[Utilization study in real clinical practice of ceftolozane/tazobactam vs aminoglycosides and/or colistin in the treatment of multirresistant or extremely resistant Pseudomonas aeruginosa]. / Estudio de utilización en práctica clínica real de ceftolozano/tazobactam frente a aminoglucósidos y/o colistina en el tratamiento de Pseudomonas aeruginosa.

OBJECTIVE: Comparative "real life" data on the effectiveness and safety of ceftolozane/tazobactam (C/T) versus other regimens (aminoglycosides/colistin/combination), in the treatment of multi-resistant (MDR) and extremely resistant (XDR) Pseudomonas aeruginosa (PA), are needed to establish positions. METHODS: Observational, retrospective study of patients with microbiological confirmation of MDR and XDR PA from July 2016 up to December 2018 in a tertiary hospital. Variables: age, sex, comorbidities, risk factors for multidrug resistance, variables related to infection, source of infection, microorganism and type of sample, antibiotic treatment, clinical cure, microbiological cure, recurrence, mortality on admission and 30 days post-discharge. Patients were classified according to received antibiotic treatment, C/T or aminoglycosides/colistin/combination. RESULTS: A total of 405 patients with PA MDR and XDR infection (73.1% men, mean age 63 ± 15 years) were studied. An 87.1% of PA XDR and a 12.9% MDR were observed. All patients received C/T as targeted therapy and in the aminoglycosides/colistin/combination group were 73.5%. Patients in the C/T group present worse prognostic factors: septic shock (30.0%) and catheterization (90.0%) (p<0.05). There were not statistically significant differences in microbiological cure (p=0.412), recurrence (p=0.880) and clinical cure (p=0.566). There were not statistically significant differences in mortality at admission (p=0.352) or at 30 days after discharge (p=0.231). A 17.2% of the patients with aminoglycosides/colistin/combination had acute kidney injury according to RIFLE criteria and 4.3% with C/T. CONCLUSIONS: The data obtained suggest that there have been no differences in effectiveness (clinical or microbiological cure) in favour of C/T, although, in the period studied, it was used in most cases in multitreated patients with a worse prognosis. Randomized and prospective studies would be needed to establish an adequate positioning.

Effect of antibiotic treatment on the formation of non-spore Clostridium difficile persister-like cells.

Background: The spore is the virulence factor identified to be involved in the recurrence of the disease caused by Clostridium difficile. Objectives: To demonstrate that lethal antibiotic concentrations induce the appearance of C. difficile persister-like non-spore cells. Methods: C. difficile and derivative spo0A mutant strains were tested for their susceptibility to antibiotics, as determined using an agar dilution method. Persister-cell generation was determined for all strains using up to 10â€Š× the MIC of every antibiotic for up to 6 days. Results: Using up to 10â€Š× the MIC of every antibiotic, we were able to induce the appearance of persister-like behaviour since biphasic killing curves could be observed in response to treatment antibiotics. Conclusions: To the best of our knowledge, this work provides, for the first time, experimental evidence of the appearance of C. difficile persister-like cells, opening a new research avenue in the pathogenesis of this nosocomial pathogen.

Is eosinophilic esophagitis an equivalent of pollen allergic asthma? Analysis of biopsies and therapy guided by component resolved diagnosis

Background: Eosinophilic esophagitis (EoE) is characterized by esophageal dysfunction and, histologically, by eosinophilic inflammation. There is not a clear etiologic treatment. Biopsies analysis using plant histology methods may show callose and pollen tubes in the esophageal mucosa. Component-resolved diagnosis (CRD) with microarrays could detect possible allergens involved and indicate an elimination diet and allergen immunotherapy (AIT). Methods: One hundred and twenty-nine patients with EoE were tested for environmental and food allergens. CRD, histological and botanical analysis were performed. Clinical scores and endoscopic biopsy were performed every six months for three years. Fifty healthy patients, 50 asthmatics due to pollen, and 53 celiac disease patients were included as comparison groups. CRD-directed AIT was administered in 91 EoE patients and elimination diet in 140 patients (87 EoE and all 53 CD patients). Results: CRD detected allergen hypersensitivity in 87.6% of patients with EoE. The predominant allergens were grass group 1 (55%), lipid transfer proteins (LTP) of peach and mugwort, hazelnuts and walnuts. Callose from pollen tubes was found in 65.6% of biopsies. After CRD-guided elimination diet and/or AIT, 101 (78.3%) EoE patients showed significant clinical improvement (p < 0.017) and 97 (75.2%) were discharged (negative biopsy, no symptoms, no medication) without relapse (AU)

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Is eosinophilic esophagitis an equivalent of pollen allergic asthma? Analysis of biopsies and therapy guided by component resolved diagnosis.

