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This paper presents the results of an observational and retrospective study on the therapeutic effects of Jusvinza, an immunomodulatory peptide with anti-inflammatory properties for critically ill COVID-19 patients. This peptide induces regulatory mechanisms on the immune response in experimental systems and in patients with Rheumatoid Arthritis. Exploratory research in COVID-19 patients revealed that Jusvinza promotes clinical and radiological improvement. The aim of this study is to describe the clinical outcome and variations of several inflammatory biomarkers in a cohort of critically ill COVID-19 patients, divided into two groups during the observational research: one group received Jusvinza and the other did not. Research physicians extracted the patients´ data from their hospital's clinical records. The study analyzed 345 medical records, and 249 records from critically ill patients were included. The data covered the demographic characteristics, vital signs, ventilatory parameters and inflammatory biomarkers. Survival outcome was significantly higher in the group receiving Jusvinza (90.4%) compared to the group without Jusvinza (39.5%). Furthermore, in patients treated with Jusvinza there was a significant improvement in ventilatory parameters and a reduction in inflammation and coagulation biomarkers. Our findings show that Jusvinza could control the extent of inflammation in COVID-19 patients. This study indicates that Jusvinza is a helpful drug for the treatment of diseases characterized by hyperinflammation.
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COVID-19 , Humanos , Chaperonina 60 , Estudios Retrospectivos , SARS-CoV-2 , Enfermedad Crítica/terapia , Inflamación , Biomarcadores , Antiinflamatorios/farmacología , Antiinflamatorios/uso terapéuticoRESUMEN
Introduction: Hospitals of greater complexity tend to care for patients with advanced chronic diseases, which is why it is important to recognize the need for palliative care. Objective: To identify the proportion of patients who require palliative care in the medicine department of a Peruvian referral hospital. Methods: Observational, analytical, cross-sectional study. All hospitalized patients were studied in the Department of Internal Medicine of the Peruvian hospital during the period April-May 2018. To determine the need for palliative care, the NECPAL CCOMS-ICO © instrument was used. The quantitative variables are presented as median and interquartile range (IQR); and numerical variables, such as frequencies and percentages. For the comparison of numerical variables, the Mann Whitney test was used and the chi-square test for categorical variables. Results: They were evaluated in 281, where 102 (37.9%) required palliative care. The median age in patients requiring palliative care was 69.5 (IQR: 58-81) years. The median hospital stay in patients with and without the need for palliative care was 7 days (IQR: 4-11) and 9 days (IQR: 5-19) respectively, the mortality in patients with and without the need for palliative care was 37.25% and 4.19% respectively. Conclusions: There is a high frequency of need for palliative care in patients hospitalized in internal medicine wards, the requirement for palliative care was associated with higher mortality and hospital stay, which evidences the need for comprehensive and personalized care based on medical services specialized.
Introducción: Los hospitales de mayor complejidad suelen atender a pacientes con enfermedades crónicas avanzadas, es por ello importante el reconocimiento de la necesidad de cuidados paliativos. Objetivo: Identificar la proporción de pacientes que requieren cuidados paliativos en el departamento de medicina de un hospital de referencia peruano. Métodos: Estudio observacional, analítico, transversal. Se estudió a todos los pacientes hospitalizados en el Departamento de Medicina Interna del hospital peruano durante el periodo abril-mayo del 2018. Para determinar la necesidad de cuidados paliativos se usó el instrumento NECPAL CCOMS-ICO©. Las variables cuantitativas se presentan como mediana y rango intercuartil (RIC); y las variables numéricas, como frecuencias y porcentajes. Para la comparación de variables numéricas se utilizó la prueba de Mann Whitney y para las categóricas la prueba de chi cuadrado. Resultados: Se evaluaron 281, donde 102 (37,9%) requerían cuidado paliativo. La mediana de edad en pacientes con requerimiento de cuidados paliativos fue 69,5 (RIC: 58-81) años. La mediana de estancia hospitalaria en pacientes con y sin requerimiento de cuidados paliativos fue de 7 días (RIC: 4-11) y 9 días (RIC: 5-19) respectivamente, la mortalidad en los pacientes con y sin requerimiento de cuidados paliativos fue 37,25% y 4,19% respectivamente. Conclusiones: Se evidencia una alta frecuencia de necesidad de atención paliativa en pacientes hospitalizados en salas de medicina interna, el requerimiento de cuidados paliativos se asoció a mayor mortalidad y estancia hospitalaria, lo que evidencia la necesidad de atención integral y personalizada en base a servicios médicos especializados.
