Analysis of radioprotection and antimutagenic effects of Ilex paraguariensis infusion and its component rutin.

DNA repair pathways, cell cycle checkpoints, and redox protection systems are essential factors for securing genomic stability. The aim of the present study was to analyze the effect of Ilex paraguariensis (Ip) infusion and one of its polyphenolic components rutin on cellular and molecular damage induced by ionizing radiation. Ip is a beverage drank by most inhabitants of Argentina, Paraguay, Southern Brazil, and Uruguay. The yeast Saccharomyces cerevisiae (SC7Klys 2-3) was used as the eukaryotic model. Exponentially growing cells were exposed to gamma rays (γ) in the presence or absence of Ip or rutin. The concentrations used simulated those found in the habitual infusion. Surviving fractions, mutation frequency, and DNA double-strand breaks (DSB) were determined after treatments. A significant increase in surviving fractions after gamma irradiation was observed following combined exposure to γ+R, or γ+Ip. Upon these concomitant treatments, mutation and DSB frequency decreased significantly. In the mutant strain deficient in MEC1, a significant increase in γ sensitivity and a low effect of rutin on γ-induced chromosomal fragmentation was observed. Results were interpreted in the framework of a model of interaction between radiation-induced free radicals, DNA repair pathways, and checkpoint controls, where the DNA damage that induced activation of MEC1 nodal point of the network could be modulated by Ip components including rutin. Furthermore, ionizing radiation-induced redox cascades can be interrupted by rutin potential and other protectors contained in Ip.

Analysis of radioprotection and antimutagenic effects of Ilex paraguariensis infusion and its component rutin

DNA repair pathways, cell cycle checkpoints, and redox protection systems are essential factors for securing genomic stability. The aim of the present study was to analyze the effect of Ilex paraguariensis (Ip) infusion and one of its polyphenolic components rutin on cellular and molecular damage induced by ionizing radiation. Ip is a beverage drank by most inhabitants of Argentina, Paraguay, Southern Brazil, and Uruguay. The yeast Saccharomyces cerevisiae (SC7Klys 2-3) was used as the eukaryotic model. Exponentially growing cells were exposed to gamma rays (γ) in the presence or absence of Ip or rutin. The concentrations used simulated those found in the habitual infusion. Surviving fractions, mutation frequency, and DNA double-strand breaks (DSB) were determined after treatments. A significant increase in surviving fractions after gamma irradiation was observed following combined exposure to γ+R, or γ+Ip. Upon these concomitant treatments, mutation and DSB frequency decreased significantly. In the mutant strain deficient in MEC1, a significant increase in γ sensitivity and a low effect of rutin on γ-induced chromosomal fragmentation was observed. Results were interpreted in the framework of a model of interaction between radiation-induced free radicals, DNA repair pathways, and checkpoint controls, where the DNA damage that induced activation of MEC1 nodal point of the network could be modulated by Ip components including rutin. Furthermore, ionizing radiation-induced redox cascades can be interrupted by rutin potential and other protectors contained in Ip.

Comparison of two negative pressure systems and syringe irrigation for root canal irrigation: an ex vivo study.

