New Insect Host Defense Peptides (HDP) From Dung Beetle (Coleoptera: Scarabaeidae) Transcriptomes.

The Coleoptera Scarabaeidae family is one of the most diverse groups of insects on the planet, which live in complex microbiological environments. Their immune systems have evolved diverse families of Host Defense Peptides (HDP) with strong antimicrobial and immunomodulatory activities. However, there are several peptide sequences that await discovery in this group of organisms. This would pave the way to identify molecules with promising therapeutic potential. This work retrieved two sources of information: 1) De-novo transcriptomic data from two species of neotropical Scarabaeidae (Dichotomius satanas and Ontophagus curvicornis); 2) Sequence data deposited in available databases. A Blast-based search was conducted against the transcriptomes with a subset of sequences representative of the HDP. This work reports 155 novel HDP sequences identified in nine transcriptomes from seven species of Coleoptera: D. satanas (n = 76; 49.03%), O. curvicornis (n = 23; 14.83%), (Trypoxylus dichotomus) (n = 18; 11.61%), (Onthophagus nigriventris) (n = 10; 6.45%), (Heterochelus sp) (n = 6; 3.87%), (Oxysternon conspicillatum) (n = 18; 11.61%), and (Popillia japonica) (n = 4; 2.58%). These sequences were identified based on similarity to known HDP insect families. New members of defensins (n = 58; 37.42%), cecropins (n = 18; 11.61%), attancins (n = 41; 26.45%), and coleoptericins (n = 38; 24.52%) were described based on their physicochemical and structural characteristics, as well as their sequence relationship to other insect HDPs. Therefore, the Scarabaeidae family is a complex and rich group of insects with a great diversity of antimicrobial peptides with potential antimicrobial activity.

Abnormal calcium signalling and the caffeine-halothane contracture test.

BACKGROUND: The variable clinical presentation of malignant hyperthermia (MH), a disorder of calcium signalling, hinders its diagnosis and management. Diagnosis relies on the caffeine-halothane contracture test, measuring contraction forces upon exposure of muscle to caffeine or halothane (FC and FH, respectively). Patients with above-threshold FC or FH are diagnosed as MH susceptible. Many patients test positive to halothane only (termed 'HH'). Our objective was to determine the characteristics of these HH patients, including their clinical symptoms and features of cytosolic Ca2+ signalling related to excitation-contraction coupling in myotubes. METHODS: After institutional ethics committee approval, recruited patients undergoing contracture testing at Toronto's MH centre were assigned to three groups: HH, doubly positive (HS), and negative patients (HN). A clinical index was assembled from musculoskeletal symptoms and signs. An analogous calcium index summarised four measures in cultured myotubes: resting [Ca2+]cytosol, frequency of spontaneous cytosolic Ca2+ events, Ca2+ waves, and cell-wide Ca2+ spikes after electrical stimulation. RESULTS: The highest values of both indexes were found in the HH group; the differences in calcium index between HH and the other groups were statistically significant. The principal component analysis confirmed the unique cell-level features of the HH group, and identified elevated resting [Ca2+]cytosol and spontaneous event frequency as the defining HH characteristics. CONCLUSIONS: These findings suggest that HH pathogenesis stems from excess Ca2+ leak through sarcoplasmic reticulum channels. This identifies HH as a separate diagnostic group and opens their condition to treatment based on understanding of pathophysiological mechanisms.

A scientist's guide for submitting data to ZFIN.

The Zebrafish Model Organism Database (ZFIN; zfin.org) serves as the central repository for genetic and genomic data produced using zebrafish (Danio rerio). Data in ZFIN are either manually curated from peer-reviewed publications or submitted directly to ZFIN from various data repositories. Data types currently supported include mutants, transgenic lines, DNA constructs, gene expression, phenotypes, antibodies, morpholinos, TALENs, CRISPRs, disease models, movies, and images. The rapidly changing methods of genomic science have increased the production of data that cannot readily be represented in standard journal publications. These large data sets require web-based presentation. As the central repository for zebrafish research data, it has become increasingly important for ZFIN to provide the zebrafish research community with support for their data sets and guidance on what is required to submit these data to ZFIN. Regardless of their volume, all data that are submitted for inclusion in ZFIN must include a minimum set of information that describes the data. The aim of this chapter is to identify data types that fit into the current ZFIN database and explain how to provide those data in the optimal format for integration. We identify the required and optional data elements, define jargon, and present tools and templates that can help with the acquisition and organization of data as they are being prepared for submission to ZFIN. This information will also appear in the ZFIN wiki, where it will be updated as our services evolve over time.

