The RNA content of human sperm reflects prior events in spermatogenesis and potential post-fertilization effects.

Transcriptome analyses using high-throughput methodologies allow a deeper understanding of biological functions in different cell types/tissues. The present study provides an RNA-seq profiling of human sperm mRNAs and lncRNAs (messenger and long non-coding RNAs) in a well-characterized population of fertile individuals. Sperm RNA was extracted from twelve ejaculate samples under strict quality controls. Poly(A)-transcripts were sequenced and aligned to the human genome. mRNAs and lncRNAs were classified according to their mean expression values (FPKM: Fragments Per Kilobase of transcript per Million mapped reads) and integrity. Gene Ontology analysis of the Expressed and Highly Expressed mRNAs showed an involvement in diverse reproduction processes, while the Ubiquitously Expressed and Highly Stable mRNAs were mainly involved in spermatogenesis. Transcription factor enrichment analyses revealed that the Highly Expressed and Ubiquitously Expressed sperm mRNAs were primarily regulated by zinc-fingers and spermatogenesis-related proteins. Regarding the Expressed lncRNAs, only one-third of their potential targets corresponded to Expressed mRNAs and were enriched in cell-cycle regulation processes. The remaining two-thirds were absent in sperm and were enriched in embryogenesis-related processes. A significant amount of post-testicular sperm mRNAs and lncRNAs was also detected. Even though our study is solely directed to the poly-A fraction of sperm transcripts, results indicate that both sperm mRNAs and lncRNAs constitute a footprint of previous spermatogenesis events and are configured to affect the first stages of embryo development.

The beneficial effect of probiotics as a supplementary treatment in drug-resistant epilepsy: a pilot study.

Epilepsy is a neurological disease with high global prevalence. Despite the range of drug-based treatments currently available to control the condition, one in 3 patients experiences epileptic seizures. Therapeutic alternatives for these patients include the ketogenic diet, surgery or the cerebral implantation of neurostimulators; however these are benefits with limits. The target of this study is to find a new complementary treatment for these patients, studying the effectiveness of probiotics for controlling epileptic seizures in patients with drug-resistant epilepsy. A prospective study was designed in which a group of patients with drug-resistant epilepsy was administered a probiotic mixture for 4 months. Patients were assessed before and after taking the probiotics; among other variables, number of seizures and patients' quality of life (QOLIE-10) were monitored. Levels of cD-14, interleukin 6, and γ-aminobutyric acid were also analysed throughout the study. 45 patients were included in the study. In an intention-to-treat analysis, 28.9% of all patients displayed a greater than 50% reduction in the number of seizures (the parameter required in clinical trials). A significant improvement was also observed in patients' quality of life. We found that probiotics may be an option for supplementary therapy. Since the use of probiotics is safe, they may contribute to improving seizure control, and therefore quality of life, in patients with drug-resistant epilepsy. The study has been registered in https://clinicaltrials.gov with number NCT03403907.

Boosted Hyperthermia Therapy by Combined AC Magnetic and Photothermal Exposures in Ag/Fe3O4 Nanoflowers.

Over the past two decades, magnetic hyperthermia and photothermal therapy are becoming very promising supplementary techniques to well-established cancer treatments such as radiotherapy and chemotherapy. These techniques have dramatically improved their ability to perform controlled treatments, relying on the procedure of delivering nanoscale objects into targeted tumor tissues, which can release therapeutic killing doses of heat either upon AC magnetic field exposure or laser irradiation. Although an intense research effort has been made in recent years to study, separately, magnetic hyperthermia using iron oxide nanoparticles and photothermal therapy based on gold or silver plasmonic nanostructures, the full potential of combining both techniques has not yet been systematically explored. Here we present a proof-of-principle experiment showing that designing multifunctional silver/magnetite (Ag/Fe3O4) nanoflowers acting as dual hyperthermia agents is an efficient route for enhancing their heating ability or specific absorption rate (SAR). Interestingly, the SAR of the nanoflowers is increased by at least 1 order of magnitude under the application of both an external magnetic field of 200 Oe and simultaneous laser irradiation. Furthermore, our results show that the synergistic exploitation of the magnetic and photothermal properties of the nanoflowers reduces the magnetic field and laser intensities that would be required in the case that both external stimuli were applied separately. This constitutes a key step toward optimizing the hyperthermia therapy through a combined multifunctional magnetic and photothermal treatment and improving our understanding of the therapeutic process to specific applications that will entail coordinated efforts in physics, engineering, biology, and medicine.

