Resultados del tratamiento médico de la embolia de pulmón en una unidad de corta estancia de un hospital de tercer nivel: ¿es el lugar adecuado? / Results of pulmonary embolism treatment in a tertiary hospital short stay unit. Is this the right place?

Objetivo. Describir la estancia media (EM) de la embolia de pulmón (EP) en una unidad de trombosis (UT) dependiente de una unidad de corta estancia (UCE) de un hospital de tercer nivel. Comparar estos datos con el resto de hospitales de nuestra región, con los del resto de comunidades autónomas (CCAA) y con el mismo hospital durante un año previo a nuestra existencia. Material y método. Estudio observacional retrospectivo descriptivo en el que se incluyeron los pacientes con diagnóstico de EP en el Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA) durante el año 2012. Clasificamos estos datos por servicio hospitalario, calculando la EM. Comparamos esta con la del resto de hospitales de nuestra región, con el resto de CCAA y con nuestros datos en el año 2007, cuando no existía aun la UT. Resultados. Se incluyeron 113 pacientes: 60 (53%) ingresaron en la UT, siendo la EM de 4,39 días, en Oncología, de 7,45, y en Medicina Interna (MI), de 15,38. No hubo ningún fallecido en la UT y solo se produjeron 3 reingresos (5%). Los datos publicados mostraron que la EM en todos los hospitales de nuestra región fue de 8,25 días; en nuestro hospital fue de 5,18 días y en el resto de hospitales, mayor. La CCAA con mejor EM fue el País Vasco con 6,85 días. En el año 2007, hubo 70 pacientes con EP en el HCUVA: 34 (49%) en MI con una EM de 8,50 días, 11 (31%) en Oncología con una EM de 9,64 días y 3 (4,3%) en Neumología, con una EM de 19 días; la mortalidad global fue del 11% y la tasa de reingresos en MI, del 6%. Conclusión. La EM de la EP en la UT en una UCE fue menor que en el resto de servicios de nuestro hospital, menor que en el resto de hospitales de nuestra comunidad, menor que en el resto de CCAA y menor que en cualquier servicio de nuestro hospital en una época anterior a nuestra existencia, sin aumentar la tasa de reingreso ni la mortalidad (AU)

Objectives. To determine the mean stay (MS) of patients with pulmonary embolism (PE) in a thrombosis unit (TU) with a short stay unit (SSU) in a tertiary hospital. To compare the data collected with those of other hospitals in the same region, of other regions (Autonomous Communities [AACC]), and within the same hospital in the year before the SSU opened. Material and methods. A descriptive retrospective observational study that included patients with a diagnosis of PE in the University Hospital Virgen de la Arrixaca (HCUVA) in 2012. These data were classified by hospital department, and used for calculating the mean stay. This was then compared with that of other hospitals in our region, with the rest of the regions, and with the data in 2007 (the last year without a TU). Results. A total of 113 patients with PE were included, 60 (53%) in the TU with an MS of 4.39, in Oncology, 7.45, and Internal Medicine (IM), 15.38 days. There were no deaths in the TU and only 3 (5%) readmissions. Published data showed that the MS in all hospitals in our region was 8.25, 5.18 in our hospital, and higher in the rest of hospitals. The best AACC was the Basque Country with an MS of 6.85 days. In 2007, there were 70 patients with PE in the HCUVA, 34 (49%) in IM, with an MS of 8.50, Oncology 11 (31%) with an MS 9.64, and Chest Diseases 3 (4.3%) with an MS 19 days, and with an overall mortality of 11% and a rate of readmissions in IM of 6%. Conclusion. The mean stay for a PE in the SSU of a TU was lower than in the rest of the hospital departments, lower than the rest hospitals of our region, lower than the rest of the regions, and lower than any department of our hospital before the SSU existed, without increasing the readmission or mortality rate (AU)

Queilitis comisural como forma de presentación de una leishmaniasis cutánea crónica / Chronic cutaneous leishmaniasis presenting as commissural cheilitis

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[Results of pulmonary embolism treatment in a tertiary hospital short stay unit. Is this the right place?]. / Resultados del tratamiento médico de la embolia de pulmón en una unidad de corta estancia de un hospital de tercer nivel: ¿es el lugar adecuado?

