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The thermodynamic characteristics, antioxidant potential, and photoprotective benefits of full-spectrum cannabidiol (FS-CBD) against UVB-induced cellular death were examined in this study. In silico analysis of CBD showed antioxidant capacity via proton donation and UV absorption at 209.09, 254.73, and 276.95 nm, according to the HAT and SPLET methodologies. FS-CBD protected against UVB-induced bacterial death for 30 min. FS-CBD protected against UVB-induced cell death by 42% (1.5 µg/mL) and 35% (3.5 µg/mL) in an in vitro keratinocyte cell model. An in vivo acute irradiated CD-1et/et mouse model (UVB-irradiated for 5 min) presented very low photoprotection when FS-CBD was applied cutaneously, as determined by histological analyses. In vivo skin samples showed that FS-CBD regulated inflammatory responses by inhibiting the inflammatory markers TGF-ß1 and NLRP3. The docking analysis showed that the CBD molecule had a high affinity for TGF-ß1 and NLRP3, indicating that protection against inflammation might be mediated by blocking these proinflammatory molecules. This result was corroborated by the docking interactions between CBD and TGF-ß1 and NLRP3, which resulted in a high affinity and inhibition of both proteins The present work suggested a FS-CBD moderate photoprotective agent against UVB light-induced skin damage and that this effect is partially mediated by its anti-inflammatory activity.
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The clinical course of COVID-19 may show severe presentation, potentially involving dynamic cytokine storms and T cell lymphopenia, which are leading causes of death in patients with SARS-CoV-2 infection. Plasma exchange therapy (PLEX) effectively removes pro-inflammatory factors, modulating and restoring innate and adaptive immune responses. This clinical trial aimed to evaluate the impact of PLEX on the survival of patients with severe SARS-CoV-2 and the effect on the cytokine release syndrome. Hospitalized patients diagnosed with SARS-CoV-2 infection and cytokine storm syndrome were selected to receive 2 sessions of PLEX or standard therapy. Primary outcome was all-cause 60-days mortality; secondary outcome was requirement of mechanical ventilation, SOFA, NEWs-2 scores modification, reduction of pro-inflammatory biomarkers and hospitalization time. Twenty patients received PLEX were compared against 40 patients receiving standard therapy. PLEX reduced 60-days mortality (50% vs 20%; OR 0.25, 95%CI 0.071-0.880; p = 0.029), and this effect was independent from demographic variables and drug therapies used. PLEX significantly decreased SOFA, NEWs-2, pro-inflammatory mediators and increased lymphocyte count, accompanied with a trend to reduce affected lung volume, without effect on SatO2/FiO2 indicator or mechanical ventilation requirement. PLEX therapy provided significant benefits of pro-inflammatory clearance and reduction of 60-days mortality in selected patients with COVID-19, without significant adverse events.
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COVID-19 , Humanos , COVID-19/terapia , Tratamento Farmacológico da COVID-19 , Troca Plasmática , Respiração Artificial , SARS-CoV-2RESUMO
Metazoan parasite communities can experience temporal structural changes related to seasonal and/or local variations in several biotic and abiotic environmental factors. However, few studies have addressed this issue in tropical regions, where changes in water temperature are less extreme than in temperate regions, so the factors or processes that can generate variations in these parasite communities are as yet unclear. We quantified and analysed the parasite communities of 421 Lutjanus peru (Nichols & Murphy, 1922) collected from Acapulco Bay in Guerrero, Mexico, over a four-year period (August 2018 to April 2021), to identify any interannual variation due to local biotic and abiotic factors influenced by natural oceanographic phenomena, such as El Niño-Southern Oscillation, or La Niña. Twenty-five metazoan parasite taxa were recovered and identified: seven Digenea species; two Monogenea; one Cestoda; one Acanthocephala; four Nematoda; and ten of Crustacea (seven Copepoda and three Isopoda). The digeneans and copepods were the best represented parasite groups. The parasite communities were characterized by a high numerical dominance of helminth larvae. Species richness at the component community level (13 to 19 species) was similar to reported richness in other Lutjanus spp. The parasite communities of L. peru had a high variability in species composition, but low aggregate variability (e.g. species diversity), suggesting that structure of these communities may be quite stable over time. A clear interannual variation pattern was not observed, suggesting that parasite species of this host may respond differently to variations in environmental factors. Interannual variations were possibly caused by a combination of biotic (i.e. host feeding behaviour and body size) and local abiotic factors (influenced by climatic anomalies) which generated notable changes in the infection levels of several component species.
