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ETHNOPHARMACOLOGICAL RELEVANCE: Uncaria tomentosa (Willdenow ex Roemer & Schultes) DC. (Rubiaceae) is a Peruvian thorny liana, commonly known as "cat׳s claw", and traditionally used in folk medicine to deal with several inflammatory diseases. Mitraphylline (MTP) is the most abundant pentacyclic oxindolic alkaloid (POA) from U. Tomentosa and has been reported to modify the inflammatory response. Herein, we have sought to identify the mechanisms underlying this modulatory effect of MTP on primary human monocytes and its ability to regulate differentiation processes on human primary monocyte and monocyte-derived macrophages. MATERIAL AND METHODS: In vitro studies with human primary monocytes and monocyte-derived macrophages were performed. Monocytes and M0 macrophages were exposed to MTP (25µM) and LPS (100ng/mL). M0 macrophages were polarized to M1 and M2 phenotypes in the absence or presence of MTP. The activation state of monocytes/macrophages was assessed by flow cytometry, gene expression and protein analysis of different specific markers. RESULTS: In human primary monocytes, the incubation of MTP for 24h reduced the number of classical (CD14(++)CD16(-)) and intermediate (CD14(++)CD16(+)) subsets when compared to untreated or LPS-treated cells. MTP also reduced the chemotactic capacity of human primary monocytes. In addition, MTP promoted the polarization of M0 macrophages toward an anti-inflammatory M2 phenotype, the abrogation of the release of pro-inflammatory cytokines such as TNFα, IL-6 or IL-1ß, as well as the restoration of markers for M2 macrophages in LPS-treated M1 macrophages. CONCLUSIONS: Our results suggest that MTP may be a key modulator for regulating the plasticity of monocytes/macrophages and the attenuation of the inflammatory response.

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INTRODUCCIÓN: En el año 2009 el Ministerio de Sanidad y Consumo de España publica una nueva guía para la vacunación de la Difteria y Tétanos. Existen discrepancias con los tiempos de inoculación de las dosis de recuerdo con otros países y sociedades médicas. MATERIAL Y MÉTODOS: Estudio descriptivo. Las variables analizadas fueron: IgG-Toxoide Tetánico, tiempo última dosis de vacunación, dosis totales, edad, sexo, hospital, habito tabáquico e índice de masa corporal. Se construyó un modelo de Regresión Logística. Con el fin de determinar los puntos de corte más sensibles y específicos para las variables temporales (tiempo desde la última dosis y edad) se calcularon las curvas R.O.C RESULTADOS: Las variables, edad O,R= 17,56 (1,840 - 167,760), dosis de vacuna inoculadas al trabajador, O,R= 0,064 (0,006 - 0,908) y tiempo de la última dosis de vacunación, O,R= 1,03 (1,017 - 1,047), son las variables significativas en el análisis multivariante. Los puntos de cortes, para la edad son 54 años (Sensibilidad S= 0,72, Especificidad SP=0,77) y 15 años tras la última dosis años (S= 0,88, SP=0,86), por encima de este corte la probabilidad de no tener anticuerpos al Tétanos es alta. CONCLUSIONES: Ante un trabajador que refiere o documenta que hace más de 15 años de la ultima dosis deberíamos plantearnos la revacunación, si además este trabajador refiere no tener más de 5 dosis inoculadas y tiene más de 54 años la revacunación sería muy recomendable

