Reference ventricular dimensions and function parameters by cardiovascular magnetic resonance in highly trained Caucasian athletes.

BACKGROUND: Data regarding cardiovascular magnetic resonance (CMR) reference values in athletes have not been well determined yet. Using CMR normal reference values derived from the general population may be misleading in athletes and may have clinical implications. AIMS: To determine reference ventricular dimensions and function parameters and ratios by CMR in high performance athletes. METHODS: Elite athletes and age- and gender-matched sedentary healthy controls were included. Anatomical and functional variables, including biventricular volumes, mass, systolic function, wall thickness, sphericity index and longitudinal function were determined by CMR. RESULTS: A total of 148 athletes (29.2 ± 9.1 years; 64.8% men) and 124 controls (32.1 ± 10.5 years; 67.7% men) were included. Left ventricular (LV) mass excluding papillary muscles was 67 ± 13 g/m2 in the control group and increased from 65 ± 14 g/m2 in the low intensity sport category to 83 ± 16 g/m2 in the high cardiovascular demand sport category; P < 0.001. Regarding right ventricular (RV) mass, the data were 20 ± 5, 31 ± 6, and 38 ± 8 g/m2, respectively; P < 0.001. LV and RV volumes, and wall thickness were higher in athletes than in the control group, and also increased with sport category. However, LV and RV ejection fractions were similar in both groups. LV and RV dimensions, wall thickness and LV/RV ratios reference parameters for athletes are provided. CONCLUSIONS: LV and RV masses, volumes, and wall thicknesses are higher in athletes than in sedentary subjects. Specific CMR reference ranges for athletes are provided and can be used as reference levels, rather than the standard upper limits used for the general population to exclude cardiomyopathy.

Impact of fascioliasis reinfection on Fasciola hepatica egg shedding: relationship with the immune-regulatory response.

Fascioliasis is a disease caused by liver flukes. In human fascioliasis hyperendemic areas, reinfection and chronicity are the norm. Control strategies in humans require the use of egg count techniques to calculate the appropriate treatment dose for colic risk prevention. The present study investigates how fascioliasis reinfection affects liver fluke egg shedding and its relationship with the immune-regulatory response. The experimental design reproduced the usual reinfection/chronicity conditions in human fascioliasis endemic areas and included Fasciola hepatica primo-infected Wistar rats (PI) and rats reinfected at 4 weeks (R4), 8 weeks (R8), 12 weeks (R12), and negative control rats. In a longitudinal study (0-20 weeks post-infection, p.i.), serical IgG1 levels and eggs per gram of faeces (epg) were analyzed. In a cross-sectional study, the expression of the genes associated with Th1 (Ifng, Il12a, Il12b, Nos2), Th2 (Il4, Arg1), Treg (Foxp3, Il10, Tgfb, Ebi3), and Th17 (Il17) in the spleen and thymus was analyzed. In R8 and R12, transiently higher averages of epg and epg/worm in reinfected groups vs PI group were detected at least in the weeks following reinfection. The kinetics of IgG1 levels shows that reinfected groups followed a pattern similar to the one in the PI group, but transiently higher averages of IgG1 levels in reinfected groups vs the PI group were detected in the weeks following reinfection. Epg correlated with IgG1 levels and also with systemic Il10 and thymic Ifng, and Il10 expression levels. These results suggest that epg depends on the Th1 and Treg phenotype and that the determination of the fluke burden by epg is likely to be an overestimation in cases of recent reinfection in low burden situations. A strategy to facilitate the implementation of epg count techniques and the subsequent decision on the appropriate treatment dose for each patient to prevent colic risk is required.

Competencias de la enfermera de prevención y control de infecciones (EPyCI) / No disponible

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[URINARY TRACT INFECTIONS IN PATIENTS WITH URINARY CATHETERIZATION WHO SUFFER NEUROLOGICAL DISORDERS. STUDY OF THE POSSIBLE CAUSES]. / Infecciones de orina en pacientes sondados con patología neurológica. ESTUDIO DE LAS POSIBLES CAUSAS.

