RESUMEN
BACKGROUND: The studies IMvigor 210 cohort 2 and IMvigor211 evaluated the efficacy of atezolizumab in patients with locally advanced or metastatic urothelial cancer (mUC) upon progression to platinum-based chemotherapy worldwide. Yet, the real impact of this drug in specific geographical regions is unknown. MATERIALS AND METHODS: We combined individual-level data from the 131 patients recruited in Spain from IMvigor210 cohort 2 and IMvigor211 in a pooled analysis. Efficacy and safety outcomes were assessed in the overall study population and according to PD-L1 expression on tumour-infiltrating immune cells. RESULTS: Full data were available for 127 patients; 74 (58%) received atezolizumab and 53 (42%) chemotherapy. Atezolizumab patients had a numerically superior median overall survival although not reaching statistical significance (9.2 months vs 7.7 months). No statistically significant differences between arms were observed in overall response rates (20.3% vs 37.0%) or progression-free survival (2.1 months vs 5.3 months). Nonetheless, median duration of response was superior for the immunotherapy arm (non-reached vs 6.4 months; p = 0.005). Additionally, among the responders, the 12-month survival rates seemed to favour atezolizumab (66.7% vs 19.9%). When efficacy was analyzed based on PD-L1 expression status, no significant differences were found. Treatment-related adverse events of any grade occurred more frequently in the chemotherapy arm [46/57 (81%) vs 44/74 (59%)]. CONCLUSION: Patients who achieved an objective response on atezolizumab presented a longer median duration of response and numerically superior 12 month survival rates when compared with chemotherapy responders along with a more favorable safety profile. PD-L1 expression did not discriminate patients who might benefit from atezolizumab.
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Anticuerpos Monoclonales Humanizados/uso terapéutico , Antineoplásicos/uso terapéutico , Carcinoma de Células Transicionales/tratamiento farmacológico , Neoplasias Ureterales/tratamiento farmacológico , Neoplasias Uretrales/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales Humanizados/efectos adversos , Antineoplásicos/efectos adversos , Antígeno B7-H1/metabolismo , Carcinoma de Células Transicionales/metabolismo , Carcinoma de Células Transicionales/mortalidad , Carcinoma de Células Transicionales/secundario , Estudios de Cohortes , Femenino , Humanos , Linfocitos Infiltrantes de Tumor/metabolismo , Masculino , Persona de Mediana Edad , Supervivencia sin Progresión , España , Tasa de Supervivencia , Resultado del Tratamiento , Neoplasias Ureterales/metabolismo , Neoplasias Ureterales/mortalidad , Neoplasias Ureterales/patología , Neoplasias Uretrales/metabolismo , Neoplasias Uretrales/mortalidad , Neoplasias Uretrales/patología , Neoplasias de la Vejiga Urinaria/metabolismo , Neoplasias de la Vejiga Urinaria/mortalidad , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
PURPOSE: Active surveillance (AS) and adjuvant chemotherapy (AC) with carboplatin are valid alternatives for managing stage I seminoma, and most relapses can be cured with cisplatin-based chemotherapy. However, some reports suggest that AC may modify the classical pattern of recurrences. METHODS: We analyzed all relapses observed in a series of 879 patients with stage I seminoma included in 4 consecutive studies of the Spanish Germ Cell Cancer Group. After a median follow-up of 67 months, recurrences were detected in 56/467 (12%) low-risk cases on AS and 13/412 (3%) high-risk cases after AC (p < 0.001). The objective was to describe clinical features, treatment and outcome. Univariate comparisons were performed between both groups. RESULTS: No significant differences were found between relapses on AS and those after AC in terms of time to relapse (13 vs 17 months), size (26 vs 27 mm), location (retroperitoneum in 88% vs 85%), and method of detection (computed tomography in 77% vs 69%). Treatment consisted of chemotherapy (etoposide + cisplatin ± bleomycin) in 89% and 92%, respectively. Late relapses (after > 3 years) were seen in 11% vs 7.7% (p = NS) and second or successive recurrences in 1.8 vs 23% (p < 0.05). With a median follow-up of 130 moths, two patients died of seminoma-unrelated causes (AS group) and the rest are alive and disease-free. CONCLUSION: In the setting of a risk-adapted treatment of stage I seminoma, the administration of two courses of AC in patients with tumor size > 4 cm and/or rete testis invasion is associated with a higher incidence of second recurrences but does not significantly modify the pattern of relapses or their outcome.
