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1.
Healthcare (Basel) ; 11(17)2023 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-37685469

RESUMEN

Secure attachment, developed through consistent relationships with attachment figures in childhood, is a crucial factor in fostering healthy interpersonal relationships and a positive self-perception. Part of the positive parenting approach and the theory of affect is taken as a basis to assess how perceived security, as an indicator of secure attachment, predicts adult self-concept through the mediating effects of resilience and positive self-esteem. A quantitative, cross-sectional, and nonprobabilistic study was conducted with 383 participants. We unveiled significant positive associations between perceived security, self-concept, resilience, and positive self-esteem. Path analysis demonstrated that resilience and positive self-esteem sequentially mediate the relationship between perceived security during childhood and adult self-concept. Findings suggest that the ability to cope with adversity and personal acceptance underlie the impact of perceived security on self-concept. It is recommended to promote family intervention programs framed within positive parenting that focus on fostering secure attachment given its influence on adult life. It is also deemed essential to incorporate the promotion of resilience and self-esteem into programs aimed at youths, and adult role models can enhance their self-perception and resilience in the face of potential effects stemming from insecure parenting practices.

2.
Rev Med Chil ; 149(6): 888-898, 2021 Jun.
Artículo en Español | MEDLINE | ID: mdl-34751348

RESUMEN

Neuroendocrine Tumors (NETs) encompass a wide variety of tumors arising from neuroendocrine cells, which produce bioactive substances. The incidence of NETs increased significantly lately, becoming one of the most common tumors of the digestive tract. Their clinical presentation is as diverse as their capacity for hormone production. Carcinoid syndrome is the most common hormonal syndrome produced by NETs and is characterized by diarrhea, flushing and cardiac valvular lesions. New research brought multiple changes in the classification of these neoplasms and a new understanding about their diagnosis and treatment, promoting a multidisciplinary approach. Somatostatin analogues, radiation, biological, and cytotoxic drugs have improved the prognosis of these patients, which entails a great challenge for healthcare providers.


Asunto(s)
Antineoplásicos , Tumores Neuroendocrinos , Antineoplásicos/uso terapéutico , Diarrea , Humanos , Tumores Neuroendocrinos/diagnóstico , Tumores Neuroendocrinos/terapia , Somatostatina/uso terapéutico
3.
Rev. méd. Chile ; 149(6): 888-898, jun. 2021. tab, graf, ilus
Artículo en Español | LILACS | ID: biblio-1389542

RESUMEN

Neuroendocrine Tumors (NETs) encompass a wide variety of tumors arising from neuroendocrine cells, which produce bioactive substances. The incidence of NETs increased significantly lately, becoming one of the most common tumors of the digestive tract. Their clinical presentation is as diverse as their capacity for hormone production. Carcinoid syndrome is the most common hormonal syndrome produced by NETs and is characterized by diarrhea, flushing and cardiac valvular lesions. New research brought multiple changes in the classification of these neoplasms and a new understanding about their diagnosis and treatment, promoting a multidisciplinary approach. Somatostatin analogues, radiation, biological, and cytotoxic drugs have improved the prognosis of these patients, which entails a great challenge for healthcare providers.


Asunto(s)
Humanos , Tumores Neuroendocrinos/diagnóstico , Tumores Neuroendocrinos/terapia , Antineoplásicos/uso terapéutico , Somatostatina/uso terapéutico , Diarrea
4.
Rev. univ. psicoanál ; (21): 47-56, mar. 2021.
Artículo en Español | LILACS | ID: biblio-1396192

RESUMEN

El arte se debate precisamente entre responder al papel asignado por la modernidad como campo de la estética, y de escapar de ese lugar e interrogar la re-presentación para abrir el horizonte de sentido, pero esta vez introduciendo lo singular como su única garantía de tratar lo real. Lo cual dista del ámbito de la investigación. El arte, en consecuencia, está expuesto al peligro de sucumbir a la demanda de la realidad en el capitalismo de la modernidad tardía. La pertinencia de tratar lo singular en su propia lógica, es decir sin la pretensión de compararlo con lo universal, mediante la creación artística y la elaboración simbólica, permite tramitar lo incomprensible, lo real, lo insoportable dándole una forma y una materia, lo cual implica contrarrestar los efectos del retorno de lo real puesto en el acto atroz


Art is debating precisely between responding to the role assigned by modernity as a field of aesthetics and escaping from that place and questioning the re-presentation to open the horizon of meaning, but this time introducing the singular as its only guarantee of trying the real. Which is far from the scope of the investigation. Consequently, art is exposed to the danger of succumbing to the demand of reality in late modern capitalism. The relevance of treating the singular in its own logic, that is, without the pretense of comparing it with the universal, through artistic creation and symbolic elaboration, allows us to process the incomprehensible, the real, the unbearable, giving it a form and a matter, which it implies counteracting the effects of the return of the real put into the heinous act


Asunto(s)
Humanos , Cambio Social , Arte
5.
Neuropsychobiology ; 80(3): 214-224, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32726779