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Introducción: La encefalitis autoinmune comprende un amplio espectro de desórdenes inmunológicos, entre ellos el anti-NMDAR es el más frecuente. El manejo de esta patología es complejo debido a múltiples circunstancias. Reporte de caso: Mujer de 19 años que inicia cuadro subagudo con trastorno conductual y neurológico asociado: Alucinaciones, heteroagresividad, mutismo acinético, crisis epilépticas, discinesias orofaciales, fiebre y arritmia cardiaca transitoria reportada. La resonancia fue normal, el EEG registró ondas delta brush, Los estudios de LCR y séricos fueron negativos para causas secundarias. Se inició tratamiento con Aciclovir, medicamento anticrisis y psicofármacos, posteriormente se inicia metilprednisolona con inmunoglobulina sin respuesta satisfactoria. Inicia tratamiento con Rituximab presentando una respuesta favorable. El panel en LCR fue positivo a NMDA. Se indica control con desescalamiento progresivo de medicamentos anticrisis y psicofármacos. Conclusión: Es importante reconocer tempranamente las manifestaciones clínicas de esta entidad para así realizar un manejo oportuno que podría mejorar el pronóstico.
Introduction: Autoimmune encephalitis comprises a wide spectrum of immunological disorders, among them anti-NMDAR is the most frequent. The management of this pathology is complex due to multiple circumstances. Case report: A 19-year-old woman who started a subacute clinical picture with associated behavioral and neurological disorder: hallucinations, heteroaggressiveness, akinetic mutism, epileptic seizures, orofacial dyskinesias, fever and reported transient cardiac arrhythmia. MRI was normal, EEG recorded delta brush waves, CSF and serum studies were negative for secondary causes. Treatment was started with Acyclovir, an anti-crisis drug, and psychotropic drugs, later methylprednisolone with immunoglobulin was started without a satisfactory response. She starts treatment with Rituximab presenting a favorable response. The CSF panel was positive for NMDA. Control with progressive de-escalation of anti-crisis medications and psychotropic drugs is indicated. Conclusion: It is important to recognize early the clinical manifestations of this entity in order to carry out timely management that could improve the prognosis.
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Sr. Editor: Los Cuidados Paliativos (CP) tienen como finalidad mejorar la calidad de vida y aliviar el sufrimiento de los pacientes con padecimientos graves e incurables. Con el envejecimiento de la población y la mayor prevalencia de las enfermedades crónicas, el número de personas con necesidad de estos cuidados se ha incrementado. Los CP tienen carácter multidimensional e interdisciplinario, se pueden brindar en diferentes niveles de atención y están a cargo tanto de médicos generales como especialistas. Se requiere por lo tanto de una adecuada formación en esta disciplina durante el pregrado de la carrera de medicina, que permita el desarrollo de las competencias necesarias para su aplicación en la práctica médica.
Dear editor, Palliative Care (PC) aims to improve the quality of life and alleviate the suffering of patients with serious and incurable conditions. With the aging of the population and the higher prevalence of chronic diseases, the number of people in need of this care has increased. PC is multidimensional and interdisciplinary; and can be provided at different levels of care by both general practitioners and specialists. Therefore, adequate training in this discipline must be required during the medicine degree to allow the development of the necessary skills for its application in medical practice.
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RESUMEN Introducción: La infección con el SARS-CoV-2 induce un estado protrombótico en los pacientes, atribuible a la combinación de la respuesta hiperinflamatoria y la hipoxia. En Cuba, se usa el fármaco Jusvinza, basado en un péptido inmunomodulador, para el tratamiento de los pacientes con la COVID-19, que presenten signos y síntomas de hiperinflamación. Objetivos: Describir la evolución clínica y las variaciones de biomarcadores asociados con la inflamación y la coagulación, en un grupo de pacientes críticos con la COVID-19, tratados con Jusvinza, en comparación con un grupo de pacientes que no recibieron tratamiento con este péptido. Métodos: Se incluyeron 40 pacientes críticos con la COVID-19; se dividieron en 2 grupos: 20 pacientes tratados con Jusvinza y 20 no fueron tratados con dicho péptido (grupo control). Las características demográficas, comorbilidades, signos vitales, parámetros respiratorios, biomarcadores de la inflamación y de la coagulación se obtuvieron a partir de las historias clínicas de cada paciente. Resultados: El tratamiento con Jusvinza indujo una mejoría clínica en los pacientes, asociada con la disminución de varios biomarcadores de la inflamación y la coagulación. La sobrevida de los pacientes tratados con Jusvinza fue significativamente superior a la sobrevida de los pacientes no tratados con este péptido. Conclusiones: Jusvinza es capaz de controlar la hiperinflamación y la hipercoagulación en pacientes críticos con la COVID-19.
