Autolytic attempt mimicking Brugada type 1 electrocardiogram pattern due to flecainide toxicity. A case report.

Background: Brugada phenocopies are a group of heterogeneous disorders that mimic Brugada syndrome (BrS) electrocardiogram (ECG) changes elicited by reversible clinical conditions. We report a novel case on flecainide toxicity causing an ECG signature of Brugada type 1 pattern in the paediatric age. Case summary: A 13-year-old Caucasian boy with untreated attention-deficit/hyperactivity disorder referred to the Pediatric Emergency Department (PED) after unknown antiarrhythmic drug overdose. He deliberately ingested 10 tablets from a labelled white box of a 100-mg single dose. The ECG showed a coved-type ST-segment elevation in right precordial leads and prolongation of PR segment with a QTc limit interval. Values of troponins gradually increased and echocardiogram was normal. The altered ECG pattern was explained by the stabilizing membrane effect of flecainide involving the inhibition of rapid Na+ channels. After offending drug removal, regression of ECG changes was observed and no cardiac events were documented during follow-up. Discussion: Flecainide-induced Brugada type 1 ECG pattern may occur in patients with no evidence of genetic susceptibility receiving a toxic dosage of this drug. With increasing dose, its action on conduction pathways manifests as prolongation of PR interval and QT and QRS complex duration and may cause BrS mimicry. A detailed clinical history considering symptoms and ECG findings may support early-raised suspicion for flecainide ingestion. The therapeutic approach implies primary detoxification, prevention of potential triggers, and management of eventual cardiotoxicity events. Finally, risk stratification for BrS should be always measured according to the clinical scenario and surveillance considered in a timely manner.

EGFR and p38MAPK Contribute to the Apoptotic Effect of the Recombinant Lectin from Tepary Bean (Phaseolus acutifolius) in Colon Cancer Cells.

Previous works showed that a Tepary bean lectin fraction (TBLF) induced apoptosis on colon cancer cells and inhibited early colonic tumorigenesis. One Tepary bean (TB) lectin was expressed in Pichia pastoris (rTBL-1), exhibiting similarities to one native lectin, where its molecular structure and in silico recognition of cancer-type N-glycoconjugates were confirmed. This work aimed to determine whether rTBL-1 retained its bioactive properties and if its apoptotic effect was related to EGFR pathways by studying its cytotoxic effect on colon cancer cells. Similar apoptotic effects of rTBL-1 with respect to TBLF were observed for cleaved PARP-1 and caspase 3, and cell cycle G0/G1 arrest and decreased S phase were observed for both treatments. Apoptosis induction on SW-480 cells was confirmed by testing HA2X, p53 phosphorylation, nuclear fragmentation, and apoptotic bodies. rTBL-1 increased EGFR phosphorylation but also its degradation by the lysosomal route. Phospho-p38 increased in a concentration- and time-dependent manner, matching apoptotic markers, and STAT1 showed activation after rTBL-1 treatment. The results show that part of the rTBL-1 mechanism of action is related to p38 MAPK signaling. Future work will focus further on the target molecules of this recombinant lectin against colon cancer.

Analysis of gene expression related to polyamine concentration and dimorphism induced in ornithine decarboxylase (odc) and spermidine synthase (spd) Ustilago maydis mutants.