RESUMEN

BACKGROUND: Major depressive disorder (MDD) is an important independent risk factor for cardiovascular disease. Cumulative data suggest that depressive patients exhibit derangement in regional cerebral blood flow (rCBF), although underlying mechanisms remain mostly unknown. Endothelial dysfunction (ED), defined as different forms of abnormal endothelial activity, plays a key role in the pathogenesis of vascular disease. ED is associated with several clinical conditions characterized by high cardiovascular risk. Diverse ED markers have been found in mood disorders. PURPOSE: To evaluate the association between rCBF and peripheral ED markers in MDD patients, at baseline and after selective serotonin receptor inhibitors (SSRIs) therapy. PATIENTS AND METHODS: Twenty-seven untreated unipolar MDD patients in their first episode were evaluated with the Hamilton Depression Rating Scale (HAM-D) and brain perfusion SPECT at baseline and after 2 months of SSRIs. Statistical Parametric Mapping (SPM) was employed to evaluate rCBF; circulating endothelial cells (CECs), plasma soluble intercellular adhesion molecule (sICAM), and high-sensitivity C-reactive protein (hsCRP) were used as independent covariates. RESULTS: Baseline CECs and sICAM were increased in MDD patients compared with matching controls (p = 0.0001) and hsCRP (p = 0.03). HAM-D scores (21 items) and CECs diminished after SSRI therapy in MDD patients (p < 0.0001). There was a significant rCBF decrease, mainly in deep central structures. HAM-D change was associated with rCBF decrease at the left amygdala, right striatum levels, and Brodmann area 25. CEC change was associated with rCBF at deep brain level and sICAM with large rCBF areas at the left caudate and tectum; hsCRP was associated, to a lesser extent, with the left dorsal striatum and mesencephalic tectum. CONCLUSION: ED markers in patients with MDD are associated with significant changes in rCBF which are features of depression. These findings suggest that systemic damage/activation of the endothelium may contribute to the abnormal rCBF observed in MDD patients.


Asunto(s)
Circulación Cerebrovascular/fisiología , Trastorno Depresivo Mayor/sangre , Trastorno Depresivo Mayor/tratamiento farmacológico , Trastorno Depresivo Mayor/fisiopatología , Endotelio Vascular/fisiopatología , Flujo Sanguíneo Regional/fisiología , Inhibidores Selectivos de la Recaptación de Serotonina/farmacología , Adulto , Circulación Cerebrovascular/efectos de los fármacos , Trastorno Depresivo Mayor/diagnóstico por imagen , Endotelio Vascular/efectos de los fármacos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Flujo Sanguíneo Regional/efectos de los fármacos , Tomografía Computarizada de Emisión de Fotón Único , Adulto Joven
6.
Horm Cancer ; 10(1): 3-10, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30465145

RESUMEN

Neuroendocrine tumors (NETs) are relatively rare and highly heterogeneous neoplasms. Despite this, recent studies from North America and Central Europe have suggested an increase in incidence. In Latin America, NET data are scarce and scattered with only a few studies reporting registries. Our goal was to establish a NET registry in Chile. Here, we report the establishment and our first 166 NET patients. We observed a slight preponderance of males, a median age at diagnosis of 53 years and a median overall survival of 110 months. As anticipated, most tumors were gastroenteropancreatic (GEP). Survival analyses demonstrated that non-GEP or stage IV tumors presented significantly lower overall survival (OS). Similarly, patients with surgery classified as R0 had better OS compared to R1, R2, or no surgery. Furthermore, patients with elevated chromogranin A (CgA) or high Ki67 showed a trend to poorer OS; however, these differences did not reach statistical significance (log-rank test p = 0.07). To the best of our knowledge, this is the first report of a NET registry in Chile. Median OS in our registry (110 months) is in line with other registries from Argentina and Spain. Other variables including age at diagnosis and gender were similar to previous studies; however, our data indicate a high proportion of small-bowel NETs compared to other cohorts, reflecting the need for NET regional registries. Indeed, these registries may explain regional discrepancies in incidence and distribution, adding to our knowledge on this seemingly rare, highly heterogeneous disease.


Asunto(s)
Tumores Neuroendocrinos/diagnóstico , Tumores Neuroendocrinos/epidemiología , Sistema de Registros , Adulto , Anciano , Anciano de 80 o más Años , Chile/epidemiología , Cromogranina A/sangre , Femenino , Humanos , Ácido Hidroxiindolacético/sangre , Incidencia , Neoplasias Intestinales/diagnóstico , Neoplasias Intestinales/epidemiología , Neoplasias Intestinales/mortalidad , Estimación de Kaplan-Meier , Antígeno Ki-67/análisis , Masculino , Persona de Mediana Edad , Tumores Neuroendocrinos/mortalidad , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/epidemiología , Neoplasias Pancreáticas/mortalidad , Serotonina/sangre , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/mortalidad , Resultado del Tratamiento , Adulto Joven
7.
Eur J Hum Genet ; 25(5): 631-636, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-28272540

RESUMEN

The Basque population inhabits the Franco-Cantabrian region in southwest Europe where Palaeolithic human groups took refuge during the Last Glacial Maximum. Basques have been an isolated population, largely considered as one of the most ancient European populations and it is possible that they maintained some pre-Neolithic genetic characteristics. This work shows the results of mitochondrial DNA analysis of seven ancient human remains from the Cave of Santimamiñe in the Basque Country dated from Mesolithic to the Late Roman period. In addition, we compared these data with those obtained from a modern sample of Basque population, 158 individuals that nowadays inhabits next to the cave. The results support the hypothesis that Iberians might have been less affected by the Neolithic mitochondrial lineages carried from the Near East than populations of Central Europe and revealed the unexpected presence of prehistoric maternal lineages such as U5a2a and U3a in the Basque region. Comparison between ancient and current population samples upholds the hypothesis of continuity of the maternal lineages in the area of the Franco-Cantabrian region.