ABSTRACT Introduction: Infection with SARS-CoV-2 induces a prothrombotic state in patients, by the combination of hyperinflammatory response and hypoxia. In Cuba, the drug called Jusvinza, based on an immunomodulatory peptide, is used for the treatment of patients with COVID-19, who present signs and symptoms of hyperinflammation. Objectives: To describe the clinical course and behavior of various biomarkers associated with the inflammation and coagulation, in a group of critically ill patients with COVID-19 treated with Jusvinza, compared to a group of patients who did not receive treatment with this peptide. Methods: 40 critically ill patients with COVID-19 were included. The patients were divided into 2 groups: 20 patients were treated with Jusvinza and 20 were not treated with this peptide (control group). Demographic characteristics, comorbidities, vital signs, respiratory parameters and inflammation and coagulation biomarkers were obtained from the medical records of each patient. Results: Treatment with Jusvinza induced a clinical improvement in the patients, associated with the decrease of several inflammation and coagulation biomarkers. Patients treated with Jusvinza had a significantly higher survival than patients not treated with this peptide. Conclusions: Jusvinza is able to control hyperinflammation and hypercoagulation in critical ill patients with COVID-19.
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Introducción: El CIGB-258 es un péptido inmunomodulador con propiedades antiinflamatorias. Objetivos: Establecer la frecuencia de dosis y el tiempo de tratamiento con el péptido CIGB-258, para pacientes críticos con COVID-19. Además, definir los criterios de uso y el esquema terapéutico del péptido, para pacientes graves con COVID-19. Métodos: Se incluyeron 9 pacientes críticos y 3 pacientes graves. Las evaluaciones clínicas, radiológicas y de laboratorio se registraron de acuerdo al protocolo establecido. Se obtuvieron muestras de suero antes y después del tratamiento con la CIGB-258, para la determinación de los biomarcadores de la inflamación. Resultados: Se estableció el protocolo de actuación con el péptido CIGB-258, el cual consiste en la administración intravenosa de 1 mg del péptido cada 12 horas a los pacientes críticos. La dosis debe aumentarse a 2 mg cada 12 horas, para los pacientes que no muestren mejoría clínica y radiológica en 24 horas. Después de la extubación, los pacientes deben recibir 1 mg de CIGB-258 al día, durante otros tres días. Los pacientes graves deben recibir 1 mg de CIGB-258 cada 12 horas, hasta que resuelvan su condición clínica. Conclusiones: CIGB-258 mostró un buen perfil de seguridad. El protocolo de actuación establecido contribuyó a que todos los pacientes críticos se recuperaran de la dificultad respiratoria y fueran extubados. Los pacientes graves mejoraron considerablemente. Los niveles de los biomarcadores asociados con hiperinflamación y las citocinas disminuyeron significativamente durante el tratamiento(AU)
Introduction: CIGB-258 is an immunomodulatory peptide with anti-inflammatory properties. Objectives: To establish the therapeutic schedule with CIGB-258 peptide for COVID-19 critically ill patients. In addition, to define the criteria for use and schedule of this peptide for COVID-19 seriously ill patients. Methods: 9 critically ill patients and 3 seriously ill patients were included in this study. Clinical, radiological and laboratory evaluations were recorded according to the established protocol. Serum samples were obtained before and after treatment with CIGB-258, for the determination of the inflammation biomarkers. Results: The therapeutic protocol was established with the CIGB-258 peptide, which consists of intravenous administration of 1 mg of peptide every 12 hours for critically ill patients. The dose should be increased to 2 mg every 12 hours, for patients who do not show clinical and radiological improvement in 24 hours. After extubation, patients should receive 1 mg of CIGB-258 daily, for another three days. Seriously ill patients should receive 1 mg of CIGB-258 every 12 hours, until their clinical condition resolves. Conclusions: CIGB-258 showed an excellent safety profile. The established therapeutic protocol contributed to all critically ill patients recovering from respiratory distress and being extubated. Seriously ill patients improved considerably. The levels of the biomarkers associated with hyperinflammation and cytokines decreased significantly during treatment(AU)
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Humanos , Masculino , Femenino , Enfermedad Crítica/terapia , Chaperonina 60 , Medicamentos de Referencia , Síndrome de Liberación de Citoquinas/epidemiología , COVID-19/tratamiento farmacológicoRESUMEN
RESUMEN Introducción: la esquizofrenia y otros trastornos psicóticos constituyen la mayor parte de los diagnósticos realizados en el Departamento de Emergencias y Admisión del Servicio de Psiquiatría del Hospital de Clínicas de la Universidad Nacional de Asunción, seguidos por los trastornos depresivos y los trastornos de ansiedad. Objetivo: determinar las características de los pacientes con diagnóstico de primer episodio psicótico, siendo esta información relevante en el contexto de la atención que pueda brindarse a los mismos y a la información epidemiológica que proporciona. Metodología: estudio observacional, descriptivo, con muestreo no probabilístico, temporalmente retrospectivo. Se incluyó las historias clínicas de pacientes del Servicio de Psiquiatría del Hospital de Clínicas, de ambos sexos, que hayan sido hospitalizados con síntomas de un primer episodio psicótico entre 2014 y 2019. Resultados: se analizaron las historias clínicas de 143 pacientes. El 62,8% era del sexo femenino. La edad media fue 31 ± 13 años. El 48,9% tenía historial de diagnósticos psiquiátricos en su familia. El 66,43% era de nivel económico medio, el 32,17% nivel bajo y el 1,4% nivel alto. El pensamiento desorganizado fue el síntoma más frecuente (86%) encontrado en el examen del estado mental. Conclusiones: la mayoría de los pacientes con diagnóstico de primer episodio psicótico provenía del Departamento Central de Paraguay, residía en zonas urbanas, era del sexo femenino, era de nivel económico medio, aproximadamente la mitad con antecedentes de trastornos mentales en la familia y presentaba casi dos meses de evolución de la enfermedad. El pensamiento (ideas delirantes), el afecto, la introspección, el humor, el lenguaje y la sensopercepción (alucinaciones) fueron los indicadores más frecuentemente alterados del examen mental.