AIM: To compare in a laboratory study two negative pressure systems and syringe irrigation, regarding the delivery of a contrast solution (CS) to working length (WL) and into simulated lateral canals and the effective volume of irrigant aspirated during negative pressure irrigation. METHODOLOGY: Twenty single-canaled incisor training models were constructed with six simulated lateral canals each (2, 4 and 6 mm to WL) and a size 40, 0.04 taper apical size canal. Each model underwent all irrigation procedures (EndoVac at WL (EndoVac-0) and WL-2 mm (EndoVac-2), iNP needle with negative pressure (iNPn) and syringe irrigation with the iNP needle (iNPs) and a 30-G side-slot needle placed at WL (SI0) and WL-2 (SI2) mm in a crossover design. CS was delivered at 4 mL min(-1) for 60 s with a peristaltic pump and a recovery device collected the volume (in mL) of irrigant suctioned by the negative pressure groups. The irrigation procedures were digitally recorded, and a still image of the 60-s time-point of irrigation was evaluated for CS distance to WL (in millimetres) after irrigation and penetration into lateral canals (3-point scale). Statistical tests used were Kruskal-Wallis and Dunn's test. RESULTS: EndoVac-0, iNPn and iNPs had median distances of CS to WL of 0 mm, followed by SI0 (0.2 mm), SI2 (0.7 mm) and EndoVac-2 (1.7 mm). There were no significant differences between EndoVac-0, iNPn, iNPs and SI0, but these were significantly different to SI2 and EndoVac-2 (P < 0.05). There were no significant differences between the volume of CS delivered by syringe irrigation and that collected by iNPn (4 mL), but these were significantly greater than EndoVac-0 (2.8 mL, P < 0.001) and EndoVac-2 (2.85 mL, P < 0.001), which were not different to each other (P = 1.0). The irrigation procedures were ineffective at penetration into lateral canals. CONCLUSION: iNPn, EndoVac-0, iNPs and SI0 achieved greater irrigant penetration to WL. iNPn was able to collect a median volume of CS (4 mL) similar to that delivered by syringe irrigation (iNPp, SI0 and SI2). An adequate irrigant penetration into lateral canals could not be achieved by any of the systems.

Visión respecto a la legislación laboral chilena, desde sujetos en situación de discapacidad con participación política / Vision regarding chilean labor legislation, from subjects in disability situation with political participation

La presente investigación aborda la temática “Discapacidad y legislación laboral chilena”, con el propósito de incorporar en el análisis la visión de sujetos en situación de discapacidad con experiencia organizativa y orientados a la acción política. El objetivo es analizar la visión respecto a la legislación laboral actual chilena desde sujetos en situación de discapacidad que participan activamente en política, pertenecientes al Colectivo Palos de Ciego durante el año 2014. Se utiliza una metodología participativa con enfoque cualitativo, orientada a la emancipación y con perspectiva etnográfica. La recolección de información se realiza a partir de la observación participante, notas de campo y entrevistas en profundidad. El análisis de la información se realiza mediante codificación abierta. Los resultados se estructuran a partir de tres ejes temáticos: visión política de la legislación laboral, limitantes percibidas y propuestas de transformación respecto de la inclusión laboral chilena. La problemática central tiene relación con la lógica dominante bajo la cual el Estado actúa de manera subsidiaria, no reconociendo los Derechos inherentes de los sujetos en situación de discapacidad. Los miembros del Colectivo proponen estrategias de transformación de orden político, con incidencia en aspectos globales y de acción política directa, destacándose la importancia de concientizar a la sociedad respecto a la comprensión de la discapacidad como problema político. Finalmente, se expresa el desafío de ampliar la Terapia Ocupacional al ámbito político, orientando la participación del profesional en los procesos de lucha política de los sujetos en situación de discapacidad.

This research is framed in the thematic “Disability and Chilean labor legislation” with the purpose of incorporating the vision of the subjects in disability situation with experience and political action. The aim of this research is to analyze the political vision regarding the current Chilean labor legislation, from the subjects in disability situation belonging to the group “Palos de ciego” during 2014. A participatory methodology with qualitative focusing is used, oriented to emancipation, with ethnographic perspective. Data gathering is from participant observation, field notes, and in-depth interviews. The analysis of information is done through open coding. Results are structured from three thematic axes: political vision of the labor legislation, limitations and proposals of transformation of the Chilean labor inclusion. The central issue is related to the dominant logic, under which the state acts on a subsidiary basis, not recognizing the inherent rights of the subjects in disability situation. The group proposes strategies of transformation of political order, with incidence in global and specific aspects, standing out the importance of awareness in society regarding compression of disability as a political problem. Finally, is expressed the challenge of enlarge occupational therapy to a political scope, encouraging the professional’s participation in the processes of political struggle of the subjects in situation of disability, as well as political participation thereof.