OBJECTIVES: To determine the mean stay (MS) of patients with pulmonary embolism (PE) in a thrombosis unit (TU) with a short stay unit (SSU) in a tertiary hospital. To compare the data collected with those of other hospitals in the same region, of other regions (Autonomous Communities [AACC]), and within the same hospital in the year before the SSU opened. MATERIAL AND METHODS: A descriptive retrospective observational study that included patients with a diagnosis of PE in the University Hospital Virgen de la Arrixaca (HCUVA) in 2012. These data were classified by hospital department, and used for calculating the mean stay. This was then compared with that of other hospitals in our region, with the rest of the regions, and with the data in 2007 (the last year without a TU). RESULTS: A total of 113patients with PE were included, 60 (53%) in the TU with an MS of 4.39, in Oncology, 7.45, and Internal Medicine (IM), 15.38days. There were no deaths in the TU and only 3 (5%) readmissions. Published data showed that the MS in all hospitals in our region was 8.25, 5.18 in our hospital, and higher in the rest of hospitals. The best AACC was the Basque Country with an MS of 6.85days. In 2007, there were 70patients with PE in the HCUVA, 34 (49%) in IM, with an MS of 8.50, Oncology 11 (31%) with an MS 9.64, and Chest Diseases 3 (4.3%) with an MS 19days, and with an overall mortality of 11% and a rate of readmissions in IM of 6%. CONCLUSION: The mean stay for a PE in the SSU of a TU was lower than in the rest of the hospital departments, lower than the rest hospitals of our region, lower than the rest of the regions, and lower than any department of our hospital before the SSU existed, without increasing the readmission or mortality rate.

Rhabdomyolysis after initial session of indoor cycling: analysis of 11 patients.

AIM: The aim of this paper was to highlight the special frequency of cases of rhabdomyolysis related to the practice of indoor cycling and to define the characteristics, course, and outcome of this disease. METHODS: Retrospective review of clinical histories of patients diagnosed with rhabdomyolysis after indoor cycling in our unit from January 2012 to April 2013. RESULTS: Eleven patients were analyzed. All patients, regardless of the degree of previous physical training, were diagnosed after a first session of indoor cycling. Mean age was 27.63 years (SD=5.74). Fifty-four percent were women. Creatine kinase (CK) levels gradually decreased in response to rest and intensive intravenous hydration. Only in two cases was renal failure observed, and in none were electrolyte disorders, disseminated intravascular coagulation (DIC) or compartmental syndrome detected. CONCLUSION: A first session of indoor cycling has become a common cause of rhabdomyolysis secondary to the physical exercise in recent years, which should alert those responsible for teaching this sport of the need for a gradual start under adequate hydration and environmental conditions, because although the condition has a benign course with adequate treatment and the complication rate is low, there are patients with increased susceptibility to very high CK blood levels requiring hospitalization for treatment and follow-up of possible complications.

Caracterización del pollo como biomodelo experimental en arteriosclerosis: lesiones en troncos supra-aórticos / Use of the chicken as experimental biomodel in atherosclerosis: supra-aortic lesions

La enfermedad cardiovascular es hoy en día la primera causa de mortalidad en las sociedades desarrolladas. Dada la complejidad del desarrollo de la lesión aterosclerótica en el ser humano resulta interesante investigar en modelos animales en los que dicho proceso sea semejante a la enfermedad humana. El pollo, al igual que otras aves, es capaz de desarrollar arteriosclerosis aórtica y coronaria de forma natural o espontánea, e inducida por una dieta enriquecida en colesterol. Teniendo en cuenta que la mayoría de los trabajos publicados describen las lesiones en segmentos aórticos y la variedad de métodos de inducción de la arteriosclerosis, el objetivo de esta investigación es caracterizar de manera adecuada en el modelo aviar utilizado, las lesiones arterioscleróticas de troncos supra-aórticos en un grupo experimental con respecto a un grupo control. Se emplearon 20 pollos de la raza White Leghorn divididos en dos grupos (control y aterogénico) que recibían una dieta normal o hiperlipémica respectivamente durante un periodo de 6 meses. Se sacrificaron entonces los animales para llevar a cabo el estudio bioquímico del plasma (perfil lipídico), evaluación histológica de los troncos supra-aórticos y valoración semicuantitativa de las lesiones según la clasificación de Stary. Se observaron diferencias estadísticamente significativas entre ambos grupos para los diferentes parámetros bioquímicos estudiados y para la cuantificación del grado de lesión de Stary. En el grupo aterogénico se observó un endotelio conservado, con íntimas muy aumentadas de tamaño (10 veces el tamaño del grupo control) y muy desorganizadas. En conclusión, estos hallazgos confirman el uso del pollo como biomodelo experimental para el estudio de la arteriosclerosis en troncos supra-aórticos, y podrían ser empleados como referencia para futuros estudios intervencionistas(AU)