Tratamiento quirúrgico de la inestabilidad de hombro: evaluación de resultados / Results in the surgical treatment of the unstable shoulder

Objective: Evaluate the functional outcome in surgically treated patients with the diagnosis of shoulder instability, analyzing subgroups of patients. Methods: We retrospectively evaluated 93 shoulders operated with a minimum of 2 years follow up. There were 80 men and 10 woman with an average age of 26 years. We evaluated shoulder range of motion, sports activity, episodes of dislocations and type of surgery. Patients answered the quick DASH and ASES tests. For the statistical analysis we used simple linear regression, Wilcoxon Test and T Test for independent samples. Results: 98 percent reported a stable shoulder, 97 percent mild or non limitations in sports activity and nobody referred problems in activities of daily living. 13 percent had another episode of dislocation after the initial surgery. The subjective functional outcome was better in patients that practiced non contact sports and in the group of under 40 years (p < 0.05). At the clinical evaluation, the group of under 40 years had a better abduction than older and patients with only one surgery had a better anterior flexion than patients with multiple surgeries (p < 0.05). Conclusion: Surgical treatment is a good alternative in unstable shoulders, because no limitation in daily activities were reported. The rate of redislocation is similar to the reported in the literature, and we think that it is related to the type of sport activity.

Objetivo: Evaluar a mediano plazo el resultado funcional de pacientes operados por luxación de hombro, analizando subgrupos de pacientes. Métodos: Estudio retrospectivo. Analizamos 93 hombros operados con un seguimiento mínimo de dos años. Ochenta hombres y 10 mujeres, edad promedio 26 años. Evaluamos tipo de actividad deportiva, número de luxaciones, tipo de cirugía (abierta vs artroscópica). Se examinó el rango de movilidad comparando al lado sano y se realizó pauta de quick DASH y ASES. Para el análisis estadístico se utilizó regresión lineal simple, Test de Wilcoxon y T Test para muestras independientes. Resultados: 98 por ciento describen su hombro estable, 97 por ciento sin limitación o limitación leve para real izar actividad deportiva. El 100 por ciento realiza actividades de la vida diana sin limitación. Hubo 13 por ciento de recidiva. Se registró mejor resultado funcional en pacientes que practicaban deporte de no contacto y en menores de 40 años vs mayores (p<0.05). Al examen, en menores de 40 años, se encontró un mejor rango en la abducción y en los pacientes con una sola cirugía, la flexión anterior fue mayor (p <0.05). Conclusión: El tratamiento quirúrgico es una alternativa óptima para los pacientes con inestabilidad glenohumeral. Permite una recuperación de las actividades de la vida diaria con mínimas complicaciones. Sin embargo, hay un porcentaje de recidiva esperable que podría estar en relación al tipo de actividad deportiva.

Enfrentamiento quirúrgico de las lesiones del tendón de biceps distal / Surgical approach in distal biceps tendon lesions

Surgical treatment of distal biceps tendon ruptures is indicated in active patients, and its aim is to recover mainly the supination strength, and flexion secondarily, focusing the controversy on its approach and fixation systems. Objective: To present a patients series results operated on for this injury, with different surgical techniques. Methods: Ten patients were evaluated retrospectively analyzing descriptively: age, evolution time, approach and fixation types, grafts use, functional and satisfaction outcome, and complications. Results: It was considered excellent in all patients, despite the use of different types of fixation and approaches, either in acute or chronic, with few complications. Conclusion: According to our results, and the literature review, it can be obtained excellent functional results, with different approaches and fixation systems, allowing an early rehabilitation.

El tratamiento quirúrgico en las roturas del tendón de bíceps distal se indica en pacientes activos, e intenta recuperar principalmente la fuerza de supinación, y secundariamente de flexión, centrando la controversia en su abordaje y sistemas de fijación. Objetivo: Presentar los resultados en una serie de pacientes operados de esta lesión, con diferentes técnicas quirúrgicas. Métodos: Se evalúan retrospectivamente diez pacientes, analizando descriptivamente edad, tiempo de evolución, tipo de abordaje y fijaciones, uso de injertos, resultados funcionales, grado de satisfacción, y complicaciones. Resultados: Fueron considerados excelentes en todos los pacientes, a pesar del uso de distintos tipos de fijación y abordajes, en roturas agudas y crónicas, con escasas complicaciones. Conclusión: De acuerdo a lo presentado, y acorde a la literatura revisada, se pueden obtener excelentes resultados funcionales, con diferentes abordajes y sistemas de fijación, que permitan una rehabilitación precoz.

