Vitamin A retinopathy secondary to Billroth II anastomosis triggered after the beginning of dialysis.

PURPOSE: To report a case of vitamin A retinopathy secondary to Billroth II anastomosis triggered after the beginning of dialysis in a patient with a chronic renal failure. CASE REPORT: A 73-year-old male complained of nyctalopia that had started 9 months ago, coinciding with the beginning of dialysis. His medical history is remarkable for hepatic cirrhosis and Billroth II anastomosis 20 years ago. Best-corrected visual acuity (BCVA) was 60 letters in both eyes. Dilated fundus examination showed faint white-yellowish dots. Optical coherence tomography (OCT) illustrated hyperreflective dots and small hyporreflective cavities between the retinal pigment epithelium (RPE) and the ellipsoid zone (EZ). En face OCT showed multiple hyperreflective dots that coincide with white-yellowish dots of the fundus, and multiple hyporreflective defects which correspond to hyporreflective cavities seen in the OCT. Visual field examination showed concentric narrowing of the visual field. A diagnosis of vitamin A deficiency was confirmed and oral vitamin A supplementation was initiated. One month after treatment, the patient reported a subjective improvement of nyctalopia, and BCVA ameliorated up to 80 and 85 letters. Fundus examination, OCT, and en face OCT showed a diminution of the observed lesions. Moreover, visual field improved. CONCLUSION: Early diagnosis of vitamin A deficiency can prevent irreversible visual sequelae. This highlights the crucial role of ophthalmologists in the prompt detection of this condition. A lifelong monitoring should be needed in patients undergoing biliopancreatic diversion surgery. Furthermore, OCT and en face OCT becomes a main tool in the diagnosis and monitor response to treatment.

Bioinspired hierarchical impact tolerant materials.

The quest for new light-weight materials with superior mechanical properties is a goal of materials scientists and engineers worldwide. A promising route in this pursuit is drawing inspiration from nature to design and develop materials with enhanced properties. By emulating the graded mineral content and hierarchical structure of fish scales of the Arapaima gigas from the nano to macro scales, we were able to develop bioinspired laminated composites with improved impact resistance. Activated by the addition of nano-particles of Al2O3 and nano-layers of TiN to a thermoplastic fiber substrate, new energy dissipation mechanisms operating at the nanoscale enhanced the energy absorption and stiffness of the bioinspired material. Remarkably, the newly developed materials are easily transferred to the industry with minimum associated manufacturing costs.

Farmacopuntura en pacientes con disfunción dolorosa de la articulación temporomandibular / Pharmacopuncture in patients with temporomandibular joint painful dysfunction

Introducción: El síndrome de disfunción temporomandibular constituye un problema de salud importante, que afecta a más de 50 % de la población mundial. Objetivo: Describir la evolución terapéutica de pacientes con afecciones temporomandibulares tratados con farmacopuntura. Métodos: Se realizó un estudio descriptivo de 60 pacientes con síndrome de disfunción temporomandibular en fase aguda, atendidos en el Hospital Clinicoquirúrgico Faustino Pérez de Matanzas, desde enero hasta diciembre de 2018. Se administró una solución compuesta por lidocaína, vitamina B12 y betametasona en puntos acupunturales determinados. Además, se utilizó la escala verbal del dolor. Resultados: Se encontró que el grupo etario de 60 años y más, así como el sexo femenino fueron los más afectados. De los factores asociados a este síndrome predominó el estrés en 100 % de los pacientes; 63,3 % presentaron dolor moderado y 53,3 % se aliviaron totalmente. Conclusiones: La farmacopuntura alivió el dolor asociado al síndrome de disfunción temporomandibular en la mayoría de los afectados, entre las 3 primeras sesiones de tratamiento.

Introduction: The temporomandibular dysfunction syndrome constitutes an important health problem that affects more than 50 % of the world population. Objective: To describe the therapeutic clinical course of patients with temporomandibular affections treated with pharmacopuncture. Methods: A descriptive study of 60 patients with temporomandibular dysfunction syndrome in acute phase was carried out, they were assisted in the Faustino Pérez Clinical Surgical Hospital from Matanzas, from January to December, 2018. A solution composed by lidocaine, B12 vitamin and betamethasone was administered in certain acupunctural points. Also, the pain verbal scale was used. Results: It was found that the 60 years and over age group, as well as the female sex were those most affected. Of the factors associated to this syndrome stress prevailed in 100 % of patients; 63.3 % presented moderate pain and 53.3 % were totally relieved. Conclusions: Pharmacopuncture relieved the pain associated with the temporomandibular dysfunction syndrome in most of those affected, in the first 3 treatment sessions.