BACKGROUND: Eosinophilic esophagitis (EoE) is characterized by esophageal dysfunction and, histologically, by eosinophilic inflammation. There is not a clear etiologic treatment. Biopsies analysis using plant histology methods may show callose and pollen tubes in the esophageal mucosa. Component-resolved diagnosis (CRD) with microarrays could detect possible allergens involved and indicate an elimination diet and allergen immunotherapy (AIT). METHODS: One hundred and twenty-nine patients with EoE were tested for environmental and food allergens. CRD, histological and botanical analysis were performed. Clinical scores and endoscopic biopsy were performed every six months for three years. Fifty healthy patients, 50 asthmatics due to pollen, and 53 celiac disease patients were included as comparison groups. CRD-directed AIT was administered in 91 EoE patients and elimination diet in 140 patients (87 EoE and all 53 CD patients). RESULTS: CRD detected allergen hypersensitivity in 87.6% of patients with EoE. The predominant allergens were grass group 1 (55%), lipid transfer proteins (LTP) of peach and mugwort, hazelnuts and walnuts. Callose from pollen tubes was found in 65.6% of biopsies. After CRD-guided elimination diet and/or AIT, 101 (78.3%) EoE patients showed significant clinical improvement (p<0.017) and 97 (75.2%) were discharged (negative biopsy, no symptoms, no medication) without relapse. AIT-treated patients had better outcomes (odds ratio 177.3, 95% CI 16.2-1939.0). CONCLUSION: CRD-directed AIT and/or elimination diet was efficient in treating EoE patients and was well tolerated.

Pilates en pacientes con espondilitis anquilosante: repercusión en la función pulmonar / Pilates physiotherapy for ankylosing spondylitis patients: Impact on lung function

Objetivo: Evaluar el impacto de la fisioterapia basada en el método de Pilates en la función pulmonar de pacientes con espondilitis anquilosante (EA). Material y método: Se realiza un ensayo clínico aleatorizado (ECA) con 49 pacientes diagnosticados de EA según los criterios de Nueva York modificados. Se establecen al azar 2 grupos de trabajo. Se aplicó ejercicio terapéutico en 26 pacientes, 17 semanas, días alternos y 1h de duración, supervisado por un fisioterapeuta. El grupo control (23 pacientes) realizó un programa de ejercicios convencionales en el domicilio. Terminan el estudio 45 de los 49 pacientes que iniciaron el ECA. Las variables analizadas son: expansión costal, capacidad vital forzada (CVF), volumen espirado forzado (FEV1) y el cociente FEV1/CVF. Resultados: No hay diferencias significativas en los valores de expansión costal entre ambos grupos (p valor=0,686) ni diferencias en el grupo experimental antes y después de la intervención (p valor=0,780). Los valores de la espirometría se comportan de forma similar. La CVF aumenta de forma discreta en el grupo experimental no de forma significativa (p valor = 0,122). Conclusiones: El impacto de los ejercicios basados en pilates sobre los valores espirométricos y la expansión costal es escaso, a pesar de la tendencia del grupo experimental a mejorar su CVF después de la intervención. Se debe considerar, para su aplicación clínica, implementar este tipo de protocolos con fisioterapia respiratoria específica

