Oral supplementation with omega-3 fatty acids and inflammation markers in patients with chronic kidney disease in hemodialysis.

Chronic kidney disease (CKD) is an increasingly common public health problem that increases the risk of death because of cardiovascular complications by 2-3 times compared with the general population. This research concerns a prospective, randomized, double-blind study in patients with CKD undergoing hemodialysis. The participants were assigned to 1 of 2 groups: the study group (group A; 46 patients) received 4 capsules (2.4 g) of omega-3 fatty acids daily during the 12-week intervention, while patients in the control group (group B; 47 patients) received 4 capsules of paraffin oil. The patients' general characteristics, nutritional indicators, renal disease markers and inflammatory markers (C-reactive protein, interleukin (IL)-6, IL-10, and tumour necrosis factor alpha (TNF-α)) were evaluated. No differences were found between the general characteristics of the patients (P < 0.05), and no differences were shown in the nutritional indicators and markers of kidney disease (P < 0.05). Patients in group A showed significant decreases in levels of C-reactive protein, IL-6, TNF-α, and the IL-10/IL-6 ratio after 12 weeks of supplementation (P < 0.05). Patients in group B did not show any significant changes in concentrations of inflammatory markers during the intervention (P < 0.05). In conclusion, oral supplementation with omega-3 fatty acids produces a significant decrease in the concentrations of inflammation markers in patients with chronic kidney disease on hemodialysis. Novelty Oral supplementation with omega-3 fatty acids produced significant decreases in the concentrations of inflammation markers. This supplementation could be given to patients with uremic syndrome and coronary heart disease to reduce cardiovascular risk.

[Endothelial microparticles in preeclampsia and eclampsia]. / Micropartículas endoteliales en preeclampsia y eclampsia.

OBJECTIVE: To compare endothelial microparticles values in eclamptic, preeclamptic and normotensive pregnant women. MATERIALS AND METHODS: Patients were selected among those who assisted to Obstetrics Emergency at Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. There were included 30 patients with mild preeclampsia (group A), 30 patients with severe preeclampsia (group B) and 30 patients with eclampsia (group C). A control group was selected for having similar age and body mass index to studied groups and consisted in 35 healthy pregnant women (group D). There were included only nuliparous patients. Blood samples were collected in all patients before delivery and in studied groups immediately after diagnosis for endothelial microparticles determination. RESULTS: There were statistically significant differences in gestational age between groups B and C compared with controls (P<.05). Higher values of endothelial microparticles were observed in eclamptic patients together with severe preeclamptic patients. Lower values were found in mild preeclamptic patients. Studied groups presented significant higher values of endothelial microparticles compared with controls (P<.05). When linear regression was performed, factors that significantly affected endothelial microparticles values were: uric acid, 24-hour proteinuria, transaminases and platelet count (P<.05). CONCLUSIONS: The findings of this research showed that eclamptic and preeclamptic patients had higher endothelial microparticles values than normotensive pregnant women.

Eficiencia diagnóstica del ca-125 como predictor preoperatorio de malignidad en tumores pélvicos / Diagnostic efficacy of the ca-125 as preoperatory predictor of malignancy in pelvic tumours

El objetivo de esta investigación fue evaluar la eficacia diagnóstica del CA-125 como predictor de malignidad en tumores pélvicos. Se seleccionaron en forma prospectiva las pacientes que se ingresaron con diagnóstico de tumoración pélvica que tenían evaluación ecográfica y determinación de las concentraciones de CA-125 antes de la cirugía. La histología de la tumoración pélvica fue el punto final del estudio y se dividió en dos grupos: lesiones benignas. El promedio de edad de las pacientes fue de 42,1 ± 12,9 años. Se encontraron 13 neoplasias malignas en las 110 pacientes evaluadas, de estas tumoraciones, 10 eran tumoraciones malignas de ovario. La sensibilidad del CA-125 fue de 61%, la especificidad de 70%, el valor predictivo positivo y negativo fue de 46% y 93%, respectivamente. El incremento del valor de corte a 65 Ul/mL no mejoró la precisión. Las pacientes con neoplasias malignas presentaron un valor promedio de CA-125 de 1557 ± 346 Ul/mL y las pacientes con neoplasias benignas de 110 ± 73 Ul/mL (p<0,05). Se concluye que el CA-125 tiene una moderada eficacia diagnóstica como predictor preoperatorio de malignidad en tumores pélvicos

