Crack cocaine inhalation increases seizure susceptibility by reducing acetylcholinesterase activity.

Crack cocaine is a highly addictive and potent stimulant drug. Animal studies have shown that the cholinergic system plays a role in neurotoxicity induced by cocaine or its active metabolites inhalation. Behavioral alterations associated with crack cocaine use include hyperactivity, depressed mood, and decreased seizure threshold. Here we evaluate the acetylcholinesterase (AChE) and reactive oxygen species (ROS) activity, behavioral profile, and the threshold for epileptic seizures in rats that received intrahippocampal pilocarpine (H-PILO) followed by exposure to crack cocaine (H-PILO + CRACK). Animals exposed to H-PILO + CRACK demonstrated increased severity and frequency of limbic seizures. The AChE activity was reduced in the groups exposed to crack cocaine alone (CRACK) and H-PILO + CRACK, whereas levels of ROS remained unchanged. In addition, crack cocaine exposure increased vertical locomotor activity, without changing water and sucrose intake. Short-term memory consolidation remained unchanged after H-PILO, H-PILO + CRACK, and CRACK administration. Overall, our data suggest that crack cocaine inhalation reduced the threshold for epileptic seizures in rats submitted to low doses of pilocarpine through the inhibition of AChE. Taken together, our findings can be useful in the development of effective strategies for preventing and treating the harmful effects of cocaine and crack cocaine on the central nervous system.

Factores genéticos y ambientales asociados al fenotipo longevo / Genetic and environmental factors associated with the longevity phenotype

Introducción: La prevalencia de la longevidad en la población abierta ha aumentado en los últimos cien años. Existen coincidencias en la literatura sobre la importancia de varios factores relacionados con el estilo de vida como elementos favorecedores de la longevidad. Objetivo: Demostrar la influencia de factores genéticos y ambientales en el fenotipo longevo. Métodos: Se estudiaron 178 individuos provenientes del municipio Santa Clara: 86 longevos de 80 años y más, y 92 no longevos (menores de 80 años). A todos se les aplicó un instrumento de recogida de información genealógica sobre antecedentes de longevidad y factores genéticos y ambientales favorecedores. Para los análisis de asociación se procedió a la confección de tablas de contingencia tetracóricas. Se evaluó la asociación mediante la prueba Ji cuadrado de Mantel-Haenszel, así como V de Cramer para medir la magnitud de asociación; cuando el nivel de significación fue p<0,05, se calculó la oportunidad relativa y el intervalo de confianza al 95 %. Resultados: Las asociaciones resultaron significativas para las siguientes variables: no hábito de fumar, no beber alcohol, tener índice de masa corporal normopeso, no padecer enfermedades respiratorias, tener madre longeva, y ser del sexo femenino. Las razones de ventajas más elevadas se alcanzaron en dos factores: no padecer de enfermedades respiratorias y no beber alcohol. La asociación más fuerte fue con la longevidad de la madre (V Cramer=0,234). Conclusiones: Los factores genéticos y ambientales que, de manera consistente, se asociaron a la longevidad, indicaron que en los individuos estudiados existen factores favorecedores de la longevidad.

Introduction: prevalence of longevity in open population has increased in the last hundred years. There are coincidences in the literature on the importance of various factors related to lifestyle as elements that favour longevity. Objective: to demonstrate the influence of genetic and environmental factors on the longevity phenotype. Methods: 178 individuals from Santa Clara municipality were studied: 86 longevous people aged 80 years and over and 92 non-longevous ones aged less than 80 years. An instrument for collecting genealogical information on longevity antecedents and favorable genetic and environmental factors was applied to all of them. Tetrachoric contingency tables were prepared for the association analysis. This association was evaluated using the Mantel-Haenszel chi-square test, as well as the Cramer's V test to measure the magnitude of association; an odds ratio and a 95% confidence interval were calculated when the significance level was p<0.05. Results: the associations were significant for the following variables: not-smoking and not-drinking alcohol, not suffering from respiratory diseases, having a normal weight body mass index and a longevous mother, as well as being female. The highest odds ratios were achieved in two factors: not suffering from respiratory diseases and not drinking alcohol. The strongest association was with maternal longevity (V Cramer=0.234). Conclusions: the genetic and environmental factors that were consistently associated with longevity indicated that there are factors that favour longevity in the studied individuals.