Bioprospecting for microbes with potential hydrocarbon remediation activity on the northwest coast of the Yucatan Peninsula, Mexico, using DNA sequencing.

Coastal environments harbor diverse microbial communities, which can contain genera with potential bioremediation activity. Next-generation DNA sequencing was used to identify bacteria to the genus level in water and sediment samples collected from the open ocean, shoreline, wetlands and freshwater upwellings on the northwest coast of the Yucatan Peninsula. Supported by an extensive literature review, a phylogenetic investigation of the communities was done using reconstruction of unobserved states software (PICRUSt) to predict metagenome functional content from the sequenced 16S gene in all the samples. Bacterial genera were identified for their potential hydrocarbon bioremediation activity. These included generalist genera commonly reported in hydrocarbon-polluted areas and petroleum reservoirs, as well as specialists such as Alcanivorax and Cycloclasticus. The highest readings for bacteria with potential hydrocarbon bioremediation activity were for the genera Vibrio, Alteromonas, Pseudomonas, Acinetobacter, Burkholderia, Acidovorax and Pseudoalteromonas from different environments in the study area. Some genera were identified only in specific sites; for example, Aquabacterium and Polaromonas were found only in freshwater upwellings. Variation in genera distribution was probably due to differences in environmental conditions in the sampled zones. Bacterial diversity was high in the study area and included numerous genera with known bioremediation activity. Functional prediction of the metagenome indicated that the studied bacterial communities would most probably degrade toluene, naphthalene, chloroalkane and chloroalkene, with lower degradation proportions for aromatic hydrocarbons, fluorobenzoate and xylene. Differences in predicted degradation existed between sediments and water, and between different locations.

Energy resolved mass spectrometry of chlorogenic acids and its application to isomer quantification by direct infusion tandem mass spectrometry.

INTRODUCTION: With the advent of high-perfomance liquid chromatography (HPLC)-tandem mass spectrometry (MS) using ion trap mass analysers it is possible to acquire unambigious structural information in particular with respect to aspects of regiochemistry and stereochemistry of organic compounds present in complex mixtures such as coffee extracts. However, HPLC-MS methods are resource extensive, laborious and lacking user friendliness. OBJECTIVE: To introduce a simple parameter - the energy threshhold for fragmentation - determined using energy resolved MS and demonstrate its value for the complete structural characterisation and even relative quantification of individual isomeric chlrogenic acids in direct infusion experiments. METHODOLOGY: Monocaffeoyl and dicaffeoyl quinic acids were investigated by direct infusion energy resolved mass spectrometry (ER-MS) in negative in mode, using a quadrupole ion trap and quadrupole time-of-flight (Q-TOF) mass spectrometer. Methanolic coffee extracts were quantitatively investigated by HPLC-MS and direct infusion ER-MS. RESULTS: Fragmentation occurs with retention of regiochemistry and regiochemistry of fragment ions can be determined using ER-MS. Analysis of breakdown graphs allows extraction of a single numerical parameter that allows assignment of regiochemistry. Analysis of monocaffeoyl and dicaffeoyl quinic acids revealed that regiosiomers could be distinguished and assigned based on their dissociation energies in collisional induced activation. Furthermore relative quantification of regioisomers by direct infusion ER-MS is possible within an error range of ±10% if compared with a conventional quantitative LC-MS method. CONCLUSION: ER-MS can be exploited in determining relative isomers quantities of chlorogenic acids (CGAs) in crude plant extracts by direct infusion tandem MS omitting time and resource intensive chromatographic separation.

Seasonal Effect on the Biological Activities of Litsea glaucescens Kunth Extracts.

