Peficitinib hydrobromide to treat rheumatoid arthritis.

Peficitinib hydrobromide is a small Janus kinase inhibitor (JAK1, JAK2, JAK3 and TYK2) molecule for the treatment of rheumatoid arthritis (RA). Phase II and phase III clinical trials and extension studies with different doses have been conducted to assess the drug's efficacy and safety with substantially improved outcomes observed in RA. This JAK inhibitor oral drug demonstrated clinical response as once-daily monotherapy in patients with moderate to severe RA, also in combination with methotrexate (MTX), who had an inadequate response to MTX. The findings from studies of this new JAK inhibitor have shown that, both in monotherapy as well as in combination with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), it has efficacy, safety and tolerability in RA patients.

[Development of animal experimental model for bacterial peritonitis]. / Desarrollo de modelo experimental animal de peritonitis bacteriana.

OBJECTIVE: The aim of the study was to develop a model of abdominal sepsis in the experimental animal. METHODS: Sprague-Dawley male rats of 5 weeks (N=39) were used. Initially, a pilot study (N = 9) was performed and distributed in 3 groups with 1cc inoculum of Escherichia coli ATCC 25922 intraperitoneally at concentrations of 10E8, 10E9 and 10E10 CFU. Subsequently, concentrations of 10E10 CFU are used in two groups of 3 rats with dilutions of 10 cc and 15 cc of distilled water respectively. Finally, a randomized trial of 24 rats was started in three treatment groups after intraperitoneal infection: Group I with physiological serum (N = 6), Group II with ceftriaxone (N = 9), Group III with ceftriaxone plus allicin (N = 9). Microbiological samples of blood and peritoneal fluid were made, as well as histopathological study of intraperitoneal organs (liver, diaphragm and peritoneum). RESULTS: Death of 100% of the rats infected with 10E10 E. coli UFC concentration with the dilution of 15 ml of distilled water and without antibiotic was oberved. The blood culture and peritoneal fluid culture was positive for the same strain in all of them. The formation of abscesses on the liver surface and polymorphonuclear infiltration in tissues were observed. CONCLUSIONS: The lethal dose of E. coli is 10E10 CFU diluted in 15 cc distilled water by intraperitoneal injection.

Laparoscopic cytoreductive surgery and HIPEC is effective regarding peritoneum tissue paclitaxel distribution.

BACKGROUND: In some patients with peritoneal carcinomatosis, we could perform the cytoreductive surgery and the HIPEC procedure by a complete laparoscopic approach to avoid morbidity. We consider that using laparoscopic approach for performing peritoneal carcinomatosis cytoreductive surgery and HIPEC with closed CO2 recirculation technique is possible and safe, with equal efficacy to conventional methods and hemodynamic complications. OBJECTIVE: Monitoring the effectiveness of the drug distribution in a laparoscopic ctoreductive and HIPEC surgery group with CO2 recirculation respect to a closed and open HIPEC group METHODS: Porcine model that included fifteen mini-pigs. Five pigs were operated with laparoscopic approach performing a pelvic and retroperitoneal lymphadenectomy. They later received a total laparoscopic closed HIPEC with CO2 recirculation (G1). Group 2 (G2): five pigs operated by an open cytoreductive surgery and closed HIPEC technique. Group 3 (G3): five animals in which an open cytoreductive surgery and an open HIPEC technique was performed. Blood and peritoneal determinations were realized after recirculation of the drug, at 60 min using chromatographic analysis. RESULTS: G1-G2: phrenic right peritoneum, p: 0.46. Phrenic left peritoneum, p: 0.46. Pelvic peritoneum, p: 0.17. Serum paclitaxel: p: 0.01. G1-G3: phrenic right peritoneum, p: 0.34. Phrenic left peritoneum, p: 0.34. Pelvic peritoneum, p: 0.17. Serum paclitaxel G1-G3, p: 0.02. CONCLUSIONS: A total laparoscopic approach for ctoreductive surgery and closed HIPEC with CO2 recirculation may be safe and feasible. In our experimental model there was no significant difference in tissue drug distribution respect the conventional techniques and there was a less toxicity because the serum drug concentration was significantly lower with laparoscopic approach respect the other groups.