The obejtive of the research was to evaluate the diagnóstic efficacy of CA-125 as predictor of pre-surgical malignacy in pelvic tumors. Patients were selective prospectively and who were admitted with diagnosis of pelvic tumors who had ultrasound evaluation and CA-125 concentration were assessed before surgery. Histology of pelvic tumors was the final point of research and was divided in two groups: bening and malignacy. Mean age of patients was 42.1 ± 12.9 years old. There were found 13 malignancies in 110 patients, from these tumors, 10 were malignancies of ovaries. CA-125 sensitivity was 61%. specificity 70%, positive and negative predictive value was 46% and 93%, respectively. Increasing the cur off value to 65 Ul/mL did not improve accuracy. Patients with malignancy presented a mean CA-125 concentration of 1557 ± 346 Ul/mL and patients with bening tumor of 110 ± 73 Ul/mL(p<0,05). It is concluded that CA-125 has a moderate diagnostic efficacy as predictor of malignancy in pelvic tumors

Concentraciones de interleucina-2 en pacientes con preeclampsia a término y pretérmino / Interleukin 2 concentrations in preterm and term preeclamptic patients

Antecedentes: Existen resultados contradictorios sobre las concentraciones de interleucina-2 (IL-2) en pre-eclámpticas y se desconoce si existen diferencias en las concentraciones al momento del diagnóstico. Objetivo: Comparar las concentraciones de IL-2 en pacientes preecláticas de término y de pretérmino. Método: Se seleccionaron 50 pacientes: 20 preeclámpticas de pretérmino (grupo A) y 30 de término (grupo B). Las muestras de sangre para la determinación de IL-2 se recolectaron antes del parto e inmediatamente después del diagnóstico de preeclampsia. Resultados: No hubo diferencias signifcativas con relación a edad materna, índice de masa corporal, valores promedio de presión arterial sistólica y diastólica al momento de la toma de la muestra. Las concentraciones de IL-2 fueron similares en el grupo de preeclámpticas pretérmino (67,5 +/- 31,8 pg/ml) y el grupo de preeclámpticas de término (69,6 +/- 28,5 pg/ml). No hubo correlación signifcativa entre las concentraciones de IL-2 con los valores promedio de presión arterial sistólica y diastólica. Conclusiones: Las pacientes preeclámpticas con embarazos pretérmino presentaron concentraciones similares de interleucina-2 al compararlo con preeclampticas a término al momento del diagnóstico. Los hallazgos de la investigación sugerirían una falta de activación de los linfocitos T en preeclámpticas.

Background: There are contradictory results about interleukin-2 (IL-2) concentrations in preeclamptic patients and is unknown if there are differences in concentrations at the time of diagnosis. Objective: To compare concentrations of IL-2 in term and preterm preeclamptic patients. Method: Fifty patients were selected. Twenty preterm preeclamptic patients (group A) and thirty term preeclamptic patients (group B) were selected. Blood samples for IL-2 were collected in all patients before labor and immediately after diagnosis of preeclampsia. Results: There were not signifcant differences related to a maternal age, body mass index and mean values of systolic and diastolic blood pressure at the moment of collecting samples. There were signifcant differences between groups in gestational age. There also was not signifcant difference in IL-2 concentrations in the study group (67.5 +/- 31.8 pg/ml) and patients in control group (69.6 +/- 28.5 pg/ml). There was not signifcant correlation between interlukin-2 and mean values of systolic and diastolic blood pressure. Conclusion: Preeclamptic patients with preterm pregnancies presented similar interleukin-2 concentrations when compared to term preeclamptic patients at the time of diagnosis. The fnding of this research suggests a lack of activation of T-lymphocytes in preeclamptic patients.

Hernia diafragmática materna estrangulada y embarazo: reporte de caso / Strangulated paternal diaphracmatic hernia and pregnancy: case report

Paciente de 24 años, primigesta, con embarazo de 26 semanas, quien consultó por presentar disnea acentuada y dolor en la espalda. La radiografía de tórax demostraba la presencia de infiltrados en el pulmón izquierdo con un derrame pleural marcado. Después de la colocación de un tubo torácico para el drenaje del líquido pleural, se observa la salida de contenido gástrico por el tubo de toracotomía, por lo cual la paciente fue operada de inmediato. Durante la exploración se observó la salida del epiplón, estómago y parte del colon transverso a través del foramen postolateral de Bochdalek.