Prognostic factors and treatment outcomes for female urinary incontinence rehabilitation.

INTRODUCTION: Urinary incontinence (UI) is the involuntary loss of urine. It is highly prevalent in women and has a great biopsychosocial impact. Rehabilitation is established as the first-line treatment, although its use has not been protocolized. OBJECTIVE: To identify which personal risk factors and type of treatment applied are statistically related to patient improvement. STUDY DESIGN: Retrospective cohort study. METHODS: Retrospective cohort study of female patients diagnosed with urinary incontinence who attended the Pelvic Floor Rehabilitation Clinic of the Río Hortega University Hospital, receiving rehabilitation treatment during the year 2021. The minimum follow-up period was 12 weeks. The presence or absence of improvement was evaluated according to seven objective and subjective variables, and improvement was established as positive evolution in at least five of the seven variables. RESULTS: A total of 114 women with urinary incontinence were analyzed. The most frequent types of incontinence were stress (53%) and mixed (36%). The most important risk factors and associated pathology were episiotomy (68%), repeated urinary tract infections (61%), and constipation (40.9%). None of these factors showed a statistically significant relationship with patient improvement. The most used rehabilitative treatment was kinesitherapy+biofeedback (51%) which showed a statistically significant relationship with the improvement of these patients (P=.037) together with biofeedback+posterior tibial nerve electrostimulation (PTNS) (P=.044). CONCLUSION: Biofeedback combined with kinesitherapy or PTNS are established as the most effective rehabilitative procedures.

Specificity of serological test for detection of tuberculosis in cattle, goats, sheep and pigs under different epidemiological situations.

BACKGROUND: Serum antibody detection has potential as a complementary diagnostic tool in animal tuberculosis (TB) control, particularly in multi-host systems. The objective of the present study was to assess the specificity (Sp) of an enzyme-linked immunosorbent assay (ELISA) based on the new multiprotein complex P22 for the detection of specific antibodies against the Mycobacterium tuberculosis complex (MTC) in the four most relevant domestic animals acting as MTC hosts: cattle, goat, sheep and pig. We used sera from an officially TB-free (OTF) country, Norway, and from a non-OTF one, Spain. The samples included sera from goats that had been vaccinated against M. avium subsp. paratuberculosis (MAP) and sheep from a herd in which Corynebacterium pseudotuberculosis had been isolated. RESULTS: In cattle, the Sp ranged from 92.5 (IC95% 90.7-94) to 99.4% (IC95% 98.3-99.8) depending on the cut-off used and the origin of the samples (Spain or Norway). Sp in cattle (cut-off point 100) was significantly higher (P < 0.05) for Norwegian samples. By contrast, Sp in goats was consistently low at the 100 cut-off [30.9 (CI95%23.4-39.5)-78% (CI95% 68.9-85)]. A higher cut-off of 150 improved Sp in Norwegian goats [97% (CI95% 91.6-99)], but still yielded a poor Sp of 56.1% (CI95% 47.3-64.6) in Spanish goats. In Norway at the 100 cut-off the Sp was 58.3 (CI95% 42.2-72.9) and 90.6% (CI95% 81-95.6) in MAP vaccinated and non-vaccinated goats, respectively, indicating interference due to MAP vaccination. Sp in sheep was between 94.4 (CI95% 91.7-96.3) and 100% (CI95% 96.3-100) depending on the cut-off and country, and no diagnostic interference due to infection with C. pseudotuberculosis was recorded. Sp in pigs was 100%, regardless the cut-off point applied, and no significant differences were observed between pigs from Norway and from Spain. CONCLUSIONS: Due to its excellent Sp in pigs and acceptable Sp in cattle and sheep, this ELISA may constitute a suitable option for TB screening at herd level, particularly in OTF-countries.

Evaluation of the Mycobacterium tuberculosis SO2 vaccine using a natural tuberculosis infection model in goats.

The development of new vaccines against animal tuberculosis (TB) is a priority for improving the control and eradication of this disease, particularly in those species not subjected to compulsory eradication programmes. In this study, the protection conferred by the Mycobacterium tuberculosis SO2 experimental vaccine was evaluated using a natural infection model in goats. Twenty-six goats were distributed in three groups: (1) 10 goats served as a control group; (2) six goats were subcutaneously vaccinated with BCG; and (3) 10 goats were subcutaneously vaccinated with SO2. Four months after vaccination, all groups were merged with goats infected with Mycobacterium bovis or Mycobacterium caprae, and tested over a 40 week period using a tuberculin intradermal test and an interferon-γ assay for mycobacterial reactivity. The severity of lesions was determined at post-mortem examination and the bacterial load in tissues were evaluated by culture. The two vaccinated groups had significantly lower lesion and bacterial culture scores than the control group (P<0.05); at the end of the study, the SO2 vaccinated goats had the lowest lesion and culture scores. These results suggest that the SO2 vaccine provides some protection against TB infection acquired from natural exposure.