ABSTRACT Introduction: Schizophrenia and other psychotic disorders make up the majority of diagnoses made in the Emergency and Admission Department of the Psychiatry Service of the "Hospital de Clínicas" of the National University of Asunción, followed by depressive disorders and anxiety disorders. Objective: The objective of the present study was to determine the characteristics of the patients diagnosed with a first psychotic episode. This information is relevant in the context of the care that can be provided to patients and the epidemiological information provided. Methodology: This was an observational, descriptive study, with non-probabilistic sampling, temporarily retrospective. The medical records of male and female patients of the Psychiatry Service of the "Hospital de Clínicas" who have been hospitalized with symptoms of a first psychotic episode were included. Results: The medical records of 143 patients were analyzed, 62.8% of them was female. The mean age was 31.5 ± 13.6 years, 48.9% had a history of psychiatric diagnoses in their family, 66.43% had medium economic level, 32.17% low level and 1.4% high level. distortion in thinking was the most frequent symptom (86%) found in the mental state exam. Conclusions: The majority of patients diagnosed with the first psychotic episode came from the Central Department of Paraguay, resided in urban areas, were female, had medium economic status, approximately half had a history of mental disorders in the family and had almost two months of disease evolution. Thought (delusions), affection, introspection, humor, language, and perception (hallucinations) were the most frequently altered indicators of the mental examination.
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Introducción: El síndrome Drug Reaction with Eosinophilia and Systemic Symptoms - DRESS, constituye una grave reacción adversa a medicamentos, principalmente a fármacos anticonvulsivantes. Objetivo: Describir la evolución clínica de un síndrome de DRESS en una paciente atendida en el Hospital Militar Central "Dr. Luis Díaz Soto". Caso Clínico: Paciente femenina de 27 años de edad con antecedentes patológicos personales de epilepsia. Tres meses luego de iniciada terapia con difenilhidantoína aparece fiebre, exantema maculopapular que progresa a eritrodermia exfoliativa, signos de daño hepático, adenopatías cervicales y eosinofilia. Se diagnosticó síndrome de DRESS secundaria al uso de anticonvulsivantes. Conclusiones: La evolución clínica resultó favorable, luego de la retirada del fármaco y la aplicación de esteroides por vía oral(AU)
Introduction: Drug Reaction with Eosinophilia and Systemic Symptoms - DRESS, syndrome constitutes a serious adverse reaction to medications, mainly anticonvulsant drugs. Objective: To describe the clinical evolution of DRESS syndrome in a patient treated at the Hospital Militar Central "Dr. Luis Díaz Soto". Case Report: 27-year-old female patient with a personal pathological history of epilepsy. Three months after initiation of diphenylhydantoin therapy, fever appeared maculopapular rash that progressed to exfoliative erythroderma, signs of liver damage, cervical adenopathies and eosinophilia. DRESS syndrome was diagnosed secondary to the use of anticonvulsants. Conclusions: The clinical evolution was favorable, after the withdrawal of the drug and the application of steroids orally(AU)
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Humanos , Femenino , Adulto , Dermatitis Exfoliativa/complicaciones , Epilepsia/tratamiento farmacológico , Exantema/inducido químicamenteRESUMEN
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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The geomagnetic field variations on the continent of Africa are still largely undeciphered for the past two millennia. In spite of archaeological artefacts being reliable recorders of the ancient geomagnetic field strength, only few data have been reported for this continent so far. Here we use the Thellier-Coe and calibrated pseudo-Thellier methods to recover archaeointensity data from Burkina Faso and Ivory Coast (West Africa) from well-dated archaeological artefacts. By combining our 18 new data with previously published data from West Africa, we construct a reference curve for West Africa for the past 2000 years. To obtain a reliable curve of the archaeointensity variation, we evaluate a penalized smoothing spline fit and a stochastic modelling method, both combined with a bootstrap approach. Both intensity curves agree well, supporting the confidence in our proposed intensity variation during this time span, and small differences arise from the different methodologies of treating data and uncertainties. Two prominent peaks at around 740 AD and 1050 AD appear to be common in ours and several reference curves from other locations, indicating a general westward movement from China to Hawaii of a rather stable feature of the geomagnetic field. However, independent smaller peaks that do not correlate in different locations may hint to localized expressions of the geomagnetic field as a result of temporarily varying non-dipole sources.