Asunto(s)
ADN Antiguo/química , Evolución Molecular , Genoma Mitocondrial , Linaje , Haplotipos , Migración Humana , Humanos , España , Población Blanca/genética
8.
Toxins (Basel) ; 7(5): 1532-43, 2015 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-25941768

RESUMEN

Renealmia alpinia (Rottb.) MAAS, obtained by micropropagation (in vitro) and wild forms have previously been shown to inhibit some toxic activities of Bothrops asper snake venom if preincubated before injection. In this study, assays were performed in a murine model in which extracts were administered for three days before venom injection. R. alpinia extracts inhibited lethal activity of B. asper venom injected by intraperitoneal route. Median Effective Dose (ED50) values were 36.6 ± 3.2 mg/kg and 31.7 ± 5.4 mg/kg (p > 0.05) for R. alpinia wild and in vitro extracts, respectively. At a dose of 75 mg/kg, both extracts totally inhibited the lethal activity of the venom. Moreover, this dose prolonged survival time of mice receiving a lethal dose of venom by the intravenous route. At 75 mg/kg, both extracts of R. alpinia reduced the extent of venom-induced pulmonary hemorrhage by 48.0% (in vitro extract) and 34.7% (wild extract), in agreement with histological observations of lung tissue. R. alpinia extracts also inhibited hemorrhage in heart and kidneys, as evidenced by a decrease in mg of hemoglobin/g of organ. These results suggest the possibility of using R. alpinia as a prophylactic agent in snakebite, a hypothesis that needs to be further explored.


Asunto(s)
Antídotos/uso terapéutico , Bothrops , Venenos de Crotálidos/toxicidad , Hemorragia/tratamiento farmacológico , Extractos Vegetales/uso terapéutico , Zingiberaceae , Animales , Riñón/efectos de los fármacos , Riñón/patología , Pulmón/efectos de los fármacos , Pulmón/patología , Ratones , Miocardio/patología , Fitoterapia , Mordeduras de Serpientes/tratamiento farmacológico
9.
J Card Fail ; 20(3): 149-54, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24412523

RESUMEN

OBJECTIVES: Heart failure (HF) is associated with changes in myocardial metabolism that lead to impairment of contractile function. Trimetazidine (TMZ) modulates cardiac energetic efficiency and improves outcomes in ischemic heart disease. We evaluated the effects of TMZ on left ventricular ejection fraction (LVEF), cardiac metabolism, exercise capacity, O2 uptake, and quality of life in patients with nonischemic HF. METHODS AND RESULTS: Sixty patients with stable nonischemic HF under optimal medical therapy were included in this randomized double-blind study. Patients were randomized to TMZ (35 mg orally twice a day) or placebo for 6 months. LVEF, 6-minute walk test (6MWT), maximum O2 uptake in cardiopulmonary exercise test, different markers of metabolism, oxidative stress, and endothelial function, and quality of life were assessed at baseline and after TMZ treatment. Left ventricular peak glucose uptake was evaluated with the use of the maximum standardized uptake value (SUV) by 18-fluorodeoxyglucose positron emission tomography ((18)FDG-PET). Etiology was idiopathic in 85% and hypertensive in 15%. Both groups were similar in age, functional class, LVEF, and levels of N-terminal pro-B-type natriuretic peptide at baseline. After 6 months of TMZ treatment, no changes were observed in LVEF (31 ± 10% vs 34 ± 8%; P = .8), 6MWT (443 ± 25 m vs 506 ± 79 m; P = .03), maximum O2 uptake (19.1 ± 5.0 mL kg(-1) min(-1) vs 23.0 ± 7.2 mL kg(-1) min(-1); P = .11), functional class (percentages of patients in functional classes I/II/III/IV 10/3753/0 vs 7/40/50/3; P = .14), or quality of life (32 ± 26 points vs 24 ± 18 points; P = .25) in TMZ versus placebo, respectively. In the subgroup of patients evaluated with (18)FDG-PET, no significant differences were observed in SUV between both groups (7.0 ± 3.6 vs 8.2 ± 3.4 respectively; P = .47). CONCLUSIONS: In patients with nonischemic HF, the addition of TMZ to optimal medical treatment does not result in significant changes of LVEF, exercise capacity, O2 uptake, or quality of life.


Asunto(s)
Insuficiencia Cardíaca/diagnóstico por imagen , Insuficiencia Cardíaca/tratamiento farmacológico , Isquemia Miocárdica , Trimetazidina/uso terapéutico , Vasodilatadores/uso terapéutico , Adulto , Anciano , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Cintigrafía , Resultado del Tratamiento
10.
Vitae (Medellín) ; 21(1): 38-48, 2014. Ilus
Artículo en Inglés | LILACS, COLNAL | ID: biblio-986734

