Intraventricular hemorrhage treated with intraventricular fibrinolysis. A 10-year experience.

PURPOSE: We evaluate the results and complications of our intraventricular fibrinolysis protocol. MATERIAL AND METHODS: A retrospective analysis was made of the cases of intraventricular hemorrhage with 13-bed Intensive Care Unit. Graeb score 6 or above subjected to intraventricular fibrinolysis. We gathered demographic parameters, clinical risk scores, tomography data and case histories showing neurological status and complications related to intraventricular treatment. The results between those who died and the survivors were compared. RESULTS: Intraventricular fibrinolysis was performed in 42 patients (69% males) with intraventricular hemorrhage. The average age was 58.36 years (SD 16.67), with a median APACHE II score of 17.5 (r 3-29). A total of 16.7% were receiving acenocoumarol, and 7.1% were on antiplatelet drugs. The median Glasgow Coma Score at the start of treatment was 8 (r 3-13). The median Graeb score was 9 (r 6-12), and was severe (Graeb 9-12) in almost 62%. In turn, 26.2% of the patients developed ventriculitis, and there was further bleeding in 7.1%. Death occurred in 50% of the cases. None of the analyzed variables were significantly related to increased mortality. In the 21 survivors, the Glasgow Outcome Score at 3 months was 2 in 23.8% of the cases, 3 in 28.57%, 4 in 23.8% and 5 in 28.57% of the patients. CONCLUSIONS: Intraventricular fibrinolysis does not appear to involve a high rate of complications, and may result in lesser mortality, with a better functional outcome after three months than that estimated and published in the literature in reference to intraventricular hemorrhage.

Acid ceramidase as a chemotherapeutic target to overcome resistance to the antitumoral effect of choline kinase α inhibition.

We have analyzed the response of primary cultures derived from tumor specimens of non small cell lung cancer (NSCLC) patients to choline kinase α (ChoKα) inhibitors. ChoKα inhibitors have been demonstrated to increase ceramides levels specifically in tumor cells, and this increase has been suggested as the mechanism that explain its proapoptotic effect in cancer cells. Here, we have investigated the molecular mechanism associated to the intrinsic resistance, and found that other enzyme involved in lipid metabolism, acid ceramidase (ASAH1), is specifically upregulated in resistant tumors. NSCLC cells with acquired resistance to ChoKα inhibitors also display increased levels of ASAH1. Accordingly, ASAH1 inhibition synergistically sensitizes lung cancer cells to the antiproliferative effect of ChoKα inhibitors. Thus, the determination of the levels of ASAH1 predicts sensitivity to targeted therapy based on ChoKα specific inhibition and represents a model for combinatorial treatments of ChoKα inhibitors and ASAH1 inhibitors. Considering that ChoKα inhibitors have been recently approved to enter Phase I clinical trials by the Food and Drug Administration (FDA), these findings are anticipating critical information to improve the clinical outcome of this family of novel anticancer drugs under development.

The influence of linear elements on plant species diversity of Mediterranean rural landscapes: assessment of different indices and statistical approaches.

This paper mainly aims to study the linear element influence on the estimation of vascular plant species diversity in five Mediterranean landscapes modeled as land cover patch mosaics. These landscapes have several core habitats and a different set of linear elements--habitat edges or ecotones, roads or railways, rivers, streams and hedgerows on farm land--whose plant composition were examined. Secondly, it aims to check plant diversity estimation in Mediterranean landscapes using parametric and non-parametric procedures, with two indices: Species richness and Shannon index. Land cover types and landscape linear elements were identified from aerial photographs. Their spatial information was processed using GIS techniques. Field plots were selected using a stratified sampling design according to relieve and tree density of each habitat type. A 50x20 m2 multi-scale sampling plot was designed for the core habitats and across the main landscape linear elements. Richness and diversity of plant species were estimated by comparing the observed field data to ICE (Incidence-based Coverage Estimator) and ACE (Abundance-based Coverage Estimator) non-parametric estimators. The species density, percentage of unique species, and alpha diversity per plot were significantly higher (p < 0.05) in linear elements than in core habitats. ICE estimate of number of species was 32% higher than of ACE estimate, which did not differ significantly from the observed values. Accumulated species richness in core habitats together with linear elements, were significantly higher than those recorded only in the core habitats in all the landscapes. Conversely, Shannon diversity index did not show significant differences.

[10 years of literature on AIDS (1983-1992): bibliometric analysis]. / Diez años de literatura sobre el sida (1983-1992): análisis bibliométrico.

BACKGROUND: Reasons for the quantitative study of the Spanish publications on AIDS are both the huge volume attained by the printed material on the subject since the first case was described in 1981 by the Center for Disease Control, and the high incidence of the cases reported on this disease. METHODOLOGY: Searches have been performed on the subject through the database of the Indice Médico Español (IME), the Indice Español de Ciencia y Technología (ICYT), the ISBN and Bibliografía Española in order to retrieve all possible Spanish journal papers' and books. The references were distributed using criteria of documentary tipology, publication date, institutions involved, autonomous communities, and, finally, after its relation with the confirmed cases of AIDS. RESULTS: A total 2,013 items have been retrieved, 1,821 journal papers' and 192 books. More than 50% of the papers are published only by five journals, being 139 the total number of journals able to carry pertinent information. The most productive journals were Medicina Clínica and Enfermedades Infecciosas y Microbiología Clínica. CONCLUSIONS: The results confirm exponential growth of the publications from 1983, the first year when a paper was published on AIDS in Spain. The grow is similar to the tend observed in other countries. Parallelism has been detected between growth in the number of publications and in the number of journals publishing on the subject, the growth in the number of journals publishing on the subject, the growth in the number of institutions which collaborate and the growing tend of reported cases in Spain. The results of the bibliometric study, showing an epidemiological growth out of comparison in the history of the scientific literature, could be useful both to information scientists, and to the research inside this scientific field.