Resistance index measured by Doppler ultrasound as a predictor of graft function after kidney transplantation.

INTRODUCTION: Doppler ultrasound (US) has become the primary imaging technique for the evaluation of renal transplants. It provides information about the intrarenal resistance index (RI). A high RI is seen in every form of graft dysfunction. In this article, we review the utility of sonography, particularly the intrarenal RI measured early after renal transplant, as a predictor of acute and chronic clinical outcome in patients. RESULTS: RI is a valuable marker to determine graft function and related vascular complications. It reveals a strong correlation with serum creatinine levels measured days after transplant. Its elevation is typical for acute tubular necrosis and can be used to predict its duration. An RI >1 (absent end-diastolic flow) seen in the first weeks after transplant is associated with impaired renal graft recovery. In addition, it is an early predictor of chronic allograft nephropathy (even correlated with biopsy results), which will allow a change in therapy. CONCLUSIONS: RI measured serially in the early period after kidney transplantation is a valuable marker for determining renal graft function. It is also useful for demonstrating various types of graft dysfunction; however, it cannot differentiate between them. In recent studies, extrarenal factors in kidney transplantation (eg, recipient's age) may significantly influence RI in the recipient, demonstrating that RI depends on the vascular characteristics of the recipient and not on the graft itself.

Overexpression of peroxiredoxin 2 in pterygium. A proteomic approach.

Pterygium is one of the most frequent pathologies in ophthalmology, and is a benign, fibrovascular lesion originating from the bulbar conjunctiva. It is composed of an epithelium and highly vascular, subepithelial, loose connective tissue. The etiology of pterygium is not clearly understood; the most widely recognized originating factor is ultraviolet radiation. It has been proposed that pterygium and neoplasia have common features, raising the possibility that pterygium is a neoplastic-like growth disorder. In this study, proteomic analysis was performed to show that peroxiredoxin 2 is overexpressed in pterygia compared to healthy conjunctivas. Twelve pterygium specimens were obtained together with healthy conjunctival tissue from the same eyes. Total proteins of pterygia and healthy conjunctivas were analyzed in SDS-PAGE. This analysis showed protein bands expressed exclusively in pterygium samples at the range of 20-25 kDa. After this, 2D electrophoresis was performed for the separation of total proteins; differential spots expressed in pterygium were excised and sequenced. Mass spectrometry (MS) data were searched in the NCBInr and EST databases using the MASCOT program. The spot was identified as peroxiredoxin 2. Real-time PCR, western blot and immunohistochemistry showed that peroxiredoxin 2 was increased in pterygium compared to healthy conjunctiva. Although, these results suggest that overexpression of peroxiredoxin 2 in pterygium could protect the cell against oxidative stress-induced apoptosis, further studies are required to establish the functional role of peroxiredoxin 2 in pterygium to determine its role in peroxidation and apoptosis in this pathology.

Envases activos antioxidantes y su efecto sobrela calidad sensorial y los compuestos volátiles en leche entera deshidratada / Antioxidant active packaging effect whole milk powder sensorial quality and production of volatile compounds

El sabor de la leche está estrechamente relacionado con su composición, especialmente con su contenido graso. Factores como la luz, los materiales de envase y las condiciones de almacenamiento pueden favorecer la oxidación de la grasa y alterar las características sensoriales del producto. El presente estudio buscó evaluar el efecto de los envases activos multicapa con diferentes antioxidantes en su capa más interna: butilhidroxitolueno, butil hidroxianisol, alfa-tocoferol y una mezcla de butil hidroxianisol-alfa-tocoferol, sobrela calidad sensorial de la leche entera deshidratada. El entrenamiento de un panel sensorial permitió la evaluación del atributo de sabor oxidado en la leche y la correlación de estos resultados con la producción de pentanal, hexanal y heptanal, cuantificados mediante cromatografía gaseosa usando microextracción enfase sólida. Los análisis sensoriales revelaron cambios en las características de sabor oxidado en las muestras de leche. La correlación general de estos datos y las concentraciones de volátiles cuantificadas permitieron encontrar una correlación moderada pero significativa entre el sabor oxidado y los volátiles pentanal, hexanal y heptanal. En general, los envases activos con butil hidroxianisol-alfa-tocoferol y alfa-tocoferol obtuvieron una menor calificación en cuanto a su sabor oxidado y, en consecuencia, representan una alternativa viable para la conservación de las propiedades sensoriales de la leche.

Milk flavor is highly related with ITS components, especially with fat content. Factors such as light, packaging material and storage conditions can produce lipid oxidation and favor changes in the sensorial characteristics of product. The aim of this study was to evaluate the effect of active packaging with different antioxidants: butylated hydroxyanisole, butylated hydroxytoluene and alfa-tocopherol, on sensorial quality of whole milk powder. The panel members were trained to recognize the taste and smell of oxidized fat in milk and these results to be correlated with volatile compounds pentanal, heptanal and hexane quantified in milk samples using gas chromatography with solid phase microextraction. Sensorial tests showed changes in oxidized fat flavor in milk. The general correlation of these data and volatiles concentration allowed finding a moderate but significant correlation between oxidized fat flavor and thepentanal, hexanal and heptanal volatiles. In general, the active packaging with alfa-tocopherol-butylatedhidroxyanisole and alfa-tocopherol presented low score in oxidized fat flavor, representing a viable alternativefor the conservation of sensorial properties in milk during storage time.

Application of a new enzyme-linked immunosorbent assay for detection of total hepatitis C virus core antigen in blood donors.

