Scientometric analysis of chemotherapy of canine leishmaniasis (2000-2020).

BACKGROUND: Zoonotic visceral leishmaniasis by Leishmania infantum is a first-order pathology in canine veterinary clinics in endemic areas. Moreover, canine infections are considered the main reservoir for human disease; despite their importance in the control of the disease within a One Health approach, no scientometric study has been published. Aims of the study included analyzing the impact of canine leishmaniasis (CanL) on the scientific literature, drugs or combinations used, trends in the period from 2000 to 2020 and efficacy criteria employed. METHODS: A Web of Science (WOS)-based analysis of publications on CanL and chemotherapy of the disease in the period 2000-2020 was carried out using a stepwise methodology. Data were analyzed by year, geographical origin, chemical groups, drugs and combinations, and efficacy criteria. RESULTS: Reports on CanL (n = 3324) represented < 16% of all publications on leishmaniasis (n = 20,968), and of these around 18% (n = 596) were related to chemotherapy. Publication records on CanL followed the distribution of the infection by L. infantum in endemic areas although Mediterranean countries were overrepresented in the reports on chemotherapy of CanL. Publications on the main antileishmanial drugs used in clinical practice showed a sustained tendency in the period analyzed. Pentavalent antimonials (SbV), alone or in combination with allopurinol, represented > 50% of all publications on chemotherapy of CanL despite the availability of more recently marketed drugs. CONCLUSIONS: Chemotherapy of CanL still relies on SbV and combinations and to a lesser extent on miltefosine (MIL). Reports on chemotherapy are scarce and mostly publicly funded, and the variability of experimental conditions hampers the direct comparison of the efficacy of drugs, combinations and schedules. The vast majority of reports on efficacy do not include any information on supportive therapy; this reduces the actual value of the studies if intended for the practical management of the disease. Complete reports on the chemotherapy (etiological + symptomatic) would add value to the trials performed.

Infection of dogs by Leishmania infantum elicits a general response of IgG subclasses.

Leishmania infantum is the etiological agent of zoonotic visceral leishmaniasis. In endemic areas, canine infections are considered the main source of infection for human populations. Therefore, any control of human leishmaniasis must include the control of canine infections. Chemotherapy of leishmaniasis is inadequate and canine immunoprophylaxis has important limitations. Reports on the response of infected dogs are abundant but no clear picture of immune events has emerged. To shed some light on these shortcomings the specific IgG subclass response was followed in 20 Beagle dogs experimentally infected with L. infantum using monoclonal antibodies (MAb) specific for canine IgG1, IgG2, IgG3 and IgG4, along with ELISA and flow cytometry. Results showed that parasitic infection elicits a general response of all IgG subclasses, with a predominant IgG1 response and without any evidence of IgG1/IgG2 dichotomy. These findings suggest that the inconsistent results reported previously could be related to the lack of specific reagents and not to the actual differences in the immune response of infected animals. Differential IgG subclass reactivity in ELISA and cytometry and the analysis of the reacting antigens could facilitate the diagnosis and prognosis of the disease and provide a useful tool for adequate therapeutics and vaccine development against leishmaniasis.

Ictus isquémico en territorio posterior como complicación de embolización de arterias bronquiales / No disponible

No disponible

Mortalidad asociada al ictus en un hospital andaluz de tercer nivel. Análisis y reflexiones / Stroke-related mortality in a tertiary care hospital in Andalusia: Analysis and reflections