INTRODUCTION: In 2009 the Ministry of Health of Spain published a new guide for the vaccination of diphtheria and tetanus. There are discrepancies with the time of inoculation of the booster with other countries and medical societies. The objective of this study was to estimate the health worker prevanlencia antibody negative to tetanus toxoid and see to it associated factors. MATERIAL AND METHODS: A descriptive study. The variables analyzed were: IgG - Tetanus Toxin, time last dose of vaccination, total dose, age, sex, hospital, smoking history and body mass index. Logistic regression model was constructed. In order to identify areas of more sensitive and specific cut for temporary variables (time since last dose and age) ROC curves were calculated. RESULTS: The variables, age O.R= 17,56 (1,840 - 167,760), inoculated vaccine doses to workers O.R= 0,064 (0,006 - 0,908) and the time of the last dose of vaccination O.R= 1,03 (1,017 - 1,047) are significant variables in the multivariate analysis. The cut-off points for age is 54 years (Sensitivity S= 0,72, Specificity SP=0,77) and 15 years after the last dose (S= 0,88, SP =0,86), above this cut the likelihood of having antibodies to tetanus is high. CONCLUSIONS: In a worker or documents referred to more than 15 years ago the last dose revaccination should ask, if this worker also reported not having more than 5 inoculated dose and has over 54 years would be highly recommended revaccination

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El ziconotide, péptido sintético análogo de la O-conotoxina de un caracol marino, ha sido introducido recientemente como un fármaco para el tratamiento del dolor rebelde a opioides. Consigue su efecto terapéutico a través de un bloqueo selectivo de los canales de calcio (Ca) tipo N dependientes de voltaje, por medio del cual reduce la liberación de neurotransmisores pronociceptivos en el asta posterior de la médula espinal, inhibiendo, de esta manera, la transmisión del impulso doloroso. Una de sus ventajas es la de no provocar tolerancia, e incluso en caso necesario, podría ser administrado conjuntamente con morfina, potenciándose la acción de ambos fármacos (AU)

The ziconotide is structurally the synthetic peptide analogue of the V-conotoxin Conus magus, a marine snail. It has recently been introduced as a drug for the treatment of pain unresponsive to opioids. Achieves its therapeutic effect via a potent selective blockade of voltage sensitive calcium channels, which in turn reduces the release of neurotransmitters pronociceptivos in the dorsal horn of the spinal cord by this action inhibits the transmission of painful stimulus.Among its advantages is to not cause tolerance. In addition, if necessary, could be co-administered with morphine, producing a synergistic effect on its action on pain (AU)

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BACKGROUND: Orthopedic surgery is commonly performed in elderly patients with higher cardiovascular surgical risk. Hemodynamic monitoring in these patients may prevent perioperative complications. AIM: To assess the usefulness of transesophageal echocardiography (TEE) for intraoperative cardiovascular monitoring during orthopedic surgery. MATERIAL AND METHODS: Patients older than 65 years subjected to orthopedic surgery using general anesthesia and with a high cardiovascular risk were studied. Intraoperative TEE was performed to assess intravascular volume, myocardial contractility and the presence of myocardial ischemia. RESULTS: Fifty three patients aged 72+/-5 years were studied. Hemodynamic stability was detected in 68% of patients, mainly reflected as episodes of hypovolemia. Myocardial ischemia was detected in two patients and embolic episodes in six (11%). CONCLUSIONS: Intraoperative TEE was useful for the hemodynamic evaluation of patients with high cardiovascular risk.

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Background: Orthopedic surgery is commonly performed in elderly patients with higher cardiovascular surgical risk. Hemodynamic monitoring in these patients may prevent perioperative complications. Aim: To assess the usefulness of transesophageal echocargiography (TEE) for intraoperative cardiovascular monitoring during orthopedic surgery. Material and methods: Patients older than 65 years subjected to orthopedic surgery using general anesthesia and with a high cardiovascular risk were studied. Intraoperative TEE was performed to assess intravascular volume, myocardial contractility and the presence of myocardial ischemia. Results: Fifty three patients aged 72±5 years were studied. Hemodynamic stability was detected in 68 percent of patients, mainly reflected as episodes of hypovolemia. Myocardial ischemia was detected in two patients and embolic episodes in six (11 percent). Conclusions: Intraoperative TEE was useful for the hemodynamic evaluation of patients with high cardiovascular risk.