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Introducción: el deterioro cognitivo está muy asociado a factores de riesgo cardiovasculares. La enfermedad renal crónica, sobre todo aquella que ha evolucionado a un estadio 5 y que requiere de un tratamiento sustitutivo de la función renal como la hemodiálisis, es considerada hoy un factor de riesgo cardiovascular. Objetivo: determinar la prevalencia de deterioro cognitivo en adultos mayores con insuficiencia renal crónica y con tratamiento sustitutivo de la función renal y su relación con la calidad de vida. Métodos: se realizó un estudio observacional, analítico y de corte transversal que incluyó a 30 pacientes con ≤ 60 años de edad del servicio de nefrología del Hospital Clínico Quirúrgico Docente Dr. Carlos J. Finlay con tratamiento de hemodiálisis y diálisis peritoneal. Para establecer el deterioro cognitivo se empleó la prueba Minimental con un valor de menos de 23 puntos y la calidad de vida se valoró con el índice de Karnofsky. Para determinar la relación entre variables cualitativas se utilizó la prueba chi cuadrado de Pearson y para el grado de asociación entre las variables asociadas, el Riesgo Relativo. Resultados: se encontró deterioro cognitivo en 16,6 por ciento de los pacientes; de estos, 80 por ciento se relacionó con una calidad de vida considerada como pobre (X 2= 4,0; p= 0,046; RR= 2,5 ICI= 1,22; ICS= 5,14). Conclusiones: se encontró una elevada prevalencia de deterioro cognitivo en el grupo de pacientes estudiados y este se relacionó con una pobre calidad de vida(AU)
Introduction: Cognitive impairment is strongly associated with cardiovascular risk factors. Chronic kidney disease, especially those that have progressed to stage 5 and require renal replacement therapy such as hemodialysis, are now considered a cardiovascular risk factor. Objective: Determine the prevalence of cognitive impairment in older adults with chronic renal failure and renal replacement therapy and its relationship with quality of life. Methods: An observational, analytical and cross-sectional study was carried out involving 30 patients with ? 60 years of age from the nephrology department of Dr. Carlos J. Finlay Clinical Surgical Teaching Hospital These subjects had treatment of hemodialysis and peritoneal dialysis. To establish cognitive impairment, the minimental test was used with a value of less than 23 points; the quality of life was assessed using the Karnofsky index. Pearson's chi-square test was used to determine the relationship between qualitative variables and the relative risk (RR) test was used to determine the degree of association between the associated variables. Results: Cognitive impairment was found in 16.6 percent of the patients; 80 percent were related to poor quality of life (X2 = 4.0, p = 0.046, RR = 2.5 ICI = 1.22, ICS = 5.14). Conclusions: High prevalence of cognitive impairment was found in the group of patients studied and it was related to poor quality of life(AU)
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Humanos , Anciano , Anciano de 80 o más Años , Calidad de Vida , Diálisis Renal/efectos adversos , Insuficiencia Renal Crónica/terapia , Disfunción Cognitiva/epidemiología , Estudios Transversales , Estudio ObservacionalRESUMEN
In captive chinchillas, one of the most challenging behavioral problems is the development of a stress-related abnormal repetitive behavior (ARB) known as "fur-chewing". We investigated whether there is a relationship between the severity of fur-chewing behavior and reproductive function in male and female chinchillas. Regardless of the severity of abnormal behavior, fur-chewing males did not show significant differences in seminal quality (sperm concentration, motility and viability; integrity of sperm membrane and acrosome) and the response to the process of semen collection (the number of stimuli needed to achieve ejaculation) when compared to those with normal behavior. Also, females showing normal or fur-chewing behavior presented similar reproductive performance in terms of number of litters per female per year and litter size. However, pup survival rate was lower (p=0.05) in fur-chewing females than in normal females. These results seem to be consistent with data suggesting non-significant effects of ARBs on reproductive performance.