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Antineoplásicos/uso terapéutico , Carboplatino/uso terapéutico , Recurrencia Local de Neoplasia , Neoplasias Testiculares , Espera Vigilante , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Bleomicina/uso terapéutico , Quimioterapia Adyuvante , Gonadotropina Coriónica Humana de Subunidad beta/sangre , Cisplatino/uso terapéutico , Supervivencia sin Enfermedad , Etopósido/uso terapéutico , Estudios de Seguimiento , Humanos , Masculino , Recurrencia Local de Neoplasia/sangre , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/patología , Orquiectomía , Red Testicular/patología , Neoplasias Retroperitoneales/patología , Estudios Retrospectivos , Seminoma/tratamiento farmacológico , Seminoma/patología , Seminoma/cirugía , España , Neoplasias Testiculares/tratamiento farmacológico , Neoplasias Testiculares/patología , Neoplasias Testiculares/cirugía , Resultado del TratamientoRESUMEN
BACKGROUND: Cancer-specific survival for patients with clinical stage I (CSI) germ cell testicular cancer (GCTC) is outstanding after inguinal orchidectomy regardless the treatment utilized. This study evaluated whether active surveillance (AS) of such patients yielded similar health outcomes to other therapeutic strategies such as adjuvant chemotherapy, radiotherapy or primary retroperitoneal lymphadenectomy as described in the literature. PATIENTS AND METHODS: Patients with CSI GCTC were screened between January 2012 and December 2016. Patients had previously undergone inguinal orchidectomy as the primary treatment and chosen AS as their preferred management strategy after receiving information about all available strategies. RESULTS: Out of 91 patients screened, 82 patients selected AS as their preferred management strategy. Relapse rate in the overall population was 20% (95% CI 12-30) and median time to relapse was 11.5 months (range 1.0-35.0). In patients with seminomatous tumors, relapse rate decreased to 13% and median time to relapse was 13 months; whereas in patients with non-seminomatous tumors, relapse rate was 33% (IA) or 29% (IB) and median time to relapse was 12 months in stage IA and 4.5 months in stage IB patients. All relapses were rescued with three or four cycles of chemotherapy and two also required a retroperitoneal lymphadenectomy. All patients are currently alive and free of disease. CONCLUSIONS: The clinical outcomes of patients with CSI GCTC managed by AS in this series were excellent. This strategy limited the administration of active treatments specifically to the minority of patients who relapsed without compromising performance.