RESUMEN

Antecedentes: las mordeduras de serpientes representan un problema de salud pública relevante en muchas regiones del mundo, particularmente en los países tropicales y subtropicales de África, Asia, América Latina y Oceanía. Los venenos de serpientes son mezclas complejas de enzimas y proteínas tóxicas, donde los componentes más importantes y abundantes que dañan los músculos en los venenos de serpientes son las fosfolipasas A2 (PLA2). Objetivo: Aislar y caracterizar una fosfolipasa A2 del veneno de Venezuela Bothrops para obtener información sobre la composición del veneno de esta especie. Materiales y métodos: La cromatografía de intercambio catiónico seguida de HPLC de fase inversa se usó para purificar la proteína. La espectrometría de masas se utilizó para determinar su masa molecular. La caracterización bioquímica se realizó utilizando un sustrato sintético (ácido 4-nitro-3-octanoiloxi-benzoico). La actividad miotóxica y de inducción de edema de la toxina se probó en ratones, midiendo la actividad de la creatina quinasa plasmática y el diámetro de la almohadilla de la pata, respectivamente. Además, se examinó la actividad citotóxica de mioblastos y miotubos C2C12 del músculo esquelético murino. Resultados: se purificó una PLA2 de Bothrops asper veneno de Colombia (BaspCol-PLA2). Su masa molecular fue de 13974.6 Da. La enzima hidrolizó un sustrato sintético con un KM de 3.11 mM y un VMax de 4.47 nmol / min, mostrando una actividad máxima a 40 ° C y a pH 8.0. La PLA2 requería Ca2 + para la actividad. La adición de Mg2 +, Cd2 +, Mn2 + y Zn2 + (10 mM) en presencia de baja concentración de Ca2 + (1 mM) disminuyó la actividad de la enzima. La sustitución de Ca2 + por los cationes divalentes mencionados también redujo la actividad a niveles similares a los de la ausencia de Ca2 +. Tres fragmentos internos (CCFVHDCCYGK, AAAI / LCFRDNI / LNTYNDKK, DAAI / LCFR) identificada mediante un análisis de espectrometría de masas mostró similitud con las PLA2 de B. asper informadas previamente. En ratones, BaspCol-PLA2 indujo un notable efecto miotóxico local y un edema moderado en la almohadilla del pie. In vitro, esta enzima indujo un efecto citotóxico tanto en los mioblastos como en los miotubos. Además, se clasificó como PLA2 débilmente anticoagulante, mostrando este efecto en concentraciones entre 3 y 10 µg / mL cuando se usa plasma humano. Conclusiones: Una PLA2 se purificó y se llamó BaspCol-PLA2, esta enzima mostró actividad catalítica y una masa molecular de 13974.6 Da. La toxina mostró actividades miotóxicas, formadoras de edema, anticoagulantes y citotóxicas. BaspCol-PLA2 indujo un notable efecto miotóxico local y un edema moderado en la almohadilla del pie. In vitro, esta enzima indujo un efecto citotóxico tanto en los mioblastos como en los miotubos. Además, se clasificó como PLA2 débilmente anticoagulante, mostrando este efecto en concentraciones entre 3 y 10 µg / mL cuando se usa plasma humano. Conclusiones: Una PLA2 se purificó y se llamó BaspCol-PLA2, esta enzima mostró actividad catalítica y una masa molecular de 13974.6 Da. La toxina mostró actividades miotóxicas, formadoras de edema, anticoagulantes y citotóxicas. BaspCol-PLA2 indujo un notable efecto miotóxico local y un edema moderado en la almohadilla del pie. In vitro, esta enzima indujo un efecto citotóxico tanto en los mioblastos como en los miotubos. Además, se clasificó como PLA2 débilmente anticoagulante, mostrando este efecto en concentraciones entre 3 y 10 µg / mL cuando se usa plasma humano. Conclusiones: Una PLA2 se purificó y se llamó BaspCol-PLA2, esta enzima mostró actividad catalítica y una masa molecular de 13974.6 Da. La toxina mostró actividades miotóxicas, formadoras de edema, anticoagulantes y citotóxicas. esta enzima mostró actividad catalítica y masa molecular de 13974.6 Da. La toxina mostró actividades miotóxicas, formadoras de edema, anticoagulantes y citotóxicas. esta enzima mostró actividad catalítica y masa molecular de 13974.6 Da. La toxina mostró actividades miotóxicas, formadoras de edema, anticoagulantes y citotóxicas.


Asunto(s)
Humanos , Fosfolipasas A2 , Venenos , Serpientes , Cromatografía
11.
Toxicon ; 64: 1-11, 2013 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-23287728

RESUMEN

An L-amino acid oxidase (LAAO) from Crotalus durissus cumanensis venom (CdcLAAO) was purified to homogeneity using a combination of size-exclusion and ion exchange chromatographies. CdcLAAO is a monomeric protein exhibiting an apparent molecular mass of 55 kDa and a calculated pI of 8. Its complete 498-amino-acid sequence was deduced through cDNA and protein sequencing. The enzyme oxidized L-Leu with K(m) and a V(Max) of 9.23 µM and 0.46 µM/min respectively, and exhibited Kcat and a Kcat/K(m) of 1.8 s(-1) and 195 mM(-1)s(-1). CdcLAAO inhibited in a dose-dependent manner the growth of Staphylococcus aureus and Acinetobacter baumannii. The inhibitory effect was more significant on S. aureus, with a Minimal Inhibitory Concentration (MIC) of 8 µg/mL and Minimal Bactericidal Concentration (MBC) of 16 µg/mL, than against A. baumannii, with a MIC of 16 µg/mL and MBC of 32 µg/mL. However, against Escherichia coli CdcLAAO did not show inhibitory capacity at the concentrations tested (2-128 µg/mL). CdcLAAO did not exhibit cytotoxic activity on the mouse myoblast cell line C(2)C(12) and on peripheral blood mononuclear cell (PBMC).


