Multiple red blood cell transfusions and iron overload in very low birthweight infants.

BACKGROUND AND OBJECTIVES: To estimate the risk of iron overload in very low birthweight (VLBW) infants who receive more than two red blood cell (RBC) transfusions, in comparison with those who receive two or less during their hospital stay. MATERIALS AND METHODS: Prospective open cohort study in VLBW infants with >2 (exposed) and ≤2 (non-exposed) RBC transfusions. Ferritin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured at birth and after each RBC transfusion. The incidence of iron overload was determined. Risk factors were analysed using a logistic regression model. RBC transfusion volume correlations with ferritin, ALT and AST were calculated with Spearman's rank correlation coefficient, as well as correlations between ferritin and aminotransferases. RESULTS: A total of 63 patients were enrolled, 18 of which were exposed and 45 non-exposed. Twelve patients developed severe iron overload, eight exposed (44·5%) vs. four (8·8%) non-exposed (RR: 5, 95% CI: 1·7-14·6). Multivariate analysis showed that the number of transfusions increased the risk of iron overload (OR: 2·07, 95% CI: 1·36-2·14) while a higher one-minute Apgar score was associated with a lower risk (OR: 0·56, 95% CI: 0·32-0·99). Severe iron overload mainly occurred with a transfusion volume higher than 120 ml/kg. There was a positive correlation between ferritin and transfusion (r = 0·53; P < 0·001). CONCLUSION: There was a higher risk of iron overload in exposed infants in comparison with non-exposed infants. Severe iron overload in VLBW infants may occur with a total transfusion volume >120 ml/kg.

Phosphodiesterase-7 inhibition affects accumbal and hypothalamic thyrotropin-releasing hormone expression, feeding and anxiety behavior of rats.

Thyrotropin-releasing hormone (TRH) has anorexigenic and anxiolytic functions when injected intraventricularly. Nucleus accumbens (NAcc) is a possible brain region involved, since it expresses proTRH. TRH from hypothalamic paraventricular nucleus (PVN) has a food intake-regulating role. TRHergic pathways of NAcc and PVN are implicated in anxiety and feeding. Both behaviors depend on cAMP and phosphorylated-cAMP response element binding protein (pCREB) intracellular levels. Intracellular levels of cAMP are controlled by the degrading activity of phosphodiesterases (PDEs). Since TRH transcription is activated by pCREB, a specific inhibitor of PDE7B may regulate TRH-induced effects on anxiety and feeding. We evaluated the effectiveness of an intra-accumbal and intraperitoneal (i.p.) administration of a PDE7 inhibitor (BRL-50481) on rats' anxiety-like behavior and food intake; also on TRH mRNA and protein expression in NAcc and PVN to define its mediating role on the PDE7 inhibitor-induced behavioral changes. Accumbal injection of 4µg/0.3µL of PDE7 inhibitor decreased rats' anxiety. The i.p. injection of 0.2mg/kg of the inhibitor was able to increase the PVN TRH mRNA expression and to decrease feeding but did not change animals' anxiety levels; in contrast, 2mg/kg b.w inhibitor enhanced accumbal TRH mRNA, induced anxiolysis with no change in food intake. PDE7 inhibitor induced anxiolytic and anorexigenic like behavior depending on the dose used. Results supported hypothalamic TRH mediated feeding-reduction effects, and accumbal TRH mediation of inhibitor-induced anxiolysis. Thus, an i.p dose of this inhibitor might be reducing anxiety with no change in feeding, which could be useful for obese patients.

Role of the catechol group in the antioxidant and neuroprotective effects of virgin olive oil components in rat brain.

The aim of the present study was to determine the role of the catechol group in the antioxidant and neuroprotective effects of minor components of virgin olive oil in rat brain tissue. Hydroxytyrosol ethyl ether (HT, 2 OH), tyrosol ethyl ether (Ty, 1 OH) and 3,4-di-ortho-methylidene-hydroxytyrosol ethyl ether (MET, no OH) were compared. Oxidative stress was induced with ferrous salts (lipid peroxidation induction), diethylmaleate (depletion of glutathione) and hypoxia-reoxygenation in brain slices. Lipid peroxidation was inhibited in direct proportion to the number of OH groups: HT>Ty>MET. Exposure to HT led to partial recovery of the glutathione system after chemical inhibition or hypoxia-reoxygenation. All three compounds inhibited cell death in hypoxia-reoxygenation experiments (HT≥Ty>MET). Peroxynitrite formation (3-nitrotyrosine) and inflammatory mediators (prostaglandin E2 and interleukin 1ß) were inhibited by all three compounds. In conclusion, the presence of OH groups in the molecule of these phenolic compounds from virgin olive oil is a determinant factor in their antioxidant effect in brain tissue, but this antioxidant effect is not the only explanation for their neuroprotective effect.