Evaluation of mutagenesis, necrosis and apoptosis induced by omeprazole in stomach cells of patients with gastritis.

BACKGROUND: Gastritis is a superficial and prevalent inflammatory lesion that is considered a public health concern once can cause gastric ulcers and gastric cancer, especially when associated with Helicobacter pylori infection. Proton pump inhibitors, such as omeprazole, are the most widely used drugs to treat this illness. The aim of the study was evaluate cytogenetic effects of omeprazole in stomach epithelial cells of patients with gastritis in presence and absence of H. pylori, through cytogenetic biomarkers and catalse and superoxide dismutase analysis. METHODS: The study included 152 patients from the Gastroenterology Outpatient Clinic of Hospital Getúlio Vargas, Teresina-Brazil, that reported continuous and prolonged omeprazole use in doses of 20, 30 and 40 mg/kg. The participants were divided into groups: (1) patients without gastritis (n = 32); (2) patients without gastritis but with OME use (n = 24); (3) patients with gastritis (n = 26); (4) patients with gastritis undergoing OME therapy (n = 26); (5) patients with gastritis and H. pylori (n = 22) and (6) patients with gastritis and H. pylori on OME therapy (n = 22). RESULTS: OME induced cytogenetic imbalance in the stomach epithelium through the formation of micronuclei (group 6 > 1, 2, 3, 4, 5; group 5 > 1, 2, 3; group 4 > 1, 2, 3); bridges (groups 4 and 6 > 1, 2, 3, 5 and group 2 > 3, 5); buds (groups 2,4,6 > , 1, 3, 5); binucleated cells (group 6 > 1, 2, 3, 4, 5; group 4 > 1, 2, 3); (groups 2 and 3 > 1); picnoses (group 6 > 1, 2, 3, 4, 5), groups 2 and 5 > 1, 3; group 4 > 1, 2, 3, 5); cariorrexis (groups 6 and 4 > 1, 2, 3, 5; groups 2, 3, 5 > 1) and karyolysis (groups 2, 4, and 6 > 1, 3, 5; groups 3 and 5 > 1). The OME cytogenetic instability was associated with H. pylori infection, indicating clastogenic/aneugenic effects, chromosomes alterations, gene expression changes, cytotoxicity and apoptosis. CONCLUSIONS: The cytogenetic changescan be attributed to several mechanisms that are still unclear, including oxidative damage, as observed by increased catalase and superoxide dismutase expresion. Positive correlations between antioxidant enzymes were found with micronuclei formation, and were negative for picnoses. Thus, the continuous and prolonged omeprazole use induces genetic instability, which can be monitored through cytogenetic analyzes, as precursor for gastric cancer.

Costus spiralis (Jacq.) Roscoe leaves fractions have potential to reduce effects of inflammatory diseases.

ETHNOPHARMACOLOGICAL RELEVANCE: Since drugs currently used to manage pain and inflammatory conditions present several side effects, the investigation of new anti-inflammatory and antinociceptive agents from folk-medicine plants is an important approach. Costus spiralis (Costaceae) has been used in Brazilian medicinal teas to treat urinary infection, cough, inflammation, arthritis, among others. AIM OF THE STUDY: The current study focused on investigating anti-inflammatory and antinociceptive effects of fractions from C. spiralis leaves using animal models. MATERIALS AND METHODS: Adults Swiss mice were used in the following experimental models: acetic acid-induced abdominal writhing, formalin-induced nociception, hot plate, zymosan-induced peritonitis, and arthritis induced by complete Freund's adjuvant. RESULTS: The presence of steroids was confirmed in all fractions. Flavonoids, condensed tannins and saponins were observed in EFL. In methanolic fraction leaves (MFL), the presence of flavonoids and pentacyclic triterpenoids was confirmed. Orally administered leaf fractions significantly reduced abdominal writhing. Fractions were ineffective in the neurogenic stage of the formalin test, but in the inflammatory stage, ethyl acetate fraction levaes (AcFL), ethanolic fraction leaves (EFL), and MFL significantly reduced paw licking time by 69.6 ± 11.9%, 58.2 ± 9.4%, and 79.6 ± 8.3%, respectively. In the hot plate test, the reaction latency was similar for treated animals and controls. However, in the peritonitis test, cell migration was significantly reduced in animals treated with chloroform fractions leaves ClFL (61.8 ± 11.4%), AcFL (58.7 ± 8.3%), EFL (39.2 ± 5.0%), and MFL (64.8 ± 4.4%). This was similar to the result observed in the chronic inflammation model, this time only the chloroform fraction was able to reduce paw edema. CONCLUSION: Our results show that leaf fractions of Costus spiralis are capable of modulating peripheral nociceptive and inflammatory responses without effects on central nervous system being potential substrates for phytochemical purification, structural and mechanistic studies.