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Copépodes , Doenças dos Peixes , Parasitos , Perciformes , Trematódeos , Animais , Doenças dos Peixes/parasitologia , Peixes , Perciformes/parasitologia , PeruRESUMO
Introducción: Los linfagiomas quísticos son malformaciones de los conductos linfáticos los cuales forman cavidades con líquido linfático. Objetivos: Determinar las características clínicas, evolución y complicaciones de los pacientes operados de malformaciones linfáticas localizados en la región de la cabeza y el cuello. Diseño: Estudio observacional descriptivo tipo serie de casos. Metodología: Se revisaron las historias clínicas de los pacientes operados con resultado de patología compatible con malformaciones linfáticas, en el periodo desde enero 2008 hasta enero del 2017. Resultados: Se encontraron 254 casos que requirieron cirugía, con una media de edad de 1 año y promedio de 2.9 años. La región cervical tuvo la mayor presentación (77.6%) especificamente en la localización supra e infrahioidea unilateral (30.3%). La aparición de tumoración fue el signo más frecuente (98.8%). Se encontraron 5.9% de recidivas para el tratamiento quirúrgico y 8.2% de casos con paresia o parálisis del nervio submandibular como secuelas. 10 casos requirieron traqueostomía y tres pacientes fallecieron por complicaciones posteriores a la cirugía. Conclusiones: El tratamiento quirúrgico está indicado para los linfangiomas quísticos, minimizando la morbilidad en el paciente y evitando las recidivas futuras.
Introduction: Cystic lymphomas are malformations of the lymphatic ducts, which form cavities with lymphatic fluid. Objective: To determine the clinical characteristics, evolution and prognosis of patients undergoing surgery due to lymphatic malformations located in the head and neck. Design: Case series Methods: The medical records of patients who underwent a lymphatic malformation resection at The Head, Neck and Maxillofacial Surgery Unit, who had a pathological analysis compatible with lymphatic malformations, during the period from January 2008 to January 2017. Results: We found 254 cases that required surgery, with a median age of 1 year and an average of 2.9 years. The cervical region had the highest presentation (77.6%) specifically in the unilateral supra and infrahyoid location (30.3%). The appearance of a tumor was the most frequent sign (98.8%). 5.9% of recurrences were found for surgical treatment and 8.2% of cases with paresis or paralysis of the submandibular nerve as sequelae. 10 cases required tracheostomy and 3 patients died due to complications after surgery. Conclusions: Surgical treatment is indicated for cystic lymphangiomas. It minimizes morbidity and prevents recurrences.
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Humanos , Linfangioma Cístico , Cirurgia Geral , Neoplasias de Cabeça e PescoçoRESUMO
BACKGROUND: Haematoxylum brasiletto is a tree that grows in Central America, commonly known as "Palo de Brasil," which is used in the traditional medicine for the treatment of cancer and gastric ulcers. OBJECTIVE: The aim of this study was to isolate the compounds responsible for antiproliferative activity of H. brasiletto. MATERIALS AND METHODS: A bioassay-guided fractionation of ethanol extract of H. brasiletto was performed using 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide cell proliferation assay to measure the antiproliferative activity on six human cancer cell lines (A549, LS180, HeLa, SiHa, MDA-MB-231, and NCI-H1299) and one human noncancer cell line (ARPE-19). The ethanol extract was partitioned with hexane, dichloromethane, and ethyl acetate. The active dichloromethane fraction was fractioned by silica-column chromatography, and active subfractions were separated using preparative-thin layer chromatography. The chemical structure of an isolated compound was elucidated with different chemical and spectroscopic methods. RESULTS: The flavonoid brazilin (1) was isolated from the heartwood of H. brasiletto. The measurement of antiproliferative activity showed that brazilin can inhibit the growth of SiHa, MDA-MB-231, A549, and NCI-H1299 cell lines by 50% at doses of 44.3, 48.7, 45.4, and 48.7 µM, respectively. Furthermore, the flavonoid showed a high antiproliferative activity on LS 180 and HeLa with IC50 values of 62.2 and 71.9 µM, respectively. Brazilin also exhibited a high antiproliferative activity on the human noncancer cell line ARPE-19 with an IC50 value of 37.9 µM. CONCLUSIONS: Brazilin: (6aS, 11bR)-7,11b-Dihidro-6H-indeno[2,1-c] cromeno-3,6a, 9,10-tetrol was isolated; this compound demonstrated antiproliferative activity against several human cancer cell lines. This work demonstrated that brazilin, a flavonoid isolated and characterized of H. brasiletto, has antiproliferative activity against cancer cell lines. SUMMARY: The flavonoid brazilin was isolated from the heartwood of H. brasilettoBrazilin is able to inhibit the growth of SiHa, MDA-MB-231, A549 and NCI- H1299 cancerous cell linesBrazilin exhibited a moderate antiproliferative activity on the human non-cancer cell line ARPE-19Brazilin demonstrated to have antiproliferative activity against human cancer cell lines and could be a potential source of anticancer agents. Abbreviations used: MTT: [3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium]; FBS: Fetal bovine serum; TLC: Thin layer chromatography.