Nota técnica tenodesis de la porción larga del tendón del bíceps: descripción de tres procedimientos / Technical note: long head of the bíceps muscle tenodesis: description of three procedures

Biceps tenodesis is frequently used for treatment of symptomatic long head of biceps injuries, usually is performed arthroscopicaly. We describe three techniques: In presence of associated rotator cuff (RC) injury, we repair with suture anchors and biceps tenodesis. With partial bicipital rupture of instability without RC rupture, we choose a tenodesis in the bicipital groove with interferential screws. In low demand of older patients, we perform tenodesis integrating biceps to rotator interval.

La tenodesis bicipital es utilizada frecuentemente en el tratamiento de lesiones sintomáticas de la porción larga del bíceps y se realizan preferentemente de forma artroscópica. Describimos tres técnicas: En rotura del manguito rotador (M R) asociada, donde realizamos reparación y tenodesis bicipital con anclas. En rotura parcial o inestabilidad bicipital sin rotura del MR, realizamos tenodesis en surco bicipital con tornillo de fijación interferencial. En pacientes mayores o con menor demanda funcional, realizamos tenodesis al intervalo rotador.

Fijación de tuberosidades en hemiartroplastía de hombro: descripción y comparación de dos técnicas / Tuberosity fixation in shoulder hemiartroplasty: technique comparison

Introduction: The results in shoulder fracture hemiartroplasty´s, or fracture dislocation, have been traditionally no predictable. These have been related to difficulty in obtaining a suitable consolidation of the tuberosities. On the other hand, reconstruction with more anatomical fixation have improved the functional results. The purpose of our study is to describe, and analyze, the functional and radiological results of two different techniques of tuberosities fixation in shoulder hemiartroplasty. Material and Methods: Between March of 1996 and December 2005, 47 patients (47 shoulders) underwent hemiarthroplasty by 3- and 4- part displaced proximal humerus fracture, or fracture dislocation. We performed in 29cases (61.7 percent) trans tuberosities sutures technique (group I), and in 18 (38.3 percent) independents sutures technique (group II). The average age and sex distribution, was similar between both groups. Constant score and radiological parameters, as head tuberosity distance (HTD) and consolidation of the tuberosities, were analyzed. Statistical analysis was done with ANOVA and Fischer exact test. P values of less than 0.05 were considered statistical significant. Results: Constant Score revealed a difference in favor to group II (66.2 versus 72.8 points; p = 0,1).Radiographic parameters, showed significant differences in favor of the group II (HTD 16.5 vs 8 mm; and 68 percent versus 100 percent consolidation respectively; p < 0,05). Conclusion: According to our results, and in concordance with international literature, tuberosities fixation with independent sutures allow better consolidation, with smaller superior migration, improving the final functional results.

Los resultados de la hemiartroplastía en fracturas o luxo fracturas de hombro, tradicionalmente han sido poco predecibles. Estos se han relacionado a la dificultad en conseguir una adecuada consolidación de las tuberosidades. Por otra parte, la reconstrucción y fijación más anatómica de éstas, ha permitido mejorar sus resultados funcionales. El objetivo de nuestro estudio es describir, y analizar, los resultados funcionales y radiológicos, de dos técnicas de fijación de las tuberosidades en la hemiartroplastía de hombro. Material y Métodos: Entre marzo de 1996 y diciembre de 2005, 47 pacientes (47 hombros) con diagnóstico de fractura de húmero proximal, o luxo fracturas, en 3 ó 4 partes, fueron tratados con prótesis parcial. Se realizó en 29 casos (61,7 por ciento), la técnica de amarras trans tuberositaria (grupo I), y en 18 (38,3 por ciento) la de amarras independientes a modo de cerclaje (grupo II). La edad promedio y sexo, fueron similares entre ambos grupos. Se analizaron variables como score de Constant, y parámetros radiológicos, como la distancia tuberosidad cabeza humeral (HTD), y la presencia de consolidación de las tuberosidades. El análisis estadístico fue hecho con los tests de ANOVA y exacto de Fisher. Los valores p < 0,05 fueron considerados estadísticamente significativos. Resultados: El score de Constant, presentó una diferencia en favor del grupo II, la que no fue significativa (66,2 vs 72,8 puntos; p = 0,1). Los parámetros radiográficos sí mostraron diferencias significativas, a favor del grupo II (HTD 16,5 vs 8 mm; y 68 por ciento vs 100 por ciento consolidación respectivamente; p < 0,05). Conclusión: De acuerdo a nuestros resultados, y en concordancia con la literatura internacional, la fijación de tuberosidades con amarras independientes permite una mejor consolidación, y menor migración superior, lo que permite mejorar los resultados funcionales.