Bacterial cellulase from the intestinal tract of the sugarcane borer.

Cellulolytic enzymes have wide use in several industrial segments (e.g. biofuels, pulp and paper, food, and cosmetics). However, one of the challenges is their large-scale production with high specific activity to eliminate the dependence of the purchase of enzymatic cocktails produced by commercial parties. The aims of this study were (1) isolation, selection, and partial characterization of bacterial cellulases present in the intestinal tract of the sugarcane borer and (2) to identify cellulase-producing bacteria by analyzing the 16S rDNA gene. Cellulase production and purification assays resulted in similar electrophoretic profiles between four bacterial strains. These strains were identified as Klebsiella pneumoniae, Klebsiella sp., and Bacillus sp. K. pneumoniae was the main cellulase-producing microorganism. Our results show the possibility of finding cellulolytic microorganisms that inhabit the gut of herbivorous animals, especially those that are predators of important crops of economic value. Furthermore, K. pneumoniae cellulase is of medical importance. In hospitals, health professionals, hospital technicians, patients and visitors wear clothes containing cellulose. Thus, K. pneumoniae within hospitals can contaminate these clothes and be spread to the environment. In that case, it would be important for the hospital's chemical sterilization products to have at least one cellulase inhibitor.

Pharmacological Effects and Toxicogenetic Impacts of Omeprazole: Genomic Instability and Cancer.

Omeprazole (OME) is commonly used to treat gastrointestinal disorders. However, long-term use of OME can increase the risk of gastric cancer. We aimed to characterize the pharmacological effects of OME and to correlate its adverse effects and toxicogenetic risks to the genomic instability mechanisms and cancer-based on database reports. Thus, a search (till Aug 2019) was made in the PubMed, Scopus, and ScienceDirect with relevant keywords. Based on the study objective, we included 80 clinical reports, forty-six in vitro, and 76 in vivo studies. While controversial, the findings suggest that long-term use of OME (5 to 40 mg/kg) can induce genomic instability. On the other hand, OME-mediated protective effects are well reported and related to proton pump blockade and anti-inflammatory activity through an increase in gastric flow, anti-inflammatory markers (COX-2 and interleukins) and antiapoptotic markers (caspases and BCL-2), glycoprotein expression, and neutrophil infiltration reduction. The reported adverse and toxic effects, especially in clinical studies, were atrophic gastritis, cobalamin deficiencies, homeostasis disorders, polyp development, hepatotoxicity, cytotoxicity, and genotoxicity. This study highlights that OME may induce genomic instability and increase the risk of certain types of cancer. Therefore, adequate precautions should be taken, especially in its long-term therapeutic strategies and self-medication practices.

The first instrument for complex PTSD assessment: psychometric properties of the ICD-11 Trauma Questionnaire

Objective: The ICD-11 Trauma Questionnaire (ITQ) was developed as a joint effort by researchers from several countries to evaluate post-traumatic stress (PTSD) and complex-PTSD (C-PTSD) symptoms. This study is part of a multi-center international collaborative research project that aims to provide psychometric support for this initial instrument in different languages, considering the specific contexts related to complex traumatization. This study verified the psychometric characteristics of the Portuguese version of the ITQ, evaluating symptoms beyond those described the existing literature. Methods: We examined the results of a convenience sample totaling 268 Portuguese and Angolan participants. Two instruments were applied: the ITQ, which evaluates symptoms resulting from a traumatic life event, and the Life Events Checklist (LEC), which evaluates stressful life events. The general characteristics of the scales are described, and reliability analysis and validity studies were performed. Results: Cronbach's alpha varied between 0.84 and 0.88, and the exploratory factorial analysis results were consistent with the concept of C-PTSD, with five components explaining 61.58% of scale variance. Conclusion: The results suggest good psychometric characteristics for the Portuguese version of the ITQ, and thus it can be included in protocols intended evaluating complex traumatic symptoms.