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The possible protective effect of Piper aduncum capsule on DMBA (dimethylbenz[α]anthracene)-induced breast cancer in rats was assessed by monitoring the tumor and lung metastases incidence and recording hematological and biochemical parameters and frequency of micronuclei. Mammary carcinogenesis was induced in 36 female Holtzman rats by providing a single subcutaneous injection of DMBA. Oral administration of P. aduncum capsule lowered adenocarcinoma and lymph node metastases incidence. Pulmonary metastasis was significantly lowered (P < 0.05). Hematological indicators showed that the triglyceride level was significantly lowered (P < 0.01) and high-density lipoprotein (HDL) level was significantly increased (P < 0.01). Also, P. aduncum capsule significantly lowered the C reactive protein (CRP) level (P < 0.01) and malondialdehyde level (P < 0.05). There was a significant decrease in the frequency of DMBA-induced micronucleated polychromatic erythrocyte (P < 0.01). Considering the antitumorigenic, hypolipidemic, anti-inflammatory, antioxidant, and antigenotoxic properties of P. aduncum capsule, we conclude that it has a protective effect on DMBA-induced breast cancer in rats.
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The aim of this study was to compare the performance of three digital X-ray systems [one flat-panel (DR) and two computed radiography (CR)] for chest radiography in terms of the entrance surface air kerma (ESAK) delivered to a polymethyl methacrylate phantom of 20 cm (equivalent to an adult patient) and image quality through of numerical evaluations using a test object (TO). The tube charge applied was ranged from 0.6 to 32 mAs, to a fixed tension of 125 kVp. The DR system presented the highest mean values of ESAK (615.9 µGy) along with the highest signal-to-noise ratio values, whereas CR systems showed a better high-contrast spatial resolution. Differences were statistically significant in both cases regarding the tube charge used. Thus, this parameter should be mainly considered to optimise the radiological protection through exposure settings selected. This survey represents the first effort to achieve optimisation in digital radiology for Chile.
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Intensificação de Imagem Radiográfica/instrumentação , Intensificação de Imagem Radiográfica/métodos , Radiografia Torácica/instrumentação , Radiografia Torácica/métodos , Adulto , Chile , Sistemas Computacionais , Humanos , Imagens de Fantasmas , Polimetil Metacrilato , Garantia da Qualidade dos Cuidados de Saúde , Proteção Radiológica/normas , Razão Sinal-Ruído , Software , Raios XRESUMO
INTRODUCTION: Escherichia coli is recognized as an etiological bacteria associated with chorioamnionitis and the preterm premature rupture of fetal membranes. This pathological condition induces pro-inflammatory cytokines and degradative metalloproteinases, which are considered biological markers secreted in an acute stage of infection. Heat-shock proteins (HSPs) are an important component of the innate immunity response and are found in different pathological conditions. They have not been previously measured in human fetal membranes in response to infectious conditions. We hypothesized that the choriodecidual tissue and amniotic epithelium secreted temporal and differential Hsp-60, Hsp-70, and interleukin (IL)-1ß mediated by E. coli infection. METHODS: Fetal membranes were mounted in a two-compartment culture system and infected with two passes of live E. coli at different doses (10², 104, 105, and 106 colony-forming units (CFU)/mL) and intervals of incubation (3, 6, and 24 h). The culture medium was collected, and Hsp-60, Hsp-70, and IL-1ß were assessed using the enzyme-linked immunosorbent assay (ELISA) method. RESULTS: After 3 and 6 h of infection, E. coli induced an increase in Hsp-70 secretion in the choriodecidual tissue. However, after 24 h of incubation, Hsp-70 was downregulated and we observed an increase in IL-1ß secretion. By contrast, E. coli induced a lower Hsp-60 secretion in the amnion compared to Hsp-70. DISCUSSION: Human fetal membranes responded actively to E. coli infection, with an increase in Hsp-70 during the first hours of infection. After 24 h, there was an increase in the liberation of IL-1ß.