Aim: To evaluate the impact of physiotherapy, based on the Pilates Method, on the lung function of patients with Ankylosing Spondylitis (AS). Material and methods: A randomised clinical trial (RCT) was performed with 49 patients diagnosed with AS according to the modified New York criteria. Two groups were randomly established. Therapeutic Pilates-based exercise was performed by 26 patients for 17 weeks, in 90minute sessions on alternative days, supervised by a physiotherapist. The control group (23 patients) used a conventional exercise program at home. The variables analysed were: rib cage expansion, forced vital capacity (FVC), forced expiratory volume (FEV1), and the FEV1/FVC ratio. Results: No significant differences were found in the values of rib cage expansion between control and experimental groups (P=.686), while there were differences before and after intervention in the experimental group (P=.780). The values of spirometry were similar in both control and experimental groups. No-significant increase in FVC was observed in the experimental group (P=.122). Conclusions: The impact of Pilates-based exercises on spirometry values and rib cage expansion is limited, although there was a tendency to improve FVC after Pilates exercises. These types of exercise protocols should be considered, for their clinical application, in specific respiratory physiotherapy

Antifungal treatment with echinocandins: a 10-year clinical experience.

OBJECTIVE: The number of studies evaluating the use of echinocandins, whether or not its indication meets international guidelines, in clinical practice is limited. The objective of the present study was to determine the use of echinocandins in a tertiary Spanish hospital in 10 years of clinical practice, and to evaluate its impact on prognosis. METHODS: This retrospective study involved adult nonneutropenic ill patients with suspicion of fungal invasion who started treatment with echinocandins between 2006 and 2015. RESULTS: The number of patients treated with echinocandins was 153, and candidemia was detected thereafter in 25.5%. Factors associated with in-hospital mortality in patients receiving echinocandins were: sex male, septic shock, Charlson comorbidity index, and total stay at the hospital. In-hospital mortality after 7, 30 and 90 days was 13.7%, 24.8%, and 56.8%, respectively. From patients receiving echinocandins, 98 did no show multifocal colonization, 50 had Candida score <2.5, and 49 did not meet Ostrosky-Zeichner prediction rule. A total of 19 patients did not show any of these 3 potential risk factors for candidemia. CONCLUSIONS: The use of echinocandins in 10 years of clinical practice in our tertiary hospital has been performed according to international guidelines; however, candidemia was only diagnosed thereafter in only 25.5% of cases. Furthermore, according to our results, the adequate use of echinocandins seems not to be associated with reduced mortality rates. Further studies, involving a large cohort of patients and more hospitals, are required to corroborate these results.

Comparative effectiveness of water and salt community-based fluoridation methods in preventing dental caries among schoolchildren.

OBJECTIVE: To compare the effectiveness of water and salt community-based fluoridation methods on caries experience among schoolchildren. METHODS: Data derived from two population-based oral health surveys of 12-year-old schoolchildren exposed to different community-based fluoridation methods were compared: artificially fluoridated water in Porto Alegre, South Brazil and artificially fluoridated salt in Montevideo, Uruguay. Data on socio-demographic characteristics, maternal education and oral hygiene were collected. Dental caries was defined according to the WHO criteria (cavitated lesions) and to the modified WHO criteria (active noncavitated lesions and cavitated ones). The association between community-based fluoridation methods and dental caries was modelled using logistic (caries prevalence) and Poisson regression (DMFT). Odds ratios (OR), rate ratios (RR), and the 95% confidence intervals (CI) were estimated. RESULTS: A total of 1528 in Porto Alegre and 1154 in Montevideo were examined (response rates: 83.2% and 69.6%, respectively). Adjusted estimates for caries prevalence and DMFT showed that schoolchildren from Porto Alegre were less affected by dental caries than their counterparts from Montevideo, irrespective of the criteria used. After adjusting for important characteristics, schoolchildren exposed to fluoridated salt had significantly higher likelihood of having caries (WHO criteria) than those exposed to fluoridated water (OR for prevalence=1.61, 95% CI=1.26-2.07; RR for DMFT=1.32, 95% CI=1.16-1.51). Similar differences were observed using the modified WHO criteria. CONCLUSION: Fluoridated water appears to provide a better protective effect against dental caries than fluoridated household salt among schoolchildren from developing countries.