[Corticospinal dysfunction in patients with primary and amyotrophic lateral sclerosis]. / Disfunción corticoespinal en pacientes con esclerosis lateral primaria y amiotrófica.

INTRODUCTION: Corticoespinal dysfunction is a common finding in primary and amyotrophic lateral sclerosis (PLS and ALS). AIM. To compare the behaviour of motor evoked potentials (MEP) with transcranial magnetic stimulation (TMS) in patients with ALS and PLS. PATIENTS AND METHODS: It was performed a retrospective analysis of MEP recordings of 11 patients with PLS and 10 patients with sporadic ALS. Central motor conduction time and amplitude ratio were the selected variables for the statistical analysis of MEP from abductor pollicis brevis and tibialis anterior muscle from the four limbs, using non-parametric methods. RESULTS: As a general observation there was a high incidence of abnormal recordings in both groups of patients; in 30% of recording from ALS patients response to TMS was absent, but only the 4.5% in the group of PLS had the same characteristic. In PLS patients abnormal central motor conduction time was the most frequent finding, as it was the low amplitude ratio in ALS patients; both variables showed statistically significant differences between groups (Kruskall-Wallis, H = 6.32, p = 0.011; and Kruskall-Wallis, H = 5.777, p = 0.0163, respectively). CONCLUSION: Corticoespinal dysfunction has different characteristics in ALS and PLS patients, and the analysis of MEP could add useful information for differential diagnosis of these diseases.

Prediction of valproate serum concentrations in adult psychiatric patients using Bayesian model estimations with NPEM2 population pharmacokinetic parameters.

Valproate serum concentrations between 45 and 125 microg/mL are associated with the drug's efficacy in acute mania. Adaptive control dosing of valproate has not been fully studied in psychiatry. The objective of this study was to derive population pharmacokinetic (PK) parameters for valproate in healthy volunteers and to test the ability of these PK parameters to estimate concentrations in adult psychiatric patients using a Bayesian program. Population PK parameters for oral valproate were estimated from 18 PK studies in six healthy volunteers (1) using NPEM2. A Bayesian PK program using these population parameters was used to predict valproate concentration-time points in a second cohort of 21 adult psychiatry patients using 0, 1, or 2 prior concentrations. Estimated population parameters (mean +/- SD) were: Ka, 1.15+/-1.75/h; V, 0.14+/-0.042 L/Kg; and CL, 0.902+/-0.133 L/h. Bayesian valproate estimations using these parameters were negatively biased (underestimations) using zero prior concentration and unbiased using 1 or 2 prior concentrations. Mean error values (95% CI) in microg/mL for predictions using 0, 1, or 2 prior concentration-time points were -12.0 (-22.5, -1.5), -9.5 (-19.1, 0.1), and -2.5 (-11.1, 6.1), respectively, and mean absolute error values in microg/mL (95% CI) were 19.8 (12.6, 27.1), 16.3 (9.4, 23.3), and 10.1 (4.9, 15.2), respectively. Population parameters derived from healthy adult volunteers provided biased predictions of valproate concentrations in adult psychiatric patients. However, estimates using 1 or 2 valproate concentration time points predicted future concentrations that were precise and unbiased, given the wide therapeutic target range.

Parálisis diafragmática iatrogénica y persistencia de ducto arterioso en un hijo de madre diabética / Diaphragmatic paralysis iatrogenic and patent ductus arterioso in child of moter diabetica

Introducción. La parálisis diafragmática neonatal se ha asociado a las siguientes causas: traumatismos obstétricos, venodisección yugular interna, aplicación de la sonda torácica y a cirugía intratorácica. Caso clínico. Se presenta el caso de un neonato de 34 semanas de gestación, masculino, de 3,00 g, que al tercer día de vida extrauterina presentó neumotórax derecho, manejándose con sonda en el tórax, la que fue colocada inadecuadamente. Simultáneamente presentó persistencia del conducto arterioso (PAC) practicándose ligadura quirúrgica y posteriormente plicatura diafragmática derecha, al décimo día y décimo séptimo día de vida, respectivamente. Su evolución fue favorable y egresó al mes de edad. Conclusión. La parálisis diafragmática iatrogénica y la PCA son dos patologías que con frecuencia requieren manejo quirúrgico. En este caso coexistieron ambas entidades

Interference between Neisseria meningitidis and PC-KLH induced anti-phosphorylcholine PFC responses in NZB/W autoimmune mice.

