Increased number of non-invariant NKT cells and low number of circulating CD1-expressing leukocytes in patients infected with hepatitis C virus.

Natural killer T (NKT) cells represent an heterogeneous T cell population involved in host immunity against several microorganisms. They also have important immunoregulatory functions. Studies on circulating levels of NKT cells during HCV infection have been focused on the invariant NKT (iNKT) subset which recognizes the non-classical Ag-presenting molecule CD1d, with little information about the non-invariant NKT (non-iNKT) cell subset. In the present study, we assessed the number of both NKT cells subsets and the surface expression of CD1a, b, c and d isoforms in peripheral blood of 31 HCV-infected patients and 31 ages matched healthy individuals. A significant increase of circulating non-iNKT cells was observed in HCV-infected patients as compared to controls (74 ± 57 cells/µL vs 42 ± 16 cells/µL respectively, p<0.0042) with no differences in the iNKT subset. In addition, the percentage of CD1a, CD1c and CD1d-expressing leukocytes was significantly low in patients as compared to controls. These findings suggest that both components, non-iNKT cells and CD1 molecules expression are involved in the control of natural immunity against HCV.

Chromosome abnormalities in northeastern Mexico: ten years of experience in a private laboratory (1999-2009).

Throughout the world, chromosome alterations are one of the main causes of major malformations in newborns and of multiple clinical characteristics in patients of other ages. The present study had as its principle objective to determine the distribution of chromosome alterations obtained from 1999-2009 at a private laboratory located in Monterrey, Nuevo Leon state, Mexico, and that received samples from other northeastern Mexican states. We studied 1,652 cases of peripheral blood karyotypes. Samples were obtained from patients in whom there was a suspicion of some chromosome alteration based on the clinical history. Of the karyotypes evaluated, 1,250 (76.0%) had normal karyotype, 320 (19.0%) presented chromosome alterations, among which 270 (84%) were numerical, 50 (16%) were structural, and 82 (5.0%) were polymorphisms. Chromosome alteration frequency and type found in the present study is similar to that found in studies conducted in other countries and to that reported in the literature.

Prognostic value of cardiac troponin T elevation is independent of renal function and clinical findings in heart failure patients.

BACKGROUND: The aim of this study is to determine the prevalence and prognostic value of elevated cardiac troponin (cTnT) and its association with clinical characteristics according to renal function status in patients with stable heart failure. METHODS: In a prospective observational study, 152 consecutive patients from the Heart Failure Clinic of the INCMNSZ were followed for a period of 42 months. All underwent clinical evaluation, echocardiography, and determination of body composition by electric bioimpedance to identify hypervolemia. Concentrations of cTnT were quantified by immunoassay with electrochemoluminescence and > or = 0.02 ng/mL levels were considered elevated. Also glomerular filtration rate (eGFR) was estimated using the Cockcroft-Gault equation. RESULTS: Elevated cTnT was significantly associated with increased all-cause mortality in the observational period even after adjusting for eGFR < 60 mL/min/1.73 m2 and clinical findings such as hypertension, functional class, loop diuretics, angiotensin converting enzyme inhibitors, pulmonary pressure and hypervolemia in Cox regression analysis with a hazard ratio of 4.58 (95% confidence interval: 1.84-11.45). CONCLUSIONS: Heart failure patients with elevated cardiac-specific troponin T are at increased risk of death independently of the presence of chronic kidney disease.

Docencia en cirugía general. Una propuesta para su perfeccionamiento / Teaching in General Surgery: a proposal for its training

La metodología propia del diseño curricular para la formación de recursos humanos de la salud, se fundamenta en el enfoque histórico cultural y por tanto tiene en cuenta el aprendizaje basado en el desarrollo social de cada etapa histórico-social concreta. La Educación Superior en Cuba marcha acorde con el desarrollo de la ciencia contemporánea, esto hace que indiscutiblemente la entrada al tercer milenio tenga que estar encaminada a la formación de profesionales con una elevada calificación científico- técnica, lo cual implica que los curriculum tengan un alto nivel científico y respondan a los intereses de la sociedad. La metodología en sí misma, tiene en cuenta como punto de partida los problemas de salud y el modo de actuación profesional, este último como objetivo supremo. No obstante lo anterior, el hecho del desarrollo científico técnico acelerado en las ciencias, como es el caso de la Cirugía General, marca una nueva pauta ya que los objetivos supremos dejan de ser la esencialidad al ser superados por los contenidos, o lo que es lo mismo dejan de ser la categoría rectora obligando a nuevos diseños, como es el caso que nos ocupa.

The typical methodology for the curricular design for the training of the health human resources is based on the historical-cultural approach, bearing in mind the learning based on the social development in every specific historical-social stage. In Cuba, Higher Education goes on according to the development of the contemporary science. This unquestionably causes the entering into the third millennium to be directed to a high scientific-technical qualification of the professionals, that means that the curricula have a high scientific level and respond to the needs of the society. The methodology itself deals with the health problems and the ways of professional performance, this being the supreme objective. In spite of the above mentioned, the fact of an accelerated scientific-technical development in sciences, and that is the case in General Surgery, makes us face the dilemma that the supreme objectives are not so essential, being overcome by the contents, that is to say, they are not the principal category which leads to new designs, this being the case we are discussing.