[The influence of alternative medicine in highly active antiretroviral treatment]. / Influencia de la medicina alternativa en el tratamiento antirretroviral de gran actividad.

OBJECTIVE: Over the last few years, there has been a notable increase in the use of alternative medicine by the general population. The aim of this study is two-fold. Firstly we will analyse the incidence of the use of medicinal plants in patients with HIV undergoing Highly Active Anti-Retroviral Therapy (HAART). Secondly, with the help of existing bibliographic information, we want to study the existence of possible interactions. MATERIAL AND METHODS: We carried out a prospective study with a targeted interview (October to December 2007) on consenting patients with HIV undergoing HAART treatment. RESULTS: Of the 193 patients that agreed to take part in the survey, 16.6 % confirmed they used alternative medicinal therapies. In 46 % of the cases there was a potential interaction with the effectiveness of HAART. 46 % of the potential interactions were in the case of the patients who used grapefruit as an alternative medicine, 21 % in the case of patients using thistle and Echinacea respectively, 4 % for those using omega-3, Chinese herbs and ginseng. CONCLUSION: There is a significant use of natural products by these groups of patients, of which a significant percentage interact with HAART. A better understanding of the possible interactions with HAART and improved information offered to patients with HIV is needed.

Anestesia local para artroscopia de rodilla en pacientes ambulatorios / Local anesthesia for arthroscopy of the knee in day-surgery patients

Objetivo. En este artículo valoramos la eficacia de la anestesia local para la cirugía artroscópica de la rodilla en pacientes ambulatorios y la analgesia postoperatoria. Material y método. De enero a diciembre de 2003 y dentro del programa de cirugía ambulatoria fueron intervenidos 56 pacientes de diferentes patologías de la rodilla mediante cirugía artroscópica y bajo anestesia local, e infiltración intraarticular postoperatoria con bupivacaína. Se ha valorado la eficacia de la anestesia local y la analgesia postoperatoria determinando la intensidad del dolor mediante la escala visual analógica y el consumo de analgésicos tras la cirugía artroscópica. Resultados. De los 56 pacientes, 50 no tuvieron dolor durante la cirugía, en los otros 6 fue necesario suplementar la analgesia. Todos los pacientes fueron dados de alta hospitalaria en las primeras 6 horas tras la cirugía y no se detectó ninguna complicación. Conclusiones. La anestesia local intraarticular es un método ideal para la artroscopia de la rodilla dentro del programa de cirugía ambulatoria, permitiendo la realización de esta técnica quirúrgica disminuyendo el consumo de analgésicos por proporcionar una adecuada analgesia y una alta satisfacción. Permite una recuperación, un alta hospitalaria y una rehabilitación precoces

Purpose. In this study we assess the effectiveness of local anesthesia in knee arthroscopies carried out in outpatients and the use of subsequent postoperative analgesia. Materials and methods. From January to December 2003, within the framework of our Outpatient Program, 56 patients with different knee conditions underwent arthroscopy with local anesthesia and postoperative intraarticular infiltration with bupivacaine. The effectiveness of local anesthesia and postoperative analgesia were assessed by determining pain intensity using a visual analogical scale and by quantifying the use of postoperative analgesia after arthroscopy. Results. Fifty of the 56 patients, had no pain during surgery, with the remaining 6 requiring supplementary analgesia. All patients were discharged from hospital during the 6 hours following surgery and no complications were seen. Conclusions. Local intraarticular anesthesia is ideal for knee arthroscopy since it allows this surgical procedure to be performed as part of an outpatient program, it decreases the need for pain-killers and shows high rates of patient satisfaction. It allows early recovery, rehabilitation, and hospital discharge (AU)

[Biofeedback therapy for urinary incontinence in children]. / Tratamiento de los trastornos miccionales en niños mediante biofeedback.

