Mouthwashes with CPC Reduce the Infectivity of SARS-CoV-2 Variants In Vitro.

Oral mouthwashes decrease the infectivity of several respiratory viruses including SARS-CoV-2. However, the precise agents with antiviral activity in these oral rinses and their exact mechanism of action remain unknown. Here we show that cetylpyridinium chloride (CPC), a quaternary ammonium compound in many oral mouthwashes, reduces SARS-CoV-2 infectivity by inhibiting the viral fusion step with target cells after disrupting the integrity of the viral envelope. We also found that CPC-containing mouth rinses decreased more than a thousand times the infectivity of SARS-CoV-2 in vitro, while the corresponding vehicles had no effect. This activity was effective for different SARS-CoV-2 variants, including the B.1.1.7 or Alpha variant originally identified in United Kingdom, and in the presence of sterilized saliva. CPC-containing mouth rinses could therefore represent a cost-effective measure to reduce SARS-CoV-2 infectivity in saliva, aiding to reduce viral transmission from infected individuals regardless of the variants they are infected with.

sFlt-1/PlGF for prediction of early-onset pre-eclampsia: STEPS (Study of Early Pre-eclampsia in Spain).

OBJECTIVE: A high ratio of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) has been linked to pre-eclampsia (PE). We evaluated the sFlt-1/PlGF ratio as a predictive marker for early-onset PE in women at risk of PE. METHODS: This prospective, Spanish, multicenter study included pregnant women with a risk factor for PE, including intrauterine growth restriction, PE, eclampsia or hemolysis, elevated liver enzymes and low platelet count syndrome in previous pregnancy, pregestational diabetes or abnormal uterine artery Doppler. The primary objective was to show that the sFlt-1/PlGF ratio at 20, 24 and 28 weeks' gestation was predictive of early-onset PE (< 34 + 0 weeks). Serum sFlt-1 and PlGF were measured at 20, 24 and 28 weeks. Multivariate logistic regression was used to develop a predictive model. RESULTS: A total of 819 women were enrolled, of which 729 were suitable for analysis. Of these, 78 (10.7%) women developed PE (24 early onset and 54 late onset). Median sFlt-1/PlGF ratio at 20, 24 and 28 weeks was 6.3 (interquartile range (IQR), 4.1-9.3), 4.0 (IQR, 2.6-6.3) and 3.3 (IQR, 2.0-5.9), respectively, for women who did not develop PE (controls); 14.5 (IQR, 5.5-43.7), 18.4 (IQR, 8.2-57.9) and 51.9 (IQR, 11.5-145.6) for women with early-onset PE; and 6.7 (IQR, 4.6-9.9), 4.7 (IQR, 2.8-7.2) and 6.0 (IQR, 3.8-10.5) for women with late-onset PE. Compared with early-onset PE, the sFlt-1/PlGF ratio was significantly lower in controls (P < 0.001 at each timepoint) and in women with chronic hypertension (P < 0.001 at each timepoint), gestational hypertension (P < 0.001 at each timepoint) and late-onset PE (P < 0.001 at each timepoint). A prediction model for early-onset PE was developed, which included the sFlt-1/PlGF ratio plus mean arterial pressure, being parous and previous PE, with areas under the receiver-operating characteristics curves of 0.86 (95% CI, 0.77-0.95), 0.91 (95% CI, 0.85-0.97) and 0.93 (95% CI, 0.86-0.99) at 20, 24 and 28 weeks, respectively, and was superior to models using the sFlt-1/PlGF ratio alone or uterine artery mean pulsatility index. CONCLUSIONS: The sFlt-1/PlGF ratio can improve prediction of early-onset PE for women at risk of this condition. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Suplementos nutricionales gelatinizados: una alternativa válida para la disfagia / Gelatinous nutritional supplements: a useful alternative in dysphagia