UNLABELLED: In previous studies carried out in our hospital (Hospital de Cabueñes, Gijón, Spain) it could be noticed/stated that every year there was a considerable difference between the patients with urine catheterization in the Neurology Service and the patients in the other hospital wards. This encourages us to carry out the following research. OBJECTIVES: The purpose of this study is to determine the causes that increase the urinary infections in neurological patients with bladder catheterization compared to catheterized patients with other diseases. Analysis of sediment and urine culture before and after the urinary bladder catheterization. METHODS. Retrospective, descriptive and observational study of fifty patients with neurological disorders who were hospitalized in the neurological care unit of Hospital de Cabueñes (Gijón, Spain) and who needed urinary catheterization. The fieldwork consisted of collecting a sample for sediment and culture before and after the urinary catheterization and also of registering the causes of the catheterization, the length of the treatment, age and sex of patients on a medical record sheet. Patients who were catheterized in the Emergency (A&E) unit, those who were taking antibiotics and those who did not suffer a neurological disease did not take part in this study. RESULTS: 20 patients (40%) out of the 50 who took part in this study and who needed urinary catheterization (UC) suffered from urinary retention, another 20 (40%) were under medical diagnosis and supervision and the last 10 (20%) were treated with manitol. 44 patients (88%) were diagnosed with strokes. 12% of them had a positive culture prior to UC placement. CONCLUSIONS: Patients who suffered stokes have a high risk of urine retention due to their functional disability. Some of them had already the urine values altered, they even had infection prior to the urinary catheter placement.

Infecciones de orina en pacientes sondados con patología neurológica. Estudio de las posibles causas / Urinary tract infections in patients with urinary catheterization who suffer neurological disorders. Study of the possible causes

Por estudios realizados en nuestro hospital, se observó que todos los años existía una diferencia considerable entre las infecciones de orina en pacientes sondados del servicio de Neurología con respecto a otras unidades de hospitalización. Esto nos llevó a realizar el presente estudio. Objetivo. Determinar las causas que aumentan las infecciones del tracto urinario (ITU) en el paciente sondado con patología neurológica. Metodología. Estudio observacional descriptivo prospectivo de 50 pacientes con patología neurológica ingresados en la planta de Neurología del Hospital de Cabueñes (Gijón), que precisaron sondaje vesical (SV). El trabajo de campo consistió en recoger una muestra para sedimento y cultivo de orina pre y post-SV, además de anotar las causas del sondaje, duración, edad, sexo y diagnóstico en una hoja de registro. Se descartaron aquellos pacientes sondados de urgencias, los que estaban tomando antibiótico y aquellos cuya patología no era neurológica. Resultados. De 50 pacientes estudiados que precisaron SV, el 40 % fue por retención de orina, un 40 % por orden médica y el 20 % por tratamiento con manitol. El 88 % tuvo un diagnóstico de ictus. Un 12 % ya tenía el cultivo positivo antes de ser portadores de SV. Conclusiones. El ictus es la patología neurológica que más precisa SV. Una de las causas más importantes de aquel es la retención de orina. Algunos de los pacientes sondados ya tenían ITU antes de la colocación de SV (AU)

In previous studies carried out in our hospital (Hospital de Cabueñes, Gijón, Spain) it could be noticed/stated that every year there was a considerable difference between the patients with urine catheterization in the Neurology Service and the patients in the other hospital wards. This encourages us to carry out the following research. Objectives. The purpose of this study is to determine the causes that increase the urinary infections in neurological patients with bladder catheterization compared to catheterized patients with other diseases. Analysis of sediment and urine culture before and after the urinary bladder catheterization. Methods. Retrospective, descriptive and observational study of fifty patients with neurological disorders who were hospitalized in the neurological care unit of Hospital de Cabueñes (Gijón, Spain) and who needed urinary catheterization. The fieldwork consisted of collecting a sample for sediment and culture before and after the urinary catheterization and also of registering the causes of the catheterization, the length of the treatment, age and sex of patients on a medical record sheet. Patients who were catheterized in the Emergency (A&E) unit, those who were taking antibiotics and those who did not suffer a neurological disease did not take part in this study. Results. 20 patients (40 %) out of the 50 who took part in this study and who needed urinary catheterization (UC) suffered from urinary retention, another 20 (40 %) were under medical diagnosis and supervision and the last 10 (20 %) were treated with manitol. 44 patients (88 %) were diagnosed with strokes. 12 % of them had a positive culture prior to UC placement. Conclusions. Patients who suffered stokes have a high risk of urine retention due to their functional disability. Some of them had already the urine values altered, they even had infection prior to the urinary catheter placement (AU)

Artritis reumatoidea de 20 años o más de evolución: experiencia preliminar / Rheumatoid arthritis 20 years and over of evolution: preliminary experience

Rheumatoid Arthritis (RA) is characterized by persistent synovitis, systemic inflammation and presence of autoantibodies, mainly Rheumatoid Factor and Anticitrullinated peptide antibody. This condition develop in genetically susceptible individuals, where environmental factors interact, although the pathogenesis is not yet fully known. Since the disease was described until now, there have been major diagnostic and therapeutic advances. In this paper was performed a retrospective and prospective evaluation of 28 patients with RA over twenty years of evolution, was held in treatment and periodic inspection at the Department of Rheumatology at Hospital San Juan de Dios...