INTRODUCTION: We evaluated the efficacy of biofeedback (BFB) therapy in childrens with functional urinary incontinence refractory to conventional treatment. MATERIALS AND METHODS: 34 patients where included (26 girls and 8 boys). They received BFB therapy during the last year for daytime urinary incontinence. 27 patients had urge syndrome with detrusor overactivity, 3 presented giggle incontinence and 4 patients had dysfunctinal voiding. Mean age was 8,4 years. All cases were refractory to bladder training and/or anticholinergics, or recidived after supression. The BFB therapy was carried out with surface electrodes during bladder filling (29 patients) and during voiding (4 patients). One received both therapies. RESULTS: 15 patients (44%) achieved total continence (daytime and nightime) and 7 (20,5%) responded partially. 9 Patients (26%) didn't obtain any benefit and 4 were losed. CONCLUSIONS: In children with functional urinary incontinence pelvic floor muscles training with biofeedback is a simple and effective method. It should be used associated to other therapies, when these fails or repeats after an initial success.

Manual therapies in the management of tension-type headache.

We describe a patient with successive attacks (40 to 90 minutes) of cluster-like headache associated with aphasia, and contralateral hemihypesthesia and hemiplegia. The condition can best be described as cluster-like headache aura status.

[Evaluation of infiltrations performed in primary care]. / Evaluación de las infiltraciones realizadas en atención primaria.

OBJECTIVES: To describe the evolution of the pain and the functional impotence in the articular and periarticular pathology after to infiltrate with local corticosteroid and anaesthetic; to analize the number of discharge certificates that maybe to give in the patients with employment transitory incapacity (ETI) during the first week post-infiltration. DESIGN: Intervention without control group. SETTING: Semiurban primary care physician's practices (ABS Piera). PARTICIPANTS: Men and women elder than 18 years old, with articular and periarticular pathology. INTERVENTION: Were infiltrated with local triamcinolone acetonid and bupivacain 2% 65 patients. MAIN MEASUREMENTS: Were gathered socio-demographic factors, diagnostic, response, number of infiltrations for patient, secondary effects, and number of discharge certificates that were given in the patients in ETI situation during the first week post-infiltration. RESULTS: Were infiltrated predominantly men (57%) with 31-65 years old (67.7%), employed (70.7%) in manual works (78.4%). Rotary joint tendinitis (46.2%) and epicondylitis (27.7%) were the most common diagnostics. Mean and CI (95%) obtained in the VAS for pain were: initially, 8.8 (7.4-9.8); week, 1.4 (1-1.8); 3 months, 2.2 (1.3-3.1), and year, 2.3 (1.1-3.5). Mean and CI (95%) found for functional impotence were: initially, 8.2 (6.7-9.7); week, 0.9 (0.7-1.1); 3 months, 1.2 (0.9-1.5), and year, 1.6 (1.4-1.8). The number of infiltrations for patient was 1.6. Hadn't important secondary effects. Were given 19 discharge certificates in 25 patients with ETI in the first week post-infiltration. CONCLUSIONS: The patients diminished the pain and the functional impotence in the articular and periarticular pathology after of the infiltration, allowing to give an elevate number of discharge certificates during the first week post-infiltration.

[Homocysteine. The cardiovascular risk factor of the next millennium?]. / La homocisteína. El factor de riesgo cardiovascular del próximo milenio?

Several epidemiologic studies have demonstrated that hyperhomocysteinemia is a risk factor for arteriosclerosis in coronary, cerebral, peripheral and aortic arteries. This risk is independent of other cardiovascular risk factors, and it is dose related. However, prospective studies show contradictory findings. Hyperhomocysteinemia is also associated with a higher risk of venous thrombosis to which other coagulation disorders, such as factor V Leiden, could contribute. Hyperhomocysteinemia can be due to genetic defects in the enzymes that control homocysteine metabolism, and also to other factors, mainly nutritional (deficiencies in vitamin B6, vitamin B12, or folic acid). Dietary supplements of these vitamins reduce plasma homocysteine levels. Randomized clinical trials are still needed to demonstrate that reducing plasma homocysteine levels will reduce the risk for cardiovascular disease.