A common factor suppresses thickening in young women with malar area port wine stains and delays low density lipoprotein elevation: is it estrogen?

Port wine stains in the malar area of the face can develop thickening in early adult life. We began a study with a hypothesis that this thickening can be associated with elevation of low density lipoprotein. In a retrospective review, we divided 53 subjects with malar port wine stains into 4 groups, adults 25-39 years of age with thickening, that age group without thickening, adults 40+ years of age with thickening, and that age group without thickening. Low density lipoprotein levels in the subjects were compared to age and sex matched controls randomly selected from the general Dermatology clinic. The younger subjects with thickening demonstrated significantly higher low density lipoprotein levels than their controls (p .0082) and without thickening lower low density lipoprotein levels than their controls with great significance (p .00058). The subjects without thickening also consisted mainly of women. The low density lipoprotein levels in the older age groups, whether thickened or not, demonstrated no significant difference in low density lipoprotein levels between subjects and controls. This led to a new hypothesis that there is a factor in a subgroup of young adult women with malar port wine stains that suppresses thickening and delays the elevation of low density lipoprotein and that this factor might be estrogen. The implications of this hypothesis are that it could define a marker for a subset of the population that might be protected from the diseases associated with early elevation of low density lipoprotein and provide a source of cutaneous tissue for studying the basic science of this protection (although limited by cosmetic considerations). Future laboratory research to test the new hypothesis might include testing blood of women with malar port wine stains with or without thickening for estrogen and other sex hormones. It might also include skin biopsies to study receptors for estrogen, other sex hormones, and angiogenic factors in malar port wine stains with or without thickening. Future clinical research might include a long term prospective project to study the development of low density lipoprotein related diseases in women with malar port wine stains with or without thickening over years.

Dynamics of carbon nanotube alignment by electric fields.

The dynamics of multiwall carbon nanotube (MWCNT) alignment inside viscous media using electric fields is investigated. Electrical current measurements were performed in situ during the application of an electric field to liquid solutions of deionized water or dissolved polymer containing MWCNTs. The variation of electrical current over time was associated to the dynamics of the MWCNT network formation. The influence of the electric field magnitude and frequency on the MWCNT network formation was studied. MWCNT migration towards the negative electrode was observed when a direct current electric field was applied, whereas formation of an aligned MWCNT network was achieved for an alternating current electric field. The increase of the electric field frequency promotes a faster formation of an aligned MWCNT network and thinner MWCNT bundles. A higher viscosity of the liquid medium yields slower MWCNT alignment evidenced by a slower change of electrical current through the viscous system. An analytical model based on the dielectrophoresis-induced torque, which considers the viscosity of the medium, is also proposed to explain the dynamics of MWCNT alignment. Furthermore, aligned MWCNT/polysulfone solid composites were fabricated and electrically characterized. The solid composites presented anisotropic electrical conductivity, which was more evident for low MWCNT concentrations (0.1-0.2 wt%).

Inhibition of development, swarming differentiation and virulence factors in Proteus mirabilis by an extract of Lithrea molleoides and its active principle (Z,Z)-5-(trideca-4',7'-dienyl)-resorcinol.

Antibacterial activity of Lithrea molleoides extract against Proteus mirabilis has been previously reported by our group. In the present study, the compound (Z,Z)-5-(trideca-4',7'-dienyl)-resorcinol (1) was isolated as its responsible active principle. The effects of the compound obtained and of L. molleoides extract on P. mirabilis growth and virulence factors were evaluated. Compound 1 showed MIC and MBC values of 4000 µg/ml. It was found that the extract, at four times the MIC, produced complete killing of the uropathogen at 2h from the beginning of the experiment, while the alkylresorcinol, at four times the MIC, produced the same effect after 24 h. Hemolysis was adversely affected in treatments with both products at 8 µg/ml, while hemagglutination was not altered. The whole extract induced complete autoaggregation of P. mirabilis at 2000 µg/ml, while compound 1 at the same concentration did not show this property. Swarming motility was delayed in treatments with the extract and with 1 at 1000 and 8 µg/ml, respectively, at 8h from the beginning of the assay. Complete inhibition of the phenomenon was still observed after 24 h when compound 1 was added at 125 µg/ml. These findings offer the possibility of new classes of antimicrobial medicines to tackle infections caused by P. mirabilis.