Objetivos: El ictus constituye una causa muy frecuente de muerte, especialmente en el sur de España; se analiza la mortalidad intrahospitalaria asociada a ictus en un hospital andaluz de tercer nivel. Métodos: Registro de pacientes con ictus como diagnóstico en su informe de defunción en el Hospital Virgen de las Nieves de Granada durante 2013. Se utilizan además datos globales sobre altas en ictus y se comparan con iguales variables en síndrome coronario agudo (SCA). Resultados: Altas con diagnóstico de ictus 825 (96 defunciones, 11,6%); 562 isquémicos (44 fallecidos, 7,8%); 263 hemorrágicos (52 muertes, 19,7%). Los hemorrágicos, por tanto, tuvieron mayor mortalidad (OR = 2,9) y más precoz durante el ingreso (mediana 4 vs. 7 días, global 6 días), aunque los isquémicos fueron más ancianos y más pluripatológicos. Altas con SCA 617 (36 fallecidos, 5,8%); OR de mortalidad en ictus/SCA = 2,1. Un 23% de los fallecidos con ictus estaban anticoagulados cuando lo presentaron. El 60% de los ictus isquémicos y el 20% de los ictus hemorrágicos fallecidos tenían fibrilación auricular; solo el 35% de los pacientes con ictus isquémico y fibrilación auricular estaban anticoagulados. Conclusiones: El ictus supera al SCA en ingresos y mortalidad intrahospitalaria. El ictus hemorrágico supera al isquémico en mortalidad asociada. La anticoagulación crónica es frecuente en pacientes con ictus fatal; 2 tercios de los pacientes con ictus isquémico mortal y fibrilación auricular no estaban anticoagulados. Según nuestros resultados, optimizar la prevención en pacientes con fibrilación auricular podría impactar favorablemente sobre la mortalidad intrahospitalaria asociada al ictus (AU)

Objectives: Stroke is a very common cause of death, especially in southern Spain. The present study analyses in-hospital mortality associated with stroke in an Andalusian tertiary care hospital. Methods: We gathered the files of all patients who had died at Hospital Universitario Virgen de las Nieves in Granada in 2013 and whose death certificates indicated stroke as the cause of death. We also gathered stroke patients discharge data and compared them to that of patients with acute coronary syndrome (ACS). Results: A total of 825 patients had a diagnosis of stroke (96 deaths, 11.6%); of these, 562 had ischaemic stroke (44 deaths, 7.8%) and 263 haemorrhagic stroke (52 deaths, 19.7%). Patients with haemorrhagic stroke therefore showed greater mortality rate (OR = 2.9). Patients in this group died after a shorter time in hospital (median, 4 vs 7 days; mean, 6 days). However, patients with ischaemic stroke were older and presented with more comorbidities. On the other hand, 617 patients had a diagnosis of ACS (36 deaths, 5.8%). The mortality odds ratio (MOR) was 2.1 (stroke/SCA). Around 23% of the patients who died from stroke were taking anticoagulants. 60% of the deceased patients with ischaemic stroke and 20% of those with haemorrhagic stroke had atrial fibrillation (AF); 35% of the patients with ischaemic stroke and AF were taking anticoagulants. Conclusions: Stroke is associated with higher admission and in-hospital mortality rates than SCA. Likewise, patients with haemorrhagic stroke showed higher mortality rates than those with ischaemic stroke. Patients with fatal stroke usually had a history of long-term treatment with anticoagulants; 2 thirds of the patients with fatal ischaemic stroke and atrial fibrillation were not receiving anticoagulants. According to our results, optimising prevention in patients with AF may have a positive impact on stroke-related in-hospital mortality (AU)

Stroke-related mortality in a tertiary care hospital in Andalusia: Analysis and reflections. / Mortalidad asociada al ictus en un hospital andaluz de tercer nivel. Análisis y reflexiones.

OBJECTIVES: Stroke is a very common cause of death, especially in southern Spain. The present study analyses in-hospital mortality associated with stroke in an Andalusian tertiary care hospital. METHODS: We gathered the files of all patients who had died at Hospital Universitario Virgen de las Nieves in Granada in 2013 and whose death certificates indicated stroke as the cause of death. We also gathered stroke patients discharge data and compared them to that of patients with acute coronary syndrome (ACS). RESULTS: A total of 825 patients had a diagnosis of stroke (96 deaths, 11.6%); of these, 562 had ischaemic stroke (44 deaths, 7.8%) and 263 haemorrhagic stroke (52 deaths, 19.7%). Patients with haemorrhagic stroke therefore showed greater mortality rate (OR=2.9). Patients in this group died after a shorter time in hospital (median, 4 vs 7 days; mean, 6 days). However, patients with ischaemic stroke were older and presented with more comorbidities. On the other hand, 617 patients had a diagnosis of ACS (36 deaths, 5.8%). The mortality odds ratio (MOR) was 2.1 (stroke/SCA). Around 23% of the patients who died from stroke were taking anticoagulants. 60% of the deceased patients with ischaemic stroke and 20% of those with haemorrhagic stroke had atrial fibrillation (AF); 35% of the patients with ischaemic stroke and AF were taking anticoagulants. CONCLUSIONS: Stroke is associated with higher admission and in-hospital mortality rates than SCA. Likewise, patients with haemorrhagic stroke showed higher mortality rates than those with ischaemic stroke. Patients with fatal stroke usually had a history of long-term treatment with anticoagulants; 2 thirds of the patients with fatal ischaemic stroke and atrial fibrillation were not receiving anticoagulants. According to our results, optimising prevention in patients with AF may have a positive impact on stroke-related in-hospital mortality.