Polyamines are ubiquitous small organic cations, and their roles as regulators of several cellular processes are widely recognized. They are implicated in the key stages of the fungal life cycle. Ustilago maydis is a phytopathogenic fungus, the causal agent of common smut of maize and a model system to understand dimorphism and virulence. U. maydis grows in yeast form at pH 7 and it can develop its mycelial form in vitro at pH 3. Δodc mutants that are unable to synthesize polyamines, grow as yeast at pH 3 with a low putrescine concentration, and to complete its dimorphic transition high putrescine concentration is require. Δspd mutants require spermidine to grow and cannot form mycelium at pH 3. In this work, the increased expression of the mating genes, mfa1 and mfa2, on Δodc mutants, was related to high putrescine concentration. Global gene expression analysis comparisons of Δodc and Δspd U. maydis mutants indicated that 2,959 genes were differentially expressed in the presence of exogenous putrescine at pH 7 and 475 genes at pH 3. While, in Δspd mutant, the expression of 1,426 genes was affected by exogenous spermine concentration at pH 7 and 11 genes at pH 3. Additionally, we identified 28 transcriptional modules with correlated expression during seven tested conditions: mutant genotype, morphology (yeast, and mycelium), pH, and putrescine or spermidine concentration. Furthermore, significant differences in transcript levels were noted for genes in modules relating to pH and genotype genes involved in ribosome biogenesis, mitochondrial oxidative phosphorylation, N-glycan synthesis, and Glycosylphosphatidylinositol (GPI)-anchor. In summary, our results offer a valuable tool for the identification of potential factors involved in phenomena related to polyamines and dimorphism.

Comparative study, homology modelling and molecular docking with cancer associated glycans of two non-fetuin-binding Tepary bean lectins.

We present the purification and characterization of the two most abundant isoforms of lectins isolated from Tepary bean (Phaseolus acutifolius) seeds, which have been shown to differentially affect the survival of different cancer cells. They were separated by concanavalin A-affinity chromatography. After purification, to release the N-glycans, they were digested with the endoglycosidases PNGase and Glycanase A. Fractions resulted from the hydrolysis products were analyzed to determine their carbohydrate composition. Mass spectrometry data indicated that both isoforms contained high mannose glycans being mannose 6 the most abundant form. Furthermore, based on sequence Ans-X-Ser/Thr, where X is any amino acid except proline, a glycosylation site was determined on asparagine 36. When their metal requirement to preserve their biological activity was determined, the lectins showed differences. While lectin A (LA) agglutination activity was best in the presence of magnesium, lectin B (LB) was best with calcium. Additionally, only LA exhibited affinity to human type-A erythrocytes. Although both lectins showed small differences in their properties, an identical structure-model for both lectins was generated by the homology modelling process. Also, the analysis of ligand binding sites and in silico glycosylation were achieved. Molecular docking with colon adenocarcinoma associated-N-glycans revealed some highly possible interactions and, on the other hand, that N-glycan interaction zones of Tepary bean lectins is not restricted to the carbohydrate binding domain but to an extended part of their surface, which could lead new strategies to explain their biological activity.

Hybridization between Crotalus aquilus and Crotalus polystictus Species: A Comparison of Their Venom Toxicity and Enzymatic Activities.

Hybridization is defined as the interbreeding of individuals from two populations distinguishable by one or more heritable characteristics. Snake hybridization represents an interesting opportunity to analyze variability and how genetics affect the venom components between parents and hybrids. Snake venoms exhibit a high degree of variability related to biological and biogeographical factors. The aim of this work is to analyze the protein patterns and enzymatic activity of some of the main hemotoxic enzymes in snake venoms, such as serine proteases (trypsin-like, chymotrypsin-like, and elastase-like), metalloproteases, hyaluronidases, and phospholipase A2. The lethal dose of 50 (LD50) of venom from the Crotalus aquilus (Cabf) and Crotalus polystictus (Cpbm) parents and their hybrids in captivity was determined, and phenetic analysis is also conducted, which showed a high similarity between the hybrids and C. polystictus. The protein banding patterns and enzymatic activity analyze by zymography resulted in a combination of proteins from the parental venoms in the hybrids, with variability among them. In some cases, the enzymatic activity is higher in the hybrids with a lower LD50 than in the parents, indicating higher toxicity. These data show the variability among snake venoms and suggest that hybridization is an important factor in changes in protein concentration, peptide variability, and enzymatic activity that affect toxicity and lethality.

Properties of a Non-canonical Complex Formed Between a Tepary Bean (Phaseolus acutifolius) Protease Inhibitor and α-Chymotrypsin.