La disfagia orofaríngea es un síndrome muy prevalente en la población mayor, más aún entre ancianos institucionalizados. La causa más frecuente de disfagia son las enfermedades neurodegenerativas y vasculares cerebrales, especialmente la demencia, cuyas fases más avanzadas se acompañan de trastornos de glutorios frecuentes que exigen texturas espesas, tipo pudin en su alimentación. Los suplementos nutricionales de consistencia pudin no están financiados por el sistema de salud, por lo que, encaso de precisar su uso, hay que afrontar su coste o espesarlos suplementos líquidos financiables, habitualmente de forma individualizada, con espesantes comerciales en polvo. Éste es un proceso laborioso, altamente variable en la consistencia obtenida y de apariencia poco homogénea ,por lo que es difícil de aplicar en los centros geriátricos grandes. Presentamos otra forma de usar estos suplementos financiados, mezclándolos con gelatina comercial que permite obtener una apariencia pulida, con textura homogénea y que permanecen estables en su composición y seguros para su consumo durante 5 días (AU)

The oropharingeal dysphagia is a very prevalent syndrome among the elderly, and even more among institutionalized individuals. Dysphagia is frequently caused by neurodegenerative and cerebrovascular conditions, the dementia syndrome being the most common of them, where the latest stages of the process are often accompanied by frequent swallowing problems requiring to incorporate thick foodstuffs in the diet of the elderly, such as the pudding. Nutritional supplements with a pudding like consistency are not financed by the National Health System. Therefore, when they are needed, patients must either pay their full price for them or thicken the liquid supplements financed by the National Health System. This is normally done in an individualized way, through the powder thickeners in the market. It is a very laborious and highly changeable process regarding the resulting consistency, with a poor homogeneous aspect; thus, it is complicated to implement this method in big community dwelling. We here by present a different way to use these financed supplements, this is: mixing them up with commercial jelly resulting in a refined product with a homogeneous texture. These supplements will remain stable in their composition and safe to be used within 5 days (AU)

[Gelatinous nutritional supplements: a useful alternative in dysphagia]. / Suplementos nutricionales gelatinizados: una alternativa válida para la disfagia.

The oropharingeal dysphagia is a very prevalent syndrome among the elderly, and even more among institutionalized individuals. Dysphagia is frequently caused by neurodegenerative and cerebrovascular conditions, the dementia syndrome being the most common of them, where the latest stages of the process are often accompanied by frequent swallowing problems requiring to incorporate thick foodstuffs in the diet of the elderly, such as the pudding. Nutritional supplements with a puddinglike consistency are not financed by the National Health System. Therefore, when they are needed, patients must either pay their full price for them or thicken the liquid supplements financed by the National Health System. This is normally done in an individualized way, through the powder thickeners in the market. It is a very laborious and highly changeable process regarding the resulting consistency, with a poor homogeneous aspect; thus, it is complicated to implement this method in big community dwelling. We hereby present a different way to use these financed supplements, this is: mixing them up with commercial jelly resulting in a refined product with a homogeneous texture. These supplements will remain stable in their composition and safe to be used within 5 days.

Meningoteliomatosis pulmonar difusa: causa infrecuente de patrón micronodular / Diffuse pulmonary meningotheliomatosis: an uncommon cause of the micronodular pattern

Los meningoteliomas pulmonares son tumores raros que se manifiestan morfológicamente como nódulos de pequeño tamaño. Aparecen con mayor frecuencia en la sexta y en la séptima década de la vida, con predilección por el sexo femenino. Su etiología es desconocida y en el diagnóstico radiológico diferencial deben incluirse las enfermedades que cursan con un patrón nodular. Diversos autores han documentado una clara asociación, estadísticamente significativa, entre esta entidad y diversas enfermedades pulmonares, y la más frecuente es el adenocarcinoma de pulmón. Existen actualmente muy pocos casos radiológicos documentados en la literatura médica. Presentamos el caso de una paciente con antecedentes de carcinoma de mama y de recto metacrónicos. En el estudio de extensión de este último se evidenció un patrón micronodular pulmonar bilateral. Los hallazgos radiológicos se interpretaron inicialmente como metástasis y se alcanzó el diagnóstico definitivo de meningoteliomatosis mediante biopsia pulmonar (AU)