Tuning glycosidase inhibition through aglycone interactions: pharmacological chaperones for Fabry disease and GM1 gangliosidosis.

Competitive inhibitors of either α-galactosidase (α-Gal) or ß-galactosidase (ß-Gal) with high affinity and selectivity have been accessed by exploiting aglycone interactions with conformationally locked sp(2)-iminosugars. Selected compounds were profiled as potent pharmacological chaperones for mutant lysosomal α- and ß-Gal associated with Fabry disease and GM(1) gangliosidosis.

[CASERIA program (Healthy Habits in Primary School Questionnaire). Responses of 6 to 10 year-old children]. / Programa CASERIA (Cuestionario hábitos Saludables en Primaria). Respuestas de escolares de 6 a 10 años de edad.

UNLABELLED: In schoolchildren examinations, carried out periodically, we detect a continuous increase in obesity and sedentarism in our schoolchildren. In this study we attempt to compare, with objective data, the real situation of the childhood population in our area, as regards their eating habits, physical activity and hygiene. MATERIAL AND METHODS: Questionnaires on eating habits, preferences as regards diet, doing exercise, and dental hygiene, were handed out to 430 schoolchildren between 6 and 10 years-old. A total of 366 were valid for the study. RESULTS: The majority (85.8%) of those surveyed lived within a "traditional" family; 22% had family members who were overweight; 96.7% had breakfast before going to school, with milk products being the most consumed; the cake and pastry industry was well used, both at breakfast (7.4%) and at playtime (16.9%). The favourite food was pasta in 29.8% of cases, followed by potatoes, particularly fried (10.4%). The least liked foods were vegetables (26.2%) and fish (8.2%). Television was watched for more than 2 hours by 70%; 34% exceeded 2 hours or more per day playing with video consoles or similar. On the other hand, homework and studying took up more than 2 hours daily for 50% of pupils. A majority (55%) of those surveyed ate sweets 2 or more time a day, and to eat and watch television at the same time was an almost constant habit in more than 60%. Of the participants in the study, 9.29% never brushed their teeth. CONCLUSIONS: The theoretical knowledge of what should be a correct diet seems adequate, but its putting into practice is not. The population studies had fairly sedentary habits, with little fruit and they did not like pulses or vegetables or fish. All these factors decrease the cardiovascular protection associated with its practice and consumption. We have shown that they are already present since childhood in our population, which without a doubt will have repercussions in their future health status and well-being, if it is not changed.

Potential application of Northern Argentine propolis to control some phytopathogenic bacteria.

The antimicrobial activity of samples of Northern Argentine propolis (Tucumán, Santiago del Estero and Chaco) against phytopathogenic bacteria was assessed and the most active samples were identified. Minimal inhibitory concentration (MIC) values were determined by agar macrodilution and broth microdilution assays. Strong antibacterial activity was detected against Erwinia carotovora spp carotovora CECT 225, Pseudomonas syringae pvar tomato CECT 126, Pseudomonas corrugata CECT 124 and Xanthomonas campestris pvar vesicatoria CECT 792. The most active propolis extract (Tucumán, T1) was selected to bioguide isolation and identified for antimicrobial compound (2',4'-dihydroxychalcone). The antibacterial chalcone was more active than the propolis ethanolic extract (MIC values of 0.5-1 µg ml(-1) and 9.5-15 µg ml(-1), respectively). Phytotoxicity assays were realized and the propolis extracts did not retard germination of lettuce seeds or the growth of onion roots. Propolis solutions applied as sprays on tomato fruits infected with P. syringae reduced the severity of disease. Application of the Argentine propolis extracts diluted with water may be promising for the management of post harvest diseases of fruits.

Differences in the in vitro antiplatelet effect of dexibuprofen, ibuprofen, and flurbiprofen in human blood.