Asunto(s)
Imagen Multimodal/métodos , Neoplasias de Células Germinales y Embrionarias/prevención & control , Orquiectomía/mortalidad , Vigilancia de la Población , Neoplasias Testiculares/prevención & control , Espera Vigilante/estadística & datos numéricos , Adolescente , Adulto , Anciano , Manejo de la Enfermedad , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Neoplasias de Células Germinales y Embrionarias/diagnóstico por imagen , Neoplasias de Células Germinales y Embrionarias/cirugía , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia , Neoplasias Testiculares/diagnóstico por imagen , Neoplasias Testiculares/cirugía , Espera Vigilante/normas , Adulto JovenRESUMEN
PURPOSE: Non-epithelial ovarian cancers (NEOCs) are rare diseases. Despite their overall good prognosis, the best management and current prognostic factors remain unclear. The objective of our study was to assess the clinical and pathological features of NEOC patients treated in our institution in the last 15 years and to explore risk factors for relapse and survival. METHODS/PATIENTS: All patients with a pathological diagnosis of NEOC referred to the medical oncology department at Hospital Universitario Virgen del Rocio between 1999 and 2014 were included. Demographics, tumor characteristics, treatment procedures, and clinical follow-up were retrospectively collected. Risk factors for disease-free survival (DFS) and overall survival (OS) were assessed. RESULTS: Fifty-seven patients were included, 33 (58 %) had a sex cord-stromal tumor (SCST) and 24 (42 %) had a germ-cell tumor (GCT). Median age, non-conservative surgery rates and DFS were lower in the GCT cohort; however, salvage chemotherapy led to a high proportion of complete responses in this group translating into a 90 % 3-year OS rate in both NEOC subtypes. The only identified risk factors statistically significant were stage and tumour relapse that associated, respectively, with DFS (HR = 8.84; 95 % CI 1.85-42) and OS (HR = 11.02; 95 % CI 1.76-68.7). CONCLUSIONS: Despite their rarity, NEOCs remain a highly curable group of neoplasm. In our series, a more conservative treatment approach in ovarian GCTs revealed comparable OS outcomes to SCST. No new risk factors that would help in patient stratification were identified.
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Recurrencia Local de Neoplasia/patología , Neoplasias de Células Germinales y Embrionarias/patología , Neoplasias Ováricas/patología , Adulto , Terapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Metástasis Linfática , Persona de Mediana Edad , Invasividad Neoplásica , Recurrencia Local de Neoplasia/terapia , Estadificación de Neoplasias , Neoplasias de Células Germinales y Embrionarias/terapia , Neoplasias Ováricas/terapia , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Tasa de SupervivenciaRESUMEN
Testicular cancer represents the most common malignancy in males aged 15-34 years and is considered a model of curable neoplasm. Maintaining success, reducing treatment burden, and focusing on survivorship are then key objectives. Inguinal orchiectomy is the first recommended maneuver that has both diagnostic and therapeutic aims. Most patients are diagnosed with stage I disease (confined to the testicle). Close surveillance and selective, short-course adjuvant chemotherapy are accepted alternatives for these cases. In patients with more advanced disease (stages II and III), 3-4 courses of cisplatin-based chemotherapy (according to IGCCCG risk classification) followed by the judicious surgical removal of residual masses represent the cornerstone of therapy. Poor-risk patients and those failing a first-line therapy should be referred to specialized tertiary centers. Paclitaxel-based conventional chemotherapy and high-dose chemotherapy plus autologous hematopoietic support can cure a proportion of patients with relapsing or refractory disease.
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Neoplasias de Células Germinales y Embrionarias/diagnóstico , Neoplasias de Células Germinales y Embrionarias/terapia , Guías de Práctica Clínica como Asunto , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/terapia , Adolescente , Adulto , Humanos , Masculino , Estadificación de Neoplasias , Factores de Riesgo , España , Adulto JovenRESUMEN
Cationic dendrimers, such as PAMAM, are known to be positively charged at neutral pH allowing their unspecific interaction with proteins and other cellular components. Especially, ferritin, which has an important role in iron homeostasis, presents a negative electrostatic potential at the 3-fold channel. This channel is important in the functionality of ferritin because it allows the iron entry into its inner cavity. In this way, the interaction between the protonated terminal amines of the dendrimer and the negatively charged 3-fold channels of ferritin is expected. Experimental measurements demonstrated that PAMAM G4 inhibits the iron storage properties of L-chain human ferritin (L-Ftn). Molecular dynamics simulations have been used to analyze the specific interaction between PAMAM G4 and L-Ftn. Results show that PAMAM G4 effectively interacts with the 3-fold channels of L-Ftn, suggesting that this interaction is responsible for the inhibition of the iron storage properties of L-Ftn.
