Synergism interaction between genetic polymorphisms in drug metabolizing enzymes and NSAIDs on upper gastrointestinal haemorrhage: a multicenter case-control study.

BACKGROUND: Interindividual genetic variations contribute to differences in patients' response to drugs as well as to the development of certain disorders. Patients who use non-steroidal anti-inflammatory drugs (NSAIDs) may develop serious gastrointestinal disorders, mainly upper gastrointestinal haemorrhage (UGIH). Studies about the interaction between NSAIDs and genetic variations on the risk of UGIH are scarce. Therefore, we investigated the effect of 16 single nucleotide polymorphisms (SNPs) involved in drug metabolism on the risk of NSAIDs-induced UGIH. MATERIALS AND METHODS: We conducted a multicenter case-control study of 326 cases and 748 controls. Participants were sub-grouped into four categories according to NSAID exposure and genetic profile. We estimated odds ratios (ORs) and their 95% confidence intervals (CI) using generalized linear mixed models for dependent binomial variables and then calculated the measures of interaction, synergism index (S), and relative excess risk due to interaction (RERI). We undertook stratified analyses by the type of NSAID (aspirin, non-aspirin). RESULTS: We observed an excess risk of UGIH due to an interaction between any NSAID, non-aspirin NSAIDs or aspirin and carrying certain SNPs. The greatest excess risk was observed for carriers of: rs2180314:C>G [any NSAID: S = 3.30 (95%CI: 1.24-8.80), RERI = 4.39 (95%CI: 0.70-8.07); non-aspirin NSAIDs: S = 3.42 (95%CI: 1.12-10.47), RERI = 3.97 (95%CI: 0.44-7.50)], and rs4809957:A>G [any NSAID: S = 2.11 (95%CI: 0.90-4.97), RERI = 3.46 (95%CI: -0.40-7.31)]. Aspirin use by carriers of rs6664:C>T is also associated with increased risk of UGIH [ORaspirin(+),wild-type: 2.22 (95%CI: 0.69-7.17) vs. ORaspirin(+),genetic-variation: 7.72 (95%CI: 2.75-21.68)], yet larger sample size is needed to confirm this observation. CONCLUSIONS: The joint effect of the SNPs s2180314:C>G and rs4809957:A>G and NSAIDs are more than three times higher than the sum of their individual effects. Personalized prescriptions based on genotyping would permit a better weighing of risks and benefits from NSAID consumption.KEY MESSAGESMulticenter case-control study of the effect of genetic variations involved in drug metabolism on upper gastrointestinal haemorrhage (UGIH) induced by NSAIDs (aspirin and non-aspirin).There is a statistically significant additive synergism interaction between certain genetic polymorphisms and NSAIDs on UGIH: rs2180314:C>G and rs4809957:A>G. The joint effect of each of these single nucleotide polymorphisms and NSAIDs on UGIH is more than three times higher than the sum of their individual effects.Genetic profiling and personalized prescriptions would be useful in managing the risks and benefits associated with NSAIDs.

Large Increase in Azithromycin-Resistant Neisseria gonorrhoeae in Northern Spain.

The aim of this study was to characterize the evolution of gonorrhea in the general population by correlating epidemiological, genotypic, and antimicrobial resistance data of Neisseria gonorrhoeae isolates collected in northern Spain from 2014 to 2018. One hundred ninety-four strains underwent antimicrobial susceptibility testing and were genetically analyzed by N. gonorrhoeae multiantigen sequence typing. Increasing cases of gonococcal infections have been observed after 2015. Most occurred in male with urethritis. Sequence type (ST)-9972 and ST-1576, the predominant genotypes identified, have not been previously described as epidemic clones. Of great concern was the significant increase in azithromycin-resistant N. gonorrhoeae. More than 30% of these isolates were obtained from men who have sex with men (MSM). ST-12302 was the most prevalent clone among the azithromycin-resistant strains, and was also resistant to penicillin, ciprofloxacin, and tetracycline. This multidrug-resistant clone was exclusively isolated from MSM during 2018. The incidence rates of gonorrhea and azithromycin-resistant N. gonorrhoeae have significantly increased due to the emergence of new clones. ST-12302 has recently been recognized as an epidemic clone; therefore, its surveillance could be the key in controlling further dissemination of azithromycin resistance. These data highlight the need to perform local studies to update treatment guidelines and reinforce preventive measures against gonorrhea.