La Artritis Reumatoide (AR) se caracteriza por presentar una sinovitis persistente, inflamación sistémica y presencia de autoanticuerpos, fundamentalmente factor reumatoideo y anticuerpo anti-péptido citrulinado. Esta patología se desarrolla en individuos genéticamente susceptibles, donde interactúan diversos factores ambientales, aunque la patogenia aún no se conoce en su totalidad. Desde que se describió la enfermedad hasta la actualidad, ha habido grandes avances diagnósticos y terapéuticos. En este trabajo se realizó una evaluación retrospectiva y prospectiva de 28 pacientes con AR sobre 20 años de evolución, en tratamiento y control periódico en el Departamento de Reumatología del Hospital San Juan de Dios...

Control ecográfico post inserción de dispositivo intrauterino / Ultrasound control post insertion of intrauterine device

INTRODUCCIÓN: Los dispositivos intrauterinos (DIU) son métodos de anticoncepción reversible, ampliamente usados en el mundo. Se estima que 120 millones de mujeres usan un DIU en el mundo como método anticonceptivo. OBJETIVO: Evaluar los factores de riesgo que puedan relacionarse con una incorrecta inserción del DIU. MÉTODO: 93 pacientes de un Centro de Salud Familiar de la ciudad de Talca, Chile. Utilizando tablas de contingencia se calcularon diferentes medidas de asociación y se compararon los casos de DIU mal posicionado con los casos con uno o más factores de riesgo identificados. RESULTADOS: Se encontró una incidencia de DIU incorrectamente posicionado de un 15,8%, de los cuales hubo un 2,1% de perforación uterina, 2,1% para DIU incrustado y 11,8% para DIU descendido. Se identificaron como factores de riesgo de DIU incorrectamente posicionado la cicatriz de cesárea (RR: 2,31), inserción dificultosa (RR: 3,31) y opinión de un resultado dudoso (RR: 3,64), con una sensibilidad de 73,3%. CONCLUSIONES: La ecotomografía transvaginal es una herramienta crucial para la confirmación de una correcta inserción del DIU y debería ser un examen de rutina ante la presencia de cualquiera de los factores de riesgo identificados.

BACKGROUND: Intrauterine devices (lUDs) are reversible birth control methods that are widely used throug-hout the world. It is estimated that 120 million women use an IUD in the world as a contraceptive. AIM: To assess the risk factors that may relate to incorrect insertion of the IUD. METHODS: The sample included 93 patients of a Family Health Center, Talca, Chile. Using contingency tables, various measures of association were calculated, and the cases of incorrectly positioned IUD were compared with the cases where one or more risk factors were identified. RESULTS: We found an incidence of 15.8% of incorrectly positioned IUD, of which 2.1% presented with uterine perforation, 2.1% with embedment of the IUD and 11.8% with a descended IUD. We identified the following risk factors for incorrectly positioned IUD: cesarean section (RR: 2.31), difficulty on insertion (RR: 3.31) and practitioner's opinión of an uncertain result (RR: 3.64), with a sensitivity of 73.3%. CONCLUSIONS: Transvaginal ultrasound is a crucial tool for confirmation of proper insertion of an IUD and should be considered a routine examination when any of the identified risk factors are present.

Measurement of dental implant stability by resonance frequency analysis: A review of the literature

Dental implant treatment is an excellent option for prosthetic restoration that is associated with high successrates. Implant stability is essential for a good outcome. The clinical assessment of osseointegration is based onmechanical stability rather than histological criteria, considering primary stability (absence of mobility in bonebed after implant insertion) and secondary stability (bone formation and remodelling at implant-bone interface).The aim of this study was to review the literature on Resonance Frequency Analysis (RFA) as a methodfor measuring dental implant stability. An online search of various databases was conducted on experimentaland clinical research published between 1996 and 2008. The studies reviewed demonstrate the usefulness ofRFA as a non-invasive method to assess implant stability. Further research is required to determine whetherthis system is also capable of measuring the degree of dental implant osseointegration (AU)

Consentimiento informado. Comunicación eficaz y decisión autónoma / Informed consent efficient. Communication and autonomous decision-making