This study shows the seasonal effect on the antioxidant, antiproliferative, and antimicrobial activities of L. glaucescens Kunth (LG) leaves extracts. Their antioxidant activity was evaluated through the DPPH, FRAP, and ORAC assays. Their phenolic content (PC) was determined by means of the Folin-Ciocalteu method, and the main phenolic compounds were identified through a HPLC-DAD analysis. Antiproliferative activity was determined by MTT assay against HeLa, LS 180, M12.C3.F6, and ARPE cell lines. Antimicrobial potential was evaluated against Staphylococcus aureus and Escherichia coli using a microdilution method. All the LG extracts presented high antioxidant activity and PC, with quercitrin and epicatechin being the most abundant. Antioxidant activity and PC were affected by the season; particularly autumn (ALGE) and summer (SULGE) extracts exhibited the highest values (p < 0.05). All extracts presented moderate antiproliferative activity against the cell lines evaluated, HeLa being the most susceptible of them. However, ALGE and SULGE were the most active too. About antimicrobial activity, SULGE (MIC90 < 800 µg/mL; MIC50 < 400 µg/mL), and SLGE (MIC50 < 1000 µg/mL) showed a moderate inhibitory effect against S. aureus. These findings provide new information about the seasonal effect on the PC and biological properties of LG extracts. Clearly, antioxidant activity was the most important with respect to the other two.

The genus Datura L. (Solanaceae) in Mexico and Spain - Ethnobotanical perspective at the interface of medical and illicit uses.

ETHNOPHARMACOLOGICAL RELEVANCE: The different species of the genus Datura have been used traditionally by some pre-Columbian civilizations, as well as in medieval rituals linked to magic and witchcraft in both Mexico and Europe. It is also noteworthy the use of different alkaloids obtained from the plants for medicinal purposes in the treatment of various groups of diseases, especially of the respiratory and muscularskeletal systems. AIM OF THE STUDY: A review of the ethnobotanical uses of the genus Datura in Mexico and Spain has been conducted. We focus on the medicinal and ritualistic uses included in modern ethnobotanical studies, emphasizing the historical knowledge from post-colonial American Codices and medieval European texts. Datura's current social emergency as a drug of recreation and leisure, as well as its link to crimes of sexual abuse is also considered. The work is completed with some notes about the distribution and ecology of the different species and a phytochemical and pharmacological review of Datura alkaloids, necessary to understand their arrival in Europe and the ethnobotanical uses made since then MATERIALS AND METHODS: A literature review and compilation of information on traditional medicinal uses of the genus has been carried out from the main electronic databases. Traditional volumes (codices) have also been consulted in libraries of different institutions. Consultations have been made with the National Toxicological Services of Spain and Mexico for toxicological data. RESULTS: A total of 118 traditional uses were collected in both territories, 111 medicinal ones to be applied in 76 conditions or symptoms included in 13 pathological groups. Although there are particular medicinal uses in the two countries, we found up to 15 similar uses, of which 80% were previously mentioned in post-Colonial American codices. Applications in the treatment of asthma and rheumatism are also highlighted. Apart from medicinal uses, it is worth noting their cultural and social uses, in the case of Mexico relating to diseases such as being scared, astonishment or falling in love, and in the case of Spain, as a recreational drug and lately, for criminal purposes. CONCLUSIONS: This review highlights the variety of uses traditionally given to the different species in both territories. The fact that most of the coincident or similar uses in both countries also appear in the classical codices can be found an example of the flow, not only of the plants from America to Europe, but also of their associated information. It is also relevant that particular uses have derived in both countries, reflecting the difference in the cultural factors and traditions linked to rituals and cultural practices. Finally, the significant growth of Datura consumption in recent years as a drug of leisure and recreation, as well as in crimes of sexual submission, should be considered as research of maximum relevance in the field of forensic botany and toxicology.

Improving risk stratification among veterans diagnosed with prostate cancer: impact of the 17-gene prostate score assay.

BACKGROUND: Active surveillance (AS) has been widely implemented within Veterans Affairs' medical centers (VAMCs) as a standard of care for low-risk prostate cancer (PCa). Patient characteristics such as age, race, and Agent Orange (AO) exposure may influence advisability of AS in veterans. The 17-gene assay may improve risk stratification and management selection. OBJECTIVES: To compare management strategies for PCa at 6 VAMCs before and after introduction of the Oncotype DX Genomic Prostate Score (GPS) assay. STUDY DESIGN: We reviewed records of patients diagnosed with PCa between 2013 and 2014 to identify management patterns in an untested cohort. From 2015 to 2016, these patients received GPS testing in a prospective study. Charts from 6 months post biopsy were reviewed for both cohorts to compare management received in the untested and tested cohorts. SUBJECTS: Men who just received their diagnosis and have National Comprehensive Cancer Network (NCCN) very low-, low-, and select cases of intermediate-risk PCa. RESULTS: Patient characteristics were generally similar in the untested and tested cohorts. AS utilization was 12% higher in the tested cohort compared with the untested cohort. In men younger than 60 years, utilization of AS in tested men was 33% higher than in untested men. AS in tested men was higher across all NCCN risk groups and races, particular in low-risk men (72% vs 90% for untested vs tested, respectively). Tested veterans exposed to AO received less AS than untested veterans. Tested nonexposed veterans received 19% more AS than untested veterans. Median GPS results did not significantly differ as a factor of race or AO exposure. CONCLUSIONS: Men who receive GPS testing are more likely to utilize AS within the year post diagnosis, regardless of age, race, and NCCN risk group. Median GPS was similar across racial groups and AO exposure groups, suggesting similar biology across these groups. The GPS assay may be a useful tool to refine risk assessment of PCa and increase rates of AS among clinically and biologically low-risk patients, which is in line with guideline-based care.

