Pomolic acid reduces contractility and modulates excitation-contraction coupling in rat cardiomyocytes.

Pomolic acid (PA) isolated from Licania pittieri has hypotensive effects in rats, inhibits human platelet aggregation and elicits endothelium-dependent relaxation in rat aortic rings. The present study was designed to investigate the effects of PA on cardiomyocytes. Trabeculae and enzymatically isolated cardiomyocytes from rats were used to evaluate the concentration-dependent effects of PA on cardiac muscle tension and excitation-contraction coupling (ECC) by recording Ca2+ transients reported with Fluo-3 and Fura-2, as well as L-type Ca2+ currents (LTCC). PA reduced the contractile force in rat cardiac trabeculae with an EC50 = 14.3 ±â€¯2.4 µM. PA also reduced the amplitude of Ca2+ transients in a concentration-dependent manner, with an EC50 = 10.5 ±â€¯1.3 µM, without reducing sarcoplasmic reticulum (SR) Ca2+ loading. PA decreased the half width of the Ca2+ transient by 31.7 ±â€¯3.3% and increased the decay time and decay time constant (τ) by 7.6 ±â€¯2.7% and 75.6 ±â€¯3.7%, respectively, which was associated with increased phospholamban (PLN) phosphorylation. PA also reversibly reduced the macroscopic LTCC in the cardiomyocyte membrane, but did not demonstrate any effects on skeletal muscle ECC. In conclusion, PA reduces LTCC, Ca2+ transients and cardiomyocyte force, which along with its vasorelaxant effects explain its hypotensive properties. Increased PLN phosphorylation protected the SR from Ca2+ depletion. Considering the effects of PA on platelet aggregation and the cardiovascular system, we propose it as a new potential, multitarget cardiovascular agent with a demonstrated safety profile.

Consideraciones científico tecnológicas y bioéticas relacionadas con el uso indiscriminado del laboratorio clínico / Scientific, technological and bioethical considerations related to the indiscriminate use of the clinical laboratory

Introducción: los avances tecnológicos posibilitan que los profesionales de la salud dispongan de novedosos métodos diagnósticos y terapéuticos cuyo empleo contribuye a aumentar las posibilidades de supervivencia y mejorar la calidad de vida de los pacientes, aunque con los inconvenientes de generar estrés y ansiedad y crear problemas de carácter bioético. Objetivo: exponer algunas consideraciones bioéticas y científico-tecnológicas relacionadas con el uso indiscriminado del laboratorio clínico.Método: se revisó la bibliografía nacional e internacional disponible en formato impreso y en las bases de datos de Internet. Se seleccionaron los trabajos más actualizados y, a partir de ellos, se elaboró una síntesis estructurada del tema desde la perspectiva bioética y de los estudios de ciencia, tecnología y sociedad.Desarrollo: los exámenes de laboratorio posibilitan al especialista confirmar o descartar diagnósticos, establecer pronósticos, controlar el curso de la enfermedad y los resultados del tratamiento, detectar complicaciones, colaborar con estudios epidemiológicos o de grupos de riesgo, participar en protocolos de investigaciones y ensayos clínicos para la introducción de nuevos medicamentos. Pero el sometimiento del criterio médico a los exámenes complementarios en detrimento del empleo del método clínico es un claro ejemplo del avance tecnológico asociado al retroceso intelectual. Conclusiones: el uso indiscriminado del laboratorio clínico implica un dilema ético y científico tecnológico, con un impacto social negativo de la ciencia y la tecnología en la práctica médica(AU)

Introduction: technological advances enable healthcare professionals to have novel diagnostic and therapeutic methods whose use contributes to increase the chances of survival and improve the quality of life of patients, although with the inconveniences of generating stress and anxiety and creating problems of bioethical character. Objective: to expose some bioethical and scientific-technological considerations related to the indiscriminate use of the clinical laboratory. Method: the national and international bibliography available in printed format and in Internet databases was revised. The most updated works were selected and, from them, a structured synthesis of the subject was elaborated from the perspective of the studies of science, technology and society. Development: laboratory tests allow the specialist to confirm or rule out diagnoses, establish prognoses, control the course of the disease and treatment outcomes, detect complications, collaborate with epidemiological studies or risk groups, participate in research protocols and clinical trials for the introduction of new drugs. But the subjection of the medical criterion to the complementary examinations to the detriment of the use of the clinical method is a clear example of the technological advance associated with the intellectual recoil.Conclusions: the indiscriminate use of the clinical laboratory implies an ethical and scientific technological dilemma, with a negative social impact of science and technology in medical practice(AU)