Iatrogenic Colonic Perforations: Changing the Paradigm.

PURPOSE: The purpose of our study was to investigate the clinical outcomes of colonoscopic perforations in patients. MATERIALS AND METHODS: We retrospectively studied patients with perforations secondary to diagnostic/therapeutic colonoscopy between 2009 and 2015 at the Pontevedra Hospital Complex. We analyzed age, closure method, length of hospitalization, and long-term progress. RESULTS: Of the 34 perforations detected, 67.6% occurred in patients aged below 75 years. Most perforations occurred in the descending colon (55%). Perforations occurred in 55.9% of outpatients and 45% of inpatients. Diagnostic and therapeutic colonoscopies caused perforations in 20.6% and 79.4% of patients, respectively. Conservative treatment alone was performed in 5.9%, complete or partial endoscopic closure in 14.7%, and surgery in 79.4% of patients. Patients treated only conservatively or with concomitant endoscopic closure showed no mortality. The mortality rate was 14.8% in those treated surgically, and 55% of these patients required a subsequent ostomy. CONCLUSIONS: Conservative management with antibiotics and parenteral nutrition concomitant with complete/partial endoscopic closure effectively treats perforations, provided intraprocedural diagnosis is possible with immediate administration of antibiotics after the procedure. Nevertheless, studies with larger number of patients and statistical analysis are necessary in the near future.

Nivel educativo de los progenitores como factor mediador del estrés académico / Parents' educational level as a mediator factor of academic stress

Introducción. El estrés académico es un problema que afecta a un importante número de universitarios y existen diferentes condicionantes que pueden generarlo, por lo que se han desarrollado numerosos estudios para identificar posibles estresores académicos. No menos importante es definir los factores que puedan influir sobre estas sensaciones; dentro de éstos se encuentran los factores socioeducativos y sociodemográficos, que pueden influir acentuando o atenuando dichas sensaciones. Objetivo. Conocer si el nivel educativo de los progenitores se asocia con la percepción de los estresores académicos en el alumnado de fisioterapia. Sujetos y métodos. La muestra estaba formada por 151 estudiantes matriculados en el Grado de Fisioterapia de la Universidad de Vigo. Como variable socioeducativa se utilizó el nivel de estudio de los progenitores, agrupándolos en estudios primarios, medios y superiores, y para el estrés académico se empleó la escala de estresores académicos del cuestionario de estrés académico (CEA). Resultados. El factor 'exámenes' correlaciona con el nivel de estudios de ambos progenitores, pero el nivel académico de la madre se muestra como un factor determinante en la percepción de los estresores académicos, ya que correlaciona con más de la mitad de los estresores, coincidiendo un mayor nivel educativo con una menor percepción de estrés. Conclusiones. Existe influencia del nivel educativo de la madre sobre la percepción de estrés académico, pero el nivel educativo del padre se asocia de forma más discreta, ya que solamente actúa sobre uno de los nueve factores analizados

Introduction. Academic stress is a problem that affects a significant number of university varying. There are different conditions that can generate therefore have developed numerous studies to identify potential academic stressors, not less important is to identify factors that may influence these feelings within these socio-educational and socio-demographic factors that may influence accentuating or attenuating these feelings are. Aim. To determine whether the educational level of the parents is associated with the perception of academic stressors in students of Physiotherapy. Subjects and methods. The sample included 151 students enrolled in Physiotherapy of University of Vigo. As socio variable used level study of grouping parents in primary, secondary and higher education and to measure academic stress student has used the scale of academic stressors stress questionnaire academic (CEA). Results. The examinations factor correlates with the level of education of both parents, but the academic level of mothers is shown as a determining factor in the perception of academic stressors, and that correlates with more than half of them, higher level education with a lower perceived academic stress. Conclusions. The educational level of the mother have influence on the perception of academic stress but nevertheless the educational level of the father is associate, in a more discreet way because it have influence in one of the nine factors analyzed

[Severe atopic dermatitis and hiper-IgE]. / Dermatitis atópica severa e hiper-IgE.

BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory and complex skin disease, typically occurring in individuals with a personal or family history of atopy. It is characterized by lesions of dermatitis, pruritus and dry skin (xerosis) that evolve with chronic course and intermittent outbreaks alternating with remission phases. AD appears from 5-15 % of the general population, 10-20 % of the pediatric population, and 1-3 % of the adult population. CLINICAL REPORT: A 19-year-old male patient with a severe AD (SCORAD of 84.3), and hyper-IgE (34 400 UI/mL), who was treated with deflazacort, Healing creams and emollients, as well as detergent-free gel. With which did not progress favorably, so a combinated therapy with deflazacort, methotrexate, tacrolimus, and transfer factor was prescribed, obtaining excellent results. CONCLUSION: There are many algorithms reported in the literature for the treatment of AD, but the evolution of the disease is the only one that will give us the guidelines for the treatment to be followed.

Antecedentes: la dermatitis atópica es una enfermedad cutánea compleja, inflamatoria y crónica, que ocurre típicamente en individuos con una historia personal o familiar de atopia. Se caracteriza por lesiones de dermatitis, prurito y piel seca (xerosis) que evolucionan con curso crónico y brotes intermitentes que alternan con periodos de remisión. La padecen entre 5 y 15 % de la población general, entre 10 y 20 % de la población pediátrica y entre 1 y 3 % de la población adulta. Caso clínico: hombre de 19 años, con dermatitis atópica severa (SCORAD de 84.3) e hiper-IgE (34 400 UI/mL). Se prescribió deflazacort y uso de cremas cicatrizantes y emolientes, así como de gel libre de detergente, tratamiento con el cual no evolucionó favorablemente, por lo que se indicó la combinación de deflazacort, metotrexate, tacrolimus y factor de transferencia, con la cual se obtuvieron excelentes resultados. Conclusión: en la literatura se describen numerosos algoritmos para el tratamiento de la DA, pero la evolución de la enfermedad es la que marca la pauta para el tratamiento que debe seguirse.

Salivary Immunoglobulin Gene Expression in Patients with Caries.

BACKGROUND: Immunoglobulins mediate the host's humoral immune response are expressed in saliva. AIM: To quantify the FcαR, FcγRIIB, and FcαµR gene expression in the saliva of Mexican patients with caries in mixed and permanent dentition. SUBJECTS AND METHODS: This was a comparative cross-sectional study. mRNA was isolated from 200 µL of saliva following the RNA III Tissue Fresh-frozen protocol of the MagNA Pure LC Instrument 2.0 (Roche Diagnostics GmbH, Nederland BV) and the FcαR, FcαµR and FcγRIIB were quantified through TaqMan Assays. RESULTS: One hundred individuals, 50 with mixed dentition and 50 with permanent dentition, were included in the study. Statistically, it was found a significant difference (p = 0.025) in the IgG (FcγRIIB) expression between the studied groups. CONCLUSION: Although we confirmed the existence of FcαR, FcγRIIB and FcαµR gene expression in saliva, only a significant difference in the expression of FcγRIIB between the mixed dentition and permanent dentition was found.

Neuroendocrine Gastroenteropancreatic Tumors: Where Are We?

AIMS: Neuroendocrine gastroenteropancreatic tumors are infrequently found neoplasms. Our objective was to analyze the survival rates for all sites that they occur in by studying different variables. MATERIALS AND METHODS: A retrospective study was carried out using records for a 7-year period from January 1, 2008 to December 31, 2014 on neuroendocrine gastroenteropancreatic tumors patients diagnosed at the Pontevedra-Salnés Hospital Complex. The variables used were as follows: age at diagnosis, tumor size, presence or absence of metastases at diagnosis, cell proliferation index, Ki-67 of each tumor, treatments received, postdiagnosis survival time, existence or not of tumor progression, and time from diagnosis to progression and from diagnosis to mortality. In relation to treatments, the information recorded was whether the treatment was endoscopic, surgical, or pharmacological. RESULTS: Ninety-three neuroendocrine tumors made up a ratio of 4.42 cases per 100,000 inhabitants per annum. The median patient follow-up time was 44 months. The overall 5-year survival rate for patients who were followed up for a minimum of 60 months (49 patients) was 65.3%. The progression-free survival was 75.6% for 41 patients who were followed up for a minimum of 60 months. The survival rate for patients receiving endoscopic treatment was 100%, as there was no patient mortality recorded for those treated by endoscopic resection during the follow-up period. CONCLUSION: Pancreatic neuroendocrine tumors may be managed conservatively in elderly patients by either monitoring them with imaging studies or treating them with somatostatin analogs. In the case of digestive tract tumors (stomach, duodenum, and rectum) that meet the criteria for endoscopic resection, this is a reliable and safe technique in the long term.