Tiempo de vida de las restauraciones dentales libres de metal: revisión sistemática / Lifetime of metal-free dental restorations: a systematic review

En la actualidad existen muchos materiales dentales para la restauraciónestética, sin embargo, su tiempo de vida clínico no se conoce ampliamente. Objetivo: Identificar las publicaciones recientes de los materiales de restauración libre de metal que incluyan estudios clínicos. Metodología: La búsqueda sistemática de la literatura se realizó en bases de datos de PubMed y SciELO; se consideraron publicacionesdel 2010-2015 y que fueran investigaciones clínicas exclusivamente.Las palabras clave utilizadas fueron: Veneer crowns, dental restorationsfree metal, metal free crowns, aesthetic crowns y restauraciones libres de metal, coronas de silicato de litio, tipos de cerámicas. Resultados: Se revisaron 40 artículos y 20 cumplieron con los criterios de selección para la revisión bibliográfica. Todas las restauraciones protésicas libres de metal muestran un desempeño clínico muy similar a los tres años. Las restauraciones de zirconia y disilicato de litio por CAD mostraronel mejor éxito clínico. Conclusión: El éxito clínico de las restauracioneslibres de metal de esta revisión de la literatura muestra que van de un92.7 al 100 por ciento a tres o más años de seguimiento...

Antimutagenic Compounds of White Shrimp (Litopenaeus vannamei): Isolation and Structural Elucidation.

According to the World Health Organization, cancer is the main cause of mortality worldwide; thus, the search of chemopreventive compounds to prevent the disease has become a priority. White shrimp (Litopenaeus vannamei) has been reported as a source of compounds with chemopreventive activities. In this study, shrimp lipids were extracted and then fractionated in order to isolate those compounds responsible for the antimutagenic activity. The antimutagenic activity was assessed by the inhibition of the mutagenic effect of aflatoxin B1 on TA98 and TA100 Salmonella tester strains using the Ames test. Methanolic fraction was responsible for the highest antimutagenic activity (95.6 and 95.9% for TA98 and TA100, resp.) and was further separated into fifteen different subfractions (M1-M15). Fraction M8 exerted the highest inhibition of AFB1 mutation (96.5 and 101.6% for TA98 and TA100, resp.) and, after further fractionation, four subfractions M8a, M8b, M8c, and M8d were obtained. Data from (1)H and (13)C NMR, and mass spectrometry analysis of fraction M8a (the one with the highest antimutagenic activity), suggest that the compound responsible for its antimutagenicity is an apocarotenoid.

Sonoran propolis and some of its chemical constituents inhibit in vitro growth of Giardia lamblia trophozoites.