Resultados de la ritidoplastia facial en el Hospital General Provincial Docente Dr Antonio Luaces Iraola en el período 2000-2015 / Results of facial rhytidectomy at the General Teaching Provincial Hospital Dr Antonio Luaces Iraola in the period 2000-2015

Introducción: la ritidoplastia, como procedimiento quirúrgico corrector, permite eliminar el exceso de piel de la cara, reposicionar los tejidos profundos y corregir los ángulos faciales alterados por efecto del envejecimiento de la cara y el cuello.Objetivo: describir los resultados del tratamiento quirúrgico de la flacidez facial.Método: se realizó un estudio descriptivo transversal, durante el período 2000-2015, con un universo de 286 pacientes tratados en el Hospital Provincial General Docente Antonio Luaces Iraola. Las variables analizadas fueron: edad, sexo, tipo de flacidez, cantidad de tejido resecado y decolado, complicaciones, grado de satisfacción del paciente.Resultados: la mayoría de los pacientes fueron féminas (95,90 por ciento), con edades entre 50 y 59 años (57,58 por ciento) y flacidez temporofaciocervical (53,14 porciento). En las áreas temporal y facial la mayor cuantía resecada correspondió al rango de 20 a 39,9 mm y en la cervical al de 40 a 59,9 mm. En las áreas facial y cervical la decolación fue de 40 a 59,9 mm y en la temporal de 20 a 39,9 mm. Las complicaciones se presentaron solo en 9,10 por ciento de los operados, siendo el hematoma la más frecuente, sobre todo en el sexo masculino (75 por ciento) y en la flacidez temporofaciocervical. La casi totalidad de los operados manifestaron alta satisfacción (98,25 por ciento).Conclusiones: predominaron las mujeres y el grupo de edades de 50-59 años. Prevaleció la flacidez temporofaciocervical. El hematoma fue la complicación más frecuente y el sexo masculino el más incidido a pesar de representar un menor número de casos(AU)

Introduction: rhytidectomy, as a corrective surgical procedure, removes excess skin from the face, repositioning deep tissues, and corrects altered facial angles due to gravity to mitigate visible signs of aging of the face and neck.Objective: to describe the behavior of surgical treatment of facial flaccidity.Method: : a cross-sectional descriptive study was carried out with a universe of 286 patients treated with facial rhytidectomy at the Plastic Surgery Service of the General Teaching Provincial Hospital Dr Antonio Luaces Iraola. The variables analyzed were: age, sex, type of flaccidity, amount of dissected tissue, complications, surgical time and average amount of anesthetic used, degree of patient satisfaction.Results: the majority of the patients were females (95,90 percent), with ages between 50 and 59 years (57,58 percent) and temporofaciocervical flaccidity (53,14 percent). In the temporal and facial areas, the largest amount resected corresponded to the range of 20 to 39,9 mm and in the cervical to 40 to 59,9 mm. In the facial and cervical areas the takeoff was of 40 to 59,9 mm and in the temporal of 20 to 39,9 mm. Complications occurred only in 9,10 percent of the operated ones, with the hematoma being the most frequent, especially in the male sex (75 percent) and in the temporofaciocervical flaccidity. Almost all of the patients showed high satisfaction (98,25 percent).Conclusions: women predominated and the group aged 50-59 years. The temporofaciocervical flaccidity prevailed. Hematoma was the most frequent complication and the male sex was the most affected despite representing a smaller number of cases(AU)

Homocisteína, marcador de riesgo vascular. Revisión bibliográfica / Homocysteine, a marker of vascular risk. Literature Review

