Equine chorionic gonadotropin administered on day 5 of a 7-days fixed-time artificial insemination program improves ovulation synchrony and corpus luteum function in anestrous beef cows.

In order to assess the effect of equine chorionic gonadotropin (eCG) administered on Day 5 or 7 of a fixed-time artificial insemination protocol (FTAI) in anestrous suckled beef cows, two experiments were performed to determine the following endpoints: Experiment 1 (n = 22), preovulatory follicle (POF) diameter, ovulation time, corpus luteum (CL) area, estradiol (E2) and progesterone (P4) concentrations; and Experiment 2 (n = 676), a field trial to evaluate conception rate using the same experimental design. In both experiments, a synchronization protocol using estradiol benzoate (EB) (Day 0), intravaginal progestin device (IVD) (Days 0 through 7), prostaglandin (PGF) (Day 7), eCG (Day 5 or 7), and GnRH (Day 9). Treatment consisted of administering 400 IU of eCG on Day 5 (T5) or Day 7 (T7 or control) concomitant with treatment with PGF2α. In experiment 1, all cows of T5 ovulated by 16 h after GnRH administration. The POF tended (P = 0.06; P = 0.07) to be larger at 1 and 2 d before ovulation in T5. The day before ovulation, E2 tended to be lower (P = 0.06) in T5 compared with T7. The CL area and the P4 concentrations were greater (P = 0.04) on day 9 in T5 compared with T7. In experiment 2, the conception rate was greater (P = 0.04) in T5 (72.2%) compared with T7 (61.0%) group. Therefore, administration of eCG on Day 5 of the designed protocol hastened ovulation of a greater follicle, which produced a larger CL and greater concentrations of progesterone by Day 9 after ovulation, resulting in 11.2% increase in cows pregnant.

Modelling of Hepatitis E virus RNA-dependent RNA polymerase genotype 3 from a chronic patient and in silico interaction analysis by molecular docking with Ribavirin.

Hepatitis E Virus (HEV) infection is an emergent zoonotic disease, where chronic hepatitis E associated to solid organ transplant (SOT) recipients, related to genotype 3, is the clinical manifestation of major concern. In this setting, ribavirin (RBV) treatment is the only available therapy, though drug-resistant variants could emerge leading to a therapeutic failure. Crystallographic structures have not been reported for most of the HEV proteins, including the RNA-polymerase (RdRp). Therefore, the mechanism of action of RBV against HEV and the molecular interactions between this drug and RdRp are largely unknown. In this work, we aimed to model in silico the 3 D structure of a novel HEV3 RdRp (HEV_C1_Uy) from a chronically HEV infected-SOT recipient treated with RBV and to perform a molecular docking simulation between RBV triphosphate (RBVT), 7-methyl-guanosine-5'-triphosphate and the modelled protein. The models were generated using I-TASSER server and validated with multiple bioinformatics tools. The docking analysis were carried out with AutoDock Vina and LeDock software. We obtained a suitable model for HEV_C1_Uy (C-Score=-1.33, RMSD = 10.4 ± 4.6 Å). RBVT displayed a binding affinity of -7.6 ± 0.2 Kcal/mol by molecular docking, mediated by 6 hydrogen-bonds (Q195-O14, S198-O11, E257-O13, S260-O2, O3, S311-O11) between the finger's-palm-domains and a free binding energy of 31.26 ± 16.81 kcal/mol by molecular dynamics simulations. We identified the possible HEV RdRp interacting region for incoming nucleotides or analogs and provide novel insights that will contribute to better understand the molecular interactions of RBV and the enzyme and the mechanism of action of this antiviral drug.Communicated by Ramaswamy H. Sarma.

Retraction: Rendon-Marin et al. Canine Morbillivirus from Colombian Lineage Exhibits In Silico and In Vitro Potential to Infect Human Cells. Pathogens 2021, 10, 1199.

The authors retract the article "Canine Morbillivirus from Colombian Lineage Exhibits In Silico and In Vitro Potential to Infect Human Cells" [...].

Canine Morbillivirus from Colombian Lineage Exhibits In Silico and In Vitro Potential to Infect Human Cells.