Cardiovascular diseases are considered first cause of human mortality in developed countries. Animal models allow adequate research of atherosclerosis, given the similarities with the human lesions. Chickens may develop spontaneous and also induced atherosclerosis by use of a cholesterol-enriched diet. Most published findings describe aortic lesions in a variety of induction methods. Therefore, the aim of this research is to characterize the used avian model, describing supra-aortic trunk lesions in atherosclerotic chickens and to compare it with control animals. Twenty White Leghorn chickens were used (10 controls fed with a normal diet and 10 atherogenic animals fed with a hyperlipidemic diet, for 6 months). After sacrifice, lipid biochemical parameters were analysed, as well as histologic evaluation of supra-aortic vessels and quantification of lesions following the Stary classification. Statistically significant differences for each parameter were observed between the control and experimental groups. Increased intima layer width with disorganization was observed in atherogenic animals. These findings confirm the use of the chicken as an adequate experimental animal for atherosclerosis, and could be used as a reference for future interventional studies(AU)

Modelos animales experimentales de enfermedad de hígado graso y síndrome metabólico / Experimental animal models of fatty liver disease and metabolic syndrome

Los estudios en modelos animales constituyen una valiosa herramienta para comprender los procesos fisiopatológicos asociados a la enfermedad del hígado graso, sus características histológicas y ensayo de nuevas terapias. Una gran parte de los trabajos se desarrollan en roedores (ratones y ratas principalmente), dada su similitud biológica con el hombre y el gran conocimiento que se tiene a todos los niveles (genético, molecular, enzimático…) de estas especies. Por su facilidad de desarrollar los procesos de esteatosis hepática también destacan las aves. En este trabajo se describen los principales modelos de enfermedad del hígado graso en diversas especies animales, y las formas de inducción de enfermedad. Básicamente, el excesivo acúmulo de grasa en hígado puede ser consecuencia de aporte elevado de grasa, aumento de la síntesis grasa, oxidación reducida, y/o reducción de su salida en forma de VLDL. Así, se describen modelos basados en alteraciones genéticas (animales transgénicos o bien mutaciones naturales) que incrementan la lipogénesis, otros que dificultan la eliminación de grasa hepática (genes que regulan la oxidación de ácidos grasos), inducción mediante dietas que dan lugar a obesidad (ricas en fructosa, sacarosa, grasas, dietas aterogénicas) o bien sin producir obesidad (dietas deficientes en arginina o ricas en fructosa y grasas), tóxicos que incrementan la lipogénesis hepática, o factores que disminuyen la oxidación de ácidos grasos (como dietas deficientes en colina o metionina, administración de estrógenos, glucocorticoides o ciertos tóxicos). Se describen por último modelos aviares inducidos por la dieta (AU)

Animal models are important tools for the study of fatty liver disease, mainly related to physiopathology, pathology and therapeutical trials. Most studies have been developed in rodents (usually in mice and rats), because of biological similarities with humans, and also because of the deep knowledge (genetics, molecular, enzymatic…) of these species. Hepatic steatosis is also easily developed in avian species. We describe the most used animal models of fatty liver disease, and the several means of disease induction. Basically, excessive fat accumulation in the liver can occur as a result of increased fat delivery, increased fat synthesis, reduced fat oxidation, and/or reduced fat export in the form of VLDL. Several animal models of hepatic steatosis are described: genetically engineered animals or spontaneous mutations, which increase lipogenesis; others show reduced fatty acid oxidation, and therefore interfere fat elimination; induction by diets producing obesity: high content in fructose, sacarose, fat, and atherogenic diets; induction by diets which don’t produce obesity (arginine deficient diets), toxic agents which increase hepatic lipogenesis, or factors inducing a decrease of fatty acid oxidation such as choline / methionine deficient diets, strogens and glucocorticoids administration, or toxic agents. Diet-induced avian models are also described (AU)

Effects of atorvastatin on progression-regression of renal injury in hyperlipidemic chickens.