Introducción: diversos estudios han demostrado la relación de varios factores de riesgo muy conocidos con la aparición de enfermedades cardiovasculares; sin embargo, en algunos pacientes con dolencias cardiovasculares incipientes no es posible encontrar tal relación, por lo que se requiere identificar nuevos factores predictivos, entre los que se encuentra el nivel plasmático elevado de homocisteína. Objetivo: describir la homocisteína como marcador de riesgo vascular. Método: se revisó la bibliografía nacional e internacional sobre hematología, correspondiente a los últimos cinco años, disponible en la Biblioteca Virtual de Salud de Cuba, en español e inglés; para la búsqueda se emplearon los términos homocisteína y aterosclerosis, homocisteína y uso diagnóstico, metionina y uso diagnóstico. A partir de los artículos seleccionados se elaboró una reseña estructurada sobre el tema. Desarrollo: se deben medir los niveles de homocisteína plasmática a todos los pacientes con historia de enfermedad arterial coronaria, tromboembolismo pulmonar, trombosis venosa, aterosclerosis inexplicable (sin factores de riesgo o causas identificables para el aumento de los niveles de homocisteína) y con insuficiencia renal crónica o trasplante renal. Conclusiones: el papel de la homocisteína como factor independiente de riesgo aterogénico ha sido confirmado por estudios y datos epidemiológicos que demuestran que la homocisteína total circulante elevada es un potente marcador pronóstico de enfermedad cardiovascular y mortalidad en pacientes con factores de riesgo preexistentes; no obstante, la homocisteína es un factor de riesgo modificable puesto que la administración de vitaminas a los pacientes, en niveles adecuados, disminuye sus niveles plasmáticos(AU)

Introduction: several studies have demonstrated the relationship of several well-known risk factors with the occurrence of cardiovascular diseases; however, in some patients with incipient cardiovascular diseases, it is not possible to find such a relationship, so it is necessary to identify new predictive factors, such as elevated plasma homocysteine level. Objective: to describe homocysteine as a marker of vascular risk. Method: the national and international bibliography on hematology, corresponding to the last five years, available in the Virtual Health Library of Cuba, in Spanish and English was revised; for the search were used terms such as homocysteine and atherosclerosis, homocysteine and diagnostic use, methionine and diagnostic use. From the selected articles a structured review on the subject was elaborated.Development: plasma homocysteine levels should be measured in all patients with a history of coronary artery disease, pulmonary thromboembolism, venous thrombosis, unexplained atherosclerosis (with no risk factors or identifiable causes for increased levels of homocysteine), and chronic renal insufficiency or renal transplantation.Conclusions: the role of homocysteine as an independent factor in atherogenic risk has been confirmed by studies and epidemiological data showing that elevated circulating total homocysteine is a potent prognostic marker of cardiovascular disease and mortality in patients with preexisting risk factors; however, homocysteine is a modifiable risk factor since the administration of vitamins to patients, at appropriate levels, decreases their plasma levels(AU)

Comportamiento de los niveles sanguíneos y de y-glutamiltransferasa y proteína C reactiva en pacientes con enfermedad renal crónica / Blood levels behaviour of Y-Glutamyltransferase and C-Reactive Protein in patients with Chronic kidney disease

La enfermedad renal crónica es actualmente un severo problema de salud. Se realizó un estudio observacional descriptivo con el objetivo de determinar el comportamiento de los niveles sanguíneos de γ-glutamiltransferasa y la proteína C reactiva en pacientes con diagnóstico presuntivo de enfermedad renal crónica, que asistieron a la consulta externa del laboratorio central de la Policlínica de Especialidades de Ciego de Ávila. Se realizó una comparación del filtrado glomerular con las ecuaciones de Cockcroft - Gault y dos sistemas de medición de la creatinina sérica. Los resultados muestran una relación estadísticamente significativa entre los niveles disminuidos del filtrado glomerular y el incremento de la γ-glutamiltransferasa y de la proteína C reactiva, además se demostraron diferencias entre las estimaciones del filtrado glomerular con la utilización de los 2 métodos de creatinina sérica (AU)

The Chronic Kidney Disease is a severe problem of health. A descriptive observational study was carried out with the aim to determine the blood levels behaviour of Y-Glutamyltransferase and C Reactive Protein in patients with presumptive diagnosis of chronic Kidney Disease, that assisted to outpatient services of Central laboratory from Polyclinic of Specialties in Ciego de Ávila. A comparison of glomerular filtration was carried out using the Cockcroft–Gault equations and using two measurement systems of serum creatinine. The results showed a significant relation between levels diminished of glomerular filtration and increased of Y-Glutamyltransferase and the C Reactive Protein. Besides It showed differences between the glomerular filtration estimation using two methods of serum creatinine (AU)

Sodium-calcium exchanger modulates the L-glutamate Ca(i) (2+) signalling in type-1 cerebellar astrocytes.