The first instrument for complex PTSD assessment: psychometric properties of the ICD-11 Trauma Questionnaire.

OBJECTIVE: The ICD-11 Trauma Questionnaire (ITQ) was developed as a joint effort by researchers from several countries to evaluate post-traumatic stress (PTSD) and complex-PTSD (C-PTSD) symptoms. This study is part of a multi-center international collaborative research project that aims to provide psychometric support for this initial instrument in different languages, considering the specific contexts related to complex traumatization. This study verified the psychometric characteristics of the Portuguese version of the ITQ, evaluating symptoms beyond those described the existing literature. METHODS: We examined the results of a convenience sample totaling 268 Portuguese and Angolan participants. Two instruments were applied: the ITQ, which evaluates symptoms resulting from a traumatic life event, and the Life Events Checklist (LEC), which evaluates stressful life events. The general characteristics of the scales are described, and reliability analysis and validity studies were performed. RESULTS: Cronbach's alpha varied between 0.84 and 0.88, and the exploratory factorial analysis results were consistent with the concept of C-PTSD, with five components explaining 61.58% of scale variance. CONCLUSION: The results suggest good psychometric characteristics for the Portuguese version of the ITQ, and thus it can be included in protocols intended evaluating complex traumatic symptoms.

Characterization and kinetic study of the brain and muscle acetylcholinesterase from Danio rerio.

Acetylcholinesterase (AChE) plays an important role in the therapy of Alzheimer's disease and in the detection of pesticides such as organophosphates which are also widely used in chemical warfare. The aim of this study is the physicochemical and kinetic characterization of brain and muscle ChE from Danio rerio (Zebrafish). Optimal activity was found for brain ChE at alkaline pH 9.0 at 30 °C, and for muscle ChE at alkaline pH 8.5 at temperatures between 20 °C and 35 °C. The apparent kinetic constants, Kmapp and Vmaxapp, for brain ChE were determined as 0.191 ±â€¯0.024 mM and 0.566 ±â€¯0.028 U/mg protein, and for muscle ChE as 0.230 ±â€¯0.030 mM and 0.677 ±â€¯0.039 U/mg protein. Both brain and muscle ChE showed inhibition at high substrate concentrations. Brain and muscle ChE showed IC50 values for physostigmine of 0.61 µM and 0.37 µM, respectively. The ChE activity in brain was significantly inhibited by BW254c51 in all concentrations tested, but not by Iso-OMPA, while muscle ChE presented a moderate decrease (13 to 29%) in the activity values, indicating that BuChE is present.

Indicators of oxidative stress in long-lived individuals belonging to the municipality of Santa Clara

Aim: To determine indicators of oxidative stress in long-lived individuals. Methods: 120 subjects were studied and two groups were formed: 50 individuals older than 85 years of nuclear families and 70 adults under 60 years old taken as a control group, all belonging to the municipality of Santa Clara. Indicators of antioxidant defense status included enzymatic activities superoxide dismutase (SOD) and catalase (CAT), as well as reduced glutathione (GSH) concentrations. The determinations were made with the use of spectrophotometric techniques, and the comparisons between the groups were made through the statistical program SPSS with a level of significance of 95 percent. Results: The activity of the antioxidant enzyme SOD and GSH levels showed significant differences when comparing both study groups. In the case of the SOD enzyme, the group of long-lived individuals showed a significant reduction in their activity compared to the controls, while GSH levels also decreased in this group. The CAT enzyme activity showed no significant differences between the two study groups. Conclusions: The decrease in enzymatic activity SOD accompanied by a decrease in GSH levels could be an indicator of a state of oxidative imbalance in individuals older than 85 years, which increases their susceptibility to the action of reactive oxygen species(AU)

A sample of non-nutritive sucking habits (pacifier and digit) in portuguese children and its relation with the molar classes of angle.