Asunto(s)
Acinetobacter/efectos de los fármacos , Antibacterianos/farmacología , Venenos de Crotálidos/enzimología , Crotalus/metabolismo , L-Aminoácido Oxidasa/farmacología , Staphylococcus aureus/efectos de los fármacos , Acinetobacter/crecimiento & desarrollo , Acinetobacter/ultraestructura , Secuencia de Aminoácidos , Animales , Antibacterianos/química , Antibacterianos/aislamiento & purificación , Línea Celular , Supervivencia Celular/efectos de los fármacos , Cromatografía Líquida de Alta Presión , Cromatografía por Intercambio Iónico , Clonación Molecular , Venenos de Crotálidos/genética , ADN Complementario/metabolismo , Humanos , L-Aminoácido Oxidasa/química , L-Aminoácido Oxidasa/genética , L-Aminoácido Oxidasa/aislamiento & purificación , Leucocitos Mononucleares/efectos de los fármacos , Ratones , Pruebas de Sensibilidad Microbiana , Datos de Secuencia Molecular , Mioblastos/efectos de los fármacos , Oxidación-Reducción , Estructura Terciaria de Proteína , Análisis de Secuencia de ADN , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Staphylococcus aureus/crecimiento & desarrollo , Staphylococcus aureus/ultraestructura
12.
J Heart Lung Transplant ; 31(10): 1096-101, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22975099

RESUMEN

BACKGROUND: Ventricular dyssynchrony is a common finding in patients with heart failure (HF), especially in the presence of conduction delays. The loss of ventricular synchrony leads to progressive impairment of contractile function, which may be explained in part by segmental abnormalities of myocardial metabolism. However, the association of these metabolic disarrangements with parameters of ventricular dyssynchrony and electrocardiography (ECG) findings has not yet been studied. METHODS: Our aim was to determine the correlation between the presence of left bundle branch block (LBBB) with left ventricular (LV) mechanical synchrony assessed by multiple-gated acquisition scan (MUGA) and with patterns of 18-fluorodeoxyglucose (18FDG) uptake in patients with non-ischemic heart failure. Twenty-two patients with non-ischemic cardiomyopathy, LV ejection fraction (LVEF) ≤45% and New York Heart Association (NYHA) Functional Class II or III symptoms under standard medical therapy were included, along with 10 healthy controls matched for age and gender. A 12-lead ECG was obtained to measure the length of the QRS. Mechanical LV synchrony was assessed by MUGA using phase analysis. All patients and controls underwent positron emission tomography with 18FDG to determine the distribution of myocardial glucose uptake. The standard deviation of peak (18)FDG uptake was used as an index of metabolic heterogeneity. Student's t-test and Pearson's correlation were used for statistical analysis. RESULTS: The mean age of the patients with HF was 54 ± 12 years and 72% were male. The length of the QRS was 129 ± 31 milliseconds and LBBB was present in 9 patients. Patients with HF had decreased LV 18FDG uptake compared with controls (7.56 ± 3.36 vs. 11.63 ± 4.55 standard uptake value; p = 0.03). The length of the QRS interval correlated significantly with glucose uptake heterogeneity (r = 0.62; p = 0.002) and mechanical dyssynchrony (r = 0.63; p = 0.006). HF patients with LBBB showed marked glucose uptake heterogeneity compared with HF patients without LBBB (41.4 ± 10 vs 34.7 ± 4.9 ml/100 g/min, respectively; p = 0.01). CONCLUSIONS: Patients with non-ischemic heart failure exhibit a global decrease in myocardial glucose uptake. Within this group, subjects who also have LBBB exhibit a marked heterogeneity in segmental glucose uptake, which directly correlates with QRS duration.


Asunto(s)
Bloqueo de Rama/metabolismo , Bloqueo de Rama/fisiopatología , Insuficiencia Cardíaca/metabolismo , Insuficiencia Cardíaca/fisiopatología , Disfunción Ventricular Izquierda/metabolismo , Disfunción Ventricular Izquierda/fisiopatología , Adulto , Anciano , Estudios de Casos y Controles , Electrocardiografía , Femenino , Fluorodesoxiglucosa F18/metabolismo , Glucosa/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Tomografía de Emisión de Positrones , Volumen Sistólico/fisiología
13.
Biomédica (Bogotá) ; 32(3): 365-374, jul.-set. 2012. ilus, graf, tab
Artículo en Español | LILACS | ID: lil-663708

RESUMEN

Introducción. La medicina tradicional es una invaluable fuente de investigación de nuevos remedios como complemento para el tratamiento del accidente ofídico, considerado como un grave problema de salud pública a nivel mundial. Objetivo. Este trabajo de investigación pretende comprobar la capacidad de neutralizar los efectos hemorrágicos, coagulantes y proteolíticos, de los extractos de hojas de Renealmia alpinia, usada tradicionalmente por los indígenas del Chocó (Colombia) contra la mordedura de la serpiente Bothrops asper, causante de la gran mayoría de los accidentes ofídicos en nuestro país. Materiales y métodos. Se llevaron a cabo ensayos de toxicidad aguda y de actividad analgésica in vivo de R. alpinia. Además, se hicieron ensayos in vitro sobre inhibición de las actividades coagulante, hemolítica y proteolítica del veneno de B. asper. Resultados. El presente estudio demuestra que R. alpinia no produce efectos tóxicos en animales de experimentación; además, presenta efectos analgésicos in vivo y antiofídicos in vitro,y protege contra los efectos letales del veneno de B. asper, in vivo. Conclusión. Renealmia alpinia puede ser una buena alternativa terapéutica como complemento al tratamiento con antiveneno en el accidente ofídico, por sus efectos analgésicos y antiofídicos.


Introduction. Traditional medicine is an invaluable source of research into new medicines as a supplement for the treatment of snakebite, considered as a serious public health problem worldwide. The extracts of the medicinal plant, Renealmia alpina, have been used traditionally by indigenous people of Chocó (Colombia) against Bothrops asper snakebite, a snake responsible for the majority of snakebite accidents in Colombia. Objective. The ability of extracts of R. alpinia leaves was tested for its ability to neutralize the hemorrhagic, coagulant and proteolytic effects of the snakebite venom of B. asper. Materials and methods. The acute toxicity tests and analgesic activity of R. alpina were evaluated in vivo. In addition, tests were undertaken in in vitro conditions to demonstrate inhibition of coagulant, haemolytic and proteolytic activity of the B. asper venom. Results. Renealmia alpinia extracts had no toxic effects in experimental animals and also provided analgesic and antiophidian effects and protection against the lethal effects of the venom of B. asper. Conclusion. Renealmia. alpinia was an effective therapeutic alternative in association with antivenom treatment in the event of a B. asper snakebite accident. It was demonstrated to protect against the lethal effects and provided analgesic properties as well.


