Placental oxygen transfer reduces hypoxia-reoxygenation swings in fetal blood in a sheep model of gestational sleep apnea.

Obstructive sleep apnea (OSA), characterized by events of hypoxia-reoxygenation, is highly prevalent in pregnancy, negatively affecting the gestation process and particularly the fetus. Whether the consequences of OSA for the fetus and offspring are mainly caused by systemic alterations in the mother or by a direct effect of intermittent hypoxia in the fetus is unknown. In fact, how apnea-induced hypoxemic swings in OSA are transmitted across the placenta remains to be investigated. The aim of this study was to test the hypothesis, based on a theoretical background on the damping effect of oxygen transfer in the placenta, that oxygen partial pressure (Po2) swings resulting from obstructive apneas mimicking OSA are mitigated in the fetal circulation. To this end, four anesthetized ewes close to term pregnancy were subjected to obstructive apneas consisting of 25-s airway obstructions. Real-time Po2 was measured in the maternal carotid artery and in the umbilical vein with fast-response fiber-optic oxygen sensors. The amplitudes of Po2 swings in the umbilical vein were considerably smaller [3.1 ± 1.0 vs. 21.0 ± 6.1 mmHg (mean ± SE); P < 0.05]. Corresponding estimated swings in fetal and maternal oxyhemoglobin saturation tracked Po2 swings. This study provides novel insights into fetal oxygenation in a model of gestational OSA and highlights the importance of further understanding the impact of sleep-disordered breathing on fetal and offspring development.NEW & NOTEWORTHY This study in an airway obstruction sheep model of gestational sleep apnea provides novel data on how swings in oxygen partial pressure (Po2) translate from maternal to fetal blood. Real-time simultaneous measurement of Po2 in maternal artery and in umbilical vein shows that placenta transfer attenuates the magnitude of oxygenation swings. These data prompt further investigation of the extent to which maternal apneas could induce similar direct oxidative stress in fetal and maternal tissues.

Platelet Rich Plasma: New Insights for Cutaneous Wound Healing Management.

The overall increase of chronic degenerative diseases associated with ageing makes wound care a tremendous socioeconomic burden. Thus, there is a growing need to develop novel wound healing therapies to improve cutaneous wound healing. The use of regenerative therapies is becoming increasingly popular due to the low-invasive procedures needed to apply them. Platelet-rich plasma (PRP) is gaining interest due to its potential to stimulate and accelerate the wound healing process. The cytokines and growth factors forming PRP play a crucial role in the healing process. This article reviews the emerging field of skin wound regenerative therapies with particular emphasis on PRP and the role of growth factors in the wound healing process.

Effects of plasma rich in growth factors (PRGF) on biomechanical properties of Achilles tendon repair.

PURPOSE: To assess the biomechanical effects of intra-tendinous injections of PRGF on the healing Achilles tendon after repair in a sheep model. METHODS: Thirty sheep were randomly assigned into one of the six groups depending on the type of treatment received (PRGF or placebo) and survival time (2, 4 and 8 weeks). The Achilles tendon injury was repaired by suturing the tendinous edges employing a three-loop pulley pattern. A trans-articular external fixation system was then used for immobilization. The PRGF or placebo was administered on a weekly basis completing a maximum of three infiltrations. The force, section and tension values were compared between the operated and healthy Achilles tendons across all groups. RESULTS: The PRGF-treated tendons had higher force at 8 weeks compared with the placebo group (p = 0.007). Between 2 and 4 weeks, a significant increase in force in both the PRGF-treated tendon (p = 0.0027) and placebo group (p = 0.0095) occurred. No significant differences were found for section ratio between PRGF-treated tendons and the placebo group for any of the time periods evaluated. At 2 weeks, PRGF-treated tendons had higher tension ratio compared with placebo group tendons (p = 0.0143). Both PRGF and placebo treatments significantly improved the force (p < 0.001 and p = 0.0095, respectively) and tension (p = 0.009 and p = 0.0039, respectively) ratios at 8 weeks compared with 2 weeks. CONCLUSION: The application of PRGF increases Achilles tendon repair strength at 8 weeks compared with the use of placebo. The use of PRGF does not modify section and tension ratios compared with placebo at 8 weeks. The tension ratio progressively increases between 2 and 8 weeks compared with the placebo.