Recent studies have shown that total hepatitis C virus (HCV) core antigen, both free and antibody bound, is an accurate indirect marker of viral replication that can be used in clinical practice. The aim of the present study was to evaluate the performance of a new total HCV core antigen enzyme-linked immunosorbent assay (ELISA) for detection and quantification of total core antigen in blood donors, testing positive for anti-HCV antibodies and for prospective low-risk population screening. A population comprising 257 samples, from blood donors detected reactive for anti-HCV antibodies [137 recombinant immunoblot assay (RIBA) positive and 120 RIBA indeterminate], were tested by using a new total HCV core antigen ELISA. HCV-RNA was quantified by using quantitative polymerase chain reaction (PCR) assays in all RIBA-positive samples and RIBA-indeterminate samples that were positive for the total core antigen. Specificity of the assay was studied in 1070 healthy blood donors negative for anti-HCV antibodies. Compared with quantitative PCR assays, the total HCV core antigen assay showed 97.37% sensitivity. The three HCV-RNA-positive samples, which tested negative for the total core antigen, had a low viral load (< 1.4 x 10(4) IU mL(-1)). All samples with more than 1.4 x 10(4) IU mL(-1) of viral RNA were positive for total core antigen, independent of the HCV genotype. Concentration of total core antigen correlated significantly with those of HCV-RNA (r = 0.614, P < 0.0001). Overall specificity in freshly collected blood donor specimens was 99.63%. Our data indicate that the total HCV core antigen ELISA has a sensitivity close to PCR assays in diagnosing HCV infection in blood donors with anti-HCV antibodies and shows an excellent specificity in volunteer donors. This assay, in combination with anti-HCV antibodies screening tests, could be an alternative to molecular assays for HCV infection screening in blood donors.

[The effect of propofol vs desflurane on recovery from anesthesia with remifentanil in outpatient surgery]. / Repercusión en la recuperación postanestésica de propofol frente a desflurano asociados a remifentanilo en cirugía ambulatoria.

OBJECTIVES: To compare the effect on parameters of postanesthetic recovery of propofol and desflurane administered with high doses of remifentanil for major outpatient surgery. PATIENTS AND METHODS: Seventy patients were randomly assigned to receive propofol (target concentration 1.5-2 microg/ml) or desflurane in perfusion (end expiratory concentration 0.5 MAC) during maintenance of anesthesia with remifentanil (0.25-1 microg/kg/min). The anesthetic agents were withdrawn after surgery. We recorded the times until eye opening, respiration, tracheal extubation, ability to cough, response to verbal orders and orientation. We also recorded the time until a score of 10 on the Aldrete recovery scale was attained, pain on a visual analog scale, sedation on the Ramsay scale, and instances of nausea or vomiting during the first 24 h after surgery. RESULTS: No statistically significant differences in patient characteristics, type of surgery or anesthesia were found. Times until early signs of postanesthetic recovery (eye opening, spontaneous breathing, tracheal extubation) were significantly less (p < 0.05) in the desflurane group. The groups were similar for all other parameters compared (times until ability to cough, respond to verbal orders, orientation and a score of 10 on the Aldrete scale). Duration of stay in the postanesthetic recovery unit, time in the day surgery ward and intensity of postoperative pain were also similar. The rate of postoperative nausea or vomiting was significantly lower in the propofol group. CONCLUSION: During anesthesia with remifentanil, the administration of desflurane is associated with better psychomotor recovery parameters than is propofol, but the rate of nausea and vomiting is higher with desflurane.

Fatal upper and lower gastrointestinal cytomegalovirus disease following autologous peripheral blood stem cell transplantation.

Although the life-threatening cytomegalovirus (CMV) disease is a well known complication following allogeneic hematopoietic stem cell transplantation (HSCT), it has been considered infrequent after autologous peripheral blood stem cell transplantation (PBSCT). On the other hand, the massive involvement of the gastrointestinal (GI) tract as the primary site of fatal CMV disease is particularly rare after autologous PBSCT. We present the case of a woman who suffered from CMV disease after high-dose busulphan/melphalan/thiotepa (BuMelTT) and autologous PBSCT. The primary site of infection was the GI tract, which was extensively affected. During the fifth week post-transplant the patient started with epigastralgia, diarrhea, fever, GI bleeding, and thrombocytopenia, and she died on day +52. Another case of fatal CMV disease among the few patients treated with BuMelTT has been recently reported, which suggests that the immunodeficiency associated with that regimen can be as intense as that occurring after allogeneic BMT.

Benzodiazepine withdrawal syndrome seizures.

In this study, we present five cases of seizures following withdrawal of flunitrazepam, lorazepam, or triazolam, representing 3% of a sample consisting of 153 patients dependent on benzodiazepines. Both abrupt cessation of benzodiazepine intake and high-dose use seem to be critical for the appearance of seizures. Pharmacological features, such as short elimination half-life and high potency, might explain the higher risk of seizures observed in these patients.

Hepatocolecistostomía en lesiones del hepático común: presentación de 1 caso / Hepato cholecystectomy in lesions of the common hepatic duct: presentation of 1 case

Se presenta el caso de 1 paciente con grave lesión del hepático comun con arma de fuego, con severos daños concomitantes del higado, vena cava y riñón derecho, en quien se exteriorizó el flujo biliar con cateter y se conservó la vesicula para una futura reconstruccion de la continuidad de la via biliar. Un mes despues se reintervino y se le practicó una hepatocolecistostomia dejando tubo transhepático hasta la anastomosis hepatovesicular, con lo que se ha obtenido un resultado excelente durante más de 2 años de seguimiento. Se plantea la posibilidad de conservar la vesicula biliar en caso de lesiones altas de las vias biliares para usaria posteriormente como "puente", siempre que la via vesicula-cistico-coledoco, se encuentre indemne. Al mismo tiempo se describe un metodo para reconstruccion de las vías biliares.