Proyecto de Atención Primaria de la Salud e Interculturalidad a Pueblos Indígenas del Chaco Central / Project of Primary Attention from Salud and Interculturalidad to Indigenous Towns of the Central Chaco

Presenta informe final del proyecto Atención Primaria de Salud e Interculturalidad a pueblos Indígenas del Chaco Central

Coprophilous fungal community of wild rabbit in a park of a hospital (Chile): a taxonomic approach

During year 2005-through 2006 a study on coprophilous fungal communities present in wild rabbit dung was carried out in the park of a regional hospital (V Region, Chile), 21 samples in seven months under two seasonable periods (cold and warm) being collected. Sixty species and 44 genera as a total were recorded in the sampling period, 46 species in warm periods and 39 in the cold ones. Major groups were arranged as follows: Zygomycota (11,6 percent) Ascomycota (50 percent), associated mitosporic genera (36,8 percent) and Basidiomycota (1,6 percent). Ascomycetes genera having the highest occurrence were: Chaetomium (5), Saccobolus and Sordaria (3) Podospora, Schizothecium and Sporormiella (2). Constant and dominant species were : Chaetomium cuniculorum, Ch. murorum, Coprinus spp., Iodophanus carneus, Pilaira anomala, Schizothecium tetrasporum, Sordaria humana, Sporormiella teretispora and Stilbella fimetaria. Under a taxonomic approach focused on the majority of meiosporic fungi (Ascomycota), the presence of new records of fungi for Chile is emphasized: Fusariella hughesii, Neurospora caulospora, Pleuroascus nicholsonii, Rhytidospora bispora, Saccobolusglobuliferellus, among others.

Durante los años 2005-2006 se efectuó un estudio de las comunidades fúngicas coprófilos en excementos de conejos silvestres en un parque de un hospital regional (V Región, Chile), colectándose 21 muestras en 7 meses en 2 períodos estacionales (fríos y cálidos). Un total de60 especies y 44 géneros fueron detectados en el período de muestreo, 46 especies en los períodos cálidos y 39 en los fríos. La distribución de los grandes grupos fue: Zygomycota(11,6 por ciento), Ascomycota (50 por ciento), géneros mitospóricos asociados (36,8 por ciento) y Basidiomycota (1,6 por ciento). Los géneros de ascomycetes con mayor frecuencia de especies fueron: Chaetomium (5), Saccobolus y Sordaria (3) Podospora, Schizothecium y Sporormiella (2).Lasespecies constantes y dominantes fueron: Chaetomium cuniculorum, Ch. murorum, Coprinus spp., Iodophanuscarneus, Pilaira anomala, Schizothecium tetrasporum, Sordaria humana, Sporormiella teretispora y Stilbellafimetaria. Bajo un enfoque taxonómico orientado hacia la mayoría de los hongos meiosporicos (Ascomycota), sedestaca la presencia de nuevos registros para Chile: Fusariella hughesii, Neurospora caulospora, Pleuroascusnicholsonii, Rhytidospora bispora, Saccobolus globuliferellus, entre otros.

Air pollution and cardiovascular admissions association in Spain: results within the EMECAS project.