[Surgical treatment for liver haematoma following endoscopic retrograde cholangiopancreatography; An unusual case]. / Tratamiento quirúrgico para hematoma subcapsular hepático posterior a colangiografía retrógrada endoscópica; caso inusual.

BACKGROUND: Even in expert hands, there can be serious complications when performing an endoscopic retrograde cholangiopancreatography. The most frequent complications are pancreatitis, cholangitis, bleeding, perforation, and acute cholecystitis. The hepatic subcapsular haematoma is a rare complication, with few cases described worldwide. OBJECTIVE: A case is presented of an extremely rare complication of endoscopic retrograde cholangiopancreatography, which required surgical treatment for its resolution without success. This is second case of mortality reported in the literature. CLINICAL CASE: Female patient of 30 years old, with indication for endoscopic retrograde cholangiopancreatography due to benign strictures. A hydro-pneumatic dilation and stent placement of 2 gauge 10 fr was performed. She presented abdominal pain after the procedure and significant decline in haemoglobin with no evidence of haemodynamic instability so an abdominal tomography scan was performed, showing no evidence of liver injury. The patient was haemodynamic unstable within 72 h. A laparotomy was required for damage control, with fatal outcome in the intensive care unit due to multiple organ failure. CONCLUSION: Subcapsular hepatic haematoma after endoscopic retrograde cholangiopancreatography is a rare complication, with few cases reported in the literature. Treatment described in the literature is conservative, resulting in a satisfactory resolution.

[Aerobiological study of anemophilous pollens in the city of Toluca, Mexico]. / Estudio aerobiológico de pólenes anemófilos en la ciudad de Toluca, México.

BACKGROUND: Due to the high incidence of allergic diseases in Mexico, caused by exposure to pollens, there have been several studies of plants and atmospheric pollens in various regions in the last decades. In the city of Toluca there have been two previous pollen samplings using gravimetric methodology, for which it is necessary to obtain new samplings with a standardized volumetric technique, in order to have updated and confident results of a region with considerable environmental changes in the last years. OBJECTIVE: To determine the different types of pollens, seasonal variations and behavior in the four seasons of the year. MATERIAL AND METHOD: A descriptive study, related to the identification of pollens by the suction and trapping of particles with the volumetric sampler type Hirst (Burkard) performed in the city of Toluca, Mexico, from October 1, 2004 to September 30, 2005. RESULTS: Twenty-nine different airborne pollen types were identified, which amounted a total of 13,542 pollen grains. During winter we found the largest number of pollens. The months with the highest and lowest amount of pollens were January and August, respectively. Pollens from trees predominated, mainly from the Cupressaceae (44%) and Pinaceae (13.8%) families, which were present in the atmosphere throughout the year. CONCLUSIONS: We identified a larger amount of pollens from trees in winter, mainly from the Cupressaceae family, and it is closely related to the number of trees planted of this species in the city.