Asunto(s)
Animales , Femenino , Masculino , Bothrops , Venenos de Crotálidos/antagonistas & inhibidores , Fitoterapia , Extractos Vegetales/uso terapéutico , Hojas de la Planta/química , Mordeduras de Serpientes/tratamiento farmacológico , Zingiberaceae , Acetatos , Analgésicos/uso terapéutico , Analgésicos/toxicidad , Coagulación Sanguínea/efectos de los fármacos , Venenos de Crotálidos/toxicidad , Evaluación Preclínica de Medicamentos , Etanol , Hexanos , Hemólisis/efectos de los fármacos , Metanol , Cloruro de Metileno , Ratones Endogámicos BALB C , Extractos Vegetales/aislamiento & purificación , Extractos Vegetales/farmacología , Extractos Vegetales/toxicidad , Proteolisis/efectos de los fármacos , Solventes
14.
Artículo en Inglés | MEDLINE | ID: mdl-22251437

RESUMEN

Snake venoms are complex mixtures of proteins among which both basic and acidic phospholipases A(2) (PLA(2)s) can be found. Basic PLA(2)s are usually responsible for major toxic effects induced by snake venoms, while acidic PLA(2)s tend to have a lower toxicity. A novel PLA(2), here named PnPLA(2), was purified from the venom of Porthidium nasutum by means of RP-HPLC on a C18 column. PnPLA(2) is an acidic protein with a pI of 4.6, which migrates as a single band under both non-reducing and reducing conditions in SDS-PAGE. PnPLA(2) had a molecular mass of 15,802.6 Da, determined by ESI-MS. Three tryptic peptides of this protein were characterized by HPLC-nESI-MS/MS, and N-terminal sequencing by direct Edman degradation showing homology to other acidic PLA(2)s from viperid venoms. PnPLA(2) displayed indirect hemolytic activity in agarose erythrocyte-egg yolk gels and bactericidal activity against Staphylococcus aureus in a dose-dependent manner, with a MIC and MBC of 32 µg/mL. In addition, PnPLA(2) showed a potent inhibitory effect on platelet aggregation with doses up to 40 µg/mL. This acidic PLA(2), in contrast to basic enzymes isolated from other viperid snake venoms, was not cytotoxic to murine skeletal muscle myoblasts C(2)C(12). This is the first report on a bactericidal protein of Porthidium nasutum venom.


Asunto(s)
Antibacterianos/aislamiento & purificación , Venenos de Crotálidos/química , Fosfolipasas A2/genética , Fosfolipasas A2/aislamiento & purificación , Viperidae , Animales , Antibacterianos/análisis , Antibacterianos/toxicidad , Secuencia de Bases , Cromatografía Líquida de Alta Presión , Venenos de Crotálidos/toxicidad , Relación Dosis-Respuesta a Droga , Electroforesis en Gel de Poliacrilamida , Espectrometría de Masas , Ratones , Datos de Secuencia Molecular , Mioblastos/efectos de los fármacos , Fosfolipasas A2/toxicidad , Análisis de Secuencia de ADN , Homología de Secuencia , Staphylococcus aureus/efectos de los fármacos
15.
Biomedica ; 32(3): 365-74, 2012 Sep.
Artículo en Español | MEDLINE | ID: mdl-23715185

RESUMEN

INTRODUCTION: Traditional medicine is an invaluable source of research into new medicines as a supplement for the treatment of snakebite, considered as a serious public health problem worldwide. The extracts of the medicinal plant, Renealmia alpina, have been used traditionally by indigenous people of Chocó (Colombia) against Bothrops asper snakebite, a snake responsible for the majority of snakebite accidents in Colombia. OBJECTIVE: The ability of extracts of R. alpinia leaves was tested for its ability to neutralize the hemorrhagic, coagulant and proteolytic effects of the snakebite venom of B. asper. MATERIALS AND METHODS: The acute toxicity tests and analgesic activity of R. alpina were evaluated in vivo. In addition, tests were undertaken in in vitro conditions to demonstrate inhibition of coagulant, haemolytic and proteolytic activity of the B. asper venom. Results. Renealmia alpinia extracts had no toxic effects in experimental animals and also provided analgesic and antiophidian effects and protection against the lethal effects of the venom of B. asper. CONCLUSION: Renealmia. alpinia was an effective therapeutic alternative in association with antivenom treatment in the event of a B. asper snakebite accident. It was demonstrated to protect against the lethal effects and provided analgesic properties as well.