Early learning failure impairs adult learning in rats.

Early life experiences may affect adult learning ability. In two experiments we tested the effect of early learning failure on adult performance in Wistar rats. In the first experiment 17-day-old rats (PN17), but not 25-day-old rats (PN25), trained in a hidden platform water maze task showed deficits in tone-shock avoidance learning when they were 3-months-old. The second experiment, which included random-platform and non-platform control groups, confirmed the effect of early (PN18) spatial learning failure on adult avoidance learning. However, post-weaning training (PN25) without platform also tended to induce adult learning deficits as long as the adult task difficulty was increased. The older non-platform group did not differ from the impaired group which received early training in a fixed hidden platform task. The results are discussed in terms of the relevance of early learning outcome and developmental stage on adult general learning deficits which may be related to the learned helplessness phenomenon and developmental neural plasticity.

Registro individual informatizado de salud y exposición laboral en la industria química y farmacéutica / The computerised individual workplace health record in the chemical and pharmaceutical industry

En la actualidad existen diversos modelos de historias clínicas laborales informatizadas que son utilizadas por el personal sanitario de los servicios de prevención de algunas empresas. Estas herramientas de trabajo que facilitan la actividad diaria de las unidades de salud, no contienen sin embargo datos relacionados con las condiciones laborales. De esta carencia podemos deducir que la explotación informática de estos sistemas de información está coartada en su esencia, ya que no sirven para correlacionar los datos médicos con los higiénicos y medioambientales por lo que no son útiles para validar la actividad preventiva desarrollada en la empresa ni tampoco ayudan a tomar decisiones correctas que sirvan para llevar adelante una aceptable prevención laboral primaria. La Ley de Prevención de Riesgos Laborales, el Reglamento de los Servicios de Prevención y el Real Decreto 374/2001 que transpone a la legislación española la Directiva 98/24 CE relativa a la protección de la salud y la seguridad de los trabajadores expuestos a agentes químicos establecen aquellos datos mínimos necesarios que el empresario está obligado a registrar y archivar en la documentación de cada trabajador. En ella se hace especial hincapié en los riesgos higiénicos a los que ha estado expuesto el trabajador durante toda su vida laboral y en las patologías descubiertas durante la vigilancia de la salud. Con el ánimo de solucionar esta carencia, un grupo multidisciplinar de una industria química y farmacéutica (médicos, higienistas industriales, técnicos de seguridad, del área de recursos humanos e informáticos) ha consensuado y elaborado, en soporte informático, un banco de datos básico de higiene industrial y medicina laboral sobre la base de los mínimos datos exigidos por la legislación laboral vigente, nacional y europea. Este documento, denominado registro individual informatizado de salud y exposición laboral, está en fase de implantación en los centros de fabricación y se estima su explotación epidemiológica a partir de finales del año 2003. Puede ser o no complementario de la historia clínica laboral (informatizada o no) y se sostiene que en el mismo marco informático en el que se ha desarrollado (SAP) o en otros (Acces, Excel, etc.) puede ser adaptado y aplicado por la mayoría de las empresas químicas y farmacéuticas sin importar la envergadura de las mismas. Su uso garantiza el cumplimiento de la legislación laboral vigente, la gestión adecuada de la prevención laboral primaria y el desarrollo de estudios epidemiológicos prospectivos de grupos homogéneos de exposición (AU)