In this work, we demonstrate that the simultaneous injection of PC-KLH and Neisseria meningitidis-derived antigens [NMB or PC-(NMB)HI] induced in old NZB/W mice defective responses as does PC-KLH challenge. On the other hand, the simultaneous injection of both immunogenic preparations of N. meningitidis evoked responses similar to those shown by old mice challenged with NMB alone. Alteration in PC-specific PFC responses also affected hapten-free inhibition profiles and their heterogeneities. The increase in PC50s of anti-phosphorylcholine PFC responses and their heterogeneities induced by certain antigens with aging is correlated with a decrease in T15 idiotype expression, suggesting that after the T15 dominant clone disappears no other clone takes control of the anti-PC response. These results suggest that the mechanism(s) involved in the regulation of T15 marker expression play an important role in the inability of old NZB/W mice to mount good anti-PC responses and suggest that regulatory mechanisms induced by PC-KLH dominate those elicited by NMB.

Efficacy of various non-oily adjuvants in immunization against the Aujeszky's disease (pseudorabies) virus.

Standard oil and various non-oily adjuvants were compared for use in immunization against the Aujeszky's disease (pseudorabies) virus, both in mice and swine, and using either inactivated virions or purified glycoproteins as antigen. Mineral oil, sodium alginate, aluminium hydroxide, and saponin were assayed in mice as adjuvants for inactivated virions, saponin being the most efficient. The addition of Mab anti-CD3 did not improve either immune response or protection achieved in mice using viral particles with oil or sodium alginate. When purified glycoproteins were used as antigens, the use of ISCOM greatly enhanced specific T-cell responses and protection of mice. The incorporation of Mab anti-CD3 into ISCOM conferred 100% protection of mice. Surprisingly, when an ISCOM containing glycoproteins was assayed in swine in a single-dose trial, no improvement on the protection conferred by the oily adjuvant was observed.

Comparison of the protective efficacy of Aujeszky's disease (pseudorabies) virus glycoproteins obtained from different sources.

The immunogenic properties of a series of glycoprotein preparations are compared using inactivated conventional vaccines as reference. Serological response and protective efficacy of vaccination of mice and pigs are evaluated for glycoprotein immunogens obtained from various sources. BHK-21 cell cultures were infected with Aujeszky's disease virus and used as antigenic source. Glycoproteins were obtained from (i) the whole culture (ii) the cell sediment and (iii) the clarified supernatant. Both in pigs and in mice, protection was greater with glycoproteins purified from infected-cell membranes than with viral mature particle glycoproteins. The specific profiles of humoral responses were basically identical regardless of the source of glycoprotein. Bartha strain, one of the gI- strains most commonly used as an attenuated vaccine, was also used as a glycoprotein source. Immunogens obtained from this strain were protective in challenge trials with the virulent E-974 strain of the Aujeszky's disease virus. Glycoproteins did not induce detectable delayed type hypersensitivity in mice but conferred greater protection than particulate antigens (which, conversely, did induce a detectable delayed type hypersensitivity reaction). Until the recent proposal of the potency criterion delta 7, no objective method was available to evaluate the degree of protection conferred by Aujeszky's disease vaccines. In this study, we thus used the protection index, a quantitative parameter designed to evaluate potency of vaccines against Aujeszky's disease virus.

Antigens involved in vaccination of swine against Aujeszky's disease (pseudorabies) virus.

The polypeptide and glycopolypeptide composition of a local virulent Aujeszky's disease virus (suid herpesvirus 1, SHV-1) strain (E-974) was determined in order to characterize the individual SHV-1 antigens inducing the serological responses in immunized and non-immunized animals. A commercially available inactivated vaccine of known efficacy and three experimental immunogen preparations (whole inactivated SHV-1 particles, lectin-purified glycoproteins from SHV-1 culture, and a combination of both) were used for immunization. Sera of two-month old immunized and non-immunized animals were analyzed by ELISA, seroneutralization and Western immunoblotting prior to and following challenge with E-974. Sera of 7- to 30-day-old piglets littered by immunized and non-immunized sows were likewise analyzed by immunoblotting. The following variables were determined: the total level of anti-SHV-1 antibodies, the level of neutralizing antibodies, the IgG responses to individual SHV-1 antigens, and the clinical parameters and degree of protection of the animals. The whole-particle experimental immunogen conferred greatest protection, but correlation between antibody levels and the degree of protection was imperfect. Serological responses seemed to be directed against certain structural polypeptides and viral envelope glycoproteins. The glycoprotein immunogen caused a selective response to bands which closely resemble the glycopolypeptides gII and gIII. A 71 kDa component of uncertain location within the viral structure appeared to be one of the main antigens involved in porcine serological response to SHV-1 and colostral protection of piglets.