Pulmonary meningotheliomas are rare tumors that manifest as small nodules. They are most common in the sixth and seventh decades of life and are more common in women. Their cause is unknown and the imaging differential diagnosis should include other diseases that course with nodular patterns. Several authors have documented a statistically significant association between pulmonary meningotheliomatosis and diverse lung diseases, with adenocarcinoma of the lung being the most frequently associated disease. Very few cases of radiologically documented meningotheliomatosis have been reported. We present a case of a patient with a history of metachronous breast and rectal cancer. A micronodular pattern was observed in both lungs during CT examination to determine the extent of rectal cancer. The radiologic findings were initially interpreted as metastases and the definitive diagnosis of meningotheliomatosis was reached after lung biopsy (AU)

[Diffuse pulmonary meningotheliomatosis: an uncommon cause of the micronodular pattern]. / Meningoteliomatosis pulmonar difusa: causa infrecuente de patrón micronodular.

Pulmonary meningotheliomas are rare tumors that manifest as small nodules. They are most common in the sixth and seventh decades of life and are more common in women. Their cause is unknown and the imaging differential diagnosis should include other diseases that course with nodular patterns. Several authors have documented a statistically significant association between pulmonary meningotheliomatosis and diverse lung diseases, with adenocarcinoma of the lung being the most frequently associated disease. Very few cases of radiologically documented meningotheliomatosis have been reported. We present a case of a patient with a history of metachronous breast and rectal cancer. A micronodular pattern was observed in both lungs during CT examination to determine the extent of rectal cancer. The radiologic findings were initially interpreted as metastases and the definitive diagnosis of meningotheliomatosis was reached after lung biopsy.

Quiste hidatídico intramiocárdico / Cardiac hydatidic cyst

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Mycobacterium tuberculosis effects on fibroblast collagen metabolism.

BACKGROUND: Type I collagen synthesis and degradation are important events during Mycobacterium tuberculosis (MTb) granuloma or cavity formation, and fibroblasts are cells involved in these processes. OBJECTIVE: We examined the MTb effects on fibroblast collagen metabolism to understand the virulence factors involved in tuberculosis pathogenesis. METHODS: Human lung fibroblasts were incubated with culture medium or sonicated MTb H37Ra (avirulent) or H37Rv (virulent) strains. The effects on collagen synthesis, fibroblast proliferation and collagenase activity were examined. Matrix metalloproteinase-1 (MMP-1), MMP-13 and tissue inhibitors of metalloproteinases (TIMP-1) mRNA levels were analyzed by quantitative real-time PCR amplification. Protein expression was explored by Western blot technique. RESULTS: Collagen synthesis and fibroblast proliferation were significantly increased by H37Ra medium. In contrast, cells incubated with H37Rv medium showed an increase in collagenase activity. MMPs quantitative real-time PCR amplification revealed an increase on MMP-13 mRNA levels in fibroblasts cultured with H37Rv medium, with little effect observed on MMP-1 expression. Western blot assay demonstrated that H37Rv medium stimulated MMP-1 and MMP-13 proenzyme synthesis. This medium had a large effect on MMP-1 activation. TIMP-1 transcription was increased in cells incubated with medium and sonicated from H37Ra, although the highest TIMP-1 protein expression was found in fibroblasts cultured with sonicated H37Rv. CONCLUSIONS: These results suggest that MTb had direct effects on fibroblast collagen turnover, with differences in collagen synthesis and degradation depending on the strain.

Adrenal metastasis of breast cancer with involvement of the inferior vena cava

Tumour thrombosis of the inferior cava vein is usually associated with primary renal cell cancer. To our knowledge, this is the first case reported of adrenal metastasis of breast cancer extending into the inferior vena cava. There are few references in the literature documenting this extension with positron emission tomography (PET) and enhanced computed tomography (CT). The authors focus on the role of combined PET-CT imaging in the accurate detection of malignant thrombus (AU)

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Perforación intestinal: complicación inusual de la tuberculosis entérica que simulaba enfermedad de Crohn / Intestinal perforation: an unusual complication of the intestinal tuberculosis that simulated Crohn´s disease

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Lesiones cavitadas pulmonares y enfermedad de Hodgkin / Cavitating lung lesions and Hodking´s disease

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Male discomfort during the digital rectal examination: does examiner gender make a difference?