BACKGROUND: Little is known about the effect of non-nutritive sucking habits (pacifier and digital sucking) in the prevalence of molar Class in mixed dentition. The aim of this study was determinate the relation between non-nutritive sucking habits, and Angle´s molar Class, in the horizontal plane, and it´s relation with gender. A convenience sample of 326 children with ages between 6 and 12 years was selected from three schools of Oporto. MATERIAL AND METHODS: To collect the epidemiologic data, was used a method recommended by the WHO. An indirect questionnaire about the medical history, dental habits, was used. It was adapted from Sanchez-Molins and validated by Clinical Dental III of Integrated Dental University Institute Health Sciences, Gandra, Portugal. RESULTS: In this study, 326 infants were examined in order to determine the prevalence of non-nutritive sucking habits. Only 45 observed children did not mentioned any kind of non-nutritive sucking habit; the remaining 281 children mentioned at least one potential bad habit. Children with non-nutritive sucking habits show a higher molar Class II percentage in females, while molar Class III is more frequent among males compared with children with no sucking habits. CONCLUSIONS: Children with non-nutritive sucking habits, presented a higher-Class II prevalence with statistically significance. It was detected a direct relationship between Angle´s molar Class and gender. Key words:Finger sucking, pacifier sucking, Angle Class malocclusion.

Electrolytes-Enriched Hemodiafiltration Solutions for Continuous Renal Replacement Therapy in Acute Kidney Injury: A Crossover Study.

AIMS: To evaluate the capability of an electrolytes-enriched solution to prevent metabolic disorders during continuous veno-venous hemodiafiltration (CVVHDF). METHODS: Serum biochemistry and clinical tolerance were compared during CVVHDF treatments with an electrolyte-enriched (Phoxilium) or standard solutions in 10 acute renal failure patients. RESULTS: As compared to standard fluids, serum potassium and phosphate levels were maintained in the normal range with Phoxilium without any supplementation but total serum calcium levels were significantly lower. Bicarbonatemia was slightly higher (24-26 vs. 21.5-24.5 mmol/l, p < 0.05) with conventional solutions and was associated with a significant increased level of pH (>7.44). Despite the absence of glucose in the Phoxilium solution, blood glucose levels and glucose supplementation were similar between treatments. Clinical tolerance and efficiency of CVVHDF sessions were comparable. CONCLUSION: Phoxilium effectively prevented hypophosphatemia and hypokalemia during CVVHDF. It was, however, associated with a slight metabolic acidosis and hypocalcemia compared with conventional solutions.

Angiotensin processing activities in the venom of Thalassophryne nattereri.

The venom of marine animals is a rich source of compounds with remarkable functional specificity and diversity. Thalassophryne nattereri is a small venomous fish inhabiting the northern and northeastern coast of Brazil, and represents a relatively frequent cause of injuries. Its venom causes severe inflammatory response followed frequently by the necrosis of the affected area. This venom presents characterized components such as proteases (Natterins 1-4) and a lectin (Nattectin) with complex effects on the human organism. A specific inhibitor of tissue kallikrein (TKI) reduces the nociception and the edema caused by the venom in mice. Our study sought to investigate the proteolytic activities against vasopeptides Angiotensin I, Angiotensin II, Angiotensin 1-9 and Bradykinin. The venom indicated angiotensin conversion against angiotensin I, as well as kininase against bradykinin. Captopril conducted the total inhibition of the converting activity, featuring the first report of ACE activity in fish venoms.

Plasma brain natriuretic peptide and troponin levels in severe sepsis and septic shock: relationships with systolic myocardial dysfunction and intensive care unit mortality.

The aim of this study was to evaluate and compare brain natriuretic peptide (BNP) and cardiac troponin I (cTnI) levels as mortality prognosticator and predictor for myocardial dysfunction in severe sepsis and septic shock. Baseline clinical and biological variables were collected from 47 patients with severe sepsis or septic shock. Ventricular systolic function assessed by echocardiography was measured over a 5-day period. Both cTnI and BNP plasmatic levels were determined at intensive care unit (ICU) admission and during the following 15 days. At admission, cTnI and BNP levels were compared to those of 12 control critically ill nonseptic patients. The plasma levels of BNP and cTnI in patients with sepsis were elevated at admission and significantly higher than in the controls. Among patients with sepsis, BNP levels were significantly more elevated in nonsurvivors compared to survivors at admission and 1 day later. The cTnI levels were also significantly more elevated in nonsurvivors compared to survivors, but only at admission. From admission to day 5, patients with sepsis with left ventricular systolic dysfunction had higher BNP plasmatic concentrations than those without; differences were significant at days 3 and 4. In contrast, plasma cTnI levels were similar between the 2 groups. In critically ill patients, sepsis induces significant increase in BNP and cTnI levels. High BNP and cTnI plasma levels during ICU admission appear to be associated with poor outcome of sepsis. Time course of BNP levels seems helpful to discriminate between surviving and nonsurviving patients with sepsis and to detect myocardial dysfunction where troponin levels fail to do so.