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Low efficiency of gene transfer is one of the major limitations of gene therapy. A solution to this problem may be transmission; by modification of the transgene, the gene product can be secreted and internalized by the surrounding cells. Cancer gene therapy using the herpes simplex thymidine kinase (HSV-TK) suicide gene is a promising treatment, and TK has been used in clinical trials with some success. However, this kind of therapy has limited efficacy due to the low level of gene transfer reached. A modified TK protein, capable of migrating from the producing cell to neighboring cells, would result in a greater proportion of cells affected by the treatment. As a first step towards transmission, we constructed a secretory form of HSV-TK by including the Igkappa leader peptide in the gene. An endoplasmatic reticulum export signal was added to the construct to further improve its secretion. Secretion and protein production in cancer cells, the enzymatic activity of the modified proteins and the ability of the modified TK to sensitize cancer cells to ganciclovir were tested. Addition of the Igkappa leader resulted in high levels of secretion of HSV-TK, with up to 70% of the total amount of protein secreted. Inclusion of an ER export signal did not further improve secretion. The enzyme activity of the secreted TK however, was decreased when compared to native TK. This study is the first to report on secretion of TK, and provides a first step in a novel strategy to improve the efficiency of cancer gene therapy. The loss of function in secreted TK however, may present a major hurdle in the development of a transmitted form of TK.

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La vacunación antigripal es la medida más eficazpara prevenir la gripe. Dentro de los colectivos laborales en los que se recomienda su inoculación, seencuentran los trabajadores sanitarios.Objetivos:, Estudiar si existen diferencias significativas entre las Campañas del 2005-06 y 2006-07dirigidas a los trabajadores del área sanitaria 2 de laComunidad de Madrid.Metodología: Estudio descriptivo de ambas campañasen el área sanitaria 2 de la Comunidad de Madrid. Se realiza un análisis univariante y se construye un modelo de Regresión Logística cuya variable dependiente son las dos campañas. Comovariables independientes se incluyeron: edad, categoría, servicio, centro de trabajo, vacunación de la gripe en el año anterior, efectos secundarios en año el anterior, enfermedad crónica, medicación, fumador y procesos alérgicos.Resultado:. En la Campaña 2005 se vacunaron más en servicios centrales, hostelería y administración.Se declararon más efectos secundarios, se vacunaron más sanitarios y más trabajadores declararon tomar algún tipo de medicación. Sin embargo en la Campaña 2006 se vacunaron más en el H. U. Princesa, en la primera semana de campaña, en los servicios médicos y más trabajadores declararon tener algún tipo de enfermedad crónica.Conclusiones: Las coberturas vacunales han sidoiguales o inferiores a años anteriores en los distintoscentros excepto en el Hospital U. de la Princesadonde fue mayor

The vaccination against the influenza is the mosteffective way of preventing this illness. Workers inthe Sanitary sector are ones of the most recommendedto be vaccinated against the flu.Objectives: To study whether there are significantdifferences between the 2005-2006 and 2006-2007Campaigns addressed to the workers in the Sanitaryarea nº 2 in the Madrid Community.Methodology: Descriptive study of both campaignsin the Sanitary area nº 2 in the Madrid Community.A uni-variant analysis is carried out to builda Logistic Regression model in which the two campaignsare the dependant variables. The followingindependent variables were also included: age, professional category, service, working center, previousyear anti-flu vaccination, side effects in previousyear, chronic diseases, medication taken, smokinghabits and allergic processes.Results: In the 2005 campaign, vaccination wasmore intense in central services, catering and administration. There were more side effects, more sanitary workers were vaccinated and more workersdeclared to have taken any sort of medication. However,in the 2006 campaign there were more vaccinationsin the “H.U. la Princesa”, within the first weekof campaign, in the medical services, and more workersdeclared to suffer any type of chronic disease.Conclusions: The coverage of the vaccination hasbeen equal or lower than in previous years in all workingcenters, with the exception of the “H.U. la Princesa”,where the coverage was higher