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Apoferritinas/antagonistas & inhibidores , Dendrímeros/farmacología , Hierro/metabolismo , Nylons/farmacología , Apoferritinas/genética , Apoferritinas/metabolismo , Dendrímeros/química , Humanos , Simulación de Dinámica Molecular , Nylons/químicaRESUMEN
Prostate cancer is the most common male malignancy in the Western world. Once it metastasizes, it is incurable. The current gold standard for metastatic disease is the combined docetaxel/prednisone regimen. Prostate cancer shows several characteristics that make it a suitable candidate for immunotherapy, as recently exemplified by the approval of sipuleucel-T, the first vaccine to treat any malignancy. Here, we review different tumor-associated antigen immunotherapy strategies currently being investigated, from a humanized radiolabeled monoclonal antibody (J-591) that targets radiation into tumor cells, moving on to vaccines and through to immunomodulator agents such as anti-CPLA-4 and anti-PD-1 monoclonal antibodies that activate T-cell responses via immune checkpoint inhibition. We explore different opinions on the best approach to integrate immunotherapy into existing standard therapies, such as androgen-deprivation therapy, radiotherapy or chemotherapy, and review different combination sequences, patient types and time points during the course of the disease to achieve a lasting immune response. We present data from recent phase III clinical trials that call for a change in trial endpoint design with immunotherapy agents, from the traditional tumor progression to overall survival and how such trials should include immune response measurements as secondary or intermediate endpoints to help identify patient clinical benefit in the earlier phases of treatment. Finally, we join in the recent questioning on the validity of RECIST criteria to measure response to immunotherapeutic agents, as initial increases in the size of tumors/lymph nodes, which are part of a normal immune response, could be categorized as disease progression under RECIST.
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Antineoplásicos/uso terapéutico , Vacunas contra el Cáncer/uso terapéutico , Terapia Combinada , Inmunoterapia , Neoplasias de la Próstata/terapia , Anticuerpos Monoclonales/uso terapéutico , Antígeno CTLA-4/inmunología , Humanos , Inmunomodulación , Masculino , Receptor de Muerte Celular Programada 1/inmunología , Neoplasias de la Próstata/inmunología , Neoplasias de la Próstata/patología , Neoplasias de la Próstata Resistentes a la Castración/patología , Neoplasias de la Próstata Resistentes a la Castración/terapia , Criterios de Evaluación de Respuesta en Tumores SólidosRESUMEN
The purpose of this article was to provide updated recommendations for the diagnosis and treatment of renal cell carcinoma. Pathological confirmation is mandatory before treatment with ablative or focal therapies before any type of systemic therapy. Renal cell cancer should be staged according to the TNM classification system. A laparoscopic nephron-sparing surgery should be the approach for tumors <4 cm if technically feasible. Otherwise, radical (or partial in selected cases) nephrectomy is the treatment of choice, with lymph node dissection only performed in patients with clinically detected lymph node involvement. Some retrospective evidence for a cytoreductive nephrectomy in the postimmunotherapy era suggests a benefit in patients with good or intermediate risk or for patients with a symptomatic primary lesion. Adjuvant treatment with chemotherapy or with targeted agents is not recommended and studies are ongoing today. Patients with metastatic disease should be staged by computed tomography scans of the chest, abdomen and pelvis. The efficacy of sunitinib, bevacizumab plus interferon-α, and pazopanib is well established in patients with good and intermediate risk as well for temsirolimus in poor-risk patients. These four agents are considered standard of care in first-line treatment. Sorafenib, axitinib and everolimus are standard of care in second line in different settings based on their benefit in PFS. Besides some benefit described for IL-2 in highly selected patients in first line, there is a promising and emerging role for the new immunotherapeutic approaches in metastatic renal cell carcinoma.