Propolis is a cereus resin with a complex chemical composition that possesses a wide range of biological activities. The aim of this study was to evaluate the in vitro anti-Giardia lamblia activity of Sonoran propolis collected from three different areas of Sonoran Desert in northwestern Mexico (Caborca, Pueblo de Alamos, and Ures) and some of its chemical constituents. Additionally, we also analyzed the seasonal effect on the anti-G. lamblia activity of propolis. G. lamblia trophozoite cultures were treated with different concentrations of Sonoran propolis or chemical compounds during 48 h cell proliferation and cell viability were determined. Ures propolis showed the highest inhibitory activity against G. lamblia (IC50 63.8 ± 7.1 µg/mL) in a dose-dependent manner (Ures > Pueblo de Alamos > Caborca). Season had a significant effect on the in vitro anti-G. lamblia activity of Ures propolis. Summer propolis showed the highest inhibitory effect on the G. lamblia trophozoite growth (IC50 23.8 ± 2.3 µg/mL), followed by propolis collected during winter (IC50 59.2 ± 34.7 µg/mL), spring (IC50 102.5 ± 15.3 µg/mL), and autumn (IC50 125.0 ± 3.1 µg/mL). Caffeic acid phenethyl ester, an Ures propolis exclusive constituent, had the highest growth-inhibitory activity towards G. lamblia [IC50 63.1 ± 0.9 µg/mL (222.1 ± 3.2 µM)]. To our knowledge, this is the first study showing that caffeic acid phenethyl ester possesses antiparasitic activity against G. lamblia. Naringenin [IC50 125.7 ± 20.7 µg/mL (461.8 ± 76.3 µM)], hesperetin [IC50 149.6 ± 24.8 µg/mL (494.9 ± 82.2 µM)], and pinocembrin [IC50 174.4 ± 26.0 µg/mL (680.6 ± 101.7 µM)] showed weak anti-G. lamblia activity. On the other hand, chrysin and rutin did not show significant antiparasitic activity. In conclusion, our results suggest that Sonoran propolis and some of its chemical constituents had inhibitory effects on the in vitro growth of G. lamblia trophozoites.

Modulatory effects of propolis samples from Latin America (Brazil, Cuba and Mexico) on cytokine production by human monocytes.

OBJECTIVES: Propolis has been used in folk medicine in different regions of the world including Latin America. Propolis is a resinous mixture of substances collected by honey bees from several botanical sources, and its composition contains a rich chemical variety, depending on the geographical area and plant sources. Our aim was to compare the modulatory effect of propolis samples from three different countries of Latin America (Brazil, Cuba and Mexico) on pro- and anti-inflammatory cytokine production (tumor necrosis factor (TNF)-α and interleukin (IL)-10, respectively) by human monocytes. METHODS: Cells were incubated with propolis for 18 h at 37°C. Cell viability was assessed by 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide method, and cytokine production was determined by ELISA. KEY FINDINGS: All samples did not affect monocyte viability. Brazilian propolis stimulated both TNF-α and IL-10 production by monocytes. Cuban propolis stimulated TNF-α and inhibited IL-10 production, while Mexican sample exerted the opposite effect, inhibiting TNF-α and stimulating IL-10 production. The major compounds found in Brazilian, Cuban and Mexican propolis samples were artepillin C, isoflavonoids and pinocembrin, respectively. CONCLUSION: Brazilian, Cuban and Mexican propolis contained different components that may exert pro- and anti-inflammatory activity depending on concentration, what may provide a novel approach to the development of immunomodulatory drugs containing propolis.

Propuesta de una nueva clasificación de los oligoelementos para su aplicación en nutrición, oligoterapia, y otras estrategias terapéuticas / Proposal of new trace elements classification to be used in nutrition, oligotherapy and other therapeutics strategies

Objetivos: 1) Proponer una nueva clasificación de los oligoelementos fundamentada en el estudio detallado de las investigaciones más recientes sobre los mismos; 2) ofrecer información detallada y actualizada sobre todos los oligoelementos. Resultados: el análisis de todos los resultados de investigación consultados pone de manifiesto que los avances en las técnicas de análisis molecular permiten dilucidar la importancia que presentan ciertos oligoelementos para la salud humana. Se ofrece un análisis detallado de la función catalítica que podrían tener determinados elementos no considerados hasta ahora como esenciales o posiblemente esenciales, gracias al uso de plataformas informáticas que permiten el análisis integrado de datos sobre enzimas. Asimismo se presenta información integrada y actualizada del papel fisiológico, cinéticas y metabolismo, fuentes dietéticas y factores que propician la carencia o la toxicidad de cada uno de los oligoelementos. Conclusiones: La Oligoterapia plantea el uso de oligoelementos catalíticamente activos con fines terapéuticos. La nueva clasificación de oligoelementos planteada en este trabajo será de interés para diversos sectores profesionales: médicos y demás personal sanitario, nutricionistas, farmacéuticos, etc. Así podrán diseñarse nuevas estrategias terapéuticas que permitan paliar la sintomatología de diversas patologías, en particular las enfermedades carenciales y metabólicas (AU)