Antecedentes: debido a la alta prevalencia de enfermedades alérgicas en México causadas por exposición a polen, en las últimas décadas se han hecho estudios de plantas y pólenes atmosféricos en varias regiones. En la ciudad de Toluca se hicieron dos muestreos polínicos, mediante metodología gravimétrica, por lo que es necesario hacer un estudio con metodología volumétrica estandarizada para obtener resultados actualizados y confiables de una región con cambios ambientales considerables en los últimos años. Objetivo: determinar los diferentes tipos polínicos, las variaciones estacionales y su comportamiento en las cuatro estaciones del año. Material y método: estudio descriptivo de la identificación de pólenes, mediante el método de succión y captura de partículas con el muestreador volumétrico tipo Hirst (Burkard), efectuado en la ciudad de Toluca, México, del 1 de octubre de 2004 al 30 de septiembre de 2005. Resultados: se identificaron 29 diferentes tipos polínicos, con un conteo total de 13,542 granos de polen. Durante el invierno se encontró la mayor cantidad de pólenes. Los meses con mayor y menor cantidad de pólenes fueron enero y agosto, respectivamente. Predominaron los árboles, principalmente de la familia Cupressaceae (44%) y polen de Pinaceae (13.8%); estos dos grupos polínicos estuvieron presentes durante todo el año. Conclusiones: identificamos una mayor cantidad de pólenes de árboles durante el invierno, principalmente de la familia Cupressaceae, lo que se relaciona estrechamente con la cantidad de árboles sembrados de esta especie en la ciudad.

Polymorphisms in Glutathione S-Transferase M1, T1, and P1 in Patients with Chronic Periodontitis: A Pilot Study.

Background. Although the direct cause of chronic periodontitis is bacterial infection, the progression of this disease depends on genetic and environmental factors, and smoking is a known risk factor in the development and severity of the disease. An individual's susceptibility may be influenced by polymorphisms in the glutathione S-transferase genes. These genes encode enzymes that metabolize xenobiotic compounds. The aim of this study was to determine the frequency of GSTM1, GSTT1, and GSTP1 polymorphisms in Mexicans with chronic periodontitis. Methods. 60 Mexicans with chronic periodontitis (30 smokers and 30 nonsmokers) were studied. A peripheral blood sample was taken for subsequent DNA extraction. The genetic material was PCR-amplified followed by restriction fragment length polymorphism with the aim of identifying GST polymorphisms. Results. Polymorphisms in the GSTT1 and GSTP1 genes were not significantly different between the smokers and nonsmokers. However, there were significant differences (P = 0.05) between groups in polymorphisms in the GSTM1 gene. The patients with chronic periodontitis have a higher frequency of null and mutant polymorphisms in GSTM1, GSTT1, and GSTP1 compared with historical data from a healthy Mexican population. Conclusions. The presence of these polymorphisms may be a risk factor for the development of chronic periodontitis.

MRI reliability in classifying thoracolumbar fractures according to AO classification.

The vertebral fracture patterns of AO classification have been established historically via radiograph and computed tomography analysis, achieving modest reproducibility values. The authors hypothesize that magnetic resonance imaging may improve reliability because it better indicates posterior ligamentous complex damage. They conducted a retrospective analysis of a prospective recruited cohort of patients using radiographs and magnetic resonance images with fat saturation sequences to classify 37 traumatic vertebral fractures. Five spine surgeons, 2 orthopedic residents, 2 musculoskeletal radiologists, and 2 radiodiagnosis residents classified the morphological pattern of each fracture per AO classification in 2 separate sessions that occurred 6 weeks apart. Inter- and intraobserver reproducibility for AO classification types A, B, and C were assessed using the kappa test (pairwise method), and standard error was assessed using the jackknife method. Quantitative comparisons were performed using the Student's t test, and the kappas were performed using normal approximation. Mean interobserver agreement was kappa=0.53 and 0.47 for the first and second sessions, respectively, for all evaluators. Greater interobserver agreement was observed between the senior doctors (kappa=0.59 and 0.54 for the first and second sessions, respectively) vs residents (kappa=0.45 and 0.31 for the first and second sessions, respectively) (P=.02) and between orthopedic surgeons vs radiologists (kappa=0.71 vs 0.48, respectively) (P=.008). Mean intraobserver agreement was kappa=0.58 (range, 0.38-0.76). Evaluators more familiar with the classification obtained higher kappas. Magnetic resonance imaging offers moderate reproducibility in assessing vertebral fractures pursuant to AO classification, and results are slightly better than those reported with computed tomography. Reliability increases in the hands of experiened spine surgeons and improves with greater familiarization with the classification.