Asunto(s)
Bothrops , Venenos de Crotálidos/antagonistas & inhibidores , Fitoterapia , Extractos Vegetales/uso terapéutico , Hojas de la Planta/química , Mordeduras de Serpientes/tratamiento farmacológico , Zingiberaceae , Acetatos , Analgésicos/uso terapéutico , Analgésicos/toxicidad , Animales , Coagulación Sanguínea/efectos de los fármacos , Venenos de Crotálidos/toxicidad , Evaluación Preclínica de Medicamentos , Etanol , Femenino , Hemólisis/efectos de los fármacos , Hexanos , Masculino , Metanol , Cloruro de Metileno , Ratones Endogámicos BALB C , Extractos Vegetales/aislamiento & purificación , Extractos Vegetales/farmacología , Extractos Vegetales/toxicidad , Proteolisis/efectos de los fármacos , Solventes
16.
Toxicon ; 59(2): 344-55, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22146491

RESUMEN

The efficacy and safety of two polyvalent horse-derived antivenoms in Bothrops asper envenomings were tested in a randomized, double-blind, clinical trial performed in Colombia. Both antivenoms were manufactured from the same pool of hyperimmune plasma. Antivenom A was made of F(ab')2 fragments, generated by pepsin digestion and caprylic acid precipitation, whereas antivenom B consisted of whole IgG molecules produced by caprylic acid precipitation followed by ion-exchange chromatography. Besides the different nature of the active substance, antivenom B had higher protein concentration, slightly higher turbidity and aggregate content. No significant differences were observed in the efficacy of antivenoms. Both halted local and systemic bleeding (P = 0.40) within 6-12 h of treatment in 100% of the cases, and restored blood coagulation (P = 0.87) within 6-24 h in 84.7% of patients, and within 48 h in all of them, in agreement with restoration of plasma fibrinogen concentration. Venom concentrations in serum dropped significantly (P < 0.001), to very low levels, 1 h after antivenom infusion. Nevertheless, eight patients (11.1%), four for each antivenom, presented recurrence of venom antigenaemia at different times, from 6 to 96 h, with clinical significance (recurrent coagulopathy) only in one group B patient (2.9%). Serum creatine kinase (CK) activity was increased, as a consequence of local myonecrosis. There was no significant difference (P = 0.51) in the incidence of early adverse reactions to antivenom administration (28.9% for patients of group A and 20.6% for patients of group B), most of the reactions being mild, mainly cutaneous. The most frequent complications were cellulitis (16.7%), abscess formation (5.6%), acute renal failure (8.3%), and compartmental syndrome (5.6%). In conclusion, IgG and F(ab')2 antivenoms, prepared by caprylic acid fractionation, presented similar efficacy and safety profiles for the treatment of B. asper envenomings in Colombia.


Asunto(s)
Antivenenos/uso terapéutico , Bothrops/metabolismo , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/metabolismo , Mordeduras de Serpientes/tratamiento farmacológico , Adolescente , Animales , Coagulación Sanguínea , Trastornos de la Coagulación Sanguínea/tratamiento farmacológico , Caprilatos/farmacología , Fraccionamiento Químico/métodos , Cromatografía por Intercambio Iónico/métodos , Colombia , Venenos de Crotálidos/metabolismo , Método Doble Ciego , Evaluación de Medicamentos , Femenino , Fibrinógeno/análisis , Hemorragia/tratamiento farmacológico , Humanos , Fragmentos Fab de Inmunoglobulinas/uso terapéutico , Inmunoglobulina G/uso terapéutico , Incidencia , Masculino , Pepsina A/metabolismo , Resultado del Tratamiento
17.
Rev Med Chil ; 138(8): 1028-39, 2010 Aug.
Artículo en Español | MEDLINE | ID: mdl-21140063

RESUMEN

It is unknown why heart failure progresses even when patients are treated with the best therapy available. Evidences suggest that heart failure progression is due to loss of neurohumoral blockade in advanced stages of the disease and to alterations in myocardial metabolism induced, in part, by this neurohumoral activation. Alterations in cardiac energy metabolism, especially those related to substrate utilization and insulin resistance, reduce the efficiency of energy production, causing a heart energy reserve deficit. These events play a basic role in heart failure progression. Therefore, modulation of cardiac metabolism has arisen as a promissory therapy in the treatment of heart failure. This review describes myocardial energy metabolism, evaluates the role of impaired energy metabolism in heart failure progression and describes new therapies for heart failure involving metabolic intervention.


Asunto(s)
Progresión de la Enfermedad , Metabolismo Energético/fisiología , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Cardíaca/fisiopatología , Miocardio/metabolismo , Humanos
18.
Rev. méd. Chile ; 138(8): 1028-1039, ago. 2010. ilus
Artículo en Español | LILACS | ID: lil-567617

RESUMEN

It is unknown why heart failure progresses even when patients are treated with the best therapy available. Evidences suggest that heart failure progression is due to loss of neurohumoral blockade in advanced stages of the disease and to alterations in myocardial metabolism induced, in part, by this neurohumoral activation. Alterations in cardiac energy metabolism, especially those related to substrate utilization and insulin resistance, reduce the efficiency of energy production, causing a heart energy reserve deficit. These events play a basic role in heart failure progression. Therefore, modulation of cardiac metabolism has arisen as a promissory therapy in the treatment of heart failure. This review describes myocardial energy metabolism, evaluates the role of impaired energy metabolism in heart failure progression and describes new therapies for heart failure involving metabolic intervention.