Síndrome de irritación meníngea tras implantación de electrodos de estimulación eléctrica medular: a propósito de un caso / Meningeal irritation syndrome after im plantation of leads for medullary electric stimulation: with regard to one case

Introducción : La estimulación eléctrica medular una técnica utilizada con éxito en el tratamiento del dolor en multitud de cuad ros patológicos, sobre todo en aquellos que no re s p o n d e n a los tratamientos habituales.Caso clínico: Paciente de 32 años intervenido de hernia discal L4-L5 d e recha. Tras la intervención comienza con cuadro de dolor intenso en pierna derecha (territorio de S1) con pare stesia asociada.A la exploración clínica el paciente presenta cojera a expensas de MID, limitación para la extensión y lateralización de la columna lumbar, disminución global de la sensibilidad en MID, con ROT conservados. En la RNM se observa una discreta pérdida de altura del espacio intervertebral L4-L5, acompañado de intesa fibrosis. En el estudio electromiográfico se pone de manifiesto una afectación residual de la raiz de L5. Dada la persistencia del c u a d ro de dolor incapacitante se decide realizar nuevo a b o rdaje neuro q u i r ú rgico. La evolución en el potoperatorio inmediato fue favorable, re a p a reciendo la clínica a las pocas semanas de la intervención.Dada la mala respuesta a los tratamientos habituales y la persistencia de la clínica incapacitante, se decide la implantación de un electrodo de estimulación medular, tras la cual p resenta un buen nivel de analgesia, pero a los nueve meses se produce una alteración de la estimulación, con aumento del dolor. Se revisa el sistema sin encontrar fallo técnico, pero sí un desplazamiento del electrodo en el control radiológico. Se decide realizar retirada del electrodo antiguo y colocación de uno nuevo, siendo el intraoperatorio del todo norm a l .A las 48 horas el paciente comienza con clínicas cefaleas, malestar general con dolor lumbar ascendente, vómitos aislados sin fiebre, refiriendo sensación de hipere stimulación, por lo que se decide apagar el generador. El aspecto de las heridas quirúrgicas era normal. Se ingre s a al paciente para control y tratamiento sintomático. Se solicita análítica general donde no hay leucocitosis, ni desviación izquierd a .A las 24 horas del ingreso la clínica persiste, por lo que se decide retirar el material implantado. Se toman cultivos de heridas, de punta de electrodo y de LCR. Se comienza con antibioterapia de amplio espectro. El resultado de los cultivos fue negativo. Asimismo, se solicitó RNM de columna lumbar y dorsal que fue informada como normal. En ningún caso hubo picos febriles.La evolución posterior fue del todo satisfactoria, con desaparición de la sintomatología a las 48 horas de la re t i r ada del material, siendo alta a los 8 días de su ingre s o .Discusión y conclusiones: La negatividad de los cultivos nos hace pensar en una etiología distinta a la infecciosa. Las opciones que planteamos como posibles etiologías de este cuadro son: -Por un lado la posibilidad de que durante la implantación del electrodo, la manipulación del mismo y la dificultad de su introducción hayan ocasionado pequeñas ero s i ones en la duramadre con pérdidas de LCR, que en un principio hayan sido de pequeña cuantía (por lo que no se obtenía tras la punción), pero que con la movilización del e n f e rmo (y posiblemente del electrodo) se haya hecho may o r, junto con el hecho de que a lo anterior haya que sumar que el reinicio de la estimulación eléctrica se pro d u j e s e una situación de hiperirritabilidad meníngea la cual sería la responsable de la sintomatología.-Por otro lado, la posible transmisión de infección a través del cableado desde el reservorio subcutáneo del gen e r a d o r, que en cierta forma estaría encubierta por la administración de la dosis de antibiótico profiláctica, re s u l t a ndo de este modo negativos los cultivos realizados (AU)

[Mediterranean diet improves low density lipoprotein susceptibility to oxidative modifications]. / La dieta mediterránea mejora la resistencia a la oxidación de las lipoproteínas de baja densidad.