Analgesia basada en infusión continua de anestésico local a nivel interfascial tras cirugía de colon laparoscópico: ensayo clínico / Analgesia with interfascial continuous wound infiltration after laparoscopic colon surgery: a randomized clinical trial

Objetivos. Tanto para cirugía laparoscópica como para cirugía abierta la analgesia multimodal puede ayudar a controlar el dolor postoperatorio. La colocación de un catéter en la herida quirúrgica de manera intraoperatoria tras cirugía de colon podría optimizar el control del dolor con menor consumo de opiáceos y menos efectos secundarios. Método. Realizamos un estudio prospectivo, aleatorizado de pacientes reclutados para cirugía de colon laparoscópica en el Hospital de Galdakao-Usansolo de enero de 2012 a enero de 2013. Los pacientes fueron asignados aleatoriamente al grupo del catéter o al grupo de la analgesia postoperatoria estándar. Un miembro de la Unidad de dolor agudo monitorizó todos los pacientes a lo largo de 48 h tras la cirugía. Las variables principales analizadas fueron la escala numérica verbal y la cantidad de morfina intravenosa utilizada por cada paciente mediante PCA. Resultados. Se incluyeron 92 pacientes en el estudio, 43 en el grupo con catéter y 49 en el estándar. Se observaron diferencias estadísticamente significativas en el consumo de morfina entre ambos grupos a lo largo de todo el periodo. La cantidad total de morfina consumida en el grupo del catéter fue de 5,63 ± 5,02 mg y de 21,86 ± 17,88 mg en el grupo de analgesia estándar (p = 0,0001). Los pacientes con catéter presentaban menores valores en la escala numérica verbal. No se encontraron efectos adversos asociados a la colocación del catéter y la administración de anestésico local. El grupo de catéter presentó menor estancia hospitalaria respecto al otro grupo (p = 0,02). Conclusión. En los pacientes intervenidos de cirugía de colon laparoscópico una infusión continua de anestésico local a través de un catéter interfascial durante 48 h tras la cirugía reduce la percepción del dolor y el consumo de morfina intravenosa, disminuyendo la estancia hospitalaria (AU)

Objectives. For major laparoscopic surgery, as with open surgery, a multimodal analgesia plan can help to control postoperative pain. Placing a wound catheter intraoperatively following colon surgery could optimize the control of acute pain with less consumption of opioids and few adverse effects. Methods. We conducted a prospective, randomized, study of patients scheduled to undergo laparoscopic colon surgery for cancer in Galdakao-Usansolo Hospital from January 2012 to January 2013. Patients were recruited and randomly allocated to wound catheter placement plus standard postoperative analgesia or standard postoperative analgesia alone. A physician from the acute pain management unit monitored all patients for pain at multiple points over the first 48 hours after surgery. The primary outcome variables were verbal numeric pain scale scores and amount of intravenous morphine used via patient controlled infusion. Results. 92 patients were included in the study, 43 had a wound catheter implanted and 49 did not. Statistically significant differences in morphine consumption were observed between groups throughout the course of the treatment period. The mean total morphine consumption at the end of the study was 5.63 ± 5.02 mg among wound catheter patients and 21. 86 ± 17.88 mg among control patients (P = .0001). Wound catheter patients had lower pain scale scores than control patients throughout the observation period. No adverse effects associated with the wound catheter technique were observed. The wound catheter group showed lower hospital stays with statistically significant difference (P = .02). Conclusions. In patients undergoing laparoscopic colon surgery, continuous infusion of local anaesthetics through interfascial wound catheters during the first 48 h aftersurgery reduced the level of perceived pain and also reduced parenteral morphine consumption with no associated adverse effects and lower hospital stays (AU)

Dietary intervention focused on phosphate intake in hemodialysis patients with hyperphosphoremia.

BACKGROUND: Elevated serum phosphorus has been identified as a cardiovascular risk factor. This study aimed to assess the effectiveness of dietary intervention to reduce phosphorus intake and to improve the calcium-phosphorus metabolism in hemodialysis patients. DESIGN: Patients were included in a 6-month, 2-group experimental study if their previous 3-month average serum phosphorus was over 5.5 mg/dl. Patients were allocated to intensive dietary intervention or usual dietary recommendations. The clinical end-points were the multivariate-adjusted change in serum phosphorus and the number of patients who achieved serum phosphorus levels of < 5.5 mg/dl and serum phosphorus levels of < 5 mg/dl. RESULTS: 80 dialysis patients completed the study, 41 in the experimental group and 39 in the control group. After 6 months, phosphorus intake (702 ± 168 vs. 872 ± 242 mg/24 h; p = 0.002) was lower in the experimental group than in the control group, with no inter-group differences in protein-caloric intake. Serum phosphorus decreased 1.67 mg/dl in the experimental group and 0.58 mg/dl in the control group (multivariate-adjusted difference 0.93 mg/ dl; 95% CI 0.34 - 1.52; p = 0.003). Serum phosphorus < 5.5 mg/dl and serum phosphorus < 5 mg/dl were attained more frequently in the experimental group (51 vs. 18%, p = 0.002 and 31.7 vs. 15.4%, p = 0.08 respectively). CONCLUSIONS: Intensive dietary intervention focusing on phosphorus intake may be useful to reduce phosphorus retention and to improve calcium-phosphorus metabolism in hemodialysis patients.