BACKGROUND: In this study, we compared the in vitro pharmacodynamic profile of dexibuprofen, ibuprofen, and flurbiprofen to identify possible differences in antiplatelet activity. METHODS: In whole blood samples from healthy volunteers, we measured platelet aggregation induced by adenosine diphosphate, collagen and arachidonic acid, platelet thromboxane B(2) (TxB(2)), lipopolysaccharide-induced prostaglandin E(2), leukocyte 6-keto-prostaglandin F(1α) (PGF(1α)), and nitric oxide induced by both constitutive and inducible pathways before and after incubation with increasing concentrations of acetylsalicylic acid, dexibuprofen, ibuprofen, or flurbiprofen. The concentration that inhibited (IC(50)) or increased each variable by 50% was calculated. RESULTS: All 3 drugs inhibited platelet aggregation in a dose-dependent manner, TxB(2), prostaglandin E(2), and 6-keto-PGF(1α), and increased calcium-induced nitric oxide production. Dexibuprofen showed greater antiplatelet potency than ibuprofen and flurbiprofen, and its profile was similar to that of aspirin. For example, IC(50) values for arachidonic acid-induced platelet aggregation were 0.85 ± 0.06 µM for dexibuprofen, 14.76 ± 1.22 µM for ibuprofen, 6.39 ± 0.51 µM for flurbiprofen, and 0.38 ± 0.03 µM for aspirin. All drugs inhibited both thromboxane and prostacyclin synthesis, but the IC(50) anti-TxB(2)/IC(50) anti-6-keto-PGF(1α) ratio was 0.21 ± 0.03 for dexibuprofen, 1.05 ± 0.08 for ibuprofen, 0.79 ± 0.11 for flurbiprofen, and 0.46 ± 0.06 for aspirin. All drugs increased calcium-dependent nitric oxide production. CONCLUSIONS: The aryl propionic acid derivative dexibuprofen was the most potent antiplatelet drug, and its pharmacodynamic profile is similar to aspirin.

[Protocolized cognitive-behavioural group therapy for inflammatory bowel disease]. / Tratamiento cognitivo-conductual protocolizado en grupo de las enfermedades inflamatorias intestinales.

INTRODUCTION: patients affected by inflammatory bowel disease have a high rate of psychiatric disorders such as depression and anxiety. OBJECTIVE: the main goal of this study was to design, to put into practice, and to validate a protocolized psychological treatment program based on the coping model, and a psycho-educational methodology in which the following intervention modules were included- illness information, coping model, problem solving techniques, relaxation, social skill training, distraction, and cognitive restructuring techniques. All these techniques were adapted to the characteristic features of inflammatory bowel disease. METHOD: the sample included 57 patients with inflammatory bowel disease from the Spanish Crohn s Disease and Ulcerative Colitis Association. The sample was randomly assigned to one of the two experimental groups -33 were assigned to the treatment group, and 24 were assigned to the waiting list control group. RESULTS: the results reflected a significant clinical and statistical improvement in anxiety (p < 0.001) and depression (p < 0.001) variables when compared to the waiting list control group. Likewise, improvement was sustained at 3, 6, and 12 months during follow-up. CONCLUSION: the protocolized psychological treatment program, administered in group sessions, is effective in reducing emotional symptoms arising as a result of inflammatory bowel disease.

Some chemical composition and biological activity of northern Argentine propolis.

Twenty-five samples of propolis were collected from seven different regions in northern Argentina; ethanolic extracts of propolis were prepared from all samples, and the respective samples were examined for UV absorption spectra, RPHPTLC, RPHPLC, antimicrobial activity, antiradical activity, and total phenolic content. It was found that 16 of the 25 samples showed a phenolic profile similar to that found in samples from southern Brazil and corresponding to poplar-based propolis and that the rest of the samples showed a different profile and higher antimicrobial and antiradical activities.

Perineal transsphincteric derivation of urine. Experimental study in rabbits.

AIM OF THE STUDY: We present the experimental results of a new technique that makes use of the anal sphincter to achieve urinary continence in individuals with major congenital defects of the urinary sphincter. METHODS: 50 New Zealand White rabbits were assigned to one of 6 groups and a different surgical procedure was carried out for each group under general anaesthesia with isoflurane alone or isoflurane and local anaesthesia. Variables of interest were: number, consistency and morphology of the faeces, number, shape and location of the stains of urine, histological changes and biochemical parameters in blood. RESULTS AND CONCLUSIONS: The best anaesthetic levels were obtained with 2 % isoflurane and local anaesthesia. The surgical procedure demonstrated its usefulness in achieving urinary continence in all rabbits, although an initial self-limited period of incontinence was common. No histologic alterations were detected, but a significant increase in the levels of urea and creatinine in blood was identified, most likely reflecting an obstructive uropathy.

Synthesis and evaluation of calystegine B2 analogues as glycosidase inhibitors.