There are currently a wide range of models for computerised clinical records used by members of some companies’ Prevention Services healthcare staff. These working tools facilitate the day-to-day work of health units, but do not contain information on working conditions. This leads us to deduce that the computerised use of these information systems is severely limited, since medical data cannot be correlated with information on the hygienic environment and thus the systems are of no use in assessing the preventative activities of the company, nor do they help in taking correct decisions which assist the implementation of an acceptable policy for primary prevention of risks at work. Spain’s Prevention of Risks at Work Act, Prevention Services Regulations and Royal Decree 374/2001, which brings Spanish legislation into line with EC Directive 98/24, on the protection of the health and safety of workers exposed to chemical agents, establish the minimum information which employers are required to record and store in each worker’s documentation. Special emphasis is placed on the hygienic risks to which workers are exposed throughout their working life and upon the pathologies discovered whilst monitoring their health. In the aim of providing a solution to this important deficiency, a multidisciplinary group from the chemical and pharmaceutical industries (doctors, industrial hygienists, safety experts, human resources and IT professionals) has developed a simple yet original workplace hygiene and medicine database on the basis of the minimum requirements of current Spanish and European employment legislation. The group calls this a Computerised Individual Workplace Health Record: it is currently undergoing implementation in production centres, with epidemiological use being forecast from the end of 2003 on. It may, if wished, be used as a complement to the Workplace Clinical Record (computerised or not), and the group maintains that, using the same computer platform upon which it has been developed (SAP) or, indeed, another (Access, Excel, etc.) it may be adapted and used by the majority of chemical and pharmaceutical businesses, whatever their size. Its use guarantees compliance with current employment legislation, proper management of primary workplace prevention and the performance of prospective epidemiological studies of homogenous risk groups (AU)

Modulation by age and gender of risk for Alzheimer's disease and vascular dementia associated with the apolipoprotein E-epsilon4 allele in Latin Americans: findings from the Maracaibo Aging Study.

An ongoing longitudinal study in Maracaibo, Venezuela, examined the interaction between apolipoprotein E (APOE) genotypes and Alzheimer's disease (AD) and vascular dementia (VD), evaluating age and gender as potential modifiers of risk. Overall, carriers of at least one epsilon4 allele were at higher risk for AD, not for VD; however, the risk was significant only for subjects older than 65, and it increased 10-fold in subjects older than 85. The risk of AD conferred by APOE-epsilon4, adjusted for age and stratified by gender, was significant only for women. No association was found between the epsilon-2 allele and AD or VD. The results support the notions that APOE-epsilon4 is relevant for late-onset, not early onset AD, and that age and gender act as modulators of this association.

The effect of temperature on sound wave absorption in a sediment layer.

The effect of temperature on sound velocity, absorption, and reflection coefficient in the seabed sediment layer is investigated. Experimental measurements of sound speed, absorption, and the reflection coefficient in a sandy sediment layer have been carried out at several temperatures. An absorption reduction of 75 dB/m and a velocity increase of 65 m/s have been measured at a frequency of 1 MHz when the temperature increases from 5 to 25 degrees C. Because of the absorption temperature dependence the amplitude of the reflected wave from the back surface of the sub-bottom layer after going back and forth across the layer increases with the temperature.

Taste Aversion Learning as a Tool for the Study of Hippocampal and Non-Hippocampal Brain Memory Circuits Regulating Diet Selection.

Diet selection is the result of different learning experiences that accumulate throughout the life of the organism. The acquisition of aversions to the taste of food followed by mild or severe visceral negative effects plays an important role in food selection. Current knowledge on the role of the critical brain areas (parabrachial area, insular cortex and amygdala) involved in the basic associative neural circuit of taste aversion learning is reviewed. In turn, as shown by a variety of learning phenomena, the development of new aversions to the taste of different types of food is profoundly modulated by the memory of previous learning experiences with the same or different tastes. Some of these phenomena may depend on memory brain systems independent of the basic circuit for taste aversion learning. This seems to be the case for contextual effects and conditioned blocking that depend on the hippocampal integrity. Experimental evidence on the neural basis of complex learning phenomena in taste aversion learning is reviewed. Thus, understanding the way in which taste aversion learning regulates diet selection in daily life requires the study of interactions between hippocampal and non-hippocampal dependent memory systems. Taste aversion learning is proposed as a useful behavioral tool in the investigation of different brain circuits that are critical for food selection.