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Carcinoma de Células Renales/diagnóstico , Neoplasias Renales/diagnóstico , Carcinoma de Células Renales/terapia , Humanos , Neoplasias Renales/terapiaRESUMEN
PURPOSE: To estimate the cost per skeletal-related event (SRE) in patients with bone metastases secondary to solid tumours in the Spanish healthcare setting. METHODS: Patients diagnosed with bone metastases secondary to breast, prostate or lung cancer were included in this multicentre, observational study. SREs are defined as pathologic fracture (vertebral and non-vertebral fracture), radiation to bone, spinal cord compression or surgery to bone. Health resource utilisation associated with these events (inpatient stays, outpatient, emergency room and home health visits, nursing home stays and procedures) were collected retrospectively for all SREs that occurred in the 97 days prior to enrolment and prospectively during follow-up. Unit costs were obtained from the 2010 eSalud healthcare costs database. RESULTS: A total of 93 Spanish patients with solid tumours were included (31 had breast cancer, 21 prostate cancer and 41 lung cancer), contributing a total of 143 SREs to this cost analysis. Inpatient stays (between 9.0 and 29.9 days of mean length of stay per inpatient stay by SRE type) and outpatient visits (between 1.7 and 6.4 mean visits per SRE type) were the most frequently reported types of health resources utilised. The mean cost per SRE was between
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Neoplasias Óseas/economía , Neoplasias Óseas/secundario , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , Costos y Análisis de Costo , Femenino , Costos de la Atención en Salud , Humanos , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Neoplasias de la Próstata/patología , EspañaRESUMEN
(1) The aim of this study was to understand the effects of thermal history in metabolic features such as maximum (MMR) and basal (BMR) metabolic rates, as well as in metabolic plasticity, considered as the total variation of MMR and BMR during the acclimation period. (2) We studied three species of the genus Phyllotis, from different thermal environments, in an altitudinal gradient from sea level to 3800m.a.s.l. Animals were acclimated to contrasting temperatures of 5 and 30 degrees C. To determine the metabolic flexibility, MMR was measured at intervals of 6 days during the acclimation period, while BMR values were obtained at the end of acclimations. Aerobic scope and the rates of change of MMR were estimated in all populations. (3) High- and low-altitude rodents did not show differences in BMR. However, both upper and lower limits of MMR, as well as aerobic scope, were significantly different between high- and low-altitude species, indicating similar ranges of metabolic plasticity. On the other hand, the rates of change of MMR were similar in all populations. (4) Our results indicate that thermal history has a profound effect on the individuals' thermogenic capacity, probably in both phylogenetic and ontogenetic levels. Low-altitude species could not increase MMR to the same levels as high-altitude species, while the later were unable to decrease MMR to achieve the values of the low-altitude species.
RESUMEN
The effects of muscarinic receptor stimulation were tested on the urethro genital reflex (UGR) in anesthetized and spinal cord-transected rats. Drugs were applied directly to the spinal cord. The electromyographic activity (EMG) of the bulbospongiosus (BS) muscle was used for recording UGR. In six animals BS as well as soleus, posterior biceps or peroneus tertius muscle EMG was recorded simultaneously. Muscarine (5, 10, 20, 50 and 100 microg) was applied in 22 animals after cutting L6-S1 dorsal roots. Some observations were made on another six animals, to which an extensive bilateral dorsal rhizotomy (L3-S2) was performed. Rhythmic bursts of similar frequency and size to those seen during UGR were found in BS muscle a few minutes after muscarine application. No rhythmic bursting was found on the hindlimb muscles, but exclusively on BS muscles. The effects of homatropine (25, 50, 100 and 200 microg), an acetylcholine muscarinic receptor antagonist, were tested in 21 rats after UGR was elicited three times at low stimulation intensity (7 mm Hg). Homatropine produced two effects: (i) A significant increase in the latency of UGR. (ii) A facilitation of UGR inhibition. In view of these results it can be speculated that muscarinic receptor stimulation is involved in the elicitation of UGR.