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Animales Domésticos/fisiología , Conducta Animal , Chinchilla/fisiología , Inmovilización/veterinaria , Reproducción , Estrés Psicológico/etiología , Destete , Animales , Animales Domésticos/crecimiento & desarrollo , Animales Domésticos/psicología , Animales Recién Nacidos , Chinchilla/crecimiento & desarrollo , Chinchilla/psicología , Femenino , Cabello , Inmovilización/efectos adversos , Inmovilización/psicología , Tamaño de la Camada , Masculino , Masticación , Análisis de Semen , Estrés Fisiológico , Estrés Psicológico/mortalidad , Estrés Psicológico/fisiopatologíaRESUMEN
In order to clarify the physiological role of ghrelin in gestation, we evaluated the effects of administration of exogenous ghrelin (2 or 4ânmol/animal per day) or its antagonist (6ânmol/animal per day of (d-Lys3)GHRP6) on fertilization, early embryo development, and implantation periods in mice. Three experiments were performed, treating female mice with ghrelin or its antagonist: i) starting from 1 week before copulation to 12âh after copulation, mice were killed at day 18 of gestation; ii) since ovulation induction until 80âh later, when we retrieved the embryos from oviducts/uterus, and iii) starting from days 3 to 7 of gestation (peri-implantation), mice were killed at day 18. In experiments 1 and 3, the antagonist and/or the highest dose of ghrelin significantly increased the percentage of atrophied fetuses and that of females exhibiting this finding or a higher amount of corpora lutea compared with fetuses (nCL/nF) (experiment 3: higher nCL/nF-atrophied fetuses: ghrelin 4, 71.4-71.4% and antagonist, 75.0-62.5% vs ghrelin 2, 46.2-15.4% and control, 10-0.0%; n=7-13 females/group; P<0.01). In experiment 2, the antagonist diminished the fertilization rate, and both, ghrelin and the antagonist, delayed embryo development (blastocysts: ghrelin 2, 62.5%; ghrelin 4, 50.6%; and antagonist, 61.0% vs control 78.4%; n=82-102 embryos/treatment; P<0.0001). In experiment 3, additionally, ghrelin (4ânmol/day) and the antagonist significantly diminished the weight gain of fetuses and dams during pregnancy. Our results indicate that not only hyperghrelinemia but also the inhibition of the endogenous ghrelin effects exerts negative effects on the fertilization, implantation, and embryo/fetal development periods, supporting the hypothesis that ghrelin (in 'adequate' concentrations) has a physiological role in early gestational events.
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Implantación del Embrión/efectos de los fármacos , Embrión de Mamíferos/citología , Embrión de Mamíferos/efectos de los fármacos , Fertilización/efectos de los fármacos , Ghrelina/farmacología , Animales , Copulación , Cuerpo Lúteo/citología , Cuerpo Lúteo/efectos de los fármacos , Femenino , Fertilización/fisiología , Ratones , EmbarazoRESUMEN
Since obesity and male subfertility have increased in parallel during the last decades, the hypothesis of an association between these two phenomena has been explored by several researchers. Although there is no consensus apparently obesity impacts men's reproductive potential by several mechanisms, like alterations on the hypothalamus-pituitary-testicular axis, modifications of spermatogenesis and semen quality and/or impairment of men's sexual health. This review intends to summarize the underlying bases of such alterations and propose new ones, without miscalculating their biological significance. Obesity is not rigorously related to subfertility; in addition, the existence of a genetic predisposition to obesity-linked sterility is currently under investigation. Nonetheless, the impact of obesity on male reproductive potential must be fully elucidated since the prevalence of obesity is increasing and consequently, the number of obese men with reduced fertility will also rise.
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Due to its complexity, in combination with a lack of scientific reports, fur-chewing became one of the most challenging behavioral problems common to captive chinchillas. In the last years, the hypothesis that fur-chewing is an abnormal repetitive behavior and that stress plays a role in its development and performance has arisen. Here, we investigated whether a relationship existed between the expression and intensity of fur-chewing behavior, elevated urinary cortisol excretion and anxiety-related behaviors. Specifically, we evaluated the following parameters in behaviorally normal and fur-chewing animals of both sexes: (1) mean concentrations of urinary cortisol metabolites and (2) anxiety-like behavior in an elevated plus-maze test. Urinary cortisol metabolites were higher only in females that expressed the most severe form of the fur-chewing behavior (P≤0.05). Likewise, only fur-chewing females exhibited increased (P≤0.05) anxiety-like behaviors associated with the elevated plus-maze test. Overall, these data provided additional evidence to support the concept that fur-chewing is a manifestation of physiological stress in chinchilla, and that a female sex bias exists in the development of this abnormal behavior.