Objectives: 1) to propose a new classification of the trace elements based on a study of the recently reported research; 2) to offer detailed and actualized information about trace elements. Results: the analysis of the research results recently reported reveals that the advances of the molecular analysis techniques point out the importance of certain trace elements in human health. A detailed analysis of the catalytic function related to several elements not considered essential o probably essentials up to now is also offered. To perform the integral analysis of the enzymes containing trace elements informatics tools have been used. Actualized information about physiological role, kinetics, metabolism, dietetic sources and factors promoting trace elements scarcity or toxicity is also presented. Results: Oligotherapy uses catalytic active trace elements with therapeutic proposals. The new trace element classification here presented will be of high interest for different professional sectors: doctors and other professions related to medicine; nutritionist, pharmaceutics, etc. Using this new classification and approaches, new therapeutic strategies could be designed to mitigate symptomatology related to several pathologies, particularly carential and metabolic diseases (AU)

Treatment of stage Ia and Ib mycosis fungoides with psoralen UVA monotherapy: an observational study in tertiary hospitals in the Canary Islands.

BACKGROUND: Mycosis fungoides (MF) is the most common form of primary cutaneous T cell lymphoma. Psoralen combined with ultraviolet A (PUVA) is a first-line treatment for early-stage disease. OBJECTIVES: This study was conducted to assess the clinical effectiveness of and tolerance to PUVA monotherapy in MF. METHODS: We retrospectively reviewed the files of patients who received PUVA for stage I disease. The study included 31 patients, of whom 32% presented with stage Ia and 67% with stage Ib disease, and 68% presented with patch and 32% with plaque disease. All patients received treatment three times per week. RESULTS: Complete response (CR) was achieved in 71% of patients. The median cumulative dose of UVA at CR was 211.7 J/cm(2) . There was a significant difference in median cumulative dose at CR between patients with plaque and patch disease, respectively, but not between patients with stage Ia and Ib disease. Median disease-free survival (DFS) was 230 weeks. Patients with patch disease achieved longer DFS than those with plaque disease (P = 0.004), although DFS was similar in stage Ia and Ib patients. Of the patients who received maintenance therapy, 58% relapsed. Univariate analysis showed patch disease to be a predictive factor for CR, but no predictors of relapse were identified. A total of 71% of patients developed clinical adverse reactions. CONCLUSIONS: Psoralen with UVA is a safe and effective treatment for early-stage MF. Patch disease responds more favorably than plaque disease and is associated with a longer period of DFS. Maintenance treatment does not appear to reduce recurrence. Current evidence suggests that the proposed revision to the classification of MF, which takes into account the extent and type of disease, more accurately predicts response to PUVA.

Infecciones en pacientes con artritis reumatoide: medicamentos moduladores de la respuesta biológica versus fármacos modificadores de la enfermedad. Seguimiento a un año / Infections in rheumatoid arthritis patients: biological therapy versus disease modifying anti-rheumatic drugs: one year follow-up

IntroducciónLos fármacos antirreumáticos modificadores de la enfermedad y los medicamentos biológicos buscan controlar la inflamación y evitar la progresión del daño articular en artritis reumatoide. Aún es controvertido si éstos aumentan la incidencia de infecciones en esta entidad.MétodosEstudio de cohorte retrospectivo en una población de pacientes de consulta externa y hospitalización, de un hospital universitario de referencia de reumatología, de cuarto nivel de complejidad, del noroccidente colombiano. Se incluyeron 383 pacientes según los criterios del American College of Rheumatology de 1987: 83 en el grupo de terapia con biológicos y 300 en el grupo de fármacos modificadores, para establecer la incidencia y factores de riesgo para infecciones no serias y serias a los 12 meses de seguimiento.ResultadosLa mayoría de la población fue femenina (85%). El grupo de biológicos presentó un mayor riesgo para infecciones no serias [HR 1.73 (IC 95% 1.07–2.77; p=0.023)] y serias [HR 2.56 (IC 95% 1.09–6.01; p=0.030)]; este hallazgo se mantuvo al ajustar los resultados por otras variables asociadas a infección (número de fármacos modificadores recibidos, uso de metotrexate, esteroides y leflunomida, diabetes mellitus) HR para infección no seria [(1.67, IC 95% 1.05–2.70; p=0.030)] y HR para infección seria [(2.67, IC 95% 1.12–6.34; p= 0.026)]. La enfermedad pulmonar crónica [HR 5.11 (IC 95% 1.18–22.08; p=0.029)] fue factor de riesgo adicional para infecciones serias.ConclusionesLa terapia con biológicos aumenta el riesgo de infecciones serias y no serias a 12 meses, en comparación con fármacos modificadores, en un grupo de pacientes con artritis reumatoide. También se aumenta el riesgo de infecciones serias con la presencia de enfermedad pulmonar crónica.