Aproximación a la actitud ante la malaria, etnias Yanomami, Piaroa y Yekuana, comunidades del Alto Orinoco. Amazonas, Venezuela - 2013 / Approach to the attitude to malaria,etnias Yanomami, Piaroa and Yekuana, High Orinoco communities. Amazon, Venezuela - 2013

En los últimos 20 años se registró una alarmante progresión de la Malaria en el continente americano. Se investigó el Municipio Autónomo Alto Orinoco por ser un área hiperendémica y completamente aislada. Existen 17 grupos étnicos, destacando los Yanomami, Piaroa, Yekuana y Guahibo, cada uno con su lenguaje, religiones, tradiciones y costumbres diferentes. Se exploró a los indígenas encuestados desde el punto de vista epidemiológico y existencial, a través de la encuesta aplicada por Rifá en comunidades maláricas de Asia. Un total de 452 individuos fueron censados (58 % del total de la población de las comunidades visitadas), de las cuales 257 pobladores mayores de 19 años, fueron entrevistados, 53% de los Yanomamis, 26% de los Piaroas, y 21% del total eran Yecuanas. 48% fueron hembras y 52% hombres, predominaron los menores de 44 años, las viviendas de las cinco comunidades estudiadas de Yanomami fueron shaponos, y hubo mayor vulnerabilidad en las comunidades Yanomami a la adquisición de otras enfermedades transmisibles. En relación a la creencia acerca de la intervención de los espíritus en la evolución de la Malaria, 60% de los encuestados de la etnia Yanomami consideraron necesaria la intervención del Chaman en el tratamiento de la Malaria. La etnia más afectada es la Yanomami por estar muy dispersa, convivir en viviendas multifamiliares y abiertas denominadas shapono, sin servicios sanitarios básicos y la mayoría distante de escuelas, ambulatorios de salud y actividades de intercambio económico El chamán continúa jugando un papel vital en las comunidades de la etnia Yanomami estudiadas.(AU)

In the past 20 years was recorded an alarming increase of Malaria in the Americas. It investigated the autonomous high Orinoco communities for being a hyperendemic area completely isolated. There are 17 ethnic groups, prominence Piaroa, Yanomami, Yekuana and Guahibo, each one with its language, religions, traditions and different customs. It explored the Indians surveyed from the existential, and epidemiological perspective through the survey by raffle in malarious from Asian communities. A total of 452 individuals were surveyed (58% of the total population of the communities visited), of which 257 residents over the age of 19, were interviewed, 53 per cent of the Yanomami, 26% of the Piaroas, and 21% of the total were Yecuanas. 48% were females and 52% men, predominated minors aged 44, dwellings of the five communities studied of Yanomami were shaponos, and there was increased vulnerability in the Yanomami communities in the acquisition of other communicable diseases. In relation to the belief about the intervention of the spirits in the evolution of Malaria, 60% of respondents of the Yanomami ethnic group considered necessary the intervention of the shaman in the treatment of Malaria. The ethnic group most affected is the Yanomami be very spread, live together in open and multi-family dwellings called shapono, without basic health services and the most distant of schools, health clinics and economic exchange activities the shaman continues to play a vital role in the communities of the Yanomami ethnic group studied.(AU)

Motivación para estudiar medicina en dos universidades públicas desde una visión integral

Las necesidades que motivan el comportamiento humano producen patrones de conducta que varían de un individuo a otro. Se realizó una investigación exploratoria con la representación de lo que serían los cuatro cuadrantes de Wilber (1996), en 207 y 107 estudiantes universitarios de las Universidades de Carabobo UC (Venezuela) y Autónoma de Madrid UAM (España) respectivamente, siendo una muestra intencional, Como instrumentos de recolección de datos se utilizaron el SODEMEM, MAPE-3 y Graffar modificado. Se encontró promedio de edad 18,95 ± 1,22años en la UC y 19,16±0,73años en la UAM; predominio del sexo femenino (cuadrante II). La mayoría manifestó ser católicos y no becados, preponderancia en las actividades o contenidos desarrollados durante sus estudios de secundaria como influencia en su decisión para de estudiar medicina (cuadrante III), y coincidieron que el motivo que los impulsó a elegir la carrera de Medicina fue la vocación de servicio, el interés clínico por la ciencia y la salud pública (cuadrante I). Estrato social en su mayoría alto, y bajo porcentaje de estudiantes trabajando, con más de 75% que solo se dedicaban solo al estudio (cuadrante IV). Se encontraron diferencias estadísticamente significativas en la religión (porcentaje de ateos) y de familiares médicos (p< 0,05). Se recomienda investigar otros aspectos no desarrollados, inclusive con metodologías y paradigmas distintos.(AU)

Needs that motivate human behaviour produce behavior patterns that vary from one individual to another. He was conducted an exploratory research with the representation of what would be the four quadrants of Wilber (1996), at 207 and 107 University students from the University of Carabobo UC (Venezuela) and Autónoma de Madrid UAM (Spain) respectively, being an intentional example. As instruments of data collection were used by the SODEMEM, MAPE-3 and two modified. Found average age 18.95 ± 1, 22años at UC and 19, 16±0, 73años at the UAM, predominio female (quadrant II). Lmajority said be Catholic and not scholarships, preponderance in the activities or content developed during high school as an influence in his decision to study medicine (quadrant III), and they agreed that the reason that drove them to choose the career of medicine was the vocation of service, clinical interest in science and public health (quadrant I). Social stratum most high, and low percentage of students working with more than 75% only involved only in the study (quadrant IV). We found statistically significant differences in religion (percentage of atheists) and medical families (p < 0,05). It is recommended researching other aspects not developed, including with methodologies and different paradigms.(AU)