A practical synthesis of polyhydroxylated 6-oxa-nor-tropanes incorporating the essential structural features of calystegine B(2) from 5-deoxy-5-thioureido and 5-ureido-L-idofuranose precursors is presented. The methodology relies on the ability of pseudoamide-type nitrogen atoms (thiourea, urea, and carbamate) to undergo nucleophilic addition to the masked aldehyde group of the monosaccharide. The generated hemiaminal functionality may further undergo in situ intramolecular glycosidation to give the bicyclic aminoacetal compounds, the whole process being favored by the anomeric effect. A series of derivatives bearing different substituents at nitrogen has been prepared and screened against several glycosidases in comparison with xylonojirimycin-type piperidine analogues. Interestingly, strong and highly specific inhibition of bovine liver beta-glucosidase was observed for 6-oxacalystegine B(2) analogues incorporating aromatic pseudoaglyconic groups. On the basis of these data, a 1-azasugar inhibition mode is proposed for this family of glycomimetics.

Antioxidant activity of Argentine propolis extracts.

Propolis is used in Argentine folk medicine. We have examined its possible protective action against oxidative modification of lipid in unfractionated serum. The kinetics of copper-induced oxidation was continuously monitored by measuring the formation of conjugated dienes, as the increase in the absorbance at 234 nm. According to the kinetics of oxidation, the propolis were classified in three different groups. Group I (CE, CO, BO, MO, BE) inhibited lipid oxidation during the initiation and propagation phases even at low concentrations. Group II (SP, CA, AM) increased the lag-phase for conjugated diene formation. All propolis in groups I and II diminished the maximal rate of diene production and the maximal amount of dienes produced. Group III (PA, RA, FE, VR, TV) had no effect on the lipid oxidation. The extent of lipoprotein oxidation was measured by the thiobarbituric acid reactive substance assay. Generation of malondialdehyde-like substances was inhibited and delayed by the presence of propolis extracts from group I and II. Our results justify the use of propolis (groups I and II) as a source of natural antioxidants.

Comparison of the free radical-scavenging activity of propolis from several regions of Argentina.

Propolis is extensively used in Argentine folk medicine. Alcoholic extracts of propolis from different regions of Argentina were prepared. The extracts were analysed for the determination of total flavonoid content (from 13.3 to 42.6 mg/g of propolis) by using the aluminum nitrate method, UV spectrophotometry and thin layer chromatography. All of them contained high total flavonoid content. It was also observed that all samples of ethanolic extracts of propolis showed free radical-scavenging activity in terms of scavenging of the radical DPPH but the highest activities were found for samples from Tucumán and Santiago del Estero. In all cases with 20 microg/ml of soluble principles, the percentage of DPPH degradation was different (Banda Oeste: 67.5%; Verónica: 45%; Forres: 35%; Saenz Peña: 20% and Juan José Castelli: 55%). These results may justify their use as a source of natural antioxidants.

Generalized anomeric effect in action: synthesis and evaluation of stable reducing indolizidine glycomimetics as glycosidase inhibitors.

A series of aminoketalic castanospermine analogues incorporating a stereoelectronically anchored axial hydroxy group at the pseudoanomeric stereocenter (C-5) have been synthesized to satisfy the need for glucosidase inhibitors that are highly selective for alpha-glucosidases. The polyhydroxylated bicyclic system was built from readily available hexofuranose derivatives through a synthetic scheme that involved (i) the construction of a five-membered cyclic (thio)carbamate or (thio)urea moiety at the nonreducing end and (ii) the intramolecular nucleophilic addition of the heterocyclic thiocarbamic nitrogen atom to the masked aldehyde group of the monosaccharide. A biological screening of the resulting reducing 2-oxa- and 2-azaindolizidines against several glycosidase enzymes is reported.

Screening of antibacterial activity of Amaicha del Valle (Tucumán, Argentina) propolis.

Propolis is extensively used in Argentine folk medicine. Alcoholic extracts of propolis from four localities of Amaicha del Valle (El Paraiso, La Banda Este, La Banda Oeste and El Molino), Province of Tucumán and from Cerrillos, Province of Santiago del Estero, Argentina were prepared. All showed antibacterial activity against Gram positive bacteria, the propolis from La Banda Este being the most active (MIC = 7.8 microg/ml) against Streptococcus piogenes, an antibiotic resistant bacterium. Thin layer chromatographic (TLC) separation profiles of propolis from Amaicha del Valle region were similar but differ from the alcoholic extract of the propolis from Cerrillos, another phytogeographical region of Argentina (provincia chaqueña). Bioautographic assays of the TLC profiles showed that several separated compounds of the Amaicha del Valle propolis have antibacterial activity. The difference in composition between Amaicha del Valle and Cerrillos propolis coincides with a different phytogeographical formation.