El consentimiento informado se enmarca en una nueva forma de entender la relación médico-paciente desde la perspectiva del principio de autonomía. Desde este punto de vista hablamos de una relación sanitaria entendida como relación de mutualidad. Para que una decisión sea autónoma debe ser intencional, emitida tras comprender adecuadamente toda la información y totalmente libre de influencias. Debemos tener en cuenta que, tanto desde el punto de vista teórico como práctico, existen objeciones tales como el paternalismo, la dificultad de comprensión o el rechazo por parte del paciente, entre otras. El consentimiento informado supone una realidad y un reto en nuestra profesión, ya que es mucho más complejo que la mera firma de un documento(AU)

Informed consent belongs to a new way to understand doctor-patient relationships from a perspective permitting a principle of autonomy. Seen from this viewpoint, we speak of a medical relationship understood as being a mutual relationship. For a decision to be autonomous, it must be intentional, taken after adequately understanding all the pertinent information and totally free from outside influences. We must realize that from both theoretical and practical views objections exist; these include paternalism, comprehension difficulties, or patient refusal to exercise informed consent. Informed consent presents a reality and a challenge for our profession since it is much more complex than a simple signature on a document(AU)

Kinetics of tienilic acid bioactivation and functional generation of drug-protein adducts in intact rat hepatocytes.

Drug-induced autoimmune hepatitis is among the most severe hepatic idiosyncratic adverse drug reactions. Considered multifactorial, the disease combines immunological and metabolic aspects, the latter being to date much better known. As for many other model drugs, studies on tienilic acid (TA)-induced hepatitis have evidenced the existence of bioactivation during the hepatic oxidation of the drug, allowing the identification of the neoantigen of anti-LKM2 autoantibodies and the pathway responsible for its formation. However, most of these results are based on the use of microsomal fractions whose relevance to the liver in vivo still needs to be established. In the more complex intact cell environment, several endogenous processes may play a significant role on triggering the reaction and should therefore be considered. In this work we have characterised the kinetics of TA biotransformation in metabolically competent hepatocytes, the influence of TA bioactivation on physiological GSH levels, and the qualitative and quantitative profile of drug-protein conjugates generated in situ, as a function of exposure time. Results confirm that intact hepatocytes reproduce in vitro the metabolic sequence that leads to the functional generation of drug-protein adducts, in conditions that simulate clinical human exposure to TA. Metabolically competent cultured hepatocytes appear as a very promising approach to investigate the early preimmunological events of drug-induced autoimmune hepatitis, adequate to identify the conditions that may modulate the formation and specificity of drug-protein adducts in vivo, to study the hepatic disposition of the TA-protein targets, and to define the specific role of the hepatocyte in the origin of this adverse reaction.

Disminución de la concentración sérica de antiepilépticos durante el tratamiento con aciclovir / Serum concentration decrease of antiepileptics during aciclovir treatment

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Constipación en el anciano / No disponible

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Nitric oxide-scavenging properties of some chalcone derivatives.

The implication of NO in many inflammatory diseases has been well documented. We have previously reported that some chalcone derivatives can control the iNOS pathway in inflammatory processes. In the present study, we have assessed the NO-scavenging capacity of three chalcone derivatives (CH8, CH11, and CH12) in a competitive assay with HbO(2), a well-known physiologically relevant NO scavenger. Our data identify these chalcones as new NO scavengers. The estimated second-order rate constants (k(s)) for the reaction of the three derivatives with NO is in the same range as the value obtained for HbO(2), with CH11 exerting the greatest effect. These results suggest an additional action of these compounds on NO regulation.

THE COLONIZATION OF DROSOPHILA SUBOBSCURA IN CHILE. II. CLINES IN THE CHROMOSOMAL ARRANGEMENTS.

Drosophila subobscura is a Palearctic species that was first detected in the New World in Puerto Montt (Chile) in February 1978. Since that time, it has spread over a broad area and increased in population density. The South American populations exhibit a high level of chromosomal polymorphism: 20 different arrangements exist, distributed among five chromosomes. Chromosomal arrangement heterozygosity varies from 0.55 to 0.61 in the nine populations examined. Incipient clines in the frequencies of the arrangements are appearing; these clines follow the same latitudinal direction as in the Old World. Wing length significantly decreases with latitude, as it does in Europe. The colonization of South America by D. subobscura appears to be a major natural experiment with outcomes that duplicate the distributional patterns-in chromosomal polymorphism and in wing length-observed in the Old World, thereby strongly supporting the adaptive significance of these patterns. The data show a very rapid effect of natural selection promoting genetic differentiation among natural populations.