Síndrome de burnout en la Facultad de Odontología de la Universidad Autónoma del Estado de México: un estudio comparativo / Burnout syndrome in the Faculty of Dentistry, Universidad Autónoma del Estado de Mexico: a comparative study

El Síndrome de Burnout (SBO) es un problema creciente, comprende alteraciones físicas, somáticas y psicológicas; así como ausentismo laboral, y cuantiosas pérdidas económicas. Desafortunadamente presenta alta prevalencia en los profesionales de la salud y en los estudiantes, principalmente los del área odontológica. El objetivo de este trabajo fue conocer las diferencias por afectación del SBO, en tres grupos (docentes, trabajadores administrativos y estudiantes) que conforman el personal de la Facultad de Odontología, de la Universidad Autónoma del Estado de México (UAEM). Se aplicó el Maslach Burnout Inventory y un cuestionario sobre las características sociodemográficas, laborales y académicas, a 108 personas de la Facultad de Odontología, de la UAEM: 36 docentes, 36 trabajadores administrativos y 36 estudiantes. El instrumento consta de 22 ítems para evaluar las tres subescalas del SBO: 1) Agotamiento Emocional (AE), 2)Despersonalización (DP), y 3) Realización Personal (RP). Se aplicó una prueba t para conocer las diferencias entre los grupos, con apoyo del software SPSS, versión 19. Al comparar las medias de afectación por el SBO entre los grupos, se encontraron diferencias estadísticamente significativas en la subescala AE entre docentes y estudiantes (p=0,00), entre docentes y trabajadores administrativos (p=0,01), y entre trabajadores administrativos y estudiantes (p=0,00). En la subescala DP sólo se encontraron diferencias entre los trabajadores administrativos y los estudiantes (p=0,01). En la subescala RP se encontraron diferencias entre los docentes y los estudiantes (p=0,00), entre los docentes y los trabajadores administrativos (p=0,01), y entre los trabajadores administrativos y los estudiantes (p=0,05). No hay estudios sobre el SBO, que incluyan todos los grupos que conforman el personal de una Facultad de Odontología. Sin embargo, es importante conocer las diferencias en la afectación por este síndrome en cada uno de los grupos, ...

Burnout syndrome (BOS) is a growing problem, involves physical, somatic and psychological alterations, as well as work absenteeism, and economic losses. Unfortunately it has high prevalence among health professionals and students, mainly on dentistry area. The aim of this study was to know the differences by affectation of the BOS, between the three groups (educational, administrative workers and students) that conforms the personnel of the Dentistry Faculty, of the Autonomous University of the State of Mexico (UAEM). The Maslach Burnout Inventory and a questionnaire on sociodemographic, labor and academic characteristics, was applied to 108 people of the Dentistry Faculty of the UAEM: 36 educational ones, 36 administrative workers and 36 students. The instrument includes 22 items to evaluate the three subscales of the BOS: 1) Emotional fatigue (EF), 2) Depersonalization (DP), and 3) Personal Realization (PR). A t test was applied to know the differences between the groups studied, with support of software SPSS, version 19. When comparing the averages of affectation by BOS between the groups studied, were statistically significant differences in the subscale of EF between the educational and students groups (p=0.00), between educational and administrative workers groups (p=0.01), and between administrative workers and students groups (p=0.00). In the subscale of DP only were differences between the administrative workers and students groups (p=0.01). In the subscale of PR were differences between educational and students groups (p=0.00), between educational and administrative workers (p=0.01) and, between administrative workers and students groups (p=0.05). There are not studies on the BOS that includes all the groups that conform the personnel of a Dentistry Faculty. Nevertheless, it is important to know the differences in the affectation by this syndrome in each one of the groups, since it will allow elaborating specific strategies for each one; and..

Effect of three fluoride compounds on the growth of oral normal and tumor cells.