Protease inhibitors are crucial for the control of proteolytic activity in different physiological processes. However, some inhibitors do not show canonical enzyme recognition of the enzyme under certain conditions. In this work, we present evidence that indicates the formation of an active complex between the protease bovine α-chymotrypsin and the Tepary bean protease inhibitor (TBPI). The composition of the active chymotrypsin-TBPI complex (AC) was confirmed by three different methods: size-exclusion chromatography, polyacrylamide gel electrophoresis (PAGE), and mass spectrometry. The kinetic parameters for the AC were similar to those of the enzyme alone, indicating that TBPI binding does not produce any large changes in chymotrypsin. The molecular model proposed here postulates that TBPI binds outside the active cleft of the protease, but near enough to hinder the binding of high molecular weight substrates into the active site. This model was experimentally supported by the inhibitory effect on casein as a substrate, and the unaltered protease activity when a small synthetic substrate was used. We also found that the formation of this complex provided the enzyme with extra stability in denaturing conditions or in the presence of a reducing agent. The chymotrypsin-TBPI complex exhibited higher stability, indicating that autolysis can be partially prevented. When the enzyme was first inactivated followed by the addition of the inhibitor, the activity of the protease was restored. We described a possible mechanism where a plant protease inhibitor binds outside the active site of the enzyme while increasing its stability.

Snake Venom Hemotoxic Enzymes: Biochemical Comparison between Crotalus Species from Central Mexico.

Snakebite envenoming is a serious medical problem in different areas of the world. In Latin America, the major prevalence is due to snakes of the family Viperidae, where rattlesnakes (Crotalus) are included. They produce hemotoxic venom which causes bleeding, tissue degradation and necrosis. Each venom has several enzymatic activities, producing different effects in the envenoming, doing its clinical effects difficult to study. Comparison between venom molecules is also difficult when different techniques are used, and therefore, their identification/characterization using the same methodology is necessary. In this work, a general biochemical characterization in snake venom of serine proteases (SVSP), phospholipases A2 (PLA2), metalloproteases (SVMP) and hyaluronidases (SVH) of Crotalus aquilus (Ca), Crotalus polystictus (Cp) and Crotalus molossus nigrescens (Cmn) was done. Differences in protein pattern, enzyme content and enzymatic activities were observed. All the venoms showed high PLA2 activity, high molecular weight SVSP, and a wide variety of SVMP and SVH forms. Ca and Cp showed the highest enzymatic activities of SVMP and SVSP trypsin-like and chymotrypsin-like, whereas Cmn showed the highest SVH and similar PLA2 activity with Ca. All the venoms showed peptides with similar molecular weight to crotamine-like myotoxins. No previous biochemical characterization of C. aquilus has been reported and there are no previous analyses that include these four protein families in these Crotalus venoms.

Immune Complex Membranoproliferative Glomerulonephritis Associated with Transjugular Intrahepatic Portosystemic Shunts in Alcoholic Cirrhosis: Two Case Reports.

OBJECTIVE: To report on 2 patients with alcoholic cirrhosis who were treated with transjugular intrahepatic portosystemic shunt (TIPS) placement. CLINICAL PRESENTATION AND INTERVENTION: The 2 patients had a history of alcoholic cirrhosis, and TIPS surgery was performed on them. In both cases, 4 months after TIPS placement, proteinuria was observed along with histological alterations characteristic of immune complex membranoproliferative glomerulonephritis (MPGN). CONCLUSION: The TIPS in one patient was successful without immediate complications, while the other patient was referred for a combined liver-kidney transplant. In both cases, immune complex MPGN might have developed after TIPS placement probably due to a reduced immune complex clearance.

Membranous glomerulonephritis and cellular crescents induced by levamisole-adulterated cocaine abuse: a case report.