High energy electron beams characterization using CaSO4:Dy+PTFE phosphors for clinical therapy applications.

In the present work high energy electron beam dosimetry from linear accelerator (LINACs) for clinical applications using dysprosium doped calcium sulfate embedded in polytetrafluorethylene (CaSO4:Dy+PTFE) was studied. The irradiations were carried out using high electron beams (6 to 18 MeV) from a linear accelerator (LINAC) Varian, CLINAC 2300C/D, for clinical practice purpose. The electron irradiations were obtained using the water solid in order to guarantee electronic equilibrium conditions (EEC). Field shaping for electron beams was obtained with electron cones. Glow curve and other thermoluminescent characteristics of CaSO4:Dy+PTFE were conducted under high electrons beams irradiations. The TL response of the pellets showed an intensity peak centered at around 215 °C. TL response of CaSO4:Dy+PTFE as a function of high electron absorbed dose showed a linearity in a wide range. To obtain reproducibility characteristic, a set of pellets were exposed repeatedly for the same electron absorbed dose. The results obtained in this study can suggest the applicability of CaSO4:Dy+PTFE pellets for high electron beam dosimetry, provided fading is correctly accounted for.

Carboxylate metabolism in sugar beet plants grown with excess Zn.

The effects of Zn excess on carboxylate metabolism were investigated in sugar beet (Beta vulgaris L.) plants grown hydroponically in a growth chamber. Root extracts of plants grown with 50 or 100µM Zn in the nutrient solution showed increases in several enzymatic activities related to organic acid metabolism, including citrate synthase and phosphoenolpyruvate carboxylase, when compared to activities in control root extracts. Root citric and malic acid concentrations increased in plants grown with 100µM Zn, but not in plants grown with 50µM Zn. In the xylem sap, plants grown with 50 and 100µM Zn showed increases in the concentrations of citrate and malate compared to the controls. Leaves of plants grown with 50 or 100µM Zn showed increases in the concentrations of citric and malic acid and in the activities of citrate synthase and fumarase. Leaf isocitrate dehydrogenase increased only in plants grown with 50µM Zn when compared to the controls. In plants grown with 300µM Zn, the only enzyme showing activity increases in root extracts was citrate synthase, whereas the activities of other enzymes decreased compared to the controls, and root citrate concentrations increased. In the 300µM Zn-grown plants, the xylem concentrations of citric and malic acids were higher than those of controls, whereas in leaf extracts the activity of fumarase increased markedly, and the leaf citric acid concentration was higher than in the controls. Based on our data, a metabolic model of the carboxylate metabolism in sugar beet plants grown under Zn excess is proposed.

Recuperación y reinfusión de hematíes durante el postoperatorio / No disponible

El desarrollo de técnicas quirúrgicas cada vez más complejas, principalmente en cirugía cardiovascular y ortopédica, cirugía oncológica, trasplantes y pacientes politraumatizados han intensificado el aumento de las demandas de transfusiones. En los últimos años, se ha hecho necesario limitar al máximo la transfusión de sangre homóloga por los posibles efectos adversos de tipo inmunológico, e infeccioso por virus y priones. Recientemente, se han desarrollado nuevas medidas terapéuticas con el fin de reducir al mínimo la utilización de sangre homóloga, principalmente en cirugía programada, entre las que destacan las diferentes modalidades de autotransfusión postoperatoria (AU)

The development of surgical techniques increases complexity, particularly in cardiovascular and orthopedic surgery, cancer surgery, transplants and patients with multiple injuries has intensified the growing demands of transfusions. In recent years it has become necessary to minimize homologous blood transfusion by the possible adverse effects of immunological, and infection by viruses and prions. Recently, we have developed new therapeutic measures to minimize the use of homologous blood, mainly in elective surgery, among which the different modalities of postoperative autotransfusion (AU)

Oleic acid content is responsible for the reduction in blood pressure induced by olive oil.