Frecuencia de microcarcinomas en piezas de tiroidectomías / Frecuency of microcarcinoma in specimens of thyroidectomy

En el examen de 110 piezas quirúrgicas de tiroidectomías totales o parciales, se hallaron 8 carcinomas ocultos o microcarcinomas, según la definición de Sampson: "tumores tiroideos de 1,5cm o menos de diámetro, no sospechados clínicamente". Se hallaron más frecuentemente en tiroides que presentaron tiroiditís de Hashimoto asociada a adenoma folicular (2 casos) y en hiperplasias difusas ( 2 casos). El tamaño promedio fue de 4mm; 6 de los casos fueron de tipo papilar, los restantes de tipo folicular y medular, uno de cada uno. Dos casos fueron descubiertos después del diagnóstico de las metástasis ganglionares. Todos fueron pacientes de sexo femenino, cuyas edades variaron entre 19 y 56 años. No se encontraron diferencias histológicas significativas entre los casos con o sin metástasis. Se discuten los resultados comparándolos con las series de otros autores

Immunoresponses to Neisseria meningitidis epitopes: primary versus secondary antiphosphorylcholine responses.

Specific antiphosphorylcholine immune responses were found to be elicited by different Neisseria meningitidis group B M986 preparations. Our results suggest the functional presence of phosphorylcholine in the bacteria. The immune responses, mostly immunoglobulin M, were measured with a plaque-forming cell assay. The secondary phosphorylcholine-specific immune response induced by intact meningococci was significantly lower than the primary phosphorylcholine-specific immune response induced by the same antigens. This suppression is priming time dependent and does not represent an early switching to the expression of other classes of immunoglobulins.

Milk progesterone radioimmunoassay using radioiodinated tracers: a rapid and reliable assay system.

Both the validity and practicability of a direct progesterone radioimmunoassay based on radioiodinated progesterone tracers were studied. The results obtained show the reliability of the assay; when compared with assays based on 3H-progesterone tracers there are fewer steps for assay execution, saving time and reducing the number of reagents used. Various commercially available 125I-progesterone tracers were assayed, and only those with an 11 alpha-hemisuccinate bridge were suitably bound by antisera raised against progesterone-bovine serum albumin conjugates having identical bridge structure. The bridge effect caused no observable alteration in validity parameters. Finally, our results support the utility of this assay as a practical method of early diagnosis of pregnancy and as a reliable experimental technique to monitor cow ovarian function.

Effect of clofibrate on the growth-kinetics of the murine P 1798(sc) lymphoma.

Clofibrate (CPIB) is a drug applied as an antilipidaemic agent in mammals. In this work we have tested its efficacy in vivo on the growth kinetics of P 1798(sc) lymphoma transplanted to recipient (BALB/c x AKR)F1 mice. Our results show a facilitation of the tumour growth rate in treated recipients. This fact may be related to an effect of the agent on the recipient which produces a decrease in the immune response as was confirmed on testing CPIB on thymus-dependent antigens in haemolytic plaque assays.

[Analysis of the escape of tumor P1798(SC) from immunologic control in hybrid mice (Balb/c X AKR)F1 (BAF1)]. / Análisis del escape del tumor P1798(SC) al control inmunológico en ratones híbridos (Balb/c X AKR)F1 (BAF1).

Expression of tumoral antigens and their masking by sialic acids were studied. Tumour with greater content in sialic acid [P1798(sc)] can surpass the histocompatibility barrier. Furthermore, removal of sialic acid residues from membrane by neuramidase treatment results in a retarded or inhibited tumoral growth. These results suggest an antigenic masking by sialic acids. On the other hand, in the anti-P1798(sc) humoral response are involved two antigens, at least, also expressed by syngeneic hepatocytes and thymocytes, as demonstrated by cytotoxicity assays.