Costes: colecistectomía laparoscópica frente a colecistectomía convencional / Costs: laparoscopic cholecystectomy versus conventional cholecystectomy

Se realizó un estudio de intervención cuasiexperimental, del tipo de las investigaciones en sistemas y servicios de salud, que evalúa los resultados de la cirugía de mínimo acceso en comparación con la cirugía convencional utilizada en pacientes con enfermedades de la vesícula biliar que requerían tratamiento quirúrgico y que fueron operados en el Hospital General Universitario Abel Santamaría Cuadrado, en Pinar del Río, entre el 1.ro de enero de 2002 y el 31 de diciembre de 2004. El grupo de estudio estuvo constituido por 1 335 pacientes operados por vía laparoscópica, mientras que el grupo control integró a los operados por el método quirúrgico convencional. Se evalúo además la relación costes-beneficios. Los datos obtenidos se incluyeron en una base de datos para el procesamiento estadístico, que se realizó mediante estadística descriptiva y aplicando la frecuencia porcentual y la frecuencia absoluta. Con la colecistectomía laparoscópica se observó una reducción significativa de la estadía hospitalaria posoperatoria y obviamente, de los costes por internación. El beneficio económico debido al egreso hospitalario precoz resultó en 389 663,10 CU(AU)

He/she was carried out a study of intervention cuasiexperimental, of the type of the investigations in systems and services of health that it evaluates the results of the surgery of minimum access in comparison with the conventional surgery used in patient with illnesses of the vesicle biliar that required surgical treatment and that they were operated in the University General Hospital Abel Squared Santamaría, in Pinegrove of the River, between January 1.ro 2002 and December 31 2004. The study group was constituted by 1 335 patients operated for via laparoscópica, while the group control integrated those operated by the conventional surgical method. You also evaluates the relationship cost-benefits. The obtained data were included in a database for the statistical prosecution that was carried out by means of descriptive statistic and applying the percentage frequency and the absolute frequency. With the colecistectomía laparoscópica a significant reduction of the demurrage hospital posoperatoria was observed and obviously, of the costs for internment. The economic benefit due to the precocious hospital expenditure was in 389 663,10 CU(AU)

Age as a determinant factor for endotoxin induced uveitis.

PURPOSE: To determine if susceptibility to systemic endotoxin-induced uveitis is an age-related phenomenon in the rabbit. METHODS: Young and adult rabbits were injected intravenously with 2.5 microg/kg of E. coli endotoxin or saline. Thereafter, the number of exudating cells at 2, 6, 12, 24 and 48 hours were determined. The levels of lipopolysaccharide-binding protein, total protein, prostaglandin-E2, nitric oxide and interleukin-6 in aqueous humor were also determined 24 hours after the injections. RESULTS: A significant increase in the number of exudating cells and the levels of lipopolysaccharide-binding protein, total protein, prostaglandin-E2 and nitric oxide in aqueous humor was observed only in adult rabbits 24 hours after endotoxin injection. No differences were observed in the increased IL-6 levels. CONCLUSIONS: Life stage seems to be a critical factor in developing an eye-inflammatory response induced by systemic endotoxin. This could be a consequence of a differential specific activation of the ocular immune response.

Nuestra experiencia en esplenectomía laparoscópica versus convencional / Our experience in laparoscopic splenectomy versus conventional splenectomy

Se realizó un estudio comparativo transversal de 28 pacientes con enfermedades hematológicas a los cuales se les realizó esplenectomía, 14 por la vía convencional y 14 por cirugía de mínimo acceso, con el objetivo de realizar una comparación entre ambas técnicas quirúrgicas, en el Servicio de Cirugía del Hospital Universitario Abel Santamaría, en el período comprendido desde Mayo de1996 hasta Mayo del 2002. Se aplicó una encuesta tomando como fuente las historias clínicas que se encuentran en el archivo del hospital, donde se analizó la edad, diagnóstico preoperatorio, tiempo quirúrgico, complicaciones, estadía hospitalaria, y a los resultados les fue aplicado el método estadístico de Chi cuadrado. Los principales resultados encontrados en nuestro trabajo fueron: en el grupo de esplenectomía laparoscópica 12 pacientes se fueron de alta en las primeras 96 horas, se operaron 8 pacientes entre 180 y 240 minutos y este grupo presentó costos hospitalarios menores. En el grupo de Esplenectomía convencional 11 pacientes se fueron de alta entre los 7 y 20 días, 12 pacientes se operaron entre 60 y 180 minutos y presentaron sepsis de la herida quirúrgica 6 casos.

A comparative cross ? sectional study is performed in 28 patients suffering from blood disorders who underwent a splecnectomy (14 using the conventional approach and 14, the minimal access procedures) aimed at performing a comparison between both surgical procedures by Surgical Department at Abel Santamaría University Hospital during May 1996 ? May 2002. A survey was being carried out taking the clinical records from the hospital archive and age, preoperative diagnosis, surgery time, complications, hospital stay were analyzed and it was used the chi ? square statistical method. The main results found in out study were: 12 patients were discharged from the hospital after 96 hours (laparoscopic splenectomy group), the surgery time in patients ranged between 180 and 240 minutes and this group presented the lower hospital cost. In the conventional splenectomy group, 11 patients were discharged ranged between 60 and 180 minutes and presented wound sepsis (6 cases).

New contribution to the ethnopharmacological study of the Canary Islands.

We present in this paper a report of 155 species used for medicinal purpose in the Canary Islands. These species have been compiled in 13 tables in accordance with their main medicinal use, indicating also other possible popular uses. We have made a short inventory of the rates of the most important medicinal applications. This new compilation shows once more the traditional use of the phytotherapeutic resources by the Canary population and also the wide possibilities of the phytochemical and pharmacological investigations of the Canary Islands Flora.