OBJECTIVE: To evaluate the short term effect of air pollution on cardiovascular admissions in 14 Spanish cities METHODS: The period under study was from 1995 to 1999. Daily emergency admissions for all cardiovascular diseases (CVD) and heart diseases (HD) were obtained from hospital records, and the corresponding daily levels of particulates, SO2, NO2, CO, and ozone were recorded. The magnitude of association was estimated using Poisson generalised additive models controlling for confounding and overdispersion. For each cause, lagged effects, up to three days, of each pollutant were examined and combined estimates were obtained. For ozone the analyses were restricted to the warm period. One and two pollutant models were performed. RESULTS: Associations were more consistent in lag 0 (concurrent day) and 1 (lag 0-1), except in the case of ozone where there was a more delayed relation (lag 2-3). For combined estimates an increase of 10 microg/m3 in the PM10 levels in lag 0-1 was associated with an increase of 0.9% (95% CI: 0.4 to 1.5%) in the number of hospital admissions for CVD, and 1.6% (0.8 to 2.3%) for HD. For ozone the corresponding estimates for lag 2-3 were 0.7% (0.3 to 1.0) for CVD, and 0.7% (0.1 to 1.2) for HD. An increase of 1 mg/m3 in CO levels was associated with an increase of 2.1% (0.7 to 3.5%) in CVD admissions, and 4.2% (1.3 to 7.1%) in HD admissions. SO2 and NO2 estimates were more sensitive in two pollutant models CONCLUSIONS: A short term association between increases in daily levels of air pollutants and the number of daily admissions for cardiovascular diseases, with specificity for heart diseases, has been described in Spanish cities.

Resección artroscópica de clavícula distal por abordaje combinado: evaluación funcional y de la técnica quirúrgica / Arthroscopic distal clavicle resection from a combine approach: functional and surgical technique evaluation

The success of the distal clavicular resection (DCR) is related with the nonarticular contact and the preservation of the stabilizers ligaments of the acromioclavicular (AC) joint. A retrospective revision of 25 patients that underwent to an arthroscopic DCR by a bursal approach associated to a posterior AC portal was done. The average age was 50 year-old. Twenty four patients presented A Costeoarthritis and one patient a microinstability. Twenty patients presented an associated pathology, and the majority of them were rotator cuff injuries. After a follow-up of 15,2 months, 92 percent of the patients presented no AC pain. The surgical technique allows the preservation of the superior and partially of the posterior AC ligament in all the cases. Two patients presented pain and one of them was reoperated. The evaluated technique show a high rate of satisfactories results an allow the preservation of the superior AC ligament.

El éxito de la resección de clavícula distal (RCD) se relaciona con la ausencia de contacto óseo y la conservación parcial de los estabilizadores de la articulación acromioclavicular (AC). Se realiza una revisión retrospectiva de 25 pacientes sometidos a una RCD artroscópica por vía bursal asociada a un portal AC posterior. La edad promedio fue 50 años. Veinticuatro pacientes presentaban artrosis AC y uno microinestabilidad de esa articulación. Veinte pacientes presentaban una patología asociada, la que en su mayoría fue del manguito rotador. Al término de un seguimiento promedio de 15,2 meses, 92 por ciento de los pacientes no presentó dolor AC. La técnica permitió la conservación del ligamento AC superior y en forma parcial del ligamento AC posterior en todos los casos. Dos pacientes persistieron con dolor y uno de éstos fue reintervenido. La técnica evaluada logra un alto porcentaje de resultados satisfactorios y permite la conservación del ligamento AC superior.

Geohongos en ambientes acuáticos: onygenales queratinofílicos aislados en la interfase y sedimento del Río Aconcagua. V Región (Chile) / Geofungi in aquatic environment: onygenales isolated from the interphase and sediment in the Aconcagua river. V Región (Chile)