Canine morbillivirus (CDV) is a viral agent that infects domestic dogs and a vast array of wildlife species. It belongs to the Paramyxoviridae family, genus Morbillivirus, which is shared with the Measles virus (MeV). Both viruses employ orthologous cellular receptors, SLAM in mononuclear cells and Nectin-4 in epithelial cells, to enter the cells. Although CDV and MeV hemagglutinin (H) have similar functions in viral pathogenesis and cell tropism, the potential interaction of CDV-H protein with human cellular receptors is still uncertain. Considering that CDV is classified as a multi-host pathogen, the potential risk of CDV transmission to humans has not been fully discarded. In this study, we aimed to evaluate both in silico and in vitro, whether there is a cross-species transmission potential from CDV to humans. To accomplish this, the CDV-H protein belonging to the Colombian lineage was modelled. After model validations, molecular docking and molecular dynamics simulations were carried out between Colombian CDV-H protein and canine and human cellular receptors to determine different aspects of the protein-protein interactions. Moreover, cell lines expressing orthologous cellular receptors, with both reference and wild-type CDV strains, were conducted to determine the CDV cross-species transmission potential from an in vitro model. This in silico and in vitro approach suggests the possibility that CDV interacts with ortholog human SLAM (hSLAM) and human Nectin-4 receptors to infect human cell lines, which could imply a potential cross-species transmission of CDV from dogs to humans.

Cytolytic activity of peptides derived from the Cry11Bb insecticidal toxin of B. thuringiensis subsp. medellin.

A few Bacillus thuringiensis Cry proteins, known as parasporins, have demonstrated cell proliferation inhibition of human cancer cells in vitro after protease activation. In this work, eight peptides derived from the Cry11Bb protoxin produced by B. thuringiensis subsp. medellin were selected and evaluated to investigate their membrane permeabilization and cytolytic activities, using red blood cells and cancer cell lines A549, MCF-7 and Caco-2, respectively. The most active peptides permeabilized red blood cells in a membrane potential-dependent manner. Half maximal inhibitory concentration in cancer cells was in the range 0.78-7.63 µM. At the same time, at peptides concentration of 25 µM, the hemolysis percentage varied in the range of 4.6-32.4%. The peptides BTM-P1 and BTM-P4 in D form had the lowest IC50 values on the MCF-7 cell line and they are considered as the most promising peptides among the evaluated. Fluorescence microscopy using AnnexinV-FLUOS staining indicates that the possible cause of MCF-7 cell death by peptide BTM-P1, is apoptosis. Real time PCR analysis showed an increased transcription of p53 in MCF-7 cells, thus confirming the probable pro-apoptotic effect of the peptide BTM-P1. In general, this study suggests that the cytolytic activity of the polycationic peptides derived from the Cry11Bb protoxin could be mediated by a pro-apoptotic mechanism that might include potential-dependent membrane permeabilization. Further studies might be accomplished to establish whether the peptides are cytolytic to other cancer cell lines and to solid tumors.

Papel del profesor asociado de ciencias de la salud y del alumno interno en la formación hospitalaria en el grado en logopedia / Role of the associate professor of health sciences and the intern student of speech therapy in hospital training in the degree in speech and language therapy

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Aislamiento de una cepa genotipo 3 del virus de la hepatitis E obtenida de heces humanas / Cell culture isolation of hepatitis e virus genotype 3 strain obtained from human feces

ABSTRACT Hepatitis E virus (HEV) is considered one of the leading causes of acute viral hepatitis worldwide, and about 20 million infections and approximately 57 000 deaths occurred every year. However, little is known about the replicative virus cycle due to the absence of a consensus cell culture model. A549 cell line is considered susceptible to HEV genotype 3, however, both viral strain and cell culture conditions could affect the viral isolation in vitro. The objective of this work was to isolate in vitro an HEV-3 strain obtained from human feces. To this, a genotype 3 HEV strain previously identified by genetic characterization was inoculated in A549 monolayers, and incubated for two hours at 37 °C. Five days post-infection, cells were passaged (subcultured) for the first time, and serial passages were done on average every four days during 41 days. HEV replication was evaluated through RT-qPCR in each passage, and reinfection of the cell line with the viral progeny derived from A549 infected monolayers was assessed through immunofluorescence and RT-qPCR. Viral RNA was detected in each passage from infected monolayers, and the highest amount was found after 26 days (2 x 106 copies/µL). In reinfection assay, capsid antigen was detected perinuclearly and forming foci, and 1x104 copies/µL of viral RNA was detected after 96 hours post infection. This shows that HEV recovered from the cell lysate monolayers was infectious. This viral isolate offers a critical tool to study the unknown aspect of HEV infection.

RESUMEN El virus de la hepatitis E (HEV) se considera como una de las principales causas de hepatitis viral aguda en el mundo; cada año ocurren aproximadamente 20 millones de infecciones y 57 000 muertes. Debido a la ausencia de un modelo de cultivo celular consenso, se sabe poco sobre el ciclo replicativo del virus. La línea celular A549 se considera susceptible al genotipo 3 de HEV, pero tanto la cepa viral como las condiciones del cultivo celular podrían afectar el aislamiento viral in vitro. Por tanto nos propusimos aislar in vitro una cepa genotipo 3 del HEV. Para ello, se inocularon células A549 con una cepa HEV-3 identificada previamente por caracterización genética, y se incubó durante dos horas a 37 °C. Cinco días después de la infección, las células se pasaron (subcultivaron) por primera vez, y se realizaron pases seriados cada cuatro días en promedio, durante 41 días. En cada pase se evalúo la replicación del HEV mediante RT-qPCR. La reinfección de la línea celular con progenie viral derivada de monocapas de A549 infectadas se evaluó mediante inmunofluorescencia y RT-qPCR. Se detectó ARN viral en cada pase a partir de monocapas, y el pico máximo se alcanzó a los 26 días post infección (2 x 106 copias/µL). En el ensayo de reinfección, se detectó antígeno de cápside perinuclearmente y formando focos, y se detectaron 1 x 104 copias/µL de RNA viral a las 96 horas post infección. El HEV recuperado de lisado de monocapas fue infeccioso. Este aislado viral ofrece una herramienta importante para estudiar aspectos desconocidos de la infección por HEV.

Chronic administration of the angiotensin type 2 receptor agonist C21 improves insulin sensitivity in C57BL/6 mice.

The renin-angiotensin system modulates insulin action. Angiotensin type 1 receptor exerts a deleterious effect, whereas the angiotensin type 2 receptor (AT2R) appears to have beneficial effects providing protection against insulin resistance and type 2 diabetes. To further explore the role of the AT2R on insulin action and glucose homeostasis, in this study we administered C57Bl/6 mice with the synthetic agonist of the AT2R C21 for 12 weeks (1 mg/kg per day; ip). Vehicle-treated animals were used as control. Metabolic parameters, glucose, and insulin tolerance, in vivo insulin signaling in main insulin-target tissues as well as adipose tissue levels of adiponectin, and TNF-α were assessed. C21-treated animals displayed decreased glycemia together with unaltered insulinemia, increased insulin sensitivity, and increased glucose tolerance compared to nontreated controls. This was accompanied by a significant decrease in adipocytes size in epididymal adipose tissue and significant increases in both adiponectin and UCP-1 expression in this tissue. C21-treated mice showed an increase in both basal Akt and ERK1/2 phosphorylation levels in the liver, and increased insulin-stimulated Akt activation in adipose tissue. This positive modulation of insulin action induced by C21 appeared not to involve the insulin receptor. In C21-treated mice, adipose tissue and skeletal muscle became unresponsive to insulin in terms of ERK1/2 phosphorylation levels. Present data show that chronic pharmacological activation of AT2R with C21 increases insulin sensitivity in mice and indicate that the AT2R has a physiological role in the conservation of insulin action.

Bladder leiomyoma.

Leiomyomas of the bladder constitute <0.5% of all bladder tumors, with about 250 cases reported. Most patients present with urinary frequency or obstructive urinary symptoms. There are rare cases with other presentations, such as dyspareunia. We report a 22-year-old female who presented with complaints of pelvic discomfort, dysuria, and dyspareunia. Imaging and cystoscopy showed a protruding bladder lesion, which was excised through a transurethral resection. The pathologic diagnosis was bladder leiomyoma. Although being a benign condition, they can cause several different symptoms and should be early diagnosed and treated.

In-silico design and molecular docking evaluation of peptides derivatives from bacteriocins and porcine beta defensin-2 as inhibitors of Hepatitis E virus capsid protein.

Hepatitis E virus (HEV) is considered the main etiological agent that causes acute hepatitis. It is estimated that 20 million cases occur annually worldwide, reaching mortality rates of 28% in pregnant women. To date, available treatments and vaccines have not been entirely effective. In this study, six antiviral peptides derived from the sequences of porcine Beta-Defensin-2 and bacteriocins Nisin and Subtilosin were generate using in silico tools in order to propose new antiviral agents. Through the use of molecular docking, interactions between the HEV capsid protein and the six new antiviral peptide candidates were evaluated. A peptide of 15 residues derived from Subtilosin showed the best docking energy (-7.0 kcal/mol) with the capsid protein. This is the first report to our knowledge involving a non-well study viral protein interacting with peptides susceptibles to being synthesized, and that could be subsequently evaluated in vitro; moreover, this study provide novel information on the nature of the dimerization pocket of the HEV capsid protein, and could help to understand the first steps in the viral replication cycle, needed for the virus entry to the host cell.

La valoración antropométrica en el contexto de la escuela como medida para detectar y prevenir efectos a largo plazo de la obesidad y del sobrepeso en niños en edad escolar / Anthropometric assessment in the school context as a means for the detection and prevention of the long-term effects of obesity and over weight in children of school age

Resumen Objetivo: El sobrepeso y la obesidad son un problema de salud pública de particular importancia en el contexto de las poblaciones en situación de mayor vulnerabilidad. Su importancia radica en el efecto de la obesidad en la infancia, sobre la salud cardiovascular futura. El objetivo de esta investigación fue describir la prevalencia del sobrepeso y la obesidad en la edad escolar en la población vulnerable en Bogotá y el contexto escolar en el cual se expresan. Materiales y métodos: Se realizó una evaluación antropométrica en dos colegios. Se obtuvieron los Z score de la talla para la edad y el índice de masa corporal de acuerdo a los estándares de crecimiento de la Organización Mundial de la Salud y de los Centros para el Control y la Prevención de Enfermedades en Atlanta. Posteriormente se caracterizaron ambos colegios y se realizó un grupo focal con los profesores sobre lo que debe hacer parte de una escuela saludable. Resultados y conclusiones: La prevalencia de la obesidad fue de 5,54% en uno de los colegios y 3,68% en el otro. La prevalencia del sobrepeso fue de 14,61% en un colegio y 9,82% en el otro. A pesar de que la alimentación saludable fue identificada por los profesores como una característica importante de las escuelas, esto no se vio reflejado en el proyecto educativo institucional. Existen diferencias en cuanto a la prevalencia de la obesidad y del sobrepeso entre los colegios y entre los sexos, por lo cual existe la necesidad de continuar generando otras investigaciones que posibiliten indagar asociaciones causales.

Abstract Objective: Overweight and obesity are a public health problem of particular importance for the most vulnerable populations. The problem is significant because of the impact of childhood obesity on future cardiovascular health. The objective of this investigation was to describe the prevalence of school- age overweight and obesity in Bogota's vulnerable population, and the school context in which they present. Materials and methods: an anthropometric assessment was performed in two schools. The height for age and body mass index Z scores were obtained according to the growth standards of the World Health Organisation and the Centres for Disease Control and Prevention in Atlanta. Subsequently both schools were identified and a focus group was formed with the teachers regarding what a healthy school should comprise. Results and conclusions: There was a 5.54% prevalence of obesity in one of the schools, and 3.68% in the other. The prevalence of overweight was 14.61% in one school, and 9.82% in the other. Despite the fact that a healthy diet was highlighted by the teachers as an important characteristic in schools, this was not reflected in the institutional education project. There were differences in the prevalence of obesity and overweight between the schools, and between the sexes. Therefore, further studies are required to enable an in-depth exploration of the causative associations.

Impact of Spodoptera frugiperda neonate pretreatment conditions on Vip3Aa19 insecticidal protein activity and laboratory bioassay variation.

BACKGROUND: Variation in response to insecticidal proteins is common upon repetition of insect bioassays. Understanding this variation is a prerequisite to detecting biologically important differences. We tracked neonate Spodoptera frugiperda (J.E. Smith) susceptibility to Vip3Aa19 over 17 generations using standardized bioassay methods. Five larval pretreatment conditions and one bioassay condition were tested to determine whether susceptibility was affected. These included: storage time; prefeeding; storage at reduced temperature; storage at reduced humidity; colony introgression of field-collected individuals. Extremes of photoperiod during the bioassay itself were also examined. RESULTS: LC50 values for two strains of S. frugiperda varied 6.6-fold or 8.8-fold over 17 generations. Storage time and humidity had no impact on Vip3Aa19 susceptibility, whereas prefeeding significantly reduced subsequent mortality (by 27%). Storage at reduced temperature increased mortality for one colony (from 45.6 to 73.0%) but not for the other. Introgression of field-collected individuals affected susceptibility at the first generation but not for subsequent generations. A 24 h bioassay photophase significantly reduced susceptibility (by 26%) for both colonies. CONCLUSION: Certain pretreatment and bioassay conditions were identified that can affect S. frugiperda Vip3Aa19 susceptibility, but innate larval heterogeneity was also present. Our observations should help to increase the consistency of insecticidal protein bioassay results.

Prevalence of latent tuberculosis infection in patients with moderate to severe psoriasis taking biologic therapies in a dermatologic private practice in Miami, Florida.

BACKGROUND: The reactivation of a latent tuberculosis infection is one of the possible major events that may occur during biologic therapies for inflammatory chronic diseases such as psoriasis. Although its main screening test is regularly used in clinical practice, there are few studies about the prevalence of this silent mycobacterial infection and the rate of positive convertors during treatment. OBJECTIVE: To assess the prevalence of latent tuberculosis infection (LTBI) in patients with moderate to severe psoriasis receiving biologic therapy by using tuberculin skin test as a screening method and to evaluate the rate of conversion of tuberculin skin test (TST) during the treatment with biologics. METHODS: A total of 445 patients were included in our retrospective study, conducted from January 2006 to September 2012. Tuberculin skin test was performed in all patients prior to treatment and once a year during the follow-up. PPD was considered positive with an induration above 5 mm, following the recommendations of Centers for Disease Control and Prevention/ America Thoracic Society. Data analysis was obtained with SPSS 20.0. RESULTS: The prevalence of LTBI in our population before initiating the treatment was 4.5% by using TST screening method. During the treatment, 10 cases that were initially TST-negative became positive. Only one of the patients developed active tuberculosis infection. The other 9 TST-positive patients were detected during the regular annual screening, and no symptoms or findings on chest x-ray were seen. All the patients were treated with isoniazid (INH) for nine months, and biologic therapy was restarted after one month of treatment with INH without development of overt TB infection in any of them during the follow-up period of the study. The mean time to becoming TST positive from start date was 26.7 months (range from 8 months to 5 years). As the PPD was done annually, it is unknown exactly when the patients became TST positive. Prior to initiating treatment, 20 patients were found to be TST positive. All patients had clear chest x-rays and were treated with nine months of INH prior to initiating biologic therapy at least month later. CONCLUSIONS: The use of a screening tool for LTBI is mandatory in patients taking biologic therapies to avoid severe infectious complications. Periodic follow-up is also crucial as positive results may be seen after prolonged use of these agents.

Treatment of folliculitis decalvans with tacrolimus ointment.

Folliculitis decalvans is an embarrassing and challenging disease with no established treatment guidelines. In this paper, we described four patients with this disease treated successfully with Tacrolimus ointment. All of them showed significant control of the condition, stopping inflammatory lesions and progression of the disease, although weak transitory outbreaks of inflammatory lesions were observed in some cases. Alopecia and tufted hairs remained unchanged. The discontinuation of the therapy produced rapid relapses in all cases. Close monitoring of these patients is recommended due to the potential risk of malignant transformation of the disease.

Hemorragia digestiva superior variceal en el Hospital Central de Maracay durante los años 2004 - 2008 / Varicose upper digestive hemorrhage at Hospital Central de Maracay during 2004 - 2008

El sangrado gastrointestinal masivo por ruptura de várices esófago- gástricas, es la principal complicación de la hipertensión portal y representa una causa frecuente de muerte o transplante de hígado en pacientes con cirrosis. Determinar las características clínicas, endoscópicas, puntaje Child - Pugh y eficacia de la terapéutica de los pacientes con hemorragia digestiva superior variceal. Se revisaron las historias clínicas de los pacientes con hemorragia digestiva superior variceal que se hospitalizaron en la Emergencia de Adultos del Hospital Central de Maracay, del 01/01/2004 al 31/12/2008. Se analizarón las historias clínicas de 42 pacientes, de los cuales 69% eran varones. El grupo etáreo más afectado fue el de 61-70 años. El 43% de casos presento hematemesis. Las várices esofágicas grado II fueron el hallazgo endoscópico más frecuente. En el 14% de los pacientes el tratamiento fue médico y la ligadura fue el tratamiento endoscópico más utilizado. El promedio de hospitalización fue de 5 días y el promedio de transfusiones fue de 1,2 unidades por pacientes. La hematemesis fue el síntoma de presentación más frecuente, el hallazgos más encontrado fueron las várices esofágicas grado II y la endoligadura de várices fue el tratamiento mas utilizado...

Massive gastrointestinal bleeding caused by esophagealgastric varices’ rupture is the main complication of portal hypertension and represents a frequent cause of death, or liver transplantation on patients with cirrhosis. Determining the clinical and endoscopic features, the Child- Pugh score, as well as the therapy efficiency on patients with varicose upper digestive hemorrhage. The clinical records of patients with varicose upper digestive hemorrhage staying hospitalized after being checked at Hospital Central de Maracay Adult ER between January 1st 2004 and December 31st 2008. The clinical records of 42 patients were studied, of which 69% was male. The age group ranging 61-70 was the most affected. 43% of cases showed hematemesis. Grade II esophageal varices were the most frequent endoscopic finding. The treatment in 14% of patients was medical, and ligature was the most used endoscopic treatment. The average inpatient time was 5 days, and the blood transfusion average was 1.2 units per patient. Hematemesis was the most frequently present symptom, while the highest rate of finding was Grade II esophageal varices, and varice endoligature was the most used treatment...

Prevalencia del síndrome de intestino irritable y la relación del estrés laboral con esta patología en los médicos especialistas de dos centros hospitalarios y uno imagenologico de Maracay edo Aragua. Venezuela 2008

El síndrome de intestino irritable (SII) es una entidad clínica crónica, recurrente y común, de difícil diagnóstico, siendo la base diagnóstica la evaluación sintomática. Se ha descrito el estrés emocional como un factor desencadenante de los síntomas que la identifican, pudiéndose presentar con una alta prevalencia en la población joven y laboralmente activa. Objetivos: Determinar la prevalencia del SII, según los Criterios de Roma III, en una población de médicos de tres centros hospitalarios de Maracay. Mayo 2008 y evidenciar la relación del estrés laboral con esta patología. Métodos: A una muestra de 83 médicos especialistas de consultas, aparentemente sanos, del HCM, ASODIAM y HS, escogidos al azar, se les aplicó una encuesta-cuestionario, previo consentimiento verbal individual, interrogando los criterios de Roma III y la Escala de Maslach para medir el estrés laboral. Resultados: Según Roma III la prevalencia del SII en médicos especialistas fue de 37,3% (77,5% femeninos y 22,5% masculinos), de los cuales el 67,7% presentaron estrés laboral. Conclusión: Según el diagnóstico por criterios de Roma III existe una alta prevalencia de SII en la población de médicos especialistas, donde se describe al estrés como posible factor desencadenante de hechos fisiopatológicos que provocan la sintomatología de este síndrome en el grupo estudiado.

Irritable bowel syndrome (IBS) is a clinical chronic entity, recurrent and common; the diagnosis is based on symptomatic diagnostic evaluation. Emotional stress has been described as a trigger for the symptoms; it can be presented with a high prevalence in young population and labor force. Objectives: To determine the prevalence of IBS according to Rome III Criteria in a population of three doctors of hospitals in Maracay, May 2008 and to demonstrate the relationship of work stress with this condition. Methods: A sample of 83 specialists for consultations, apparently healthy of the HCM, and ASODIAM HS, chosen randomly, were interviewed with a questionnaire survey, previous individual verbal consent, using the Rome III Criteria and the Scale of Maslach to measure work stress. Results: According to the Rome III Criteria, the prevalence of IBS in medical specialists was 37.3% (77.5% female and 22.5% male), of which 67.7% had work-related stress. Conclusion: Accordingwith the Rome III Criteria there is a high prevalence of IBS in the physiciansÊ population, which describes stress as a possible trigger for pathophysiological events that cause the symptoms of this syndrome in this study.