Numerous studies have shown that high olive oil intake reduces blood pressure (BP). These positive effects of olive oil have frequently been ascribed to its minor components, such as alpha-tocopherol, polyphenols, and other phenolic compounds that are not present in other oils. However, in this study we demonstrate that the hypotensive effect of olive oil is caused by its high oleic acid (OA) content (approximately 70-80%). We propose that olive oil intake increases OA levels in membranes, which regulates membrane lipid structure (H(II) phase propensity) in such a way as to control G protein-mediated signaling, causing a reduction in BP. This effect is in part caused by its regulatory action on G protein-associated cascades that regulate adenylyl cyclase and phospholipase C. In turn, the OA analogues, elaidic and stearic acids, had no hypotensive activity, indicating that the molecular mechanisms that link membrane lipid structure and BP regulation are very specific. Similarly, soybean oil (with low OA content) did not reduce BP. This study demonstrates that olive oil induces its hypotensive effects through the action of OA.

Fungal transformations of uranium oxides.

The biogeochemical activities of free-living and symbiotic fungi must be acknowledged in attempts to understand uranium cycling and dispersal in the environment. Although the near-surface geochemistry of uranium is very complex and a wide variety of mineral phases is known, uranium trioxide (UO3) and triuranium octaoxide (U(3)O(8)) can be used as well characterized models in the study of biotransformations. We have used a complex methodological approach involving advanced solid state speciation and scanning electron microscopy to study the ability of saprotrophic, ericoid and ectomycorrhizal fungi to transform these model oxides. This study has revealed that fungi exhibit a high uranium oxide tolerance, and possess the ability to solubilize UO3 and U(3)O(8) and to accumulate uranium within the mycelium to over 80 mg (g dry weight)(-1) biomass. X-ray absorption spectroscopy of uranium speciation within the biomass showed that in most of the fungi the uranyl ion was coordinated to phosphate ligands, but in ectomycorrhizal fungi mixed phosphate/carboxylate coordination was observed. Abundant uranium precipitates associated with phosphorus were found in the mycelium and encrusted the hyphae. Some of the fungi caused the biomineralization of well-crystallized uranyl phosphate minerals of the meta-autunite group. This is the first experimental evidence for fungal transformations of uranium solids and the production of secondary mycogenic uranium minerals.

Acute and chronic leptin reduces food intake and body weight in goldfish (Carassius auratus).

The purpose of the present study was to elucidate the possible role of leptin in food intake and body weight regulation in goldfish. We examined the effects of i.c.v. or i.p. acute leptin administration on food intake in food-deprived goldfish at different time intervals post-injection (0-2, 2-8 and 0-8 h). Food intake was reduced by i.p. administered leptin (1 microg) at 8 h post-injection, without statistically significant differences after i.c.v. treatment. The present study shows for the first time in a teleost that chronic (10 days) leptin treatment (i.p.) reduces food intake, body weight gain, specific growth rate and food efficiency ratio. Moreover, lipid and carbohydrate metabolism seems to be regulated by leptin in fish. Chronic leptin treatment increased lipid mobilization and carbohydrate storage as hepatic and muscle glycogen. Finally, leptin could mediate its actions on energy homeostasis in fish, at least in part, through interactions with hypothalamic catecholamines, since chronic leptin treatment reduced both hypothalamic noradrenergic and dopaminergic turnover without significant modifications in hypothalamic serotoninergic and neuropeptide Y (NPY) systems. In summary, our results suggest that leptin can regulate feeding behaviour and body weight homeostasis in fish.