Mediante 6 muestreos efectuados en el período 1999-2000, se estudió la presencia de Onygenales queratinofílicos en el río Aconcagua utilizando como métodos de muestreo: trampas, interfase, sedimentos y tierras en dos estaciones, Juncal y Chagres, empleándose la técnica del anzuelo queratínico. Cada estación fue caracterizada por parámetros biológicos en la interfase y sedimento del río: presencia de hongos filamentosos y levaduriformes con la técnica de dilución y recuentos en placas e indicadores fecales (Eschericia coli y Streptococcus faecalis) a través del MPN/100ml. Se consideraron también los parámetros físico-químicos: caudal, demanda bioquímica de oxígeno, nitratos, fosfatos, materia orgánica, pH, temperatura y metales pesados (Cobre, Zinc, Plomo y Cadmio). En Juncal se aislaron 327 cepas distribuídas en 9 géneros y 14 especies (n=324), con los siguientes porcentajes en trampas: 31,2 porciento, interfase, 30,9 porciento, sedimentos 15 porciento, tierras 22,3 porciento. En Chagres se aislaron 611 cepas distribuídas en 12 géneros y 17 especies (n-590)con los siguientes porcentajes: en trampas 24,4 porciento; interfase 14,7 porciento; sediementos 36,8 porciento y en tierras 24,1 porciento. A nivel de trampas y sedimentos en ambas estaciones, Aphanoascus keratinophilus obtuvo porcentajes entre 10-34 porciento, Arthroderma quadrifidum entre 8,9-38 porciento y Chrysosporium pannocola entre 7,4-18 porciento, constituyendo las principales especies aisladas tomando como referencia su mayor presencia en las trampas. Se destaca su importancia como indicadores del crecimiento total de Onygenales que han desarrollado una alternativa de disperción y sobrevivencia en ambientes acuáticos con excedentes de materia orgánica. A pesar del comportamiento euritopo de estas especies su empleo como bioindicadores de contaminación ambiental es discutible debido a su notable capacidad de adaptación. Por su relación con los dermatofitos, algunas de las especies aisladas podrian constituir un potencial riesgo en salud pública, debido al oportunismo presente en este grupo, en especial Microsporum gypseum aislado entre un 2 a 6,5 porciento. En Chagres, en los sedimenos, se detectó la mayor presencia de indicadores fecales.

The molecular epidemiology of tuberculosis in Caracas, Venezuela, with IS6110 DNA fingerprinting.

In this retrospective study we asses the molecular epidemiological situation of Tuberculosis of the city of Caracas, Venezuela in the year 1994, applying IS6110 DNA Fingerprinting of clinical isolates. Fingerprinting of Mycobacterium tuberculosis strains of sixty-four patients TB patients from all the 5 districts of the city revealed fifty-one distinct IS6110 patterns. Isolates from 20 patients (30%) had fingerprints that were shared with at least one other patient. Based on this sampling we conclude that at least a third of the tuberculosis cases in Caracas in the year 1994 were the result of recent and ongoing transmission, indicating micro-epidemics in the town.

GABAergic presynaptic inhibition of rat neostriatal afferents is mediated by Q-type Ca(2+) channels.

Population spikes associated with the paired pulse facilitation paradigm have been successfully used to measure presynaptic inhibition in several systems. In the present work, this paradigm was used to evaluate the action of baclofen on neostriatal glutamatergic transmission. Baclofen enhanced synaptic facilitation with an EC(50)=0.57 microM and a maximal effect of 457%. Selective antagonists for N-, P- and Q-type Ca(2+)-channels enhanced paired pulse facilitation; suggesting that these channel types participate in the release of transmitter. Nevertheless, neither 1 microM omega-conotoxin GVIA, nor 20 nM omega-agatoxinTK occluded the action of baclofen. Baclofen's action was occluded only by 400 nM omega-agatoxinTK. These data suggest that Q-type Ca(2+)-channels mediate gamma-aminobutyric acid(B) presynaptic inhibition of neostriatal afferents.

Symptomatic crystalluria associated with indinavir.

OBJECTIVE: To report a case of severe and recurrent crystalluria resulting from the use of indinavir and to review the literature describing this adverse effect. CASE SUMMARY: A 26-year-old HIV-positive white woman had recurrent episodes of left-sided flank pain accompanied by dilation of the left renal collecting system while undergoing treatment with a triple-drug regimen including indinavir 1200 mg every 12 hours (full dosage). Typical indinavir crystalluria was observed, with no evidence of stones. Acute episodes were treated with intravenous fluids, diclofenac, and ciprofloxacin. Crystalluria and clinical symptoms eventually resolved with withdrawal of indinavir and substitution with a different protease inhibitor. Renal function remained normal. DISCUSSION: A wide spectrum of disorders of the urinary tract can occur in subjects taking indinavir, with potentially severe complications caused by crystalluria and stones. Indinavir is excreted in the urine; the low solubility of those crystals is the critical factor accounting for the risk of stone formation. An elevated pH with a reduced excretion of citric acid contributes to the low urinary solubility of indinavir. Pharmacokinetic interactions with other drugs, leading to elevated plasma concentrations of indinavir, and dehydration could also increase the risk of stone formation. The impact on renal function can be unfavorable over the long-term period. Cornerstones of treatment and prevention are increased fluid intake and possibly urinary acidification. Emergency drainage may be required for patients with severe obstruction. Reducing the dosage of indinavir has been proposed, but this carries the risk of viral mutations with development of resistance. CONCLUSIONS: Treatment with indinavir can result in crystalluria with potentially severe obstruction. All patients taking indinavir, not only those with documented crystalluria or renal effects from the drug, should greatly increase their fluid intake and have renal function checked at baseline and then monitored regularly. Urinalysis also should be performed regularly for appropriate monitoring and prevention.