UNLABELLED: Most experts, specially from Anglo-Saxon countries, recommend a low fat diet in order to prevent cardiovascular diseases. However, mortality rate by ischemic cardiopathy is low in Mediterranean countries, probably because of the consumption of a Mediterranean diet, with a high level of monounsaturated fats provided by the olive oil. We have conducted this study in order to investigate the possible influence of this kind of diet on the oxidation of LDL in vitro, the key element for the development of atherosclerosis. PATIENTS AND METHODS: 41 healthy male subjects were submitted to three consecutive 4-week diets. The first was a saturated fat-rich diet (SAT diet, 38% fat, 20% saturated). This was followed by a low fat diet (NCEP-I, 28% fat, 10% saturated) and after that a Mediterranean diet (38% fat, 22% monounsaturated fat). Plasma levels of total cholesterol, LDL-c, HDL-c, triglycerides, apolipoproteins A-I and B, -tocopherol, and the in vitro susceptibility to oxidation of LDL particles. Both hypolipidemic diets produced a significant decrease in total cholesterol, LDL-c, and apo-B plasma levels. However, it was only the NCEP-I diet that revealed a decrease in the HDL-c. The shift from a saturated fat-rich diet, or a diet rich in carbohydrates, to a Mediterranean diet increased the resistance of LDL particles to oxidation increasing the lag time period (p < 0.038), and decreasing (p < 0.001) the progression rate of the curve of oxidation of LDL. Our results point out two positive consequences of the consumption of a Mediterranean diet by healthy young males, compared with the low fat diet recommended by most Anglo-Saxon experts. On the one hand, the Mediterranean diet increases HDL-c plasma levels, and on the other hand, it decreases the susceptibility of LDL to oxidation. This is why the Mediterranean diet must be recommended in order to prevent cardiovascular diseases.

Dipeptidyl-peptidase IV-beta--further characterization and comparison to dipeptidyl-peptidase IV activity of CD26.

Dipeptidyl peptidase IV-beta (DPP IV-beta) is a novel protein which shows a peptidase activity similar to the T-cell-activation antigen CD26. To further characterize this DPP IV-beta and confirm its cell surface expression, we have developed a purification strategy using the CD26- cell line C8166. The purification process includes biotinylation of cell surface proteins before preparation of cell extracts and processing by gel-filtration, ion-exchange and lectin chromatographies. Consistent with the molecular mass of DPP IV-beta estimated by gel-filtration chromatography, the final purified fraction, manifesting a typical DPP IV activity, showed a major biotinylated 75-80-kDa band in SDS/PAGE, thus suggesting the monomeric nature of this enzyme. Kinetic parameters of DPP IV-beta and the sensitivity to a new family of irreversible DPP IV inhibitors, were studied in comparison to CD26. Both enzymes followed a Michaelis kinetics with different Km values for Gly-Pro-NH-Np (NH-Np, para-nitroanilide) hydrolysis (0.28+/-0.05 mM and 0.12+/-0.02 mM). More significant differences were observed in the sensitivity to inhibitors, which exerted a much higher activity on CD26 than on DPP IV-beta. These differences permitted us to study DPP IV-beta expression in CD26-expressing cells, showing the expression of this new enzyme in all lymphoid cells tested, and a rapid enhancement in phytohemagglutinin-stimulated or protein-A-stimulated peripheral blood mononuclear cells. Our results indicate that, although DPP IV-beta and CD26 are coexpressed and manifest a typical DPP IV activity, there are distinct features in their catalytic activities that may confer to each enzyme a complementary role in peptide processing.

Chlorhexidine versus sterile water vaginal wash during labor to prevent peripartum infection.