Levamisole is illicitly employed as a cocaine adulterant. The consumption of levamisole-adulterated cocaine can provoke anti-neutrophil cytoplasmic antibody (ANCA)-associated syndromes. Patients carrying an HLAB27 allele are known to be at higher risk of developing agranulocytosis when treated with levamisole. Likewise, patients with ANCA-associated vasculitis (AAV) and internal organ involvement have typically been exposed to offending agents for prolonged periods of time, often on the order of years. Here, we report an unusual case of a patient in which kidney biopsy showed membranous glomerulonephritis with cellular crescents associated with levamisole-contaminated cocaine use.

Estilos y trastornos de personalidad: características psicométricas del “Cuestionario exploratorio de personalidad-III” (CEPER-III) / Personality styles and disorders: psychometric characteristics of the “Personality Exploratory Questionnaire-III” (CEPER-III)

Los trastornos de la personalidad constituyen un tema de permanente actua­lidad. Su evaluación y tratamiento son controvertidos y queda mucho por hacer en ambos aspectos. El objetivo de este estudio es presentar algunas características psicométricas del “Cuestionario exploratorio de personalidad-III” (CEPER-III), que permite evaluar los diferentes estilos de personalidad con base en el sistema de diagnóstico del DSM-IV-TR (APA, 2000), pero sin suponer, necesariamente, patolo­gía ni desadaptación. Los resultados del estudio muestran un nivel de consistencia interna del CEPER-III (alfa de Cronbach) de 0,97, así como de las escalas que lo componen (desde 0,75 hasta 0,89), su fiabilidad (Guttman= 0,93) y la validez con­vergente de los estilos (desde r= 0,50 hasta r= 0,72) utilizando como criterio las subescalas centradas en los trastornos de personalidad del “Inventario clínico mul­tiaxial de Millon-III” (Millon Clinical Multiaxial Inventory-III, MCMI-III; Millon, 1994). Las diferencias de sexo aparecen sólo en seis de los 14 estilos de personalidad del CEPER-III (cinco de ellas confirmadas por las mismas diferencias en el caso de los trastornos). Para concluir, queremos señalar que el CEPER-III puede ser una buena medida para evaluar tendencias de comportamientos, en pacientes y no pacientes, basadas en los síntomas diagnósticos del DSM-IV-TR (AU)

Personality disorders are a topic of ongoing interest. Their assessment and treatment are controversial and there is a lot of work still to be done in both areas. The aim of this study is to present certain psychometric characteristics of the “Cuestionario Exploratorio de Personalidad-III” (CEPER III) (Exploratory Questionnaire of Personality-III), which assesses different styles of personality based on the diagnostic system of the DSM-IV-TR (APA, 2000), but without necessarily assuming a pathology or adjustment problems. The results of the study show an internal consistency for the CEPER-III of 0.97 (Cronbach’s alpha), as well as for its component scales (from 0.75 up to 0.89), its reliability (Guttman = 0.93) and the convergent validity of the styles (from r= 0.50 to r= 0.72) using as criterion the personality disorder sub-scales of the “Millon Clinical Multiaxial Inventory-III” (MCMI-III; Millon, 1994). Sex differences appear in only six of the 14 styles of personality in CEPER-III (five of them confirmed by the same differences as in the case of personality disorders). In short, the CEPER-III may be a good way of measuring behavioral trends in both patients and non-patients, based on the diagnostic symptoms of the DSM-IV-TR

Relaciones entre ansiedad social y estilos, trastornos y rasgos de la personalidad / Relationships between social anxiety and personality traits, styles, and disorders

l objetivo de esta investigación ha sido averiguar qué relaciones hay entre ansiedad social, por una parte, y rasgos, estilos y trastornos de la personalidad y estilos de afrontamiento, por la otra. En el estudio han participado estudiantes universitarios que han contestado a cuatro instrumentos de autoinforme para evaluar la fobia social, a dos sobre estilos y trastornos de la personalidad, a uno sobre rasgos de personalidad y a otro sobre estrategias de afrontamiento. Los resultados han mostrado que la ansiedad social se relaciona positivamente y significativamente con los estilos/trastornos de la personalidad por evitación, por dependencia y depresivo, principalmente, y con el esquizoide, el esquizotípico y el pasivo-agresivo en un grado menor. Por el contrario, con el estilo/trastorno histriónico de la personalidad la relación es negativa. En el caso de los cinco grandes rasgos, hay una relación positiva con el neuroticismo y negativa con la extraversión. La ansiedad social se asocia positivamente con el estilo evitativo de afrontamiento y de forma negativa con los estilos asertivo y agresivo. Se presentan también las dimensiones de la ansiedad social que están más relacionadas con las distintas variables de personalidad y afrontamiento. Estos datos son novedosos y muestran la importancia de considerar las distintas dimensiones de la ansiedad social y no sólo la puntuación global (AU)

The goal of this research was to find out what the relationships are between social anxiety, on the one hand, and personality traits, styles, disorders, and coping styles, on the other. Participants were university students who responded to four self-report instruments measuring social phobia/anxiety, a further two instruments assessing personality styles/disorders, another assessing personality traits, and, finally, one assessing coping styles. Results showed that social anxiety is positively and significantly related to avoidant, dependent, and depressive personality styles/disorders and, to a lesser extent, to schizoid, schizotypal, and passive-aggressive personality styles/disorders. There is also a negative relationship with histrionic personality style/disorder. In the case of the big five, social anxiety is positively related to neuroticism and negatively related to extraversion. Finally, social anxiety is positively related to the avoidant coping style and negatively related to the assertive and aggressive coping styles. Results also show which dimensions of social phobia/anxiety are most highly related to personality and coping variables. These data are interesting and show the importance of taking into account the different dimensions of social anxiety and not only the social anxiety global score

Estilos, rasgos y trastornos de la personalidad: interrelaciones y diferencias asociadas al sexo / Estilos, traços e transtornos da personalidade: inter-relações e diferenças associadas ao sexo / Styles, traits and disorders of personality: inter-relationships and differences associated to sex

La búsqueda de la estructura básica de la personalidad es un tema relevante y en los últimos años las investigaciones se han centrado en el modelo de los cinco grandes rasgos o factores. Este trabajo averigua las relaciones que existen entre la personalidad normal y la patológica y las relaciones entre los cinco grandes factores y los trastornos de la personalidad del DSM-IV. La muestra fue de 545 universitarios. Los instrumentos fueron el Cuestionario Big Fiv, el Cuestionario exploratorio de la personalidad y el Inventario Clínico Multiaxial de Millon-II. Los resultados muestran que tres factores, Extraversión, Estabilidad emocional y Amabilidad, se relacionan significativamente con algunos trastornos. Los hombres puntuaban significativamente más alto que las mujeres en factores como extraversión, estabilidad emocional y en los trastornos antisocial, narcisista y sádico. Las mujeres tenían puntuaciones superiores en el factor de la amabilidad y en los trastornos límite, dependiente y depresivo. Se discuten las implicaciones de estos resultados para la práctica clínica.

A pesquisa da estrutura básica da personalidade é um tema relevante e nos últimos anos as investigações tem se centrado no modelo dos cincos grandes fatores. Este trabalho investiga as relações que existem entre a personalidade normal e a patológica, e entre as relações dos cinco grandes fatores e os transtornos da personalidade do DSM-IV. A amostra foi de 545 universitários. Os instrumentos utilizados foram o Questionário Big Five, o Questionário exploratório da Personalidade e o Inventário Clínico Multiaxial de Millon-II. Os resultados mostram que três fatores, extroversão, estabilidade Emocional e amabilidade, se relacionam significativamente com alguns transtornos. Os homens pontuaram significativamente mais alto que as mulheres nos fatores como extroversão, estabilidade emocional e em os transtornos anti-social, narcisista e sádico. As mulheres tinham pontuações superiores no fator de Amabilidade e nos transtornos limítrofe, dependente e depressivo. São discutidas as implicações desses resultados para a prática clínica.

