Active paraplegics are protected against exercise-induced oxidative damage through the induction of antioxidant enzymes.

STUDY DESIGN: Experimental study. OBJECTIVES: Exercise improves functional capacity in spinal cord injury (SCI). However, exhaustive exercise, especially when sporadic, is linked to the production of reactive oxygen species that may have a detrimental effect on SCI. We aimed to study the effect of a single bout of exhaustive exercise on systemic oxidative stress parameters and on the expression of antioxidant enzymes in individuals with paraplegia. SETTING: The study was conducted in the Physical Therapy department and the Physical Education and Sports department of the University of Valencia. METHODS: Sixteen paraplegic subjects were submitted to a graded exercise test (GET) until volitional exhaustion. They were divided into active or non-active groups. Blood samples were drawn immediately, 1 and 2 h after the GET. We determined plasma malondialdehyde (MDA) and protein carbonylation as markers of oxidative damage. Antioxidant gene expression (catalase and glutathione peroxidase-GPx) was determined in peripheral blood mononuclear cells. RESULTS: We found a significant increase in plasma MDA and protein carbonyls immediately after the GET (P<0.05). This increment correlated significantly with the lactate levels. Active paraplegics showed lower levels of exercise-induced oxidative damage (P<0.05) and higher exercise-induced catalase (P<0.01) and GPx (P<0.05) gene expression after the GET. CONCLUSIONS: These results suggest that exercise training may be useful in SCI patients to develop systemic antioxidant defenses that may protect them against exercise-induced oxidative damage.

Chromoblastomycosis in children and adolescents in the endemic area of the Falcón State, Venezuela.

The present paper describes 22 cases of chromoblastomycosis (CBM) caused by Cladophialophora carrionii in children and adolescents (2-19 years old). The patients were seen between 1992 and 2004 and all resided in a CBM endemic area in the semi-arid zone of the Falcón state, Venezuela. Twelve of the 22 patients (54.55%) had close relatives who also had CBM and 19 (86.36%) were male. Lesions consisted of erythematous papules with desquamation or squamous plaques (0.12-14.19 cm in diameter), located primarily on the upper limbs (77.27% of patients). Thirteen of the patients were treated with topical 5-fluorouracil (5-FU; 1% cream), seven with topical ajoene (0.5% gel) and two had electrodesiccation and/or fulguration. Two patients who did not respond to 5-FU were treated with oral itraconazole (100 mg/day for 1 month). Complete clinical and mycological remission was achieved in 17/20 (85%) of the patients treated with 5-FC, ajoene and electrodesiccation and/or fulguration. In addition, similar results were obtained with the two patients who received itraconazole therapy. These cases emphasize the importance of early diagnosis in difficult-to-treat mycotic diseases such as CBM. By early intervention we were able to employ topical treatment with a minimum of adverse effects to achieve a high percentage of favorable therapeutic responses. The patients were thus able to avoid the evolution of the chronic, deforming and incapacitation clinical manifestations associated with CBM.

Niveles de inmunoglobulina A secretora en saliva en una población sana del Estado Carabobo / Salivary IgA levels in a healthy population of Carabobo state

Se cuantificaron los nievelesde IgA secretora (IgAs) en 267 individuos sanos de ambos sexos, provenientes de Valencia, Venezuela. Se distribuyeron en 7 grupos etarios: 1: <30 días (18); 2: 1 - 11 meses (34); 3: 12 - 23 meses (28); 4: 2 - 5 años (51); 5: 6 - 13 años (58); 6: 14 - 20 años (37); 7: 21 - 40 años (41). Criterios de exclusión: Grupos 1 y 2: Antecedentes prenatales de enfermedades crónicas, infecciones virales - bacterianas durante el embarazo, ruptura prematura de membranas, presencia de patologías. Grupos 3 al 7: infecciones crónicas, infecciones virales o bacterianas, alergia, ingesta de medicamentos, infecciones cavidad oral, hábitos tabáquicos positivos. Consentimiento informado por escrito indispensable. Promedio concentración IgA (Nefelometría ARRAY 360): 8,3 ± 8,7 mg/dL (mediana: 5,53 mg/dL, valores máximo y mínimo: 0 y 48,1 mg/dL). Grupo 1: 3,0 ± 6,5; 2: 10,4 ± 11.6; 3: 5,3 ± 6,3; 4: 6,3 ± 7,1; 5: 7,0 ± 4,7; 6: 10,6 ± 11,7; 7: 12,9 ± 84 mg/dL. Los niveles de IgA salival se relacionan con edad y condiciones genético ambientales, siendo importante la utilización de tablas de referencia locales

Ajoene and 5-fluorouracil in the topical treatment of Cladophialophora carrionii chromoblastomycosis in humans: a comparative open study.