Complex interrelationships exist between hyperlipidemia and the progression of renal injury. The aim of this study was to evaluate the impact of high plasma cholesterol and triglyceride levels on renal structure and the effects of atorvastatin on progression-regression of renal injury. One-hundred chickens were divided into five groups: Group A: Standard diet (SD) for 6 months; Group B: Hyperlipidemic diet (HD) for 6 months; Group C: HD for three months and SD during the next 3 months; Group D: HD for 3 months and SD during the next 3 months, when they received oral atorvastatin (3 mg/kg/d); Group E: HD for the whole 6 months, and atorvastatin (3 mg/kg/d) during the last 3 months. Increased alpha-actine immunostaining was found in glomeruli of groups B and C. An important decrease of immunostaining was observed in glomeruli of atorvastatin treated groups. Group D showed the lowest value for presence of lipids, and significant differences were found with respect to the rest of the groups. The glomeruli of group B presented the highest damage grades and those of group D showed the lowest grades and presented significant differences from the rest of the groups. The combination of atorvastatin therapy and proper diet proved to be effective in promoting renal disease regression. However, the study of several parameters indicates that neither only diet nor atorvastatin in the progression group resulted completely effective in decreasing the progression of the disease.

[Idiopathic cholestasis associated with bloody diarrhea as the first manifestation of Hodgkin's lymphoma]. / Colestasis idiopática asociada a diarrea sanguinolenta como primera manifestación de linfoma de Hodgkin.

Jaundice in Hodgkin's disease occurs in 3-13% of the cases reported in the medical literature and can be due to several causes. Cholestatic jaundice associated with ductopenia may be a consequence of an associated paraneoplastic process and can occur several months before the development of Hodgkin's disease. When there is a finding of jaundice of unknown etiology associated with ductopenia, the possible existence of Hodgkin's disease should be investigated. We describe a case of cholestatic jaundice associated with Hodgkin's disease. The first clinical and laboratory manifestations were symptoms of bloody diarrhea months before the development of Hodgkin's disease. We discuss the differential diagnoses considered, given the complexity of the case.

Colestasis idiopática asociada a diarrea sanguinolenta como primera manifestación de linfoma de Hodgkin / Idiopathic cholestasis associated with bloody diarrhea as the first manifestation of Hodgkin’s lymphoma

La ictericia asociada a la enfermedad de Hodgkin (EH) aparece entre un 3 y un 13% de los casos comunicados en la bibliografía médica y puede deberse a diversas causas. Por otro lado, la ictericia colestásica asociada a ductopenia puede ser consecuencia de un proceso paraneoplásico y aparecer varios meses antes del desarrollo de la EH. Ante el hallazgo de ictericia de origen no filiado con presencia de ductopenia se propone la investigación de la existencia de una posible EH. Describimos un caso de ictericia colestásica asociada a EH que se presentó tras un cuadro de diarrea sanguinolenta como primera manifestación clínica y analítica varios meses antes del desarrollo de la EH. Se comentan los diferentes diagnósticos diferenciales planteados ante la complejidad del cuadro clínico

Jaundice in Hodgkin's disease occurs in 3-13% of the cases reported in the medical literature and can be due to several causes. Cholestatic jaundice associated with ductopenia may be a consequence of an associated paraneoplastic process and can occur several months before the development of Hodgkin's disease. When there is a finding of jaundice of unknown etiology associated with ductopenia, the possible existence of Hodgkin's disease should be investigated. We describe a case of cholestatic jaundice associated with Hodgkin's disease. The first clinical and laboratory manifestations were symptoms of bloody diarrhea months before the development of Hodgkin's disease. We discuss the differential diagnoses considered, given the complexity of the case