Severe Measles Infection: The Spectrum of Disease in 36 Critically Ill Adult Patients.

France has recently witnessed a nationwide outbreak of measles. Data on severe forms of measles in adults are lacking. We sought to describe the epidemiologic, clinical, treatment, and prognostic aspects of the disease in adult patients who required admission to an intensive care unit (ICU). We performed a retrospective analysis of a cohort of 36 adults admitted to a total of 64 ICUs throughout France for complications of measles from January 1, 2009, to December 31, 2011. All cases of measles were confirmed by serologic testing and/or reverse transcription polymerase chain reaction.The cohort consisted of 21 male and 15 female patients, with a median age of 29.2 years (25th-75th interquartile range [IQR], 27.2-34.2 yr) and a median Simplified Acute Physiology Score (SAPS II) of 13 (IQR, 9-18). Among the 26 patients whose measles vaccination status was documented, none had received 2 injections. One patient had developed measles during childhood. Underlying comorbid conditions included chronic respiratory disease in 9 patients, immunosuppression in 7 patients, and obesity in 3 patients, while measles affected 5 pregnant women.Respiratory complications induced by measles infection led to ICU admission in 32 cases, and measles-related neurologic complications led to ICU admission in 2 cases. Two patients were admitted due to concurrent respiratory and neurologic complications.Bacterial superinfection of measles-related airway infection was suspected in 28 patients and was documented in 8. Four cases of community-acquired pneumonia, 6 cases of ventilator-associated pneumonia, 1 case of tracheobronchitis, and 2 cases of sinusitis were microbiologically substantiated.Of 11 patients who required mechanical ventilation, 9 developed acute respiratory distress syndrome (ARDS). Among the patients with ARDS, extraalveolar air leak complications occurred in 4 cases. Five patients died, all of whom were severely immunocompromised.On follow-up, 1 patient had severe chronic respiratory failure related to lung fibrosis, and 2 patients had mild lower limb paraparesis along with bladder dysfunction, both of which were ascribable to measles-induced encephalitis and myelitis. Among the 5 pregnant patients, the course of measles infection was uneventful, albeit 1 patient underwent emergent cesarean delivery because of fetal growth restriction.Measles is a disease with protean and potentially deceptive clinical manifestations, especially in the immunocompromised patient. Measles-associated pneumonitis and its complications, and less commonly postinfectious encephalomyelitis, are the main source of morbidity and mortality. In contrast with the usually benign course of the disease in immunocompetent patients, measles occurring in immunocompromised patients gives rise to lethal complications including ARDS, with or without bacterial superinfection. Other patients potentially at high risk for severe measles are young adults and pregnant women. Measles pneumonitis may predispose to air leak disease in patients using mechanical ventilation. To date, vaccination remains the most potent tool to control measles infection.

Large litters rearing changes brain expression of GLUT3 and acetylcholinesterase activity in adult rats.

Effects of malnutrition in the brain are more pronounced during the period of growth spurt, corresponding to the suckling in rodents. Neuronal glucose transporter GLUT3 expression and acetylcholinesterase activity were studied in the brain of adult young rats (84 days old) suckled in litters formed by 6 (control group) or 12 pups (malnourished group). In the adult rats, brain weight, blood glucose levels and GLUT3 expression were decreased in malnourished group (5%, 18%, 58%, respectively, P<0.001, Student's t test) compared to the control. Increased activity of acetylcholinesterase was found in cerebral cortex homogenates and a significant interaction (P=0.019, ANOVA two-way, Tukey's test) was found between nutritional state and homogenate fraction. In summary, malnutrition during suckling period decreased GLUT3 expression and increased acetylcholinesterase activity in the rat brain that could contribute to possible cognitive deficits and changes of brain metabolic activity.