An update on the discovery, pathophysiological actions, clinical manifestations and possible physiology of parathyroid related peptide.

PTHrP has had an unidentified role in medicine since 1930, when Albright described a patient with renal cortical cell carcinoma with hypercalcemia. Since then hypercalcemia has been recognized as the most common paraneoplastic syndrome. At that time the concept of "ectopic PTH syndrome" was introduced, and remained in literature until the true etiology was finally described. In the early 1970's Roof and Benson presented evidence that PTH in humoral hypercalcemia differed from "authentic" PTH. This marked the starting point for researchers to try identifying the molecule that mimicked PTH action and structure. This molecule, named parathyroid-related peptide, has been associated to hypercalcemia seen with solid tumors, such as squamous cell carcinoma of the lung and renal cortical cell carcinoma. PTHrP has been demonstrated to have similar actions to PTH but to differ in decreasing osteoblastic activity while increasing osteoclastic activity. The more fascinating finding was the presence of the PTHrP genes throughout the body, mostly the lactating breast as well as the heart, lungs and skin among others. Despite its identification, finding its physiological roles on normal tissue still remains to be clarified.

An update on the discovery, pathophysiological actions, clinical manifestations and possible physiology of parathyroid related peptide

PTHrP has had an unidentified role in medicine since 1930, when Albright described a patient with renal cortical cell carcinoma with hypercalcemia. Since then hypercalcemia has been recognized as the most common paraneoplastic syndrome. At that time the concept of ®ectopic PTH syndrome® was introduced, and remained in literature until the true etiology was finally described. In the early 1970's Roof and Benson presented evidence that PTH in humoral hypercalcemia differed from ®authentic® PTH. This marked the starting point for researchers to try identifying the molecule that mimicked PTH action and structure. This molecule, named parathyroid-related peptide, has been associated to hypercalcemia seen with solid tumors, such as squamous cell carcinoma of the lung and renal cortical cell carcinoma. PTHrP has been demonstrated to have similar actions to PTH but to differ in decreasing osteoblastic activity while increasing osteoclastic activity. The more fascinating finding was the presence of the PTHrP genes throughout the body, mostly the lactating breast as well as the heart, lungs and skin among others. Despite its identification, finding its physiological roles on normal tissue still remains to be clarified

[A clone of Neisseria meningitidis serogroup C was responsible in 1994 of an unusual high rate of strains with a moderate resistance to penicillin in Caracas (Venezuela)]. / Un clon de Neisseria meningitidis serogrupo C fue responsable en 1994 de una inusual alta tasa de cepas con resistencia moderada a penicilina en Caracas (Venezuela).

BACKGROUND: The aim of the study was to analyse meningococcal strains isolated from patients in Caracas (Venezuela) with epidemiological markers and to determine their susceptibility to antimicrobial agents. METHODS: We analyzed 29 meningococcal clinical strains isolated during 1994 in Caracas by serogrouping, serotyping and subserotyping, multilocus enzyme analysis (MEE), ribotyping and pulse field electrophoresis (PFGE) profile. We also determined the Minimal Inhibitory Concentration (MIC) to 5 antimicrobial agents. RESULTS: Twenty four (82.7%) were group C meningococcal strains. All group C meningococci were characterized as C: 2b: P1.5, belonging to the same electrophoretic type (ET) by MEE and showing the same profile by PFGE by using Bg/II endonuclease restriction enzyme. These group C meningococci showed two different patterns by ribotyping, with only one band difference. All Group C and one group B N. meningitidis isolates were moderately resistant to penicillin (MIC > or = 0.12 mg/l). CONCLUSIONS: During 1994 an unusual high incidence of meningococcal strains moderately resistant to penicillin (PenMR) was detected in Caracas (Venezuela). A clone of C: 2b: P1.5 meningococci seem to be responsable for this high incidence of PenMR isolates.