Evaluación macroscópica y microscópica del efecto de la atorvastatina sobre la progresión-regresión de la esteatosis hepática en un modelo aviar / Effects of atorvastatin on macroscopic and microscopic characteristics of hepatic steatosis progression-regression in an avian model

Introducción. La enfermedad grasa del hígado no alcohólica (EGHNA) se asocia a patología vascular subsidiaria de ser tratada con estatinas, por ello creemos de interés desarrollar un modelo de esteatosis hepática en animales y valorar el efecto de la atorvastatina en la lesión hepática inducida, así como presentar métodos de evaluación macroscópica y microscópica de los grados de esteatosis. Métodos. Se emplearon pollos de la raza White-Leghorn, clasificados en 5 grupos experimentales con diferentes dietas y tratamiento con atorvastatina. Los hígados fueron valorados y clasificados macroscópica y microscópicamente en 4 grados de lesión. Resultados. En el presente trabajo se ha conseguido desarrollar un modelo de hígado graso inducido por una dieta aterogénica empleando el pollo como animal de experimentación. Conclusión. Se demuestra que este modelo es adecuado para el estudio de la esteatosis hepática. Además, se muestran dos métodos de valoración de los grados de lesión: macroscópico y microscópico. Se concluye que la valoración macroscópica es útil para una discriminación rápida del efecto de la dieta, observándose también una tendencia al efecto beneficioso de la atorvastatina aunque no sea estadísticamente significativa. La evaluación microscópica, basada en los depósitos lipídicos, completa este estudio dando un mayor detalle de los grados de lesión, especialmente en los grados de lesión intermedios. Por este análisis microscópico se demuestra una reducción de la lesión hepática en los grupos tratados con atorvastatina. La combinación de los dos métodos, macroscópico y microscópico, es de gran utilidad para las valoraciones de los grados de lesión de esteatosis hepática (AU)

Introduction. Nonalcoholic fatty liver disease is commonly associated with vascular disease secondary to statin therapy. Therefore, the development of a hepatic steatosis animal model could be useful to evaluate the effect of atorvastatin on induced hepatic lesions, as well as to provide macroscopic and microscopic methods for evaluating hepatic steatosis. Methods. White Leghorn chickens were used, classified into five experimental groups, with different protocols of atorvastatin therapy and diets. Livers were assessed by means of macroscopic and microscopic analysis and classified into four grades of lesions. Results-conclusions. The chicken is useful and suitable as an animal model of hepatic steatosis induced by an atherogenic diet. Two methods of assessment are described: macroscopic and microscopic analysis. It was concluded that macroscopic evaluation rapidly identifies the effect of diet; atorvastatin showed a beneficial effect, although this was not statistically significant. Histological analysis (by evaluation of lipidic deposits) provided a more detailed classification of the grades of lesion, especially in intermediate grades. The histological analysis showed a decrease in the severity of induced hepatic lesions in atorvastatin-treated groups. The combination of the two evaluation methods (macroscopic and microscopic) was useful for determining the grades of severity of hepatic steatosis (AU)

Manifestación atipica de una lesión infrecuente: vídeo y ecoendoscopia de un schwanoma gástrico / Atipic manifestation of an infrequent lesion. Video- and ecoendoscopy in a gastric schwannoma

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Desarrollo y validación de una técnica de cromatografía líquida de alta resolución para la determinación de atorvastatina en plasma en un biomodelo experimental de arteriosclerosis en pollo / Development and validation of an HPLC method for the measurement of atorvastatin in an experimental model of atherosclerosis in chickens