To determine if examiner gender affects men's perceived pain and embarrassment during an emergency department (ED) digital rectal examination, we prospectively studied male ED patients undergoing rectal examination. Each subject's perceived pain and embarrassment was gauged using 100 mm visual analog scales. Age, complaint, and examiner gender and training level were recorded. Two-tailed Mann-Whitney or Kruskal-Wallis tests examined significant differences among group mean pain and embarrassment scores. Of 126 subjects, 60 had female and 66 had male examiners. Mean pain scores were similar for patients of female (36.5 mm) and male (37.4 mm) examiners (95% CI -9.8 to 11.5, P = .73). Mean embarrassment scores were similar for female (36.6 mm) and for male (32.9 mm) examiners (95% CI -7.9 to 15.3, P = .67). Younger male patients experienced more pain and embarrassment (P < .027). Examiner training level and prostatic examination did not affect the score.

Bioavailability, biodistribution, and toxicity of BioZn-AAS(1): a new zinc source. comparative studies in rats.

Food fortification with a proper zinc compound is an economic and effective strategy to prevent zinc deficiency. BioZn-AAS, a zinc gluconate stabilized with glycine, was compared with zinc sulfate (reference standard), zinc hydroxide, and zinc gluconate, all of them labeled with (65)Zn. This preclinical study was performed on Sprague-Dawley rats of both sexes, and the administered dose was 85 microg/kg of zinc. Bioavailability studies showed that absorption of BioZn-AAS was not statistically different than absorption from other sources in female rats (25.65% +/- 2.20% for BioZn-AAS, 28.24% +/- 4. 60% for ZnSO(4), 24.91% +/- 4.02% for Zn[OH](2), and 25.51% +/- 2. 70% for Zn-gluconate). In the case of the male rats, absorption of BioZn-AAS (27.97% +/- 4.20%) was higher (P<0.05) than that from the other compounds (23.15% +/- 2.90% for ZnSO(4), 22.62% +/- 3.90% for Zn[OH](2), and 22.30% +/- 3.90% for Zn-gluconate). Biodistribution studies demonstrated that the zinc from BioZn-AAS followed the same metabolic pathway as zinc from the other sources. Toxicity studies were performed with 50 female and 50 male rats. The value of oral lethal dose 50 (LD(50)) was 2000 mg/kg for female rats and 1900 mg/kg for male rats. Therefore, we conclude that BioZn-AAS has adequate properties to be considered a proper zinc compound for food fortification or dietary supplementation.

Kikuchi-Fujimoto necrotizing lymphadenitis associated with cutaneous lupus erythematosus: a case report.

Histiocytic necrotizing lymphadenitis or Kikuchi-Fujimoto disease is a rare entity, and even more rarely, it is associated with other diseases. In a few cases, the condition is associated with cutaneous lupus erythematosus (CLE). Histiocytic necrotizing lymphadenitis predominantly affects young women, who present with solitary or multiple cervical lymphadenopathy accompanied by symptoms such as fever, weight loss, sweating, or, in exceptional cases, hepatosplenomegaly. Laboratory examinations show normal or nonspecific results. The disease is of unknown origin, although a viral origin has been suggested, with the suspected agents including Epstein-Barr virus, herpesvirus type 6, and cytomegalovirus (CMV). Although the first and most of the more recent cases have been reported in Oriental patients, the disease has a wide geographic distribution. The clinical evolution is favorable, with spontaneous remission in less than 4 months in almost all cases. We present a case of a 37-year-old woman from Peru who presented with cervical adenopathies on two occasions. Biopsy of a lymph node revealed a histopathologic picture compatible with Kikuchi-Fujimoto histiocytic necrotizing lymphadenitis. The adenopathy disappeared in a few months. A year later, she presented with a maculopapular rash in the nasal and malar regions. The results of the skin biopsy and immunofluorescence examination were compatible with chronic CLE. The results of the serology testing for CMV were positive. Treatment with chloroquine was initiated, with almost complete recovery by 5 months. No manifestations of systemic lupus erythematosus have occurred since. The epidemiologic, clinical, and anatomopathologic aspects as well as the differential diagnosis of this entity are reviewed.