We have previously demonstrated that rat type-1 cerebellar astrocytes express a very active Na(+)/Ca(2+) exchanger which accounts for most of the total plasma membrane Ca(2+) fluxes and for the clearance of Ca (i) (2+) induced by physiological agonist. In this chapter, we have explored the mechanism by which the reverse Na(+)/Ca(2+) exchange is involved in agonist-induced Ca(2+) signalling in rat cerebellar astrocytes. Laser-scanning confocal microscopy experiments using immunofluorescence labelling of Na(+)/Ca(2+) exchanger and RyRs demonstrated that they are highly co-localized. The most important finding presented in this chapter is that L-glutamate activates the reverse mode of the Na(+)/Ca(2+) exchange by inducing a Na(+) entry through the electrogenic Na(+)-glutamate co-transporter and not through the ionophoric L-glutamate receptors as confirmed by pharmacological experiments with specific blockers of ionophoric L-glutamate receptors, electrogenic glutamate transporters and the Na/Ca exchange.

The activity of the Na+/Ca2+ exchanger largely modulates the Ca2+i signal induced by hypo-osmotic stress in rat cerebellar astrocytes. The effect of osmolarity on exchange activity.

We recently demonstrated that rat cerebellar Type-1 astrocytes express a very active Na(+)/Ca(2+) exchanger highly colocalized with ryanodine receptors (RyRs), which in turn play a key role in glutamate-induced Ca(2+) signaling through a calcium-induced calcium release (CICR) mechanism. In this work we have explored whether the Na(+)/Ca(2+) exchanger has any role in the Ca(2+)(i) signal induced by hypo-osmotic stress in these cells, using microspectrofluorometric measurements with Fura-2, pharmacological tools, and confocal microscopy image analysis. We present evidence for the first time that the increase in [Ca(2+)](i) in rat cerebellar Type-1 astrocytes, resulting from moderate hypotonic shock, is mediated by Ca(2+) release from ryanodine-operated Ca(2+)(i) stores, and that the magnitude of the intracellular Ca(2+) signal induced by hypotonicity in the short term (up to 240 s) is small and controlled by the activity of the Na(+)/Ca(2+) exchanger operating in its extrusion mode. With longer times in the hypotonic medium, intracellular Ca(2+) store depletion leads to Ca(2+) entry through store-operated Ca(2+) channels. We found it interesting that the activity of the Na(+)/Ca(2+) exchanger measured during this reverse mode operation (Ca(2+) entry in exchange for internal Na(+)) was found to be greatly increased in hypotonic solutions and decreased in hypertonic ones. The buffering of the [Ca(2+)](i) rise induced by hypo-osmotic stress may prevent excessive increases in [Ca(2+)](i), which otherwise might impair the normal function of this glial cell.

Na+ entry via glutamate transporter activates the reverse Na+/Ca2+ exchange and triggers Ca(i)2+-induced Ca2+ release in rat cerebellar Type-1 astrocytes.