Introducción. La atorvastatina es un inhibidor de la HMG-CoA reductasa que ha mostrado una gran eficacia en la reducción de las concentraciones de colesterol y triglicéridos en los pacientes con hiperlipidemia primaria o hiperlipidemia combinada. Cuando se utilizan biomodelos animales de arteriosclerosis con frecuencia se extrapolan erróneamente dosis de humanos a los animales de experimentación, lo que puede evitarse mediante estudios farmacocinéticos previos que permitan diseñar regímenes de dosificación adecuados. Para ello, es preciso disponer de técnicas que nos permitan detectar el fármaco en cuestión en plasma --en nuestro estudio la atorvastatina en un biomodelo de arteriosclerosis en el pollo-- y que la cromatografía líquida de alta resolución (HPLC) utilizada tenga una buena reproducibilidad y exactitud. Métodos. La técnica utilizada para detectar y cuantificar las concentraciones de atorvastatina en plasma fue la HPLC con detector de fluorescencia. Previamente se realizó un estudio de fluorescencia de la molécula con el fin de determinar las longitudes de onda utilizadas, tanto de excitación como de emisión. Una vez puesta a punto la técnica, se utilizó para la determinación de las concentraciones en el estado estacionario del fármaco en el biomodelo de arteriosclerosis en el pollo. Resultados. Tras el procesamiento de las muestras correspondientes y la inyección en el sistema HPLC, se obtuvo un pico correspondiente a la atorvastatina a los 16,3 min. La concentración de atorvastatina en plasma fue lineal (r > 0,999) en el rango de concentraciones utilizadas. El porcentaje de recuperación de la técnica estuvo en el rango comprendido entre el 88 y el 96%. Conclusiones. Los datos obtenidos en nuestro estudio han mostrado unos buenos resultados en cuanto a su facilidad, bajo coste y buena reproducibilidad de la técnica (AU)

Introduction. Atorvastatin is a hydroxy-methyl-glutaryl coenzyme A (HMG-CoA) reductase inhibitor that has shown to be efficacious in reducing both cholesterol and triglycerides in patients with primary hyperlipidemia or combined hyperlipidemia. An erroneous extrapolation of human doses to animal arteriosclerosis biomodels is often employed. This practice can be avoided through pharmacokinetics studies aimed to designing correct dosing regimens. Therefore, it is necessary to develop methods of drug analysis in plasma. In our study, atorvastatin was used in a biomodel of atherosclerosis in chickens. It is essential for these methods to have optimum precision and accuracy. Methods. We used a High Performance Liquid Chromatography (HPLC) method with fluorescence detection for atorvastatin analysis and quantification. Previously, a fluorescence study of atorvastatin molecule in order to establish excitation and emission wavelengths was conducted. The method was used to determine the steady-state concentrations of this drug in the chicken atherosclerosis biomodel. Results. After processing of plasma samples and injection in the HPLC system, the peak corresponding to atorvastatin appeared at 16.3 min. Plasma atorvastatin concentrations were lineal (r > 0.999) for the range of concentrations used. Recovery obtained in our study showed the present method to be easy, low-cost and with acceptable precision. Conclusions. Our present data show a technical procedure providing good results regarding its easiness, low cost and good reproducibility (AU)

Uso de estatinas en biomodelos experimentales de arteriosclerosis / Use of statins in atherosclerosis animal models

Desde principios del siglo XX se ha intentado con distintos modelos experimentales y distintos fármacos disminuir los eventos cardiovasculares disminuyendo los factores de riesgo y las lesiones asociadas a éstos en aorta y arterias coronarias. Se han utilizado distintos fármacos y preparados aunque el descubrimiento que marcó el inicio de la verdadera reducción de los eventos cardiovasculares fue la incorporación de las «Estatinas », que son inhibidores de la HidroxiMetilGlutaril-CoA reductasa (HMG-CoAr), un enzima limitante en la síntesis del colesterol. Como se refleja en esta revisión, se han conseguido reducciones significativas tanto en cuánto a los niveles de lípidos en sangre como en las lesiones arteriosclerosas en aorta y arterias coronarias con los distintos fármacos y en distintos modelos experimentales, todos ellos extrapolados al ser humano y comprobados científicamente en éste (AU)

Animals have been used as experimental models in atherosclerosis-related research since the turn of the past century. Several drugs have been proved in order to reduce coronary events, risk factors and associated vascular lesions in aorta and coronary arteries. Statins, inhibitors of hydroxymethylglutaryl-coenzyme A reductase, are highly potent cholesterol-lowering agents. The therapeutic potential of these drugs has been experimentally studied in several atherosclerosis animal models, showing reductions in plasmatic cholesterol levels and atherosclerotic lesions of aorta and coronary arteries. Furthermore, these effects have been also proved in humans (AU)