AIM: Comparative study of the growth inhibition by different types of fluoride compounds used in dentistry has been limited. We investigated the effects of sodium fluoride (NaF), diammine silver fluoride [Ag(NH3)2F] and 5-fluorouracil (5-FU) on the growth of eleven human normal and tumor cells in total. MATERIALS AND METHODS: Viable cell number was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Apoptosis induction was evaluated by caspase-3 activation and DNA fragmentation. Fluoride was determined using a fluoride-specific electrode. RESULTS: All compounds had little or no growth stimulating effect (hormesis) on all cells. Ag(NH3)2F exhibited the highest cytotoxicity towards both normal and tumor cells. 5-FU had the selective cytostatic activity towards oral squamous cell carcinoma cell lines, whereas NaF was selectively cytotoxic towards glioblastoma cell lines. None of the compounds induced internucleosomal DNA fragmentation and only 5-FU induced slight activation of caspase-3 in an oral squamous cell carcinoma cell line (HSC-2). Cytotoxicity of fluoride compounds was not reduced by superoxide dismutase and catalase, reducing the possibility of the involvement of reactive oxygen species in the mechanism of action. Approximately 0.01-0.09% initially added NaF was recovered from the cells, whereas the cellular uptake of Ag(NH3)2F and 5-FU was below the detection limit. CONCLUSION: Cytotoxicity of fluoride compounds may not be directly linked to their tumor specificity nor to their apoptosis-inducing activity.

Synergism between prior Anisakis simplex infections and intake of NSAIDs, on the risk of upper digestive bleeding: a case-control study.

BACKGROUND: The aim of this study was to investigate the relationship between prior Anisakis infections and upper gastrointestinal bleeding (UGIB), and its interaction with non-steroidal anti-inflammatory drug (NSAID) intake. METHODS/PRINCIPAL FINDINGS: We conducted a hospital-based case-control study covering 215 UGIB cases and 650 controls. Odds ratios (ORs) with their confidence intervals (95% CIs) were calculated, as well as the ratio of the combined effects to the sum of the separate effects of Anisakis allergic sensitization and NSAIDs intake. Prior Anisakis infections were revealed by the presence of anti-Anisakis IgE antibodies specific to the recombinant Ani s 1 and Ani s 7 allergens used as the targets in indirect ELISA. Prior Anisakis infections (OR 1.74 [95% CI: 1.10 to 2.75]) and the intake of NSAIDs (OR 6.63 [95% CI: 4.21 to 10.43]) increased the risk of bleeding. Simultaneous NSAIDs intake and Anisakis allergic sensitization increased the risk of UGIB 14-fold (OR=14.46 [95% CI: 6.08 to 34.40]). This interaction was additive, with a synergistic index of 3.01 (95% CI: 1.18-7.71). CONCLUSIONS: Prior Anisakis infection is an independent risk factor for UGIB, and the joint effect with NSAIDs is 3 times higher than the sum of their individual effects.

Guía de práctica clínica para el diagnóstico y tratamiento de la hepatitis crónica por el virus de la hepatitis B / Practice guideline for diagnosis and treatment of chronic hepatitis virus hepatitis B

La presente guía establece los criterios técnicos para el diagnóstico y tratamiento de la hepatitis crónica secundaria a hepatitis viral B con la finalidad de contribuir a reducir la morbimortalidad de esta enfermedad. Da las definiciones para comprender las recomendaciones aquí dadas. Descripción de aspectos epidemiológicos, factores de riesgo asociados; aspectos clínicos y de diagnóstico de la hepatitis crónica por virus B. Se dan las recomendaciones de manejo incluyendo circunstancias especiales tales como el paciente con cirrosis, el paciente con coinfección VIH ó con coinfección con hepatitis C. Las recomendaciones aquí mencionadas se convierten en la guía nacional para el manejo de la Hepatitis crónica por hepatitis B.

This guide sets out the technical criteria for the diagnosis and treatment of chronic hepatitis secondary to viral hepatitis B. The guide intend to reduce the morbidity and mortality of this disease. The Guide give practical definitions to help understand the terminology, describe epidemiology, risk factors, and clinical aspects and the diagnosis of chronic hepatitis B. Finally the guide give recommendations for the management including special circumstances such as patients with cirrhosis, patients coinfected with HIV or coinfected with hepatitis C. The recommendations of the guide become the national guide for the management of chronic hepatitis B.