[Prenatal diagnosis. I: Prenatal diagnosis program at the Medical Genetics Unit of the Universidad de Zulia, Maracaibo, Venezuela]. / Diagnóstico prenatal. I: Programa de diagnóstico prenatal de la Unidad de Genética Médica de La Universidad del Zulia, Maracaibo, Venezuela.

The Prenatal Diagnosis Program of the Medical Genetic Unit of University of Zulia has the following objectives: Identification of Genetic Risk Factors (GRF) in those couples who attend to the Prenatal Genetic Clinic, application of different prenatal diagnostic procedures (PDP), and providing adequate genetic counseling. The goal of this paper is to show preliminary results obtained between January 1993 and December 1996. Three hundred and twenty one pregnant women were analyzed by determining the GRF and taking into account the genetic clinical history. The GRF analyzed were: Advanced maternal age (AMA), congenital malformation history (CMH), previous child with chromosomic anomalies (PCCA), defects of neural tube history (DNTH), congenital heart disease history (CHDH), any parent carrier of chromosomic anomaly (PCA), habitual abortion (HA), abnormal fetal echography (AFE), altered maternal serum levels of alpha-feto-protein (AMSAFP) and OTHERS: exposure to teratogenic agents, history of Mendelian diseases, maternal systemic diseases and anxiety in the mother or in her partner. The PDP was designed according to the GRF, which included fetal echography (FE), fetal echocardiography (FEc), amniocentesis (AMN), chordocentesis (CCT) and AMSAFP. Results showed that 58.4% of the expectant mothers asked for counseling during the 2nd trimester, 70% of the total showed only one GRF, and AMA was the most frequent GRF found (40.3%), followed by PCCA, AFE, CHDH, HA, DNTH, PCA, and OTHERS in that order. The specific PDP applied to the identified GRF allowed a health evaluation of the fetus. The GRF identification gave the opportunity of establishing a Prenatal Diagnostic Program producing a response to the couple's needs and showed the utility of an integral and multidisciplinary management directed to any expecting mother in order to identify any high GRF.

[Prenatal diagnosis. II. Importance of ultrasonographic markers in prenatal diagnosis of chromosome abnormalities]. / Diagnóstico Prenatal II: importancia de los marcadores ecográficos en el diagnóstico prenatal de cromosomopatías.

The Medical Genetic Unit of the University of Zulia (MGUUZ) has developed a Prenatal Diagnosis Program (PDP) since January-1993, in which Genetic Risk Factors are determined in couples who request prenatal genetic counseling. In this program, different prenatal diagnostic procedures are performed to detect congenital defects during intrauterine life. One of these procedures is the Fetal Sonogram (FS). FS is a non invasive technique which permits the prenatal diagnosis of many genetic dysmorphic syndromes. Through the search of abnormal specific characteristics in the fetus, chromosomopathies may be suspected. These findings are named "Echosonographic Markers of Chromosomal Abnormalities" (EMCA). During three years (January-1993 to December-1996), patients attended in the PDP included 321 pregnant women in which 312 FS were performed. Abnormal outcomes were 22 (17 with isolated congenital malformations and 5 with EMCA). Only one fetus with chromosome abnormality (46,XX21q-) could not be detected by FS. The goals of this paper are: 1) to report 5 patients with sonographic markers suggestive of chromosomal abnormalities and 2) to show the FS usefulness in prenatal diagnosis of chromosompathies. We conclude that, in the search of the EMCA the FS should be offered systematically to all pregnant women without recognizable genetic risk. They are the main group with optimal reproductive age and in consequence, with the possibility of having a relatively major number of conception outcomes with congenital defects, with or without chromosomic etiology. The majority of those defects can be detected by FS and could allow us to select the patients in which the use of an invasive prenatal diagnostic procedure could be justified.

[Complete third nerve paralysis as clinical presentation of multiple sclerosis]. / Parálisis completa del tercer par como forma de presentación de esclerosis múltiple.

An acute attack of cephalea and third nerve palsy with pupillary involvement may be caused by a variety of entities, but aneurysm of the posterior communicating artery must certainly be ruled out. We describe a 22 year old patient in whom this clinical profile was an unusual first sign of multiple sclerosis.