Study of industrial microencapsulated ferrous sulfate by means of the prophylactic-preventive method to determine its bioavailability.

Radio-iron tests are frequently used to measure the bioavailability of different iron sources for food fortification. As the labeling procedures must be done under laboratory conditions, complementary studies should be carried out to evaluate the bioavailability of iron sources produced on an industrial scale. The iron bioavailability of SFE-171 (ferrous sulfate microencapsulated with phospholipids) was studied in previous reports using the compounds labeled with 59Fe and 55Fe; the results showed an iron bioavailability similar to that of ferrous sulfate. In the present work, the iron bioavailability of industrial SFE-171 was studied by the prophylactic-preventive method in rats using ferrous sulfate as the reference standard. Elemental iron powder was also studied by the same method for comparative purposes. The liver iron concentration of each animal was determined at the end of the experiment in order to evaluate the influence of each iron source on the liver iron stores. Relative biological values of 98 and 34% were found for SFE-171 and elemental iron powder, respectively, while the corresponding relative liver iron concentrations were 104 and 45%. The results provided by the prophylactic-preventive method show that the iron bioavailability of industrial SFE-171 is similar to that of ferrous sulfate; these results are also in agreement to those obtained with the radioactive compounds. We can conclude that the SFE-171 obtained by industrial procedures for massive use in iron food fortification has the same bioavailability as that of the SFE-171 produced and labeled under laboratory conditions.

Estudio clínico controlado doble ciego, dobesilato de calcio (Doxium) vs. fracción flavonoide purificada y micronizada de diosmina (Daflón): en el tratamiento de las crisis hemorroidales / Control clinical study double blind, calcium of dobesilate (Doxium) vs. flavonoide fraction purify and micronized of diosmin (Daflon): in the treatment of the hemorrhoidal crisis

Veintiocho (28) pacientes con diagnóstico de crisis hemorroidal fueron randomizados en dos grupos paralelos y tratados con dobesilato de calcio (Doxium) o fracción flavonoide purificada y micronizada de diosmina (Daflón), en un estudio comparativo doble ciego en los primeros 10 días y abierto durante al menos cuatro semanas. La mejoría de todos los síntomas fue similar en ambos grupos y alcanzó significación estadística al 8vo. día de tratamiento, cuando se comparó con los scores iniciales. Al final del estudio todos los pacientes estaban asintomáticos, no encontrándose diferencia estadística entre los grupos. Ningun paciente experimentó efectos secundarios importantes

[Zinc: concepts on an essential micronutrient]. / Cinc: conceptos actuales sobre un micronutriente esencial.

It is now well known that zinc is an essential micronutrient. Even though much information is available, there are many points that remain to be studied. zinc is absorbed by the intestine and transported in the plasma by albumin, forming a small exchangeable pool, which is rapidly exhausted even in cases of mild deficiency. zinc is essential for the activity of about 70 enzymes among other functions. Therefore, zinc deficiency produces a great number of clinical disorders, the symptoms of which may range between mild up to serious dysfunctions. These problems are corrected by a dietary supplementation with zinc. The lack of a reliable method to determine the zinc nutritional status reflects the problem to estimate the metal recommended dietary allowances, which are difficulty met specially by children, old persons and pregnant women which constitute the main risk groups. Although our knowledge concerning zinc toxicity is scarce, it is well known that the amounts of zinc that produces toxic effects are much higher than those that are contained in regular diets as well as in diets supplemented with this metal. Therefore, the need of the development of effective strategies, like food fortification with proper zinc compounds, appears as an attractive alternative in order to prevent and/or correct the deficiency of this vital element and to improve the health and the life quality of the whole population.