Ajoene and 5-fluorouracil (5-FU) are compounds that have shown in-vitro activity against Cladophialophora carrionii, an important etiologic agent of chromoblastomycosis. An open comparative trial was conducted to assess safety and effectiveness of topical ajoene and 5-FU in the treatment of localized chromoblastomycosis. Thirty-seven patients with a clinically and mycologically confirmed diagnosis were randomly distributed into two groups allocated to ajoene (0.5% gel; n = 19) or 5-FU (1% cream; n = 18). Topical treatment was applied to localized lesions (< or = 2.5-cm diameter) once a day, with occlusion, for 12-16 weeks. Complete clinical and mycological remission was achieved in 14/19 patients (74%) treated with ajoene and 14/18 patients (78%) treated with 5-FU. All 5-FU-treated patients developed a post-treatment scar at the site of the lesion, while ajoene-treated patients showed only a slight depigmentation of the skin. The differences observed in cure rate between ajoene and 5-FU are not statistically significant. Follow-up of all patients for 4 years revealed no relapses in the ajoene-treated group, while one patient in the 5-FU-treated group had a relapse 6 months after the end of therapy. This trial represents the first clinical use of ajoene in the control of a deep mycosis.

Utilización de cisaprida y su relación con arritmia cardiaca. Estado actual en la literatura médica / use cisapride and its relationship to cardiac arrhythmia. State of the art in medical literature

El monohidrato de cisaprida es el procinético más utilizado para el tratamiento de desórdenes sintomáticos de la motilidad intestinal; ha sido utilizado tanto en niños como en adultos; se encuentra disponible en presentación como suspensión pediátrica en un gran número de países incluyendo México desde 1984. Se calcula que ha sido prescrito en más de 140 millones de pacientes. Los aspectos con relación a su farmacocinética y farmacodinámica han sido reevaluados desde los reportes de su utilización y su asociación con alargamiento del segmento electrocardiográfico QT, arritmia ventricular y muerte. Hasta diciembre de 1999 se habían reportado 80 muertes asociadas con su utilización. Janssen decidió limitar su producción en los Estados Unidos, dejándolo en disponibilidad sólo para protocolos de investigación. Con estos antecedentes se han realizado análisis retrospectivos, estudios prospectivos en poblaciones de distintas edades, con búsqueda y hallazgo de factores de riesgo hasta en 85 por ciento de los pacientes que han presentado arritmias ventriculares. La finalidad de este documento es revisar los aspectos farmacológicos de la cisaprida, comentar los factores identificables asociados con arritmia ventricular, y realizar una revisión de los aspectos seguridad y eficacia de la cisaprida, así como establecer factores de riesgo para presentar arritmia ventricular.

[Peripheral arteriopathy in type 2 diabetes mellitus]. / Arteriopatía periférica en la diabetes mellitus tipo 2.

OBJECTIVES: To find the prevalence of peripheral arteriopathy (PA) in type 2 diabetics registered at a Health Centre, to detect their main risk factors and examine the usefulness of the portable Doppler in Primary Care consultations. DESIGN: A crossover descriptive study. SETTING: Urban Health Centre. PATIENTS: All the type 2 diabetics registered. MEASUREMENTS AND RESULTS: Anamnesis, physical examination, analysis and base ECG were performed. A portable Doppler determined systolic blood pressure in the lower extremities (foot and posterior tibial arteries) and brachial arteries in order to calculate the ankle/arm index (AAI). PA well recorded in the clinical history and AAI < or = 0.90 were considered criteria of PA. Diabetics with AAI > or = 1.25 were analysed separately. 289 patients with an average age of 65.3 (+/- 10.8 SD) were studied. 45.7% were men and 67% had Diabetes Mellitus for less than 10 years. 37.4% followed a dietary treatment and 21.1% were treated with insulin. Multivariate analysis showed that risk factors were: tobacco dependency, age, Hypertension and the type of treatment for the DM. CONCLUSIONS: The prevalence of PA found (21.4%) was very much higher than what had been previously diagnosed (6.9%). Identified risk factors were tobacco dependency, age, Hypertension and the type of DM treatment. A portable Doppler is easy to handle and allows peripheral arteriopathy to be diagnosed at an early stage.

Signet-ring squamous cell carcinoma: a case report.

A-50-year-old Hispanic man presented to the dermatology clinic with a 0.6-cm eroded, erythematous, scaly plaque on the left side of his neck. On shave biopsy, the lesion was composed of intra-epidermal and invasive dermal cells characterized by a signet-ring appearance. One area suggestive of typical squamous cell carcinoma prompted the inclusion of that entity in the differential diagnosis. Mucicarmine stains were negative, while the extra-vacuolar cytoplasm focally reacted with periodic acid-Schiff staining, the positive reaction for which was abolished by diastase, consistent with glycogen. Malignant cells expressed keratins by reacting to antibodies, Mak6, AE1/AE3, Ker 903, and CAM5.2. Additionally, weak reactivity occurred with antibodies to CEA and EMA. Tumor cells did not express S-100, HM-B45, Leu M1, or actin. By ultrastructural examination, the large vacuoles corresponded to markedly dilated endoplasmic reticulum. A diagnosis of signet-ring squamous cell carcinoma, a rare form of cutaneous squamous cell carcinoma which has been described in only one case report in the last 10 years, was made. Immunohistochemical staining provided information useful in differentiating this lesion from other clear cell and signet-ring cell tumors which involve the skin.

