 years.

Electric shock delivery system for rhesus monkeys: its effect on escape responding.

The present experiment evaluated a simple chronic electric shock delivery system for rhesus monkeys restrained by a harness and arm arrangement used in experiments involving intravenous drug delivery. Electric shock was delivered via two small electrodes surgically implanted in the lumbar muscle. During experimental sessions, responding on a fixed-ratio 10 schedule terminated the delivery of a train of 100 electric shock pulses and produced a 3 min timeout. A maximum of 19 trials were possible during each daily session. Overall rate of responding increased as electric shock intensity was increased from 0 to 4 mA and the characteristics of responding were similar to previous studies using other systems and species. The results demonstrate that electric shock delivered by the present system is a negative reinforcer. In addition, the system is easy to implant, causes little tissue damage, relatively long-lasting and can be used in experimental situations which involve responding maintained by intravenous drug delivery in rhesus monkeys.