Pollination system of the Pilosocereus leucocephalus columnar cactus (tribe Cereeae) in eastern Mexico.

It has been suggested that there is a geographic dichotomy in the pollination systems of chiropterophilous columnar cacti: in intra-tropical areas they are pollinated almost exclusively by bats, whereas in extratropical areas they are pollinated by bats, birds and bees. However, currently the studies are clumped both taxonomically (mainly Pachycereeae species) and geographically (mainly in the Tehuacan Valley and the Sonoran Desert). This clumping limits the possibility of generalising the pattern to other regions or cactus tribes. Only four of the 36 chiropterophilous cacti in Pilosocereus have been studied. Despite the tropical distribution of two Pilosocereus species, bees account for 40-100% of their fruit set. We examined how specialised is the pollination system of P. leucocephalus in eastern Mexico. As we studied tropical populations, we expected a bat-specialised pollination system. However, previous studies of Pilosocereus suggest that a generalised pollination system is also possible. We found that this cactus is mainly bat-pollinated (bats account for 33-65% of fruit set); although to a lesser degree, diurnal visitors also caused some fruit set (7-15%). Diurnal visitors were more effective in populations containing honeybee hives. P. leucocephalus is partially self-compatible (14-18% of fructification) but unable to set fruit without visitors. Despite the variation in pollination system, P. leucocephalus shows more affinity with other columnar cacti from tropical regions than with those from extratropical regions. Although we report here that a new species of tropical Pilosocereus is relatively bat-specialised, this Cereeae genus is more flexible in its pollination system than the Pachycereeae genera.

Amplificación isotérmica de ácidos nucleicos tipo LAMP para la detección de Plasmodium: nueva técnica diagnóstica: [revisión] / Isothermal nucleic acid amplifi cation type LAMP for the detection of Plasmodium: a new diagnostic technique: [review]

Recientemente se introdujo en el diagnóstico de malaria una técnica llamada amplificación isotérmica de ácidos nucleicos, que usa el material genético plasmodial. Este escrito revisa la información disponible sobre amplificación isotérmica de ácidos nucleicos, especialmente en el campo del paludismo. Metodología: se revisaron las bases electrónicas Lilacs, Scielo, PubMed (Medline) y Ovid. Resultados: solo se encontraron tres referencias sobre amplificación isotérmica de ácidos nucleicos y malaria pero hubo abundante información sobre amplificación isotérmica de ácidos nucleicos en otras infecciones y campos de la medicina, en especial la infectología. La reacción de amplificación isotérmica de ácidos nucleicos requiere de una ADN polimerasa con actividad de desplazamiento de cadena y cuatro cebadores especialmente diseñados para reconocer seis secuencias distintas. Esto garantiza alta especificidad para la amplificación. Varias alternativas de amplificación isotérmica de ácidos nucleicos se han desarrollado para la identificación de virus, bacterias, micoplasmas, protozoos, hongos y levaduras. Ventajas de amplificación isotérmica de ácidos nucleicos son capacidad de amplificar ácidos nucleicos bajo condiciones isotérmicas (60-65 ºC); posibilidad de lectura y semicuantificación a simple vista y de cuantificación con un turbidímetro; altas sensibilidad y especificidad y, en general, capacidad diagnóstica; rapidez, bajo costo y facilidad de aplicación; tolera los componentes de los medios de cultivo y las sustancias biológicas. Entre las desventajas están que la baja concentración de ADN molde disminuye la eficacia del reconocimiento de los cebadores; la observación de la turbidez fue menos sensible que la visualización de los productos en gel de agarosa teñidos con bromuro de etidio y es crítica la prevención de la contaminación...