Historia del Hospital Luis Calvo Mackenna / History of the Hospital Luis Calvo Mackenna

Las instituciones que le dieron origen y que tuvieron su sede en los terrenos ya sean próximos o incluso en los que actualmente ocupa el hospital fueron:- “Patronato Nacional de la Infancia”- “La Casa de Huérfanos”- “La Casa Nacional del Niño”. La Casa Nacional del Niño adquirió así, un sólido y bien ganado prestigio. Pero el Dr. Calvo Mackenna, no descansaba, pese a estos éxitos y luchaba sin descanso para obtener la autorización para la construcción de nuevos y modernos pabellones, destinados a estos lactantes, que con tanto cariño y desvelo cuidaba. Sus esfuerzos dieron frutos y el edificio, tantas veces soñado, lentamente inició su construcción. Este Pabellón se ubicó al Sur de los edificios en ése momento en actividad, con un fácil acceso por la Avenida Antonio Varas, lo que haría posible en un futuro, la edificación de otros pabellones análogos. En el subterráneo de este nuevo edificio estaba consultado el alojamiento para el personal y un depósito general de leche, ropería, colchones, etc. El estilo sería de líneas modernas, pero de aspecto sencillo. El costo total de la obra se estimó en $3.700.000, la que se encargó al ingeniero Sr. Guillermo Franke.

Síndrome de Wolf Parkinson White asociado a embarazo / Wolf Parkinson White syndrome associated to pregnancy

El embarazo se ha asociado con un incremento en la incidencia de arritmias. Aunque las palpitaciones, la ansiedad y eventualmente el síncope son síntomas relativamente común en el embarazo normal, estos serán raramente asociados con las arritmias cardíacas. Una reducción en la presión sanguínea asociadas con tales arritmias pueden resultar en bradicardia fetal y necesitan un tratamiento inmediato con drogas antiarrítmicas, cardioversión eléctrica o cesárea de urgencia. En el puerperio existe una asociación con un aumento significativo del riesgo de eventos cardíaco, incluyendo muerte, infartos cardíacos y síncopes. Algunos pacientes tienen conexiones anatómicas anómalas, que pueden evitar total o parcialmente el paso a través del nódulo aurículo ventricular. El Haz de Kent (comunicación anómala entre la aurícula y el ventrículo) constituyen la base anatómica del síndrome de Wolf Parkinson White (WPW). Este es una enfermedad congénita con incidencia familiar y en ocasiones se asocia a otras anomalías congénitas. La prevalencia de este síndrome oscila entre 0,1 y 3 por cada 1.000 personas. Puede constituir un hallazgo cardiográfico fortuito y cursar de forma asintomática durante toda la vida del paciente. No obstante, en estos enfermos existe una incidencia elevada de taquiarritmias

A relacao "A/V" do pulso venoso jugular na estenose pulmonar - estudo de 60 casos com comprovação hemodinâmica e/ou cirúrgica / The A-V ratio of jugular venous pulse in pulmonary stenosis - study of 60 cases with hemodynamic and/or surgical confirmation

Estudou-se a amplitude da onda "a" em relacao a da onda "v" (A/V), do pulso venoso jugular (PVJ) em um grupo de 60 pacientes portadores de estenose pulmonar (GEP) e em um de 30 pessoas normais (GN). O GEP foi dividido em dois subgrupos: o de 36 pacientes portadores de estenose pulmonar pura (GEPP) e o de 24 pacientes portadores de estenose pulmonar associada a defeito septal (GEPS). No GN, o valor A/V foi de 1,27 +/- 0,17 (media +/- desvio-padrao), enquanto no gep foi de 1,81 +/- 0,51, com diferenca altamente significativa comparada com o GN (p < 0,0001). No GEPP, o valor foi de 1,88 +/- 0,51, enquanto que no GEPS foi de 1,70 +/- 0,50, mostrando pequena diferenca entre as medias, porem nnao significativa (p < 0,05). Contudo, ambos subgrupos apresentaram uma diferenca altamente significativa comparados ao GN (P < 0,0001). Relacionando-se o GEP com o GN, observou-se que em 63% dos casos A/V estava anormalmente aumentada, sendo que a pressao sistolica de ventriculo direto (PSVO) era maior que 50 mmHg em todos eles. Alem disso, quando a relacao A/V foi maior ou igual a 2,00, a PSVD era maior ou igual a 80,00 mmHg em 95% dos casos.