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Hemos estudiado la prevalencia y significación pronóstica del síndrome del enfermo eutiroideo (SEE) en 91 pacientes ingresados en la Unidad de Cuidados Intensivos (UCI) mediante la determinación de hormonas tiroideas libres (FT3 y FT4), T3 inversa (rT3) y hormona tiroestimulante (TSH). La prevalencia del SEE es menor de la esperada, siendo la del SEE tipo I mayor que la del tipo II. La cardiopatía isquémica aguda presenta menor prevalencia de SEE que el resto de patologías estudiadas. Los pacientes críticos que desarrollan el tipo II presentan mayor mortalidad (AU)

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The prevalence and prognosis of the sick euthyroid syndrome (SES) was studied in 91 patients admitted to the ICU by determining free thyroid hormones (FT3 and FT4), T3 reverse (rT3) and thyrotropin (TSH). The prevalence of SES was lower than expected, type I being higher that type II. The acute coronary syndrome had a lower prevalence of SES than other clinical conditions. Patients who developed type II SES had a higher mortality rate.

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BACKGROUND: To obtain a better knowledge of the determining factors and circumstances giving rise to occupational accidents will foster the implementation of corrective measures. The aim of this study is that of describing the trend of occupational accidents (OA's) over the course of time and of determining the risk factors regarding workers being forced to take time off for sick leave at the "Dr. Peset" Hospital in Valencia. METHODS: Description and retrospective analysis of the occupational accidents having occurred at the "Dr. Peset" Hospital in Valencia throughout the 1992-1995 period. The trend and seasonality of the series (seasonal indexes, SI's) were estimated by deterministic methods. A logistic regression model was employed to identify the factors providing a prior indication workers being off on sick leave and to determine the probability of the occurrence thereof. RESULTS: The highest OA rates were found among the kitchen and laundry workers (10.00 OA's per 100 workers/year). The OA's involving sick leave continued to show a trend of around zero, February being the months showing the highest SI (SI = 139.8). Those processed without sick leave showed an upward trend (r2 = 0.23, p < 0.0001), May being the month involving the largest number of casualties (SI = 134.2). The probability of an accident resulting in a worker being forced to take time of for sick leave increases significantly with age, when the accident in question takes place in the afternoon/evening, if it takes place in the kitchen/laundry, and if a sprain or tendinitis is involved. CONCLUSIONS: The measures taken involving the number of casualties entailing OA's which result in temporary incapacity should revolve around the less-skilled positions and the kitchen and laundry departments.

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BACKGROUND: The recombinant hepatitis B vaccine provides immunity in approximately 95% of all cases, but there is a certain percentage which responds insufficiently. The purpose of this work consists of assessing the factors which are linked to an inadequate immune response. METHODS: This is an observational, analytical study in which a retrospective follow-up is made of a group of subjects vaccinated to prevent against hepatitis B (HBV). The variables of interest of the health care personnel meeting the requirements to be included in this study in Health Care District No. 9 of the Autonomous Region of Valencia (No. 827) were gathered. Following vaccination, the titration of surface antibodies (antiHB's) was determined for checking the response, levels of over 10 m UI/ml being considered to provide protection. RESULTS: An adequate serum changeover was achieved in 94.4% of those vaccinated. The low-degree or zero response to the vaccine was significantly linked independently to variables such as male gender, age, the body mass index (BMI) and the habit of smoking. Drinking alcohol and the levels of GPT, although they did not react significantly with the response to the vaccine, were possibly misleading factors. CONCLUSION: The immunogenicity of this vaccine is satisfactory. It is important to quantify the levels of antiHB's, especially when factors predicting a poor response are involved. Therefore, it is possible to identify those which require a booster shot and those showing no response, hence avoiding situations involving a false sense of being protected against HBV.