Background: Disease modifying anti-rheumatic drugs and biological disease modifying drugs are used to control inflammation and prevent progression of joint damage in rheumatoid arthritis. It is still controversial whether these drugs increase the incidence of infection in this disease.Methods:A retrospective cohort study was conducted on a population sample of 383 inpatients and outpatients from a university hospital and referral rheumatology tertiary hospital complex in northwestern Colombia. They were classified according to American College of Rheumatology 1987 classification criteria, with 83 in the biological therapy group, and 300 in the disease modifying antirheumatic drugs group, in order to establish the incidence and risk factors for serious and non-serious infections at 12 months follow-up. Results: The majority were females (85%). The biological therapy group presented a greater risk for non-serious [HR 1.73 (95% CI 1.07-2.77; P=.023)] and serious infections [HR 2.56 (95% CI 1.09-6.01; P=.030)]. This finding remained when adjusting for other variables associated with infection (number of disease modifying antirheumatic drugs received, methotrexate, leflunomide and steroids use, diabetes mellitus), with HR for non-serious infection [(1.67, 95% CI 1.05-2.70; P=.030)], and HR for serious infection [(2.67, 95% CI 1.12-6.34; P=.026)]. Chronic lung disease [HR 5.11 (95 % CI 1.18-22.08; P=.029)] was an additional risk factor for serious infections.Conclusions: Biological therapy increases the risk of serious and non-serious infections at 12 months, compared to disease modifying drugs, in a group of patients with rheumatoid arthritis. The risk of serious infections also increases with the presence of chronic lung disease.

[Proposal of new trace elements classification to be used in nutrition, oligotherapy and other therapeutics strategies]. / Propuesta de una nueva clasificación de los oligoelementos para su aplicación en nutrición, oligoterapia, y otras estrategias terapéuticas.

OBJECTIVES: 1) to propose a new classification of the trace elements based on a study of the recently reported research; 2) to offer detailed and actualized information about trace elements. RESULTS: the analysis of the research results recently reported reveals that the advances of the molecular analysis techniques point out the importance of certain trace elements in human health. A detailed analysis of the catalytic function related to several elements not considered essential o probably essentials up to now is also offered. To perform the integral analysis of the enzymes containing trace elements informatics tools have been used. Actualized information about physiological role, kinetics, metabolism, dietetic sources and factors promoting trace elements scarcity or toxicity is also presented. RESULTS: Oligotherapy uses catalytic active trace elements with therapeutic proposals. The new trace element classification here presented will be of high interest for different professional sectors: doctors and other professions related to medicine; nutritionist, pharmaceutics, etc. Using this new classification and approaches, new therapeutic strategies could be designed to mitigate symptomatology related to several pathologies, particularly carential and metabolic diseases.

Objetivos: 1) Proponer una nueva clasificación de los oligoelementos fundamentada en el estudio detallado de las investigaciones más recientes sobre los mismos; 2) ofrecer información detallada y actualizada sobre todos los oligoelementos. Resultados: el análisis de todos los resultados de investigación consultados pone de manifiesto que los avances en las técnicas de análisis molecular permiten dilucidar la importancia que presentan ciertos oligoelementos para la salud humana. Se ofrece un análisis detallado de la función catalítica que podrían tener determinados elementos no considerados hasta ahora como esenciales o posiblemente esenciales, gracias al uso de plataformas informáticas que permiten el análisis integrado de datos sobre enzimas. Asimismo se presenta información integrada y actualizada del papel fisiológico, cinéticas y metabolismo, fuentes dietéticas y factores que propician la carencia o la toxicidad de cada uno de los oligoelementos. Conclusiones: La Oligoterapia plantea el uso de oligoelementos catalíticamente activos con fines terapéuticos. La nueva clasificación de oligoelementos planteada en este trabajo será de interés para diversos sectores profesionales: médicos y demás personal sanitario, nutricionistas, farmacéuticos, etc. Así podrán diseñarse nuevas estrategias terapéuticas que permitan paliar la sintomatología de diversas patologías, en particular las enfermedades carenciales y metabólicas.

Specialized appendages in fuxianhuiids and the head organization of early euarthropods.