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Genitales Masculinos/fisiología , Receptores Muscarínicos/fisiología , Médula Espinal/cirugía , Animales , Relación Dosis-Respuesta a Droga , Genitales Masculinos/efectos de los fármacos , Genitales Masculinos/inervación , Masculino , Muscarina/farmacología , Agonistas Muscarínicos/farmacología , Parasimpatolíticos/farmacología , Erección Peniana/efectos de los fármacos , Ratas , Ratas Wistar , Receptores Muscarínicos/efectos de los fármacos , Reflejo/efectos de los fármacos , Rizotomía , Tropanos/farmacologíaRESUMEN
Behavioral experiments were conducted to examine the role of the cholinergic receptor-agonist muscarine or its antagonist homatropine on the mating behavior of sexually experienced male rats. Male copulatory behavior was recorded after intrathecally administered saline, muscarine (7.5 microg), or homatropine (25 microg). Changes in copulatory behavior were assessed by the following parameters: intromission latency, intromission frequency, intercopulatory interval, ejaculation latency, and postejaculatory interval. Intromission frequency, intercopulatory interval, and ejaculation latency were decreased significantly by muscarine. Intrathecal homatropine decreased the number of copulating animals (five out of 13). In the five animals that were able to ejaculate after homatropine, intromission latency, intercopulatory interval, and ejaculation latency increased significantly. The effects of both drugs on locomotion were also tested. Muscarine induced no significant changes in locomotion compared with saline. A significant increase in locomotion was found after homatropine treatment. These results suggest that acetylcholine, acting at spinal-cord muscarinic receptors, may be involved in ejaculation.
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Copulación/efectos de los fármacos , Actividad Motora/efectos de los fármacos , Muscarina/farmacología , Animales , Copulación/fisiología , Eyaculación/efectos de los fármacos , Eyaculación/fisiología , Inyecciones Espinales , Masculino , Actividad Motora/fisiología , Muscarina/administración & dosificación , Parasimpatolíticos/administración & dosificación , Parasimpatolíticos/farmacología , Ratas , Ratas Wistar , Tiempo de Reacción , Médula Espinal/efectos de los fármacos , Médula Espinal/fisiología , Tropanos/administración & dosificación , Tropanos/farmacologíaRESUMEN
In anesthetized rats it was tested whether or not the activity of the ON and OFF cells within the rostral ventromedial medulla (RVM) is modulated by the mechanical stimulation of the uterine cervix (VS). ON cells were identified by an abrupt increase in their firing rate before the tail flick in response to a noxious heat. OFF cells were identified by a sudden decrease in their firing rate before the tail flick. All (27 out of 27) identified ON cells decreased their firing rate immediately after VS was applied. The effect of VS on the activity of the cells persisted for the entire stimulation period. On the other hand, all (19 out of 19) identified OFF cells increased their firing rate immediately after VS. The effect of VS on the activity of these cells also persisted for the entire stimulation period. The activity of the neutral cells showed no change, neither during the application of noxious heat, nor during VS. These results suggest that the analgesic-like effect produced by VS can be mediated by the activity of the antinociceptive circuit at the RVM. Alternatively, it can be suggested that the afferent inflow from the genital tract can induce the activity of the antinociceptive circuit at RVM, either by projections to the periaqueductal gray matter or by direct projections to RVM.
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Cuello del Útero/inervación , Bulbo Raquídeo/fisiología , Dolor/fisiopatología , Vagina/inervación , Animales , Potenciales Evocados/fisiología , Femenino , Calor , Bulbo Raquídeo/citología , Ratas , Ratas Wistar , Estrés MecánicoRESUMEN
It was evaluated in the spinal cord-transected rats whether the urethrogenital (UG) reflex shows some of the features that are present during ejaculation in intact animals. It was found that the UG reflex was facilitated after its first elicitation: the latency of the reflex was shorter than the previous one and low intensity of stimulation was needed to produce the reflex. In addition, a change in the latency of the reflex was found that was correlated with the number of stimulation trials. The latency change showed a J-shaped curve that is similar to that found for the ejaculation latency in a copulatory series. An inhibition of the reflex appeared after several trials: the reflex could not be elicited after three continuous trials. The reflex could be elicited again if the intensity of stimulation was increased. The UG reflex also showed 'exhaustion': it could not be elicited, even with high intensities of stimulation, after 3 h of rest. All these findings were present when the UG reflex was elicited by applying pressure to the urethra or when it was evoked by the electrical stimulation to the pudendal nerve. According to these findings, it can be concluded that the UG reflex maintains some of the features that are found during ejaculation in intact animals. According to this view, it can be speculated that some of the mechanisms that control ejaculation in intact animals can be localized at a spinal level.