OBJECTIVE: Our purpose was to determine whether a dilute solution of chlorhexidine used as a one-time vaginal wash intrapartum can reduce the incidence of intraamniotic infection or endometritis in laboring pregnant women. STUDY DESIGN: Term pregnant women in labor were prospectively randomized to receive either 20 ml of 0.4% chlorhexidine (n = 481) or 20 ml of sterile water (n = 466) placebo. All patients were monitored for risk factors associated with intraamniotic infection. Continuous variables were compared with the Mann-Whitney U test and discrete variables were compared with Fisher's exact test. RESULTS: No significant differences in infection were found between the chlorhexidine and placebo groups. During the study period 21 of 466 women (4.5%) had intraamniotic infection in the control group compared with 25 of 481 women (5.2%) receiving chlorhexidine (p = 0.65, 95% confidence interval 0.82 to 1.41). Nine women in the placebo group (1.9%) and 9 women in the chlorhexidine group (1.9%) had endometritis (p = 1.0, 95% confidence interval 0.62 to 1.56). CONCLUSIONS: Our findings suggest that a one-time 0.4% chlorhexidine vaginal wash does not decrease the incidence of infectious morbidity in parturients, compared with the use of sterile water.

[Pleurodesis with the patient's own blood: the initial results in 14 cases]. / Pleurodesis con sangre del propio paciente: resultados iniciales en 14 casos.

Fourteen adults with spontaneous pneumothorax (SP), 9 of whom had primary SP (PSP) and 5 of whom had secondary forms (SSP), were given intrapleural infusions of self-donated blood for pleurodesis. Instillations of 50 ml were given to all except 1, who required a total volume of 120 ml. The procedure was performed in each patient's bed in all cases. With apical chest tube placement in most cases and the lung expanded, the outer tip of the tube was elevated and the patient's own blood was taken from a superficial forearm vein and instilled. Them, with the tube occluded, the patient's were rotated un bed for a period of 2 hours to distribute the blood evenly throughout the pleural cavity. Tolerance was excellent, with no pain reported by any patient. The only noteworthy complication was 1 case of infectious pleural effusion of unknown etiology which was treated by evacuation and antibiotics. In 13 (92%) patients closure of the fistula was achieved, in under 12 h in 7 (53%), in under 24 h in 3 (23%), in under 48 h in 2 (15%), and in under 72 h in the remaining 2 (15%). In 4 (28.5%) there was recurrence (2 SSP and 2 PSP patients). Over a 10 to 32 month follow-up period (mean 16 months), 10 (71.4%) patients experienced no recurrences or complications. These results allow us to speculate that blood instilled in the pleural cavity may act in 2 ways: in the short term as a blood patch that adheres to and closes the fistula in the visceral pleura, and over the longer term by creating pleural symphysis by adhesions and fibrous tissue. Our limited experience indicates that pleurodesis with self-donated blood is an easy-to-perform, painless, convenient, rapid and inexpensive procedure that is moderately effective in the short and medium term. Its main drawbacks are the lack of consensus on certain technical considerations, such as the optimum amount of blood to be instilled, the number of instillations to perform and, if multiple instillations are carried out, what the interval between them should be. Further study is needed to confirm or discount our results and to determine the place this technique may have in the clinical management of pneumothorax.

Lipoprotein concentrations in normolipidemic males consuming oleic acid-rich diets from two different sources: olive oil and oleic acid-rich sunflower oil.

The effects on plasma lipid concentrations of two oleic acid-rich diets, prepared with two different plant oils--olive oil and sunflower oil high in monounsaturated fatty acids (MUFAs)-- were compared with a National Cholesterol Education Program (NCEP) I diet. Twenty-one healthy, normolipidemic, young males consumed an NCEP-I diet (30% of energy as fat) during a 25-d period. Subjects were then assigned to two 4-wk study periods, according to a randomized, crossover design. Group one was placed on an olive oil-enriched diet (40% fat, 22% MUFAs), followed by a 4-wk period of a sunflower oil-enriched diet (40% fat, 22% MUFAs). In group two, the order of the diets was reversed. Both MUFA dietary periