Current smoking status is associated to a non-ACR 50 response in early rheumatoid arthritis. A cohort study.

The purpose of this study is to determine factors associated with a non-ACR 50 response at 6 months of follow-up, in a cohort of patients with early rheumatoid arthritis (RA). Early RA patients (symptom duration <1 year), treated with the same combination treatment (methotrexate and sulfasalazine), were included. Demographic characteristics of the patients including current smoker status (defined as a patient that smokes at least one cigarette per day), years of formal education, a 28-joint count for swelling and tenderness were registered. A basal HAQ questionnaire, visual scales for global assessment, and pain were answered by all patients, and a CDAI basal score was calculated. The ACR 50 response was determined at 6 months follow-up. Multivariable logistic regression analysis was used to calculate adjusted ORs. Two hundred twenty-five patients were evaluated, but only 144 had a complete follow-up, 43% of the latter did not reach an ACR 50 response. The only factor associated with this outcome was current smoking (OR 3.58, P < 0.008, 95% CI 1.23-11.22). Low level of formal education (≤6 years) had a tendency towards a statistical difference (P < 0.08). After controlling with low level of formal education, sex, age in years, and CDAI baseline value with multivariable logistic regression analysis, current smoking status had an adjusted OR of 3.91 (P < 0.009, 95% CI 1.41-10.81). Smoking is associated with a non-ACR 50 response in early rheumatoid arthritis in patients treated with a combination therapy with methotrexate and sulfasalazine.

Uso de antimicrobianos profilácticos en cirugía y gineco-obstetricia / Use of prophylactic antibiotics in surgery and obstetrics and gynecology

El concepto de guías terapéuticas no es nuevo y aunque se conocen las limitaciones en el uso de las mismas a nivel clínico, se considera como una de las herramientas adecuadas para promover el uso adecuado de antimicrobianos, el cual se considera una de las herramientas básicas para la prevención de la diseminación de la resistencia bacteriana. La Oficina Sanitaria Panamericana promovió durante los años 2001 y 2002 la creación de una Guía Genérica de tratamiento de las enfermedades infecciosas más comunes en el continente americano. Un grupo de especialistas latinoamericanos desarrolló el concepto y logró...

Antitumor activity of a recombinant soluble betaglycan in human breast cancer xenograft.

We have demonstrated previously that ectopic expression of a soluble betaglycan, also known as transforming growth factor (TGF) beta type III receptor, can suppress the malignant properties of human carcinoma cells by antagonizing the tumor-promoting activity of TGF-beta (A. Bandyopadhyay et al., Cancer Res., 59: 5041-5046, 1999). In the current study, we investigated the potential therapeutic utility of a recombinant preparation of human and rat soluble betaglycan (sBG). Purified recombinant human sBG showed similar properties to its rat counterpart (M. M. Vilchis-Landeros et al., Biochem J., 355: 215-222, 2001). It bound TGF-beta with high affinity and isoform selectivity and neutralized the activity of TGF-beta(1) in two bioassays. Peritumoral (50 micro g/tumor, twice a week) or i.p. (100 micro g/animal, every alternate day) injection of sBG into human breast carcinoma MDA-MB-231 xenograft-bearing athymic nude mice significantly inhibited the tumor growth. The administration of sBG also reduced metastatic incidence and colonies in the lungs. The tumor-inhibitory activity of sBG was found to be associated with the inhibition of angiogenesis. Systemic sBG treatment significantly reduced tumor microvessel density detected with histological analyses and CD-31 immunostainings, as well as tumor blood volume measured with hemoglobin content. In an in vitro angiogenesis assay, treatment with the recombinant sBG significantly reduced the ability of human dermal microvascular endothelial cells to form a capillary tube-like structure on Matrigel. These findings support the conclusion that sBG treatment suppresses tumor growth and metastasis, at least in part by inhibiting angiogenesis. As such, it could be a useful therapeutic agent to antagonize the tumor-promoting activity of TGF-beta.

Utilidad del fragmento 1 + 2 de protrombina y del dímero de fibrina en la detección de hipercoagulabilidad en pacientes obstétricos con factores de riesgo de trombosis / Usefulness of 1 + 2 prothrombin fragment and of dimer of fibrin in detecting hyporcoagulability in obstetricial patients with thrombosis risk

La cuantificación del fragmento 1+2 de protrombina se hizo por método inmunoenzimático en 75 mujeres (55 embarazas y 20 post-cesárea) y el dímero D por determinación semicuantitativa mediante aglutinación en placa en 97 casos (77 embarazadas y 20 post-cesárea). El fragmento 1+2 se encontró significativamente elevado en el 85 por ciento de los casos, sin embargo no mostró tener utilidad predictiva de enfermedad tromboembólica. La cuantificación del dímero D no fue detectada en 40 casos, en 33 fluctuó entre 500 y 1000 ng/ml y en los 24 restantes fue superior a los 2000 ng/ml. Valores mayores a 1000 ng/ml fueron observados en el 78 por ciento de las que tenían antecedentes de enfermedad tromboembólica, en las de cesárea 60 por ciento, en el 37 por ciento de las hipertensas y en 23 por ciento de las diabéticas. El dímero D que en el 59 por ciento de las embarazadas y puérperas registró valores superiores a 500 ng/ml tiene valor predictivo, ya que en 24 casos que cursaban con más de 2000 ng/ml, el 25 por ciento presentaron ETE y/o anormalidades de la coagulación sugestivos de actividad trombótica. Estos hallazgos no fueron observados en la 73 mujeres evaluadas que tuvieron dD negativo o < de 1000 ng/ml