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Glándulas Suprarrenales/metabolismo , Ansiedad/etiología , Conducta Animal/fisiología , Chinchilla/fisiología , Masticación/fisiología , Glándulas Suprarrenales/fisiología , Animales , Ansiedad/metabolismo , Ansiedad/fisiopatología , Ansiedad/orina , Chinchilla/metabolismo , Chinchilla/psicología , Chinchilla/orina , Femenino , Cabello , Hidrocortisona/metabolismo , Hidrocortisona/orina , Masculino , Aprendizaje por Laberinto , Caracteres Sexuales , Estrés Psicológico/fisiopatologíaRESUMEN
Obesity and male infertility have increased in the last decades; therefore, a possible association between these pathologies has been explored. Studies inform that obesity may affect fertility through different mechanisms, which alltogether could exert erectile dysfunction and/or sperm quality impairment. These include: 1) hypothalamic-pituitary-testicular (HPG) axis malfunction: obese hormonal profile is characterized by reduction of testosterone, gonadotrophins, SHBG and/or inhibin B concentrations (marker of Sertoli cells function) and hyperestrogenemy (consequence of aromatase overactivity ascribed to adipose tissue increase); 2) increased release of adipose-derived hormones: leptin increase could be responsible for some of the alterations on the HPG axis and could also exert direct deleterious effects on Leydig cells physiology, spermatogenesis and sperm function; 3) proinflammatory adipokines augmentation, higher scrotal temperature (due to fat accumulation in areas surrounding testes) and endocrine disruptors accumulation in adiposites, all of these responsible for the increase in testes oxidative stress and 4) sleep apnea, frequent in obese patients, suppresses the nocturnal testosterone rise needed for normal spermatogenesis. Finally, although controversial, all the above mentioned factors could comprise gametes quality; i.e. decrease sperm density and motility and increase DNA fragmentation, probably disturbing spermatogenesis and/or epididymal function. In summary, although obesity may impair male fertility by some/all of the described mechanisms, the fact is that only a small proportion of obese men are infertile, probably those genetically predisposed or morbidly obese. Nevertheless, it is likely that because the incidence of obesity is growing, the number of men with reduced fertility will increase as well.
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Infertilidad Masculina/etiología , Obesidad/complicaciones , Humanos , MasculinoRESUMEN
OBJECTIVES: Concomitantly with the actual trend towards later fathering, more detailed studies are necessary to establish the relationship between male age and seminal features. The objective of the present paper was to evaluate the relationship of men age with semen quality and with the seminal levels of epididymal and accessory gland markers. METHODS: The study was conducted as a retrospective study of 9168 cases obtained from the Andrology and Reproduction Laboratory in Cordoba, Argentina for 10 years (1995-2004) (men ages 20 to 77). An important number of factors such as abstinence time, toxic habits, work conditions and drugs consumption has been statistically considered. The parameters measured were: seminal volume, sperm concentration, total sperm count, sperm motility, morphology and viability. Seminal levels of alpha-glucosidase, fructose and citric acid were also evaluated. RESULTS: We detected a significant decrease in seminal volume, sperm count, motility, viability and normal morphology, and a reduction in alpha-glucosidase and fructose levels in relation to age. CONCLUSIONS: Since semen quality is a tool for fertility prognosis estimation, the weight of evidence indicates that men may become progressively less fertile as they get older. Couples who decide to delay childbearing should be warned about this matter.
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Envejecimiento , Análisis de Semen , Adulto , Argentina , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
OBJECTIVES: To evaluate sperm quality, levels of markers of epididymal and accessory gland function, and T in semen from men grouped according to their body mass index (BMI). DESIGN: Blind prospective study. SETTING: Andrology and reproduction laboratory in Cordoba, Argentina (2006-2007). PATIENT(S): Seven hundred ninety-four men. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): In semen samples, sperm quality (volume, density, motility, morphology, viability, hypoosmotic swell test, and nuclear maturity) and levels of neutral alpha-glucosidase, fructose, citric acid and T. RESULT(S): Multivariate analysis showed a negative association between BMI and motility, rapid motility and neutral alpha-glucosidase levels, and a positive association between BMI and seminal fructose levels. No associations were found among BMI and sperm concentration, the other parameters evaluated, or seminal T levels. CONCLUSION(S): Results found in our study support a deleterious effect of obesity on seminal quality, probably by alterations in the function of the epididymis (i.e., in epididymal maturation).