Asunto(s)
Humanos , Progresión de la Enfermedad , Metabolismo Energético/fisiología , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Cardíaca/fisiopatología , Miocardio/metabolismo
19.
Rev. med. nucl. Alasbimn j ; 12(47)jan. 2010. ilus
Artículo en Español | LILACS | ID: lil-552970

RESUMEN

Introducción. Los sujetos dependientes de cocaína pueden presentar deterioro neurocognitivo y alteraciones conductuales con importantes implicancias sociales. En esos pacientes se han demostrado diversas anormalidades en la perfusión cerebral, especialmente en la corteza prefrontal. Esta región cortical está relacionada con funciones ejecutivas y con el control de impulsos. El Wisconsin Card Sorting Test (WCST) fue diseñado específicamente para activar la corteza prefrontal. Objetivo. En sujetos dependientes de cocaína, cuantificar cambios en la perfusion cerebral basal y post activación con WCST inducidos por la detoxificación. Método. Se estudió a 23 pacientes entre 24 y 49 años de edad (19 hombres) que cumplían criterios DSM-IV para dependencia de cocaína y con consumo reciente demostrado. En todos ellos se obtuvo SPECT de perfusión cerebral en condiciones de reposo al ingreso y tras 4 semanas de hospitalización con abstinencia controlada. En 19 sujetos se realizó además SPECT cerebral con activación usando WCST, al inicio y al final de la hospitalización. Para comparar estas cuatro condiciones se utilizó Statistical Parametric Mapping (SPM). Resultados. Al comparar la perfusión en condiciones de reposo inicial y al mes de abstinencia se observó mejoría significativa de múltiples áreas corticales especialmente en región parieto-occipital bilateral y corteza prefrontal izquierda.El análisis grupal no demostró activación de corteza prefrontal con WCST al ingreso a la terapia de detoxificación. Luego de 4 semanas de abstinencia estricta, se observó significativa activación post WCST de corteza prefrontal dorsolateral izquierda.Conclusiones. Un mes de abstinencia estricta de cocaína produce mejoría de la perfusión cerebral en pacientes dependientes. Post consumo reciente, no se demuestra activación a nivel prefrontal con el estímulo del WCST, la cual se observa luego de abstinencia, lo que indica mejoría neurocognitiva...


Introduction. Cocaine-dependent subjects might have socially disruptive behavior. Several regional cerebral blood flow (rCBF) abnormalities have been described in these patients, mainly in the prefrontal cortex, area related to executive functions and impulse control. Wisconsin Card Sorting Test (WCST) was specifically designed to activate this cortical area. Aim. To quantify rCBF and to assess prefrontal activation pre and post detoxification on cocaine-dependant subjects. Methods. We studied 23 patients who met DSM-IV criteria for cocaine dependency ranging from 24 - 49 years old (19 males), all with positive urine cocaine test. Baseline 99mTc-ECD brain perfusion SPECT was performed at admission and after 4 weeks of controlled in-hospital abstinence; in 19 patients SPECT was acquired also after WCST activation. Statistical Parametric Mapping (SPM) was used to compare SPECT studies on these 4 conditions. Results. rCBF of bilateral parieto-occipital area, left prefrontal cortex and multiple small cortical region improved after 4 weeks of cocaine detoxification. The group analysis did not show significant prefrontal cortex activation induced by WCST on admission. After 4 weeks of strict cocaine abstinence, WCST was able to induce left dorsolateral prefrontal cortex activation. Conclusions. A month of strict cocaine abstinence improved brain perfusion in dependant patients. After recent consumption, there was no prefrontal activation when using WCST, but this was observed after abstinence, supporting neurocognitive improvement. These findings may have clinical implications as potential predictors of therapy response.


Asunto(s)
Humanos , Masculino , Adulto , Femenino , Persona de Mediana Edad , Circulación Cerebrovascular/fisiología , Pruebas Neuropsicológicas , Síndrome de Abstinencia a Sustancias , Síndrome de Abstinencia a Sustancias/fisiopatología , Trastornos Relacionados con Cocaína , Trastornos Relacionados con Cocaína/fisiopatología , Corteza Prefrontal , Corteza Prefrontal/irrigación sanguínea , Tomografía Computarizada de Emisión de Fotón Único , Trastornos Relacionados con Cocaína/rehabilitación
20.
Rev. méd. Chile ; 137(11): 1457-1462, nov. 2009. tab, graf
Artículo en Español | LILACS | ID: lil-537008

RESUMEN

Background: Cardiac dyssynchrony is common in advanced heart failure (HF), but the changes in cardiac synchrony after myocardial infarction (MI) have not been adequately descríbed. Aim: To study the relationship between cardiac synchrony and left ventricular remodeling after acute myocardial infarction. Material and methods: Forty nine patients aged 59±10 years (77 percent men) with a first episode of a ST segment elevation MI, were studied. Scintigraphic left ventricular function and synchrony analyses were performed at baseline and after a six months follow-up. Determinations were compared with 33 healthy subjects. Results: At baseline, patients with MIhad a decreased left ventricular ejection fraction (LVEF) and significant dyssynchrony, when compared with controls. LVEF was 36.4 percent±10 percent, left ventricular end-diastolic volume (LVEDV) 127±38 mL, interventricular delay (IEV) 29±35 miliseconds (ms), and intraventricular delay (IAV), 234±89 ms. After 6 months, LVEF significantly improved (38 percent±10 percent, p =0.042) without significant changes in LVEDV (129±32 mL, p =0.97), IEV (24±17, p =0.96) or IAV (231±97, p =0.34). At baseline there were significant correlations between IAV and LVEF, and between IAV and LVEDV (r =0.48, p =0.001 and r =0.41, p =0.004, respectively). These correlations remained significant after 6 months. There was a positive correlation between IAV and LVEDV changes at six months (r =0.403, p =0.04). Conclusions: The development of cardiac dyssynchrony correlates with adverse left ventricular remodeling after MI.


Asunto(s)
Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/complicaciones , Disfunción Ventricular Izquierda/etiología , Remodelación Ventricular/fisiología , Métodos Epidemiológicos , Infarto del Miocardio/fisiopatología , Volumen Sistólico/fisiología , Disfunción Ventricular Izquierda/patología , Disfunción Ventricular Izquierda/fisiopatología , Disfunción Ventricular Izquierda
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