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Escherichia coli/imunologia , Membranas Extraembrionárias/metabolismo , Membranas Extraembrionárias/microbiologia , Proteínas de Choque Térmico HSP110/metabolismo , Proteínas de Choque Térmico HSP70/metabolismo , Interleucina-1beta/metabolismo , Regulação para Cima , Âmnio/imunologia , Âmnio/metabolismo , Âmnio/microbiologia , Chaperonina 60/metabolismo , Corioamnionite/imunologia , Corioamnionite/metabolismo , Corioamnionite/microbiologia , Córion/imunologia , Córion/metabolismo , Córion/microbiologia , Decídua/imunologia , Decídua/metabolismo , Decídua/microbiologia , Regulação para Baixo , Ensaio de Imunoadsorção Enzimática , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/imunologia , Infecções por Escherichia coli/metabolismo , Infecções por Escherichia coli/microbiologia , Membranas Extraembrionárias/imunologia , Feminino , Humanos , Imunidade Inata , Cinética , Proteínas Mitocondriais/metabolismo , Gravidez , Técnicas de Cultura de TecidosRESUMO
AIMS: Cloning, expression and characterization of a new cold-adapted protease with potential biotechnological application, isolated from Antarctic bacteria. METHOD AND RESULTS: A subtilisin-like gene was isolated from several Antarctic bacterial genus using CODPEHOP-designed primers and a genome walking method. This gene encodes a precursor protein, which undergoes an autocatalytic cleavage resulting in a 34.6 kDa active cold-adapted protease with a maximum activity at 25-35°C and optimum pH of 8.0-9.0. It showed a higher catalytic efficiency at lower temperatures compared to its mesophilic counterpart. Heat-induced inactivation resulted in a very low melting point. Local packing analysis using the homology model indicated Ala284 as an important cold-adaptation determinant, which was corroborated by the site-directed mutagenesis. CONCLUSIONS: A new thermolabile subtilisin-like protease has been successfully cloned and analysed, and an important hot spot in the evolution of the cold adaptation and substrate specificity of this enzyme was identified and tested. SIGNIFICANCE AND IMPACT OF THE STUDY: This work reports a new cold-adapted protease with a vast representation amongst Antarctic genus, suggesting therefore its evolutionary success in this cold environment. Likewise, important sites for genetic potentiation have been identified, which are extrapolated to other enzymes of the same kind.
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Aclimatação , Proteínas de Bactérias/metabolismo , Temperatura Baixa , Subtilisina/metabolismo , Regiões Antárticas , Bactérias/enzimologia , Proteínas de Bactérias/química , Proteínas de Bactérias/genética , Clonagem Molecular , Estabilidade Enzimática , Mutagênese Sítio-Dirigida , Análise de Sequência de Proteína , Especificidade por Substrato , Subtilisina/química , Subtilisina/genéticaRESUMO
AIMS: The objective of this study was to evaluate the safety and efficacy of pregabalin at flexible doses of 150-600 mg/day in Latin American patients with neuropathic pain. METHODS: A prospective, multicentre, open-label, non-comparative study included patients age >or= 18 years diagnosed with neuropathic pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, chemotherapy-induced peripheral neuropathic pain (PNP), or human immunodeficiency virus-related PNP. Eligible patients (N = 121) had a score of >or= 40 mm on the visual analogue scale and a daily pain rating scale (DPRS) score of >or= 4 throughout screening. Patients received flexible-dose pregabalin (150-600 mg/day) for 12 weeks, which included a 4-week dose-adjustment phase. The primary efficacy measure was change from baseline to end of treatment/last observation carried forward (EOT/LOCF) in weekly mean pain score on the DPRS. Secondary efficacy measures included pain, anxiety, sleep interference, treatment satisfaction and Patient and Clinician Global Impression of Change. RESULTS: Pregabalin significantly reduced the weekly mean pain score on DPRS from baseline to EOT/LOCF [-3.8 (95% CI: -4.2 to -3.3); p < 0.0001]. Reductions from baseline to EOT/LOCF were observed for all secondary efficacy outcomes (p < 0.0001). Pain and sleep interference were significantly improved compared with baseline across all weeks of the study, as early as 1 week after initiation of pregabalin (p < 0.0001). The most common adverse events (AEs) were somnolence, dizziness, weight gain and peripheral oedema. Nine (7.4%) patients discontinued the study because of AEs and 25 (20.7%) temporarily stopped or reduced their pregabalin dose because of AEs. CONCLUSIONS: Flexible-dose pregabalin (150-600 mg/day) significantly reduced pain and anxiety and improved sleep and was generally well tolerated in Latin American patients with neuropathic pain.