Tecnica alternativa para prevenir la estimulación del nervio obturador durante la RTU vesical de neoformaciones en cara lateral / An alternative technique to prevent of obturator nerve stimulation during lateral bladder tumors transurethral resection

Objetivo: Presentamos una alternativa de abordaje para el bloqueo del nervio obturador durante la RTU vesical. Material y Metodos: Se revisan retrospectivamente 400 tumores vesicales intervenidos, correspondientes a 218 pacientes, localizándose un 46,8% de estos en caras laterales. Se utiliza una vía de abordaje alternativa para el bloqueo del nervio obturador. Resultados: Mediante este abordaje, que simplifica, en posición de litotomía, el bloqueo nervioso del obturador, conseguimos en más del 95% de resecciones el que no se produzca estimulación muscular. Conclusiones: Aplicando esta técnica, disminuimos el riesgo de perforación vesical por esta causa, evitando las complicaciones asociadas

Objetives: We presents an alternative to prevent the obturator nerve stimulation during TUBR. Material and Method: We revise 400 bladder tumours corresponding to 218 patients, 46,8% of them localized in lateral bladder wall. An alternative technique is used for that blockade. Results: There have been no adductor contractions in more than 95% of TUBR. Conclusions: The alternative technique may reduce the stimulation of the obturador nerve and the risk of bladder perforation. Objetives: We presents an alternative to prevent the obturator nerve stimulation during TUBR. Material and Method: We revise 400 bladder tumours corresponding to 218 patients, 46,8% of them localized in lateral bladder wall. An alternative technique is used for that blockade. Results: There have been no adductor contractions in more than 95% of TUBR. Conclusions: The alternative technique may reduce the stimulation of the obturador nerve and the risk of bladder perforation (AU)

Vegetation-derived cues for the selection of oviposition substrates by Anopheles albimanus under laboratory conditions.

Oviposition response of gravid Anopheles albimanus Wiedemman (Diptera: Culicidae) females to water containing Brachiaria mutica, Cynodon dactylon, Jouvea straminea, Fimbristylis spadicea, and Ceratophyllum demersum was investigated. Gravid An. albimanus females deposited similar egg numbers in cups containing natural plants in water from natural breeding sites and in cups containing natural plants in distilled water. Gravid mosquitoes deposited significantly more eggs in cups containing natural plants in water from natural breeding sites than in cups containing artificial plants in water from the corresponding natural breeding sites. These results were confirmed in experiments conducted in a wind tunnel, indicating that female response is mediated by chemical cues from plants. Bioassays with organic extracts of all 5 plant species indicated that these extracts at 100%, 10%, and 1% concentrations had an oviposition repellent effect, while attractiveness was observed at 0.1%, 0.01%, and 0.001%. Gas chromatography and mass spectrometry analysis of the organic extracts found in all 5 plants showed a mixture of terpenoid and alcohol compounds, among them: guaiacol, phenol, isoeugenol, longifolene, caryophyllene, phenyl ethyl alcohol, and p-cresol. These results suggest that middle-range volatiles from plants may function as chemical cues for the female's oviposition response in this mosquito species.

Prevalencia del uso preconcepcional del ácido fólico en el área norte de Pontevedra / Prevalence of the pre-conception use of folic acid in the northern part of Pontevedra

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Regiospecific synthesis and anti-human immunodeficiency virus activity of novel 5-substituted N-alkylcarbamoyl and N,N-dialkylcarbamoyl 1,2,3-triazole-TSAO analogues.

Several 5-N-alkyl and 5-N,N-dialkylcarbamoyl substituted analogues of the anti-human immunodeficiency virus (HIV) type 1 lead compound [1-[2',5'-bis-O-(tert-butyldimethylsilyl)-beta-D-ribofuranosyl]-5- (N,N-dimethylcarbamoyl)-1,2,3-triazole]-3'-spiro-5"-(4"-amino-1",2"- oxathiole-2",2"-dioxide) have been prepared and evaluated as inhibitors of HIV-1 replication. A new regiospecific synthetic procedure is described. The compounds were prepared by cycloaddition of the appropriate glycosylazide to 2-oxoalkylidentriphenyl-phosphoranes, followed by treatment with primary or secondary amines, to yield, exclusively, 5-substituted 1,2,3-triazole-TSAO analogues. Several 5-substituted 1,2,3-triazole-TSAO derivatives proved to be potent inhibitors of HIV-1 replication with higher antiviral selectivity than that of the parent TSAO prototype.