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Sobrepeso/fisiopatología , Análisis de Semen , Recuento de Espermatozoides , Motilidad Espermática/fisiología , Adulto , Anciano , Índice de Masa Corporal , Supervivencia Celular/fisiología , Epidídimo/fisiología , Genitales Masculinos/fisiología , Humanos , Infertilidad/etiología , Infertilidad/fisiopatología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Sobrepeso/complicaciones , Estudios Prospectivos , Método Simple Ciego , Espermatozoides/metabolismo , Testosterona/metabolismoRESUMEN
OBJECTIVE: To investigate in mice the effect of diets enriched with soy or sunflower oil with different omega-6:omega-3 ratios on gestation, reproductive success, physical maturation, and the neurobiological development of the pups. METHODS: Dams were assigned, throughout gestation and lactation, to different groups: a commercial diet (CD), a soy oil-enriched diet (SOD), or a sunflower oil-enriched diet (SFOD). Measurements during gestation were dams' body weights and daily food intakes. Measurements in the offspring were physical parameters (body weight, body length, body mass index, fur appearance, pinna detachment, incisor eruption, eye opening, and puberty onset) and behavioral preweaning tests (surface righting reflex, negative geotaxis, and cliff avoidance). RESULTS: The SOD and SFOD dams became significantly heavier than the CD dams from gestational days 14 and 19, respectively, to parturition. There were no significant differences in gestational length or food consumption during pregnancy or lactation or in maternal weight during lactation. Diets did not modify litter size, sex ratio, survival index at weaning, or body weight. The SFOD and SOD offspring were significantly shorter than the CD offspring at weaning. The mean offspring physical scores of SOD and SFOD offspring were higher than CD offspring and simple reflexes were earlier in the SOD and SFOD groups. In SFOD offspring, puberty onset was significantly delayed, at postnatal days 26 and 27 in male and female offspring, respectively. CONCLUSION: This study suggests that the maintenance of an adequate omega-6:omega-3 ratio is necessary for the optimal growth and development of murine offspring. In populations that do not have sufficient provision of polyunsaturated fatty acids in the diet, their consumption would be advisable during gestation and lactation because these improve most neurodevelopmental outcomes included in this study.
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Conducta Animal/efectos de los fármacos , Ácidos Grasos Omega-3/farmacología , Ácidos Grasos Omega-6/farmacología , Crecimiento/efectos de los fármacos , Efectos Tardíos de la Exposición Prenatal , Fenómenos Fisiologicos de la Nutrición Prenatal , Reflejo/efectos de los fármacos , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Peso Corporal/efectos de los fármacos , Dieta/métodos , Conducta Alimentaria/efectos de los fármacos , Femenino , Lactancia , Masculino , Fenómenos Fisiologicos Nutricionales Maternos , Ratones , Actividad Motora/efectos de los fármacos , Sistema Nervioso/efectos de los fármacos , Aceites de Plantas/administración & dosificación , Embarazo , Preñez/efectos de los fármacos , Reproducción/efectos de los fármacos , Aceite de Soja/administración & dosificación , Aceite de GirasolRESUMEN
Although nonsteroidal-antiinflamatory drugs (NSAIDs) are widely employed, reproductive side effects of prostaglandins long-term inhibition remain unknown. The objective of the present study was to evaluate the effects of chronic low/moderate NSAIDs doses upon mice reproductive functions. Male or female mice were injected (i.p. for 60 or 35 days respectively) with: ibuprofen doses A, B or C (0.56, 1.12 or 1.68 mg/100 g/day respectively) or piroxicam doses A, B or C (0.028, 0.056 or 0.084 mg/100 g/day respectively). Parameters evaluated were: a) in females, spontaneous and induced ovulation, oocyte maturity and spermatozoa migration through genital tract, b) in males, epididymal spermatozoa concentration, motility, viability, resistance to hypoosmotic shock, acrosomal status and membrane maturity and c) in both genders, in vitro and in vivo fertilization, reproductive hormones plasma levels and cyclooxigenase inhibition in reproductive tissues. In females ibuprofen (dose A) elicited a significant reduction in spontaneous and induced ovulation rates and piroxicam (dose A) diminished the concentration of spermatozoa found in the uterus after mating. Males treated with ibuprofen (dose B) showed a reduction in the in vitro fertilization ability. Our data reveal that chronic administration of ibuprofen or piroxicam can exert detrimental effects upon reproductive physiology, which depends on the doses and/or the drug employed.