[Mycetomas caused by Microsporum canis. Report of one case]. / Micetomas por Microsporum canis. Caso clínico.

We report an eight years old boy presenting with a pyogenic granuloma of the scalp, generalized alopecia, descamative plates in the neck, trunk and limbs and nail involvement. Cultures for fungus of all these lesions disclosed Microspore canis. The patient was treated with oral griseofulvin, miconazole and topical tolnaftate. Five years later and after several incomplete treatments, the patient returns with a fistulous mass of 15 x 8 cm in the dorsal area whose culture revealed Microspore canis. The mass was excised and oral ketoconazole was indicated. After three months of follow up, the patient was lost from control.

[White piedra. Report of a case]. / Piedra blanca. Informe de un caso.

The most common superficial mycosis caused by Trichosporon beigelii is white piedra. We report a 18 years old male that had in several hairs of the scalp, white-yellowish nodules of 1 mm diameter, agglutinated or forming chains, even forming threads, with a greasy aspect. Trichosporon beigelii was identified in cultures. Oral and topical antimycotics were prescribed and the patient was lost from follow up.

Agentes de onicomicosis en manos y pies en Valdivia (Chile) / Onichomycosis agents in hands and feet in Valdivia (Chile)

Se estudiaron 78 muestras de uñas de manos y pies de 74 pacientes con diagnóstico de onimicosis. Para la obtención de la muestra se raspó la lámina interna de la uña, excepcionalmente la lámina externa y se efectuó el examen microscópico directo ya sea en koh-20 porciento-tinta parker 51 azul permanente o con koh-20 porciento-chloroback e. Todas las muestras fueron sembradas en agar sabouraud dextrosado, agar lactrimel y agar selectivo para dermatofitos (dim) e incubadas a 28ºC por 10-15 días. De las muestras estudiadas, en el 79,5 porciento se observaron hongos al examen microscópico directo, aislándose estos en el 61,5 porciento de los cultivos. La frecuencia de agentes de onimicosis fue: c. albicans (43,75 porciento), t. rubrum (31,25 prociento) y t. mentagrophytes (10,42 porciento). C.albicans se aisló en el 70,8 porciento de las onimicosis en manos de mujeres. T.rubrum se aisló en un 50 y 25 porciento de hombres y mujeres respectivamente. En pie se aisló en el 52,9 porciento y en mano en un 19,3 porciento. S. brevicaulis fue aislado en un solo caso

[Kerion Celsi. A diagnostic problem? Experience with 6 cases]. / Querion de Celso. Un problem diagnóstico? Experiencia en 6 pacientes.

We report six patients with Kerion Celsi due to Trichophyton verrucosum. Five of the patients were hospitalized with the diagnosis of Staphylococcal abscess. This confusion is due to that highly suppurative and inflammatory nature of the infection. Griseofulvin is the antimicrobial of choice for treatment, associated with imidazolics and corticosteroids to prevent alopecia. The authors suggest that an adequate use of simple microbiological diagnostic tests in the diagnosis of pyodermitis in rural children, may prevent unnecessary hospitalizations and permanent hair loss.

Parenteral nutrition in hyperemesis gravidarum.

Hyperemesis gravidarum (HG) is a clinical condition that threatens fetal viability and even the mother's life when the severity of symptoms almost completely prevents the intake of food. Parenteral nutrition (PN) is a possible alternative. We present eight patients with HG. There were 10 PN treatments because two of the patients required the treatment twice. There were 9 central venous and 1 peripheral treatment delivery. The average age of the patients was 27.5 yr. Gestational ages varied from 8 to 19 wk. PN treatments were formulated as amino acid and glucose solutions (fat emulsions in 2 of the 8 cases) blended with vitamins and electrolytes. These treatments lasted 5-16 days. Before PN deliveries were initiated, five of the patients presented some degree of protein-calorie and/or visceral protein malnutrition. All of them showed minor liver dysfunction, which did not change during PN. Newborns were term deliveries, except for one case of missed abortion. Results show that PN constitutes a therapeutic alternative in cases of HG that do not respond to the standard treatment of parenteral hydration and antiemetics. In fact, symptoms disappear promptly, and no significant complications arise.