Evaluation, prevention and mitigation of pounding effects in building structures

Pounding between inelastic structures is investigated using an energy approach. A comprehensive state of the art review, summarizing previous used to model pounding, and important results and conclusions from previous studies, is presented. The main characteristics of the pounding problem are identified and formulated in terms of energy.Making use of the improved correlation coefficient based on the above mentioned Pseudo Energy Radius, the Double Difference Combination rule may be used to calculate the critical gap to avoid pounding.The formulation can be extended to determine more rational critical gap formulations in seismic codes.(AU)

IDARC2D version 4.0 : A computer program for the inelastic damage analysis of buildings

This report summarizes the modeling of inelastic structures and enhancements to the program series IDARC developed for analysis, design and support experimental studies. This report presents a synthesis of all the material presented in previous reports NCEER-87-0008, NCEER-92-0022 (and in other related reports). This report presents also the new developments regarding modeling of inelastic elements and structures with supplemental dampimg devices, infill panels, etc. (AU)

[Mycetoma: report of 3 cases in Falcón State, Venezuela]. / Micetoma: reporte de tres casos en el Estado Falcón, Venezuela.

This is a report of three cases of mycetome studied in our laboratory during the last four years. We also informed about the evolution of the first case produced by Pyrenochaeta romeroi nova species reported by Borelli in 1959. All the patients were farmer men, 18, 42 and 54 years old, from the semiarid and subhumid zones of Falcon State, located on the northwest region of Venezuela. Clinically, all patients presented the mycetome syndrome (subcutaneous edema, sinus tract and "granules"), with a evolution of six months to three years. The lesions were localized in the inferior limbs in two of the patients and in the thorax in one of them. The clinical diagnose was confirmed by microbiological and mycological studies, isolating Nocardia brasiliensis in two cases and Madurella grisea in one. Two patients treated with Sulfas showed remission of the disease in a two years follow up. Including this report, 15 cases of mycetome have been reported in the Falcon State (Venezuela) in a period of thirty five years, representing only 9, 14% of the national casuistic. Actinomadura madurae and N. brasiliensis have been the most frequently isolated agents in this region. In order to determine the real endemicity of the mycetome in Venezuela, multidisciplinary clinical, inmunological, microbiological and epidemiological studies are recommended. According to the reported casuistic (15 cases), the mycetome should be a low frequency disease in Falcon State, Venezuela. We confirm that early diagnosis favors an efficient therapy.

[Spontaneous splenic hypofunction in systemic lupus erythematosus and primary Sjögren syndrome]. / Hipofunción esplénica espontánea en lupus eritematoso sistémico y síndrome de Sjogren primario.

UNLABELLED: The objective of this study was to evaluate hyposplenism in autoimmune diseases by the presence of Howell-Jolly bodies in blood erythrocytes and 99Tc spleen scan. Blood smears of 174 patients with autoimmune diseases and 126 controls were studied. Other possible causes for the presence of Howell-Jolly bodies were excluded. Evidence of hyposplenism was demonstrated in 4 of 79 patients with Systemic Lupus Erythematosus (SLE) and in 2 of 18 cases of primary Sjögren Syndrome (PSS), whereas no hyposplenism was found in the remaining cases of other autoimmune diseases. In one of the patients with SLE, hyposplenism was transient. Among the control cases, a patient with Chronic Lymphocytic Leukemia with splenomegaly presented hyposplenism. IN CONCLUSION: 1) Hyposplenism is more frequently found in SLE and PSS than in other autoimmune diseases. 2) Hyposplenism in autoimmune diseases can be transient. 3) Splenomegaly and enlarged spleen scan do not exclude hyposplenism.

Hipofunción esplénica espontánea en lupus eritematoso sistémico y síndrome de Sjogren primario. / [Spontaneous splenic hypofunction in systemic lupus erythematosus and primary Sj÷gren syndrome]

The objective of this study was to evaluate hyposplenism in autoimmune diseases by the presence of Howell-Jolly bodies in blood erythrocytes and 99Tc spleen scan. Blood smears of 174 patients with autoimmune diseases and 126 controls were studied. Other possible causes for the presence of Howell-Jolly bodies were excluded. Evidence of hyposplenism was demonstrated in 4 of 79 patients with Systemic Lupus Erythematosus (SLE) and in 2 of 18 cases of primary Sj÷gren Syndrome (PSS), whereas no hyposplenism was found in the remaining cases of other autoimmune diseases. In one of the patients with SLE, hyposplenism was transient. Among the control cases, a patient with Chronic Lymphocytic Leukemia with splenomegaly presented hyposplenism. In conclusion: 1) Hyposplenism is more frequently found in SLE and PSS than in other autoimmune diseases. 2) Hyposplenism in autoimmune diseases can be transient. 3) Splenomegaly and enlarged spleen scan do not exclude hyposplenism.