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Genitales/fisiología , Reflejo/fisiología , Médula Espinal/fisiología , Uretra/fisiología , Animales , Estimulación Eléctrica , Genitales/inervación , Masculino , Estimulación Física , Ratas , Ratas Wistar , Uretra/inervaciónRESUMEN
The rise in blood pressure and heart rate produced by the mechanical stimulation of the uterine cervix (VS) was examined after adrenalectomy, after pelvic or hypogastric neurectomies or after spinal cord transection in anesthetized rats. Neither adrenalectomy, nor hypogastric neurectomy prevented the rise in heart rate and blood pressure produced by VS. After the spinal cord transection at T6 level, VS was still able to produce the rise in blood pressure. However, the rise in blood pressure was significantly lower than that produced in the same animals before the transection. No changes in heart rate were produced by VS after spinal cord transection. This result can be explained because this level of transection prevents the reach of the afferent inflow to the superior cervical ganglia. Pelvic neurectomy abolished completely the effects of VS on blood pressure and heart rate. Low intensity (1-2 times the threshold) electrical stimulation of the pelvic nerve produced a rise in blood pressure. Even though heart rate increased during electrical stimulation, the change in heart rate was not statistically different from the pre-stimulation value. These results suggest that the changes in blood pressure and heart rate produced by VS represent a neuronal reflex response mediated by the pelvic nerve. The fact that the effects of VS on blood pressure persist in spinal cord-transected animals suggests that the reflex is integrated at the spinal level. However, the cardiovascular responses to VS were significantly lower than before transection, suggesting that supraspinal centers are also involved in the reflex.
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Presión Sanguínea/fisiología , Cuello del Útero/inervación , Frecuencia Cardíaca/fisiología , Sistema Nervioso Simpático/fisiología , Vagina/inervación , Adrenalectomía , Anestesia , Animales , Desnervación Autonómica , Fenómenos Fisiológicos Cardiovasculares , Sistema Cardiovascular/inervación , Cuello del Útero/irrigación sanguínea , Cuello del Útero/fisiología , Estimulación Eléctrica , Femenino , Plexo Hipogástrico/cirugía , Pelvis/inervación , Ratas , Ratas Wistar , Médula Espinal/cirugía , Vagina/irrigación sanguínea , Vagina/fisiologíaRESUMEN
The utility of the amide II absorption band at 1537 cm-1 as internal reference for calculation of monomer conversion in urethane dimethacrylates (UDMA)-based dental restorative materials and sealants by means of Fourier transform infrared spectroscopy (FTIR) is demonstrated in this paper.
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Resinas Compuestas/química , Metacrilatos/química , Poliuretanos/química , Amidas/química , Espectroscopía de Resonancia Magnética , Estructura Molecular , Polímeros/química , Análisis de Regresión , Espectroscopía Infrarroja por Transformada de FourierRESUMEN
La intervencion nutricional juega un papel central en el manejo de las lipoproteinemías. Se diseño un modelo de intervencion nutricional para reducir las concentraciones elevadas de lipidos y lipoproteinas en los pacientes con hiperlipoproteinemias primarias y secundarias. Este modelo emplea un aborde educativo, a traves del cual los pacientes aprenden los conceptos basicos de nutricion y el efecto potencial de los nutrientes sobre la concentracion sanguinea de lipidos y lipoproteinas. Se plantea que el mejor conocimiento que los pacientes tengan acerca de su problema metabolico los estimulara a continuar adheriendose a la dieta.