Implementing on-line hemodiafiltration as a renal replacement therapy for ICU acute renal failure: a single-center report of feasibility, safety and hemodynamic tolerance over a seven-year period.

BACKGROUND/AIMS: On-line hemodiafiltration (HDF) is not yet routinely used in ICUs given the potential risk of microbial contamination of dialysis fluids. We evaluated the safety and the tolerance of its use in our ICU. METHODS: A weekly measurement of bacterial growth (CFU/ml) and endotoxin level (endotoxin units/ml) was performed in dialysis fluids over a 7-year period. Intradialytic hypotensive events and pyrogenic reactions were collected during 466 on-line HDF sessions. RESULTS: A bacterial count <0.1 CFU/ml was achieved in 977/978, 288/290, and 278/280, and an endotoxin level <0.03 endotoxin units/ml in 564/576, 330/337 and 318/323 ultrapure water, dialysate, and infusate samples, respectively. Seventy-six intradialytic hypotensive events but no pyrogenic reaction occurred. CONCLUSION: The great majority of dialysis fluid samples were considered suitable with a 99% compliance rate. Use of on-line HDF, at a large scale of dialysate and infusate flows, is well tolerated and may be safely performed in critically ill.

Epidemiología genética en una muestra de gemelos con cáncer en Santa Clara / Genetic epidemiology in a sample of twins with cancer in Santa Clara

Objetivo: Se realizó un estudio para investigar la participación genética en el origen del cáncer y encontrar la concordancia para esta enfermedad en gemelos. Métodos: Se efectuó un estudio analítico transversal en el año 2009, y el universo se obtuvo del Registro Cubano de Gemelos en Santa Clara, constituido por 17 parejas, de las que al menos uno de los miembros estaba afectado por cáncer; se integró una muestra de 12 parejas de gemelos, las cuales tenían al menos un miembro del par actualmente vivo. Se calculó la concordancia para el par y para el caso índice, y se realizó el estimado de la heredabilidad. Se consideró como factor de riesgo la presencia de antecedentes familiares en parientes de primer grado, y cuando se comprobó riesgo, se interpretó que la probabilidad de enfermar el cogemelo monocigótico, cuando tenía antecedentes familiares, era mayor que la del dicigótico. En otro análisis, con los pares de gemelos (concordantes y discordantes), se interpretó que la presencia de familiares de primer grado afectados constituye un riesgo para que el cogemelo sea concordante. Resultados: Las concordancias para el par y para el caso índice fueron mayores en los gemelos monocigóticos. El componente genético medido por la heredabilidad fue de 16 por ciento, lo que no resultó muy elevado, y debe interpretarse con cautela. El riesgo de enfermar un cogemelo monocigótico fue de 33,3 pior ciento y el dicigótico de 25 por ciento Conclusiones: Los estudios en gemelos constituyen una vía para dilucidar el componente genético del cáncer, y las concordancias más elevadas en parejas monocigóticas atestiguaron el interés de su contribución.

Objectives: A study was carried out in order to investigate the genetic participation in the origin ofcancer, as well as, to find the concordance for this disease in twins. Methods: A transversalanalytic study was made in 2009, Santa Clara, and the universe was obtained from the CubanRegister of Twins, it was constituted by 17 couples, in which at least, one of the members wasaffected due to cancer; a sample of 12 couples of twins was integrated, considering that they had atleast, one member of the pair currently alive. Concordance for the pair and the index case wascalculated; and the estimated of heritability was performed. It was considered as a risk factor thepresence of family antecedents in first- grade relatives, and when it was proved that existed somerisk, it was interpreted that the probability of making sick the monozygotic co- twin when they hadsome family antecedents, is higher than making sick the dizygotic one. In another analysis, withpairs of twins (concordants and disconcordants), it was interpreted that the presence of first-graderelatives affected, constitutes a risk for the co- twin being concordant. Results: Concordances forthe pair and the index case were higher in monozygotic twins. The measured genetic component forthe heritability was the 16 %, which didn't mean very high, but must be interpreted with precaution.The risk of making sick a monozygotic co-twin was the 33, 3 % and a dizygotic one was the 25 %.Conclusions: The studies of twins constituted a way for clearing up the genetic component ofcancer, and the most elevated concordances in monozygotic couples confirmed the interest of itscontribution.