Introduction: isothermal nucleic acid amplification (LAMP) was recently reported in the diagnosis of malaria. This uses plasmodial DNA to confi rm the diagnosis. This paper reviews the most relevant available information on LAMP, especially in the field of malaria. Methodology: the electronic databases Lilacs, Scielo, PubMed (Medline) and Ovid, were reviewed. Results: only three references were found on LAMP and malaria but there was abundant information on LAMP and other infections in fields of medicine, mainly in infectious diseases. The LAMP reaction requires a strand displacement DNA polymerase and a system of four primers specifically designed to recognize a total of six different sequences in the DNA target. This guarantees high specificity. Several alternatives of LAMP have been developed to identify viruses, bacteria, mycoplasma, protozoa, fungi and yeast. Advantages of LAMP: ability to amplify nucleic acids under isothermal conditions (60 and 65 ºC9; possibility of semi-quantitative reading by observation and quantitative interpretation using a turbidimeter; high sensitivity and specificity and, in general, diagnostic capacity, speed, low cost and ease of implementation; better performance than PCR when culture media and biological substances are processed. Disadvantages: the low concentration of DNA template reduces the primers effi cacy recognition; turbidimetry was less sensitive than the agarose gel and ethidium bromide analysis, prevention of contamination is critical...

On a new method to study drastic change in ecosystems.

We describe a novel method to study drastic change in ecosystems, based on generic functions used in the study of phase transitions and related physical phenomena. We illustrate its use by applying it to the problem of shallow lake eutrophication, and express our results in terms of an interplay between phosphorus content in the water column and fluxes of this substance between the lake and both its biological community and its surroundings. We contrast our solution to this problem with a previous one based on the concept of resilience, and on bifurcation analysis of a dynamical equation that also involves phosphorus concentration and fluxes. We then suggest a generalized dynamical scheme incorporating the generic functions above, that reduces to our original method in the stationary condition, and allows in addition dealing with cyclic and chaotic regimes, as illustrated through a particular example.

Localización pancreática de fasciola hepática en un caso humano autóctono proveniente del Edo. Bolívar, Venezuela

La fasciolosis humana es una entidad poco frecuente reportada previamente 8 veces en Venezuela, de personas provenientes del centro y los estados occidentales. Se presenta el caso de un paciente masculino de 25 años, natural y procedente del Estado Bolívar, donde practica equitación y supervisa tareas de corral del ganado equino y bovino. La enfermedad actual se inicia con diarreas desde los 14 años, acompañada de persistente eosinofilia. ELISA e "Immunoblot", resultaron francamente positivos al antígeno de excreción- secreción de Fasciola hepática. Ante persistente dolor epigástrico, se practicó eco-endoscopia, resultando en la visualización de dilatación quística del ducto pancreático con una estructura interna probablemente correspondiente a un parásito. El examen parasitológico del contenido duodenal y heces reportó huevos de Fasciola hepática en este último material. Se administró tratamiento con Bithionol luego de lo cual disminuyó la eosinofilia y hubo franca mejoría clínica. Es el primer caso de fasciolosis humana proveniente del sureste del país, donde la fasciolosis bovina o humana no había sido descrita y en el cual además, ocurrió una localización ectópica pancreática de difícil diagnóstico clínico.