The search for the basic structure of personality is a current topic of interest and in the last years the research has focused in the big five traits or factors model. The possibility to establish a reliable classification of the personality disorders is a permanent concern for the researchers in the field; an example of its current state can be found in the section on personality disorders of the DSM-IV. The present work has tried to found the existing relationships between those two fields, the normal and the pathological personalities and more specifically, the relationships between the big five traits and the styles/disorders of personality in base to the DSM-IV. The sample in this work was composed by 545 university students of diverse careers. The self-report instruments used to assess personality areas were the “Big Five Questionnaire” (BFQ; Caprara, Barbaranelli, & Borgogni, 1995) (for traits), the “Exploratory Questionnaire of Personality” (Cuestionario exploratorio de la personalidad, CEPER; Caballo, 1997) (for styles) and the “Millon Clinical Multiaxial Inventory-II” (MCMI-II; Millon, 1987) (for disorders). The results show that three of the big traits, extroversion, emotional stability and agreeableness were significantly related to some styles/disorders of personality, particularly the last two traits. On the other hand, men scored significantly higher that women in traits like extroversion and emotional stability and in styles/disorders such as antisocial, narcissistic and sadistic, while women scored higher on the Agreeableness trait and in styles/disorders of personality such as borderline, dependent and depressive. The implications of these results for clinical practice are discussed.

Estilos, rasgos y trastornos de la personalidad: interrelaciones y diferencias asociadas al sexo / Estilos, traços e transtornos da personalidade: inter-relações e diferenças associadas ao sexo / Styles, traits and disorders of personality: inter-relationships and differences associated to sex

La búsqueda de la estructura básica de la personalidad es un tema relevante y en los últimos años las investigaciones se han centrado en el modelo de los cinco grandes rasgos o factores. Este trabajo averigua las relaciones que existen entre la personalidad normal y la patológica y las relaciones entre los cinco grandes factores y los trastornos de la personalidad del DSM-IV. La muestra fue de 545 universitarios. Los instrumentos fueron el Cuestionario Big Fiv, el Cuestionario exploratorio de la personalidad y el Inventario Clínico Multiaxial de Millon-II. Los resultados muestran que tres factores, Extraversión, Estabilidad emocional y Amabilidad, se relacionan significativamente con algunos trastornos. Los hombres puntuaban significativamente más alto que las mujeres en factores como extraversión, estabilidad emocional y en los trastornos antisocial, narcisista y sádico. Las mujeres tenían puntuaciones superiores en el factor de la amabilidad y en los trastornos límite, dependiente y depresivo. Se discuten las implicaciones de estos resultados para la práctica clínica.(AU)

A pesquisa da estrutura básica da personalidade é um tema relevante e nos últimos anos as investigações tem se centrado no modelo dos cincos grandes fatores. Este trabalho investiga as relações que existem entre a personalidade normal e a patológica, e entre as relações dos cinco grandes fatores e os transtornos da personalidade do DSM-IV. A amostra foi de 545 universitários. Os instrumentos utilizados foram o Questionário Big Five, o Questionário exploratório da Personalidade e o Inventário Clínico Multiaxial de Millon-II. Os resultados mostram que três fatores, extroversão, estabilidade Emocional e amabilidade, se relacionam significativamente com alguns transtornos. Os homens pontuaram significativamente mais alto que as mulheres nos fatores como extroversão, estabilidade emocional e em os transtornos anti-social, narcisista e sádico. As mulheres tinham pontuações superiores no fator de Amabilidade e nos transtornos limítrofe, dependente e depressivo. São discutidas as implicações desses resultados para a prática clínica.(AU)