The organization of the head provides critical data for resolving the phylogenetic relationships and evolutionary history of extinct and extant euarthropods. The early Cambrian-period fuxianhuiids are regarded as basal representatives of stem-group Euarthropoda, and their anterior morphology therefore offers key insights for reconstructing the ancestral condition of the euarthropod head. However, the paired post-antennal structures in Fuxianhuia protensa remain controversial; they have been interpreted as both 'great appendages' and as gut diverticulae. Here we describe Chengjiangocaris kunmingensis sp. nov. and Fuxianhuia xiaoshibaensis sp. nov. from a new early Cambrian (Stage 3) fossil Lagerstätte in Yunnan, China. Numerous specimens of both species show a unique 'taphonomic dissection' of the anterodorsal head shield, revealing the cephalic organization in detail. We demonstrate the presence of a pair of specialized post-antennal appendages (SPAs) in the fuxianhuiid head, which attach at either side of the posteriorly directed mouth, behind the hypostome. Preserved functional articulations indicate a well-defined but restricted range of limb movement, suggestive of a simple type of sweep feeding. The organization of the SPAs in fuxianhuiids is incompatible with the (deutocerebral) anterior raptorial appendages of megacheirans, and argue against the presence of protocerebral limbs in the fuxianhuiids. The positions of the fuxianhuiid antennae and SPAs indicate that they are segmentally homologous to the deutocerebral and tritocerebral appendages of crown-group Euarthropoda respectively. These findings indicate that antenniform deutocerebral appendages with many podomeres are a plesiomorphic feature of the ancestral euarthropod head.

External validation of a virtual reality transurethral resection of the prostate simulator.

PURPOSE: Virtual reality surgical simulation is an emerging technology that may eventually fill the gaps in surgical education created by changes in our medical system. We assessed the construct validity of a commercially available, virtual reality transurethral prostate resection simulator. MATERIALS AND METHODS: Participants performed 2, 5-minute transurethral prostate resection exercises on a standardized virtual reality prostate. Data from the first exercise were discarded. Simulator based metrics from the second exercise were tabulated, including tissue resected in gm, number of cuts, coagulation time, number of coagulation attempts, tissue per cut in gm and blood loss. Complications were recorded. Performance metrics were compared between groups based on urological training level and prior real-world experience with transurethral prostate resection. RESULTS: A total of 35 participants with varied levels of transurethral prostate resection experience completed the exercise. Several performance metrics had statistically significant correlations with urology training level and prior experience with transurethral prostate resection. There was a positive correlation of all measures of experience with mass resected, mass resected per cut and blood loss. Number of cuts correlated significantly with transurethral prostate resection experience in the previous year. Complications were present in most groups with medical students more likely to encounter external urethral sphincter and rectal injuries. CONCLUSIONS: We report the construct validity of a commercially available, virtual reality transurethral prostate resection simulator. The more experienced participants resected more tissue in a more efficient manner but with increased blood loss. Further investigations are needed before the widespread application of transurethral prostate resection simulators for training, certification and accreditation.

Sonoran propolis: chemical composition and antiproliferative activity on cancer cell lines.

In this study, we have analyzed the chemical composition and antiproliferative activity of propolis from three different arid and semiarid regions of Sonora, Mexico. We identified and quantitated the main chemical constituents of propolis by HPLC-MS. The most abundant constituents of propolis were pinocembrin, pinobanksin 3-acetate, and chrysin. Sonoran propolis had a strong antiproliferative activity on both murine and human cancer cell lines in a concentration-dependent manner. The propolis constituents CAPE, galangin, xanthomicrol and chrysin showed significant antiproliferative activity on most of the cancer cells tested. DNA harvested from cancer cell cultures treated with Sonoran propolis exhibited a ladder of internucleosomal DNA cleavage characteristic of apoptosis. In summary, we have identified and quantitated the main constituents of Sonoran propolis. These propolis samples possess a strong antiproliferative activity on cancer cell lines.

What's new in the field of prostate cancer chemoprevention?

Chemoprevention trials for several malignancies are completed, planned, or underway. Prostate cancer is one of the most common forms of cancer and understandably has received considerable recent attention as a potential target for chemoprevention. This article examines chemoprevention trials for prostate cancer, including the Prostate Cancer Prevention Trial, Selenium and Vitamin E Cancer Prevention Trial, and cyclooxygenase inhibitors in the prevention of prostate cancer.