Estudio comparativo de diversos métodos de inducción de aterogénesis experimental en el pollo / Comparative study of several induction methods of experimental atherogenesis in the chicken

Dada la importancia de la arteriosclerosis y sus consecuencias clínicas en las sociedades desarrolladas (primera causa de muerte en Europa y EEUU) resulta interesante disponer de modelos animales en los que reproducir la enfermedad de cara a la investigación básica y aplicada en esta materia. El pollo reproduce espontáneamente y de forma inducida estos procesos, además de otras ventajas como su fácil disponibilidad, precio o similitud de las lesiones con el hombre. El objetivo de este trabajo era estandarizar los métodos de inducción de la aterogénesis en este biomodelo aviar, de cara a plantearnos ensayos con diversos principios activos, para conseguir la regresión de las lesiones arterioscleróticas. En base a las experiencias realizadas, se llega a la conclusión que, para conseguir resultados uniformes mediante el uso del biomodelo de arteriosclerosis del pollo, resulta más conveniente el uso de colesterol puro añadido a una dieta estándar que la mezcla a base de huevo. Por otro lado, debe utilizarse un vehículo como el aceite de palma líquido para facilitar la absorción del colesterol a nivel digestivo, y suministrar la mezcla ad libitum (AU)

Atherosclerosis and its consequences continue to be the major cause of death in Europe and the United Status. Animals have been used as experimental models in atherosclerosis-related research since the turn of the past century. The chicken is a good animal model and offers economic and technical advantages over mammalian models. Furthermore, it is able to develop spontaneous and induced atherosclerosis, and there is no essential difference between vascular lesions seen in chickens as a result of cholesterol diet and that of atherosclerosis observed in man. In this work, we examine several induction methods of atherogenesis in the chicken experimental model. It may be concluded that adding cholesterol to an standard diet gives better results, than using an egg-based diet. Palm oil results an excellent mean of increasing the digestive absortion of cholesterol. The atherogenic diet must be administered ad libitum (AU)

[Multiple angiodysplasia of the small intestine. A diagnostic and therapeutic challenge]. / Angiodisplasia múltiple de intestino delgado. Un reto diagnóstico y terapéutico.

Small bowel bleeding is infrequent and presents a challenge to the clinician. Approximately 30-40% of gastrointestinal bleeding localized in the small bowel is due to angiodysplasia, a vascular malformation. We present the case of a patient with multiple angiodysplasia of the small bowel who required push enteroscopy and capsule endoscopy to establish the diagnosis. Treatment with subcutaneous octreotide was successful. In conclusion, in doubtful cases or in patients with persistent hemorrhage, capsule endoscopy can improve the diagnostic yield of enteroscopy in bleeding gastrointestinal vascular lesions such as angiodysplasia. Endoscopic treatment (laser coagulation) and drug therapy (somatostatin or analogs) are valid alternatives in inoperable or non-resectable cases.

Planimetric and histological study of the aortae in atherosclerotic chickens treated with nifedipine, verapamil and diltiazem.

Calcium appears to be involved in many of the cellular events which are thought to be important in atherogenesis. Calcium channel blockers have been shown to reduce arterial lipid accumulation in animals without altering serum cholesterol. Avian models of atherosclerosis offer economic and technical advantages over mammalian models. In this study, we examine the effects of nifedipine, verapamil and diltiazem at clinical and higher doses, on the extent of atherosclerosis of egg-fed chickens. In order to assess the extent of atherosclerosis quantitatively, the aortic lesions of the thoracic and abdominal aorta, aortic arch and supraaortic regions were measured by planimetry. Atherosclerotic lesions were evaluated histologically. Statistically significant reductions in the lipid deposition of the aorta were found in all the treated groups. The extent and distribution of atherosclerotic lesions were decreased in a significant way by verapamil, nifedipine and diltiazem. The higher the dosage used, the higher the regression of the atherosclerotic lesions. At clinical dosage, nifedipine showed the highest decrease of the lesions. In addition, the chicken atherosclerosis model has proved itself useful and very suitable for in vivo drug intervention studies.