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En 10 pacientes portadoras de artritis reumatoide se evaluó la fuerza global de la musculatura inspiratoria a través de la presón inspiratoria máxima (PIM). Seis sujetos presentaron alteraciones radiológicas pulmonares, 6 manifestaciones de tos y 2 de disnea. La PIM resultó significativamente disminuida (p< 0,05) con respecto al grupo control normal. En 8 pacientes se encontró que a mayor duración de la terapia esteroidal, la PIM era significativamente menor (p< 0,05). Se concluye que en el grupo estudiado, existe una disfunción de la musculatura inspiratoria probablemente en relación a la terapia esteroidal, la que se explicaría en parte por la presencia de una miositis esteroidal y/o reumática de acuerdo a lo publicado recientemente

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Se presenta el primer caso de rinosporidiosis diagnosticado en la provincia Ciego de Avila, Cuba, analizándose las características clinico epidemiológicas del caso. Paciente de 13 años de edad, de sexo masculino, proveniente de un área rural que presentaba localización nasal de las lesiones. Se revisa la literatura al respecto

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BACKGROUND: Fear of adverse reactions is one of the reasons why influenza immunization programs for hospital workers have not met wide acceptance. We conducted a study in order to compare the frequency of adverse reactions following administration of standard split-virion (VVF) and subunit-virion (VAS) influenza vaccines, mostly among hospital personnel. METHODS: Trial with volunteers who were systematically assigned to receive one of the vaccines, alternating every ten participants, during the influenza inmunization campaing 1994-95. The adverse effects were recorded by telephone interview 10 days after vaccination. RESULTS: Out the 182 subjects recruited, 163 were included in the study, of whom 100 received VAS and 63, VVF. Almost 13% of the participants reported any adverse effects with no significant difference between both groups (VAS: 11% and VVF: 15.6%, p = 0.38). There were also no significant differences relating to systemic and local reactions, separately. The subjects who had adverse reactions to previous influenza vaccination showed more frecuent systemic reactions (25% vs. 7.5%, p = 0.04) in a significant way. CONCLUSIONS: Both vaccines have been proved to be very safe, only causing adverse reactions in a small proportion and very mild in every case. The VAS presents a frequency of adverse effects similar to that of VVF, in spite of containing only surface antigens. It's likely that a certain hypersensitivity to influenza vaccine exists in some people, specially to the split-virion one.

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A configuration with internally coupled valves and a reductant column located in the loop of the secondary valve is proposed for the simultaneous determination of nitrite and nitrate. Depending on the column characteristics, a washing stream flowing in the opposite direction to the sample may or may not be required. The washing step may conveniently be performed by use of the proposed configuration.

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Con el objetivo de caracterizar el contexto hormonal de personas con 65 años se realiza la selección de 100 sujetos,50 de cada sexo,las mujeres con edad 68,66+11,58 y los hombres 66,16+11,25 aparentemente sanos a los que se le realizó determinación de los niveles plasmáticos de PRL,T4,insulina,estradiol,corticol y TSH.Los resultados se comparan con los resultados de las determinaciones analizadas en plasma tomado del banco de sangre provincial de Guantánamo,provenientes de 24 sujetos previamente aprobados por dicha entidad como donantes:12 mujeres con edad de 31,51+5,41 y 12 hombres con edades de 30,33+5,25 años.Todos los resultados se procesaron con el paquete de programa Micorstat,a través del cual se calculó la media y la desviación estándar,y se compararon con el uso de la prueba de Student en los grupos creados.Se encontro en la personas de 65 y más años, niveles inferiores de las hormonas analizadas respecto a los jóves,con significación en el caso del estradiol,la PRL y la T4 en mujeres y de T4 y control en hombres (AU)

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Se realizó un estudio de casos y controles,con el objetico de identificar algunos de los factores de riesgo que influyen en la aparición de la diabetes mellitus, en una comunidad de laciudad de guantánamo.Se identificarón como factores de riesgo mayor o más fuerte los antecedentes de otras endocrinopatías en los padres,de diabetes mellitus en las madres,así como la edad de comienzo 48 años,antecedentes de diabetes mellitus de los hermanos y partos de macrofetos al menos una vez.Se midio el impacto de intervención y se comprobó que la eliminación de factores identificados reduciría en altos porcentajes la incidencia de diabetes mellitus (AU)

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