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Analgésicos/administração & dosagem , Neuralgia/tratamento farmacológico , Ácido gama-Aminobutírico/análogos & derivados , Adulto , Idoso , Idoso de 80 Anos ou mais , Analgésicos/efeitos adversos , Colômbia , Relação Dose-Resposta a Droga , Equador , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Medição da Dor , Peru , Pregabalina , Estudos Prospectivos , Resultado do Tratamento , Venezuela , Adulto Jovem , Ácido gama-Aminobutírico/administração & dosagem , Ácido gama-Aminobutírico/efeitos adversosRESUMO
ABSTRACT The use of different substances for the storage of the entomopathogenic nematodes Steinernemacarpocapsae A11 and Heterorhabditis sp. JPM4 was evaluated. The nematodes were kept in distilled water (control) and the other treatments were made with water with the addition of: Tween 80® (0.1%), ethylene glycol (0.1%), glycerin (1%), glucose (1%), CaCO3 (0.1%), Triton® (0.1%), KMnO4 (0.01%) and NaOCl (0.1%). The evaluations were made at 30, 60, 90, 120, 150 and 180 days, counting the number of infective juveniles (IJ) and determining their survival and infectivity. It was found that glycerin acted as a preserving substance at the temperature of 28º C for both nematodes and also in 16º C for S. carpocapsae A11. The other substances tested, even when they kept the nematodes alive, did not show this effect in relation to infectivity.
RESUMO Foi avaliado o uso de diferentes substâncias com potencial conservante no armazenamento dos nematóides entomopatogênicos Steinernema carpocapsae A11 e Heterorhabditis sp. JPM4. Os nematóides foram mantidos em água destilada (testemunha), sendo os demais tratamentos compostos por água adicionada de: Tween 80® (0,1%), etileno glicol (0,1%), glicerina (1%), glicose (1%), CaCO3 (0,1%), Triton® (0,1%), KMnO4 (0,01%) e NaOCl (0,1%), ambos armazenados em diferentes temperaturas. As avaliações foram realizadas aos 30, 60, 90, 120, 150 e 180 dias, por meio de contagens dos juvenis infectantes (JI), sendo determinadas a sua viabilidade e infectividade. Constatou-se que a glicerina agiu como substância conservante na temperatura de 28º C para os dois nematóides testados e também a 16º C para o nematóide S. carpocapsae A11. As demais substâncias usadas, mesmo quando mantiveram os nematóides vivos, não preservaram a infectividade.
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Se presentan los resultados de la biopsia de ganglio centinela en 77 mujeres portadoras de cáncer ductal in situ (CDIS) multifocal o cáncer de mama T1-2 , todas con axila clínicamente negativa, utilizando inyección periareolar intradérmica de 99mTc-Dextran, linfocintigrafía y detección radioisotópica intraoperatoria. En 72/77 pacientes además se usó colorante azul de Isosulfan. Se obtuvo al menos un ganglio centinela en la totalidad de las pacientes. Se encontró 1 o 2 ganglios metastásicos en 14 pacientes. En 13 de ellas el ganglio centinela estaba comprometido y en 6/10 con disección axilar (DA) el resto de los ganglios estaban negativos.
Sentinel lymph node biopsy (SLNB) was performed in 77 consecutive women with clinically node-negative T1 and T2 breast cancer or multifocal ductal carcinoma in situ (DCIS). They had periareolar subdermal injection of 99mTc-Dextran, preoperative lymphoscintigraphy and intraoperative handheld probe detection. Isosulfan blue dye was also used in 72/77 patients. At least one sentinel node was found at surgery for all patients. In 14 patients one or two metastatic nodes were found, 13 of them in the sentinel node(s). Axillary lymph node dissection was otherwise negative in 6/10 positive SLNB patients.