Características clínicas y terapéuticas de los pacientes que ingresaron con diagnóstico de hemorragia digestiva superior, en el hospital central de Maracay, Edo. Aragua-Venezuela. 2001-2005

La Hemorragia Digestiva Superior (HDS) es la emergencia más importante y seria en gastroenterología. A pesar de los avances en el manejo médico-quirúrgico y endoscópico la mortalidad ha permanecido invariable. La causa más frecuente son las úlceras gastroduodenales. El abordaje inicial es médico. La utilidad de la Endoscopia Digestiva Superior es ilimitada, diagnostica la lesión, la ubica, permite efectuar tratamiento y orienta el pronóstico, resangrado y la mortalidad. Objetivo: analizar manifestaciones clínica, etiología y manejo terapéutico de los pacientes con HDS que ingresaron en el HCM 2001-2005. Métodos: estudio descriptivo-retrospectivo para caracterizar clínicamente a los pacientes con diagnóstico de HDS en HCM 2001-2005. Resultados: se revisaron 223 casos, encontrando predominio del grupo etario de 61-80 años (38%), del sexo masculino (63%), úlceras gastroduodenales (37%) como causa más frecuente, la melena (49%) como manifestación clínica, el 64% tuvieron antecedentes patológicos personales, 15% consume Antinflamatorios no Esteroideos (AINES), con un promedio de estancia hospitalaria de 4 días y de 1 transfusión sanguínea por evento de sangrado. Conclusión: la HDS se caracterizó por ocurrir más frecuentemente entre la quinta y sexta década de la vida, en el sexo masculino, asociada a patologías de base, donde se aplicó un manejo terapéutico conservador.

Upper Gastrointestinal Bleeding (UGB) is the most important and serious emergency in the area of Gastroenterology. In spite of the great advances in endoscopic and surgical techniques, the mortality rate has remained invariable. Gastro-duodenal ulcers are the most frequent cause. The preliminary approach is medical. The value of Upper Digestive Endoscopy is unlimited, it diagnoses and locates the lesion, allowing treatment procedures and permitting a prognosis assessment (re - bleeding and mortality). Objective: To analyze clinical manifestations, etiology and therapeutic handling of patients with UGB admitted to the HCM during 2001-2005. Methods: Retrospective- Descriptive Study to clinically characterize the patients with a diagnosis of UGB at the HCM during 20001-2005. Results: 223 cases were considered, finding predominance in the 61-80 age group (38%), males (63%), gastroduodenal ulcers (37%) as the most frequent cause, melena (49%) as clinical manifestation, and 64% had a personal pathological background, 15% used non-steroidal anti-inflammatory drugs (NSAID), with an average hospital stay of 4 days and 1 blood transfusion per bleeding event. Conclusion: UGB occurred more frequently between the fifth and the sixth decade, in males, associated with base pathologies. They were handled through a conservative therapeutic approach.

Efecto del tegaserod sobre el pH y las relajaciones transitorias del esfinter esofágico interior en pacientes con enfermedad de reflujo gastroesofágico / Tegaserod effects in the hP and the transit lower esophageal shincter relaxitions in the gastro esophageal reflux disease patients

Determinar el efecto del tegaserod sobre el número de las relajaciones transitorias del esfínter esofágico inferior (RTEEI) y el número de episodios de reflujo ácido durante las mismas, en el estado de ayuno y postprandial inmediato, en pacientes con enfermedad de reflujo gastro-esofágico (ERGE). Se seleccionaron 10 pacientes con ERGE y esofagitis grado I y II a los cuales se les realizo una manometría inicial de 2 horas (1 h ayuno y 1 h postprandial) para evaluar el número de RTEEI y medir el pH durante las mismas. Posteriormente los pacientes se dividieron en 2 grupos al azar: Grupo A y B. El grupo A tomo tegaserod 6 mg OD por 7 días después placebo por 7 días y el grupo B tomaron placebo durante 7 días y después tegaserod 6 mg OD por 7 días. La manometría fue realizada después de terminar cada periodo de 7 días de tratamiento. Tegaserod redujo significativamente la tasa de RTEEI postprandial de una media de 5 en una hora a 1,1 y la tasa de RTEEI totales de 9,2 en dos horas a 2,2 (p<0,000008 y p<0,00002 respectivamente). La tasa de episodios de reflujo ácido durante las RTEEI en ayuna disminuyeron de una media de 0,8 en una hora a 0,1 y en el periodo postprandial de 1,5 en una hora a 1,1, esta reducción no fue significativa (p<0,62 y p<0,06 respectivamente). El tegaserod tiene la capacidad de disminuir las RTEEI efecto que pudiera ser considerado para ser utilizado como tratamiento en la ERGE