Human fasciolosis in Venezuela is an infrequent disease, reported only 8 times previously in persons coming from the center and the western states of the country. The case of a 25 years old masculine patient from Bolivar State, where he practices equitation and supervises tasks of corral of equine and bovine cattle is reported. The disease began with diarrhea at 14 years old, accompanied by persistent eosinofilia. ELISA and "Immunoblot" were strongly positive to excretion-secretion Fasciola hepatica antigen. Given the presence of persistent epigastric pain, echo-endoscopy was practiced, resulting in the visualization of cyst expansion of the pancreatic duct with an internal structure probably corresponding to a parasite. The parasitologic examination of the duodenal content and feces reported Fasciola hepatica eggs this last material. After treatment with Bithionol, eosinofilia diminished and there was frank clinical improvement. It is the first case of human fasciolosis of the southeastern part of the country, where bovine or human fasciolosis had not been described in which additionally, an ectopic pancreatic location of difficult clinical diagnosis occurred.

Effects of haemodilution and rewarming with regard to digital amputation in frostbite injury: an experimental study in the rabbit.

Peripheral vascular failure with haematological and haemodynamic changes occurs after frostbite injuries. In order to study the effects of normovolemic haemodilution on the extent of digital necrosis, the paws of rabbits were haemodiluted and frozen to -15 degrees C. Dextran or gelatin was used as the plasma substitute in two groups and the rewarming after the cold injury was performed either at room temperature (22 degrees C) or with hot water baths (38 degrees C). The extent of necrosis was significantly less in the rabbits haemodiluted with dextran or gelatin and rewarmed in hot water baths.

New aspects of the role of MR/P fimbriae in Proteus mirabilis urinary tract infection.

Proteus mirabilis, a common cause of urinary tract infection (UTI), produces a number of different fimbriae including mannose-resistant Proteus-like fimbriae (MR/P). The precise role of different P. mirabilis fimbriae in ascending UTI has not yet been elucidated. In this study, a clinical isolate of P. mirabilis and an isogenic mutant unable to express MR/P were tested using different experimental approaches. They were tested for their ability to cause infection in an ascending co-infection model of UTI and in a haematogenous model in the mouse. In both models, the mutant was less able than the wild-type strain to colonise the lower and upper urinary tracts although infectivity was not abolished. In vitro adherence to uroepithelial cells was also assessed. Significant differences in adherence between both strains were observed at 1 h but not at 15 min post infection. We have also shown that a wild-type strain carries two copies of the mrpA gene. These data reinforce the importance of MR/P fimbriae in P. mirabilis UTI although other virulence factors may be necessary for efficient colonisation and development of infection.

[Utility of SPECT with 99m Tc-tetrofosmin and stimulus with dipyridamole in patients with permanent ventricular pacemakers]. / Utilidad del SPECT con 99mTc-tetrofosmin y estímulo con dipiridamol en pacientes portadores de marcapasos ventricular permanente.

BACKGROUND AND OBJECTIVE: Patients with permanent ventricular pacemakers (PP) are a difficult subgroup to assess in the study of coronary artery disease. The objective of this study was to evaluate the diagnostic value of the myocardial perfusion scintigraphy with 99mTC-Tetrofosmin (Tc-Tf) and stimulus with dipyridamole in patients with PP and suspected coronary artery disease. PATIENTS AND METHODS: Fourteen patients with suspected coronary artery disease and without structural cardiopathy, who underwent Tc-Tf and cardiac catheterization, were studied retrospectively. Sensitivity, specificity, predictive values and Kappa index were calculated for the diagnosis of coronary artery disease, multivessel disease, and for each one of the coronary arteries (left anterior descending, right coronary, and circumflex). In addition, the correlation between the number of territories with perfusion defects and the number of diseased vessels was studied. RESULTS: In regards to the diagnosis of coronary artery disease, sensitivity, specificity, positive predictive value, negative predictive value and the Kappa index were 100%, 50%, 83%, 100% and 0.55, respectively. For multi-vessel disease, these values were 83%, 64%, 64%, 83% and 0.43 respectively. The correlation coefficient between the number of territories with perfusion defects and the number of diseased vessels was 0.61 (p = 0.02). In the diagnosis of anterior descending disease, sensitivity and specificity were 83% and 88% respectively. For the right coronary artery, these values were 100% and 44% and for the circumflex artery 38% and 83%, respectively. CONCLUSION: In patients with PP and suspected coronary artery disease, myocardial perfusion scintigraphy with Tc-Tf and stimulus with dipyridamole is of great value in the diagnosis of coronary artery disease and in the assessment of its extension.