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Feminino , Adulto , Pessoa de Meia-Idade , Humanos , Biópsia de Linfonodo Sentinela/métodos , Carcinoma Intraductal não Infiltrante , Compostos de Organotecnécio , Neoplasias da Mama/patologia , Linfonodos , Axila/patologia , Dextranos , Estadiamento de Neoplasias , Seguimentos , Fatores de Tempo , Metástase Linfática , Linfonodos/cirurgia , Linfonodos/patologia , Resultado do TratamentoRESUMO
Diversa evidencia sugiere que las litotripsias a menor frecuencia son más eficientes en el tratamiento de las urolitiasis al aumentar la fragmentación en modelos experimentales y en algunas series clínicas. El objetivo de este trabajo es comparar la eficiencia del tratamiento con 60 respecto a 120 golpes por minuto (gpm) en un estudio prospectivo randomizado. Materiales y métodos: Pacientes con litiasis radioopaca, sin tratamiento previo, fueron prospectivamente sometidos a litotripsia a 60gpm (grupo 1) o 120 gpm (grupo 2), en forma randomizada. Se registró la ubicación (renal o ureteral) y tamaño (en mm) del cálculo. Se definió como éxito la ausencia del cálculo tratado al mes de seguimiento, controlado con radiografía simple. En el análisis estadístico se utilizó test chi cuadrado, con intervalo de confianza de 95 por ciento, considerando significativo p<0,05. Resultados: Se trataron 92 pacientes, de los cuales 46 recibieron litotripsia a 60 gpm y 46 a 120 gpm. Ambos grupos no presentan diferencias estadísticas en cuanto a la ubicación y tamaño del cálculo. El éxito global del tratamiento fue de 67,4 por ciento. El grupo 1 presentó mayor éxito (78 por ciento) que el grupo 2 (56 por ciento), siendo diferencias significativas (p=0,0008). En los cálculos renales, el grupo 1 tuvo un éxito de un 70,8 por ciento y el grupo 2 un 58,6 por ciento (p<0,05). En los cálculos ureterales, el grupo 1 tuvo un éxito de un 86,4 por ciento y el grupo 2 un 52,9 por ciento (p<0,05). El número de golpes promedio por litotripsia en el grupo 1 fue de 2326 y en el grupo 2 fue de 2842 (p<0,05). El tiempo requerido para realizar la litotripsia fue mayor en el grupo 1, sin diferencias significativas. Conclusiones: Las litotripsias a bajas frecuencias presentan una mayor efectividad en comparación con las realizadas a mayor frecuencia, requiriendo incluso un menor número de golpes para lograr una fragmentación exitosa, con una duración comparable.
Several experimental and clinical trials have shown that slow rate shock wave lithotripsy (SWL) improves stone fragmentation with a better outcome. The purpose of this trial is to compare the efficiency of slow versus fast rate SWL in a prospective randomized study. Materials and Methods: Previously untreated patients with radiopaque calculi were randomized to undergo treatment with SWL at 60 (group 1) or 120 (group 2) shocks per minute (spm). The location (renal uretheral) and size (mm) of the stone was registered. Treatment success was considered as stone-free patients at one month follow-up with simple x-rays. For statistical analysis we used the chi-square test. Results: 92 patients were treated, 46 patients with SWL at 60 spm and 46 at 120 spm. There were significant differences in location and size between both groups. Global treatment success was 67,4 percent. Group 1 had a success rate (78 percent) higher than group 2 (56 percent), that was stadistically significant. In renal stones, group 1 showed a higher success rate (70,8 percent) than group 2 (58,6 percent). In uretheral stones, group showed a higher success rate (86,4 percent) than group 2 (52,9 percent). Both renal and uretheral locations showed statistical difference (p<0,05). The average number of shock waves used in group 1 was 2326 and 2842 group 2 (p<0,05). The time required to complete the SWL was longer in group 1, without statistical difference. Conclusions: Slow rate SWLs are more efficient than ones performed at fast rates, with a greater success in fragmentation of stones at a lower number of total shock waves, and with a similar treatment time.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Cálculos Renais/terapia , Cálculos Ureterais/terapia , Litotripsia/métodos , Estudos Prospectivos , Fatores de TempoRESUMO
Spondylothoracic dysplasia (STD, MIM#277300) is an autosomal recessive disorder with high prevalence in the Puerto Rican population. It is generally regarded as a lethal condition. Since Jarcho and Levin described it in 1938, it has been referred to as spondylocostal dysplasia, costovertebral dysplasia, Jarcho-Levin syndrome and STD. We have prospectively characterized 27 patients with STD by detailed physical examination, pedigree analysis, thoracic CT scans, and pulmonary function tests (PFTs). Diagnoses were established using spinal radiographs and 3-D reconstructive CT scans to demonstrate fusion of the ribs at the costo-vertebral junction with a fan-like (crab-like) configuration of the thorax. Vertebral segmentation and formation defects were seen throughout the spine with a decrease in the number of vertebral bodies. Characteristic vertebral shape consisted of a decrease in antero-posterior diameter and an increase in lateral length, giving the vertebra a sickle shape. Eight out of 18 prospectively follow patients died within the first 6 months of life, a 44% mortality rate. Cause of death was respiratory insufficiency secondary to pneumonia and pulmonary restriction. This is an important finding since the vast majority of STD syndrome patients cited in the medical literature have died in the newborn and early childhood periods. Age of the remaining patients ranged from 4 months to 47 years. This represents the largest collection of patients with STD reported and it has allowed us to determine a detailed phenotype. Given 56% survival at 6 months, we show that STD is not a lethal syndrome.