The search for the basic structure of personality is a current topic of interest and in the last years the research has focused in the big five traits or factors model. The possibility to establish a reliable classification of the personality disorders is a permanent concern for the researchers in the field; an example of its current state can be found in the section on personality disorders of the DSM-IV. The present work has tried to found the existing relationships between those two fields, the normal and the pathological personalities and more specifically, the relationships between the big five traits and the styles/disorders of personality in base to the DSM-IV. The sample in this work was composed by 545 university students of diverse careers. The self-report instruments used to assess personality areas were the “Big Five Questionnaire” (BFQ; Caprara, Barbaranelli, & Borgogni, 1995) (for traits), the “Exploratory Questionnaire of Personality” (Cuestionario exploratorio de la personalidad, CEPER; Caballo, 1997) (for styles) and the “Millon Clinical Multiaxial Inventory-II” (MCMI-II; Millon, 1987) (for disorders). The results show that three of the big traits, extroversion, emotional stability and agreeableness were significantly related to some styles/disorders of personality, particularly the last two traits. On the other hand, men scored significantly higher that women in traits like extroversion and emotional stability and in styles/disorders such as antisocial, narcissistic and sadistic, while women scored higher on the Agreeableness trait and in styles/disorders of personality such as borderline, dependent and depressive. The implications of these results for clinical practice are discussed.(AU)

Experimental toxocariosis in BALB/c mice: effect of the inoculation dose on brain and eye involvement.

Ocular toxocarosis (OT) is a well-established disease. However, our understanding of the migratory route, time and circumstances that produce ocular invasion are not clear. To improve our knowledge of factors related to ocular invasion, BALB/c mice were inoculated with simple doses (SD) of 6, 12, 50, 100, 200 and 1000 embryonated eggs (EE) and multiple doses (MD) of 200 and 1000 EE. Brains and eyes were studied for the presence of larvae in animals sacrificed on days 3, 5, 7, 9, 11, 13, 15, 17, 19, 40, 80 and 120 in SD and on days 28, 30, 32, 34, 36, 38, 40, 42, 46, 87 and 127 in MD. The humoral immune responses were studied by ELISA using excretory-secretory antigen. Due to the considerable number of days tested, results showed are based on one set of experiments. However, each point studied represents the result obtained from a group of five mice. We have shown that the eye involvement with Toxocara canis larvae is a phenomenon mainly produced once larvae have reached the brain. There is a direct relationship between the parasitic load and the number of ocular larvae. Moreover, the arrival of larvae to the eye is an independent event, unrelated to the kind of administered dose (SD, MD), although the number of the brain larvae was higher in the cases of MD. High levels of specific antibodies were observed but they did not prevent the arrival of the larvae to the brain and the eye.

De la metadona al LAAM: nuevos perfiles terapeúticos. Utilidad de la monitorización terapeútica (MT) / From methadone to LAAM: new therapeutic profiles: utility of therapeutic monitoring (TM)

La introducción del LAAM en el tratamiento farmacológico de la dependencia a opiáceos, supone un avance importante, al poder diversificar el uso de opioides que hasta el momento, en nuestro país, se había reducido a la metadona.El objetivo de este trabajo ha sido la identificación de nuevos perfiles de uso del LAAM , teniendo en cuenta aspectos farmacocinéticos y posibles interacciones con otros fármacos y apoyado por los resultados obtenidos sobre niveles plasmáticos de metadona y su posible aplicación al LAAM. En el momento actual, su perfil de uso sólo ha sido para pacientes en metadona estabilizados, con buena respuesta al tratamiento, y a los que se deseaba flexibilizar y espaciar la administración diaria . En este artículo se proponen otros perfiles de uso, tales como programas de alto umbral orientados al cambio con desintoxicación y posterior paso a programa libre de drogas y sobre todo pacientes en metadona que pierden estabilidad y presentan síndrome de abstinencia a opiáceos, con disminución de los niveles plasmáticos de metadona, debido a interacciones medicamentosas o a otros motivos. Será necesario realizar estudios con los perfiles propuestos, que amplíen el uso del LAAM para pacientes que tienen problemas con la metadona, como una alternativa terapeútica, complementada con la monitorización en plasma como un instrumento de ayuda y evaluación que mejore la eficacia de los mismos. (AU)