Tratamiento comparativo entre talidomida y factor de transferencia en dermatitis atópica severa / Comparative treatment between talidomida and factor of transference in dermatitis atopic severe

Antecedentes: la dermatitis atópica es una enfermedad inflamatoria crónica de la piel. Existe una interrelación compleja de factores genéticos, ambientales, inmunológicos, farmacológicos y psicológicos que contribuyen al desarrollo y gravedad de la enfermedad. Las aberraciones inmunológicas son la respuesta incrementada de anticuerpos IgE específicos hacia antígenos comunes: liberación de mediadores proinflamatorios por los basófilos y mastocitos, eosinófilos periféricos y locales, además de la actividad bifásica Th1/Th2 con liberación de citocinas (IL-4, IL-5, IL-13), GM-CSF y disminución de IFN-? por las células Th1. Debido a la complejidad de la enfermedad existen diversas alternativas de tratamiento. Objetivo: comparar la seguridad y la eficacia clínicas de la talidomida y el factor de transferencia en la dermatitis atópica severa. Material y métodos: se estudiaron pacientes con diagnóstico de dermatitis atópica severa de acuerdo con los criterios de Hanffin y Rajka, que ingresaron al servicio de alergia e inmunología clínica del Hospital Regional Lic. Adolfo López Mateos, ISSSTE. Se incluyeron 19 pacientes (12 mujeres y 7 hombres, con edad promedio de 30 ñ 4 años). Se distribuyeron en dos grupos. El primer grupo de cinco pacientes recibió talidomida 200 mg/día durante seis meses, al segundo grupo se le administraron 15 unidades de factor de transferencia, por vía oral, durante seis meses. Se solicitaron estudios de laboratorio para valoración inmunológica y metabólica pretratamiento y postratamiento. Resultados: en el grupo A, tratado con talidomida, cinco pacientes y el grupo B, tratado con factor de transferencia, ambos tuvieron disminución estadísticamente significativa de la extensión de las lesiones (p <0.0.1) y se observó mayor disminución en cuanto a la intensidad de los síntomas, y del índice SCORAD (p < 0.001 y p <0.001, respectivamente) sin ninguna diferencia estadística entre ellos. Ningún fármaco dio lugar a alteraciones inmunológicas y metabólicas secundarias y no fue necesario suspender el tratamiento. Durante el periodo de estudio se mantuvieron controladas la rinitis alérgica y el asma. Discusión: debido a la complejidad clínica consecutiva a la multifactorialidad de causas de la dermatitis atópica, las alternativas de tratamiento utilizadas en este estudio son una opción más segura, eficaz y con mejoría clínica.

Utilidad del SPECT con 99mTc-tetrofosmin y estímulo con dipiridamol en pacientes portadores de marcapasos ventricular permanente / Utility of spect with 99mtc-tetrofosmin and stimulus with dipyridamole in patients with permanent ventricular pacemakers