Assuntos
Anormalidades Múltiplas/patologia , Anormalidades Musculoesqueléticas/patologia , Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/genética , Anormalidades Múltiplas/mortalidade , Adolescente , Adulto , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Anormalidades Musculoesqueléticas/diagnóstico , Anormalidades Musculoesqueléticas/genética , Anormalidades Musculoesqueléticas/mortalidade , Linhagem , Fenótipo , Estudos Prospectivos , Porto Rico , Radiografia Torácica , Costelas/anormalidades , Costelas/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/patologia , Síndrome , Tórax/anormalidades , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
PROPÓSITO: Comparación en la incidencia de prurito en las primeras 24 horas del postoperatorio en las pacientes sometidas a operación cesárea cuando se les administra hidromorfona o morfina peridural. ANTECEDENTES: Se conoce que el efecto analgésico de la morfina y la hidromorfona son comparables, la literatura reporta en forma controvertida, la aparición del prurito como un efecto adverso más pronunciado con el uso de la morfina. MÉTODOS: Entre Abril y Diciembre de 1.997, en nuestra institución, se realiza un ensayo clínico, doble ciego, con 59 pacientes embarazadas programadas para cesárea, las cuales recibieron anestesia peridural lumbar con inserción de catéter. Como anestésico local se aplicó xilocaína simple o con epinefrína, adicionando 50 - 75 mcr. de Fentanyl, hasta adquirir un nivel sensitivo de T4. Fueron aleatorizados en dos grupos: El grupo 1 (n=28) recibió 1.5 mgrs de Morfina diluidos en 10cc de solución salina normal. El grupo 2 (n=31) recibió 0.5 mgrs de hidromorfona diluidos en 10cc de solución salina normal. Ambas mezclas se administraron una vez se clampeó el cordón umbilical. Se realizo el seguimiento desde el ingreso a sala de recuperación, 2, 6, 12 y 24 horas después; evaluando EVA, aparición de efectos adversos, uso de dosis de rescate de dipirona, uso de clemastina parenteral. Se utilizaron pruebas de chi cuadrado, de Fisher y análisis de varianza de las variables a medir. RESULTADOS: Se encontró una diferencia estadísticamente significante entre la aparición de los efectos adversos en cada uno de los grupos: el prurito moderado se presento en forma predominante en el grupo Hidromorfona (p=0.006) durante las primeras 24 horas del postquirúrgico. Mientras que otros efectos colaterales, tales como mareo y náuseas, se reportaron en el grupo de la Morfina (p=0.0014 y 0.002 respectivamente). CONCLUSIÓN: Este estudio demuestra que la incidencia de prurito en las 24 primeras horas del postoperatorio es mayor cuando se utiliza Hidromorfona que Morfina peridurales
Assuntos
Cesárea , Hidromorfona , Incidência , Morfina , Período Pós-Operatório , PruridoRESUMO
A therapeutical clinical trial was designed to study the effectiveness of Paico and Albendazole, for the treatment of ascariasis in a group of 60 children, between 3 and 14 years old, from a rural community in Huaraz. It was carried out between May and August, 2000. The sample was randomly divided into 30 cases for Paico and 30 for Albendazole, the criteria for entering the trial being a positive examination for Ascaris lumbricoides in feces. The treatment consisted in Paico juice: 1 ml/Kg for less than 10 Kg, and 2 ml/Kg in larger children, one dose before breakfast, for three consecutive days. The Albendazole was administered in a single dose of 400 mg in those over five years of age, and 200 mg in younger children. The effectiveness was evaluated qualitatively (the disappearance of the ascaris eggs from the feces) and quantitatively (decrease in the parasitic burden); in the stool examinations carried out in all cases on entering the study and 15 days after the treatment. All the stool samples were processed in the Referential Laboratory of the Regional Health Authority in Ancash. The qualitative effectiveness between Paico and Albendazole for the eradication of ascariasis was similar at 86.7%. The quantitative effectiveness was 59.5% for Paico and 58.3% for Albendazole. However, it was observed that, unlike Albedazole, Paico is 100% effective in the treatment of Hymenolepsis nana. Adverse effects were presented in 23.3% of the cases for both drugs. It is concluded that, although Paico and Albendazole have a similar effectiveness against Ascaris lumbricoides, Paico has the additional benefit of being effective against Hymenolepsis nana.