We have previously demonstrated that rat cerebellar Type-1 astrocytes express a very active genistein sensitive Na(+)/Ca(2+) exchanger, which accounts for most of the total plasma membrane Ca(2+) fluxes and for the clearance of loads induced by physiological agonists. In this work, we have explored the mechanism by which the reverse Na(+)/Ca(2+) exchange is involved in agonist-induced Ca(2+) signaling in rat cerebellar astrocytes. Microspectrofluorometric measurements of Cai(2+) with Fluo-3 demonstrate that the Cai(2+) signals associated long (> 20 s) periods of reverse operation of the Na(+)/Ca(2+) exchange are amplified by a mechanism compatible with calcium-calcium release, while those associated with short (< 20 s) pulses are not amplified. This was confirmed by pharmacological experiments using ryanodine receptors agonist (4-chloro-m-cresol) and the endoplasmic reticulum ATPase inhibitor (thapsigargin). Confocal microscopy demonstrates a high co-localization of immunofluorescent labeled Na(+)/Ca(2+) exchanger and RyRs. Low (< 50 micromol/L) or high (> 500 micromol/L) concentrations of L-glutamate (L-Glu) or L-aspartate causes a rise in which is completely blocked by the Na(+)/Ca(2+) exchange inhibitors KB-R7943 and SEA0400. The most important novel finding presented in this work is that L-Glu activates the reverse mode of the Na(+)/Ca(2+) exchange by inducing Na(+) entry through the electrogenic Na(+)-Glu-co-transporter and not through the ionophoric L-Glu receptors, as confirmed by pharmacological experiments with specific blockers of the ionophoric L-Glu receptors and the electrogenic Glu transporter.

Role of Na+/Ca2+ exchange in [Ca2+]i clearance in rat culture Purkinje neurons requires reevaluation.

Previous studies have shown that in contrast to other neuronal cells, Na(+)/Ca(2+) exchange contributes little to Ca(i)(2+) homeostasis in rat cerebellar Purkinje neurons under intracellular perfused conditions and at room temperature [Fierro et al.: J Physiol (Lond) 510: 499-512, 1998]. The purpose of this study was to clarify the role of this transporter in cerebellar Purkinje neurons by using intact cells at nearly physiological body temperature. Using Fluo-3 microfluorometry, we have examined the role of the Na(+)/Ca(2+) exchange in the buffering of calcium loads in cultured rat Purkinje neurons at two temperatures: 20 and 34 degrees C. At 20 degrees C, the recovery of the K(+)-induced [Ca(2+)](i) signal was little affected by the presence of external Na(+) (tau(e) = 35.5 +/- 1.2 s [n = 49]), or by its absence (tau(e) = 36.6 +/- 2.2 s [n = 29]), i.e. in a Li(+)-containing medium. In contrast, at 34 degrees C, the recovery of the [Ca(2+)](i) signal was highly dependent on external Na, i.e. tau(e) = 19.9 +/- 1.2 s (n = 119) and tau(e) = 41.7 +/- 2.6 s (n = 39), in Li(+)-containing media, respectively. A comparison of the rate of clearance of [Ca(2+)](i) in Na(+) or Li(+) media, shows that at a room temperature of 20 degrees C, the Na(+)/Ca(2+) exchange contributes at most to 15-20% of the total [Ca(2+)](i) clearance, compared to 55-65% at 34-36 degrees C. We also demonstrate that under normal physiological conditions forward and reverse Na(+)/Ca(2+) exchanges operate in the same neuron. We conclude that the Na(+)/Ca(2+) exchange is strongly suppressed at room temperature and therefore its role should be reevaluated among different neuronal preparations.

Hipercinesia un equivalente epiléptico: beneficio del tratamiento integral / Hiperkinesy a epileptic equivalent: integral of treatment benefit

De un grupo de doscientos setenta y ocho pacientes hiperactivos en el INAPSI, durante los años 1988 a 1992, se tomó una muestra de setenta y cuatro. El tratamiento farmacológico utilizado fue la Difenilhidantoína o la Carbamazepina, por considerar la hiperactividad, trastornos caracteriales (irritabilidad, impulsividad, baja tolerancia a las frustraciones), sueño intranquilo, bruxismo y sonambulismo, un "equivalente epiléptico". Se obtuvo un buen resultado. Desde 1965 el doctor A. Pimentel utiliza estos dos medicamentos y posteriormente el Clonazepán en pacientes adultos con hiperactividad, trastornos caracteriales, del sueño, algunos cuadros depresivos y otros, con resultados igualmente satisfactorios, pareciendo apoyar nuestras observaciones en niños. El tratamiento multidisciplinario consistió en ofrecer simultáneamente el control farmacológico, educación y orientación familiar, psicoterapia grupal, terapia educativa y otras terapias especiales según requerimientos del paciente