Introducción y objetivo: En el estudio de la cardiopatía isquémica, los pacientes portadores de marcapasos ventricular permanente (MVP), constituyen un subgrupo de muy difícil valoración. El objetivo fue evaluar el valor de la gammagrafía de perfusión miocárdica con 99mTc-Tetrofosmina (Tc-Tf) y estímulo con dipiridamol en el diagnóstico de enfermedad coronaria en pacientes portadores de MVP. Pacientes y métodos: Se estudiaron retrospectivamente 14 pacientes con sospecha de enfermedad coronaria, y sin cariopatía estructura, a los que se realizó Tc-Tf y coronariografía. Se calcularon la sensibilidad, especificidad, valores predictivos e índice de concordancia Kappa para la existencia de enfermedad coronaria, para la enfermedad multivaso y para cada una de las arterias coronarias (descendente anterior, coronaria derecha, circunfleja). Asimismo, se estudió la correlación entre el número de territorios con defectos de perfusión y el número de vasos enfermos encontrados en la coronariografía. Resultados: En cuanto al diagnóstico de enfermedad coronaria, se obtuvo una sensibilidad, especificidad, valor predictivo positivo, valor predictivo negativo e índice Kappa de 100 por ciento, 50 por ciento, 83 por ciento, 100 por ciento y 0,55 por ciento, respectivamente. Para la enfermedad multivaso, estos valores fueron 83 por ciento, 63 por ciento, 63 por ciento, 83 por ciento y 0,43 por ciento respectivamente. La correlación entre el número de territorios con defectos de perfusión y el número de vasos enfermos mostró un índice de correlación de 0,61 (p = 0,02). Para la arteria descendente anterior, la sensibilidad y especificidad fueron 83 por ciento y 88 por ciento, respectivamente. Para la coronaria derecha, estos valores fueron 100 por ciento y 44 por ciento, y para la circunfleja 38 por ciento y 83 por ciento, respectivamente. Conclusiones: En pacientes portadores de MVP y con sospecha de enfermedad coronaria, la gammagrafía de perfusión miocárdica con Tc-Tf y estímulo con dipiridamol es de gran utilidad en la detección de enfermedad coronaria y la valoración de su extensión (AU)

[Meaning of clinical and electrical positivity in the myocardial perfusion scintigraphy during the administration of dipyridamole]. / Implicaciones de la positividad clínica y eléctrica en la gammagrafía de perfusión miocárdica durante la administración de dipiridamol.

BACKGROUND AND OBJECTIVES: Administration of dipyridamole produces angina and ST depression in 20%-30% and 6%-34% of patients, respectively. This study aimed to evaluate the clinical implications of the presentation of angina and/or ST depression during the administration of dipyridamole in the study of coronary heart disease by myocardial perfusion SPECT (MPS). METHODS: The study population is constituted by 593 consecutive patients without left branch block or ventricular pacemaker rhythm who were referred to our service to undergo MPS with dipyridamole. A SPECT was performed after the administration of 99mTc-tetrosfosmine and drug stimulation with dipyridamole (0.142 mg/kg/min for 4 minutes). A coronariography was performed in 338 patients (57%). The frequency of clinical and electrical positivity and their relationship with the MPS and the coronariography were studied. RESULTS: The rate of angina and ST depression was 32% (n = 190) and 10% (n = 58), respectively. Myocardial perfusion defects were observed in 465 patients (78%), and signs of scintigraphic ischemia in 311 (52%). The patients with ST depression presented a higher frequency of perfusion defects (93% vs 76%, p = 0.0012) and scintigraphic ischemia (89% vs 49%, p < 0.0001). In addition, perfusion defects in more than one territory were observed in these patients in a higher percentage (53% vs 34%, p = 0.0036). Among the patients who underwent cardiac catheterization, those who had a ST depression had a greater extension of coronary heart disease (1.8 +/- 1.2 vs 1.3 +/- 1.0 diseased vessels, respectively. p = 0.0100) and a higher frequency of multivessel disease (61% vs 43%, p = 0.0380). Those patients who had clinical positivity showed a scintigraphic ischemia more frequently (66% vs 47%, p < 0.0001), however no statistically significant differences were observed between the presence of patients with perfusion defects or in the extension of these defects as well as in the number of diseased vessels in the coronariographic study. CONCLUSIONS: During the administration of dipyridamole, the ST depression is associated with more frequent scintigraphic ischemia, larger extension of perfusion defects and more diseased vessels. The appearance of angina is associated with scintigraphic ischemia, but it is not necessarily associated with the extension of perfusion defects or greater number of diseased vessels.