Assuntos
Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Ascaridíase/tratamento farmacológico , Chenopodium ambrosioides , Fitoterapia , Óleos de Plantas/uso terapêutico , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , PeruRESUMO
OBJECTIVE: In the United States hepatitis C virus infection (HCV) affects approximately 20 percent of hemodialysis patients but its prevalence in Puerto Rico has not been established. We have sought to determine the prevalence of HCV infection in a homogeneous sample of patients on hemodialysis in the western region of Puerto Rico and to identify its risks factors. METHODS: All patients in the hemodialysis units of Aguadilla, Mayagüez and San Germán, during December 1997 to March 1998, completed a written questionnaire in which they were asked about transfusions, multiple sexual partners, i.v. drugs use, tattooing, occupation, imprisonment, organ transplantation and years on hemodialysis. Serum samples were analysed for HCV antibodies by an enzyme-linked immunoadsorbent assay (ELISA). Sera with positive results for HCV were subjected to a confirmatory test by the polymerase chain reaction (PCR). RESULTS: Thirteen of the 376 (3) subjects had a positive ELISA (one patient died prior the confirmatory test with PCR). Six out of the twelve patients had a positive PCR. Two had been transfused. Three were illicit i.v. drug users and one had received a renal transplant. The liver biopsies in all patients showed chronic hepatitis and in two there was cirrhosis. CONCLUSIONS: Our prevalence was two percent. As reported elsewhere blood transfusion, organ transplantation and illicit i.v. drug abuse were the major risk factors for HCV infection in our patients. Nosocomial factors were irrelevant in the results
Assuntos
Humanos , Unidades Hospitalares de Hemodiálise , Hepatite C/epidemiologia , Anticorpos Anti-Hepatite C/sangue , Hepatite C/imunologia , Prevalência , Porto Rico/epidemiologia , Fatores de Risco , Estudos SoroepidemiológicosRESUMO
Large-conductance Ca2+-activated K+ channels (BK) are believed to underlie interburst intervals and contribute to the control of hormone release in several secretory cells. In crustacean neurosecretory cells, Ca2+ entry associated with electrical activity could act as a modulator of membrane K+ conductance. Therefore we studied the contribution of BK channels to the macroscopic outward current in the X-organ of crayfish, and their participation in electrophysiological activity, as well as their sensitivity toward intracellular Ca2+, ATP, and voltage, by using the patch-clamp technique. The BK channels had a conductance of 223 pS and rectified inwardly in symmetrical K+. These channels were highly selective to K+ ions; potassium permeability (PK) value was 2.3 x 10(-13) cm(3) s(-1). The BK channels were sensitive to internal Ca2+ concentration, voltage dependent, and activated by intracellular MgATP. Voltage sensitivity (k) was approximately 13 mV, and the half-activation membrane potentials depended on the internal Ca2+ concentration. Calcium ions (0.3-3 microM) applied to the internal membrane surface caused an enhancement of the channel activity. This activation of BK channels by internal calcium had a KD(0) of 0.22 microM and was probably due to the binding of only one or two Ca2+ ions to the channel. Addition of MgATP (0.01-3 mM) to the internal solution increased steady state-open probability. The dissociation constant for MgATP (KD) was 119 microM, and the Hill coefficient (h) was 0.6, according to the Hill analysis. Ca2+-activated K+ currents recorded from whole cells were suppressed by either adding Cd2+ (0.4 mM) or removing Ca2+ ions from the external solution. TEA (1 mM) or charybdotoxin (100 nM) blocked these currents. Our results showed that both BK and K(ATP) channels are present in the same cell. Even when BK and K(ATP) channels were voltage dependent and modulated by internal Ca2+ and ATP, the profile of sensitivity was quite different for each kind of channel. It is tempting to suggest that BK and KATP channels contribute independently to the regulation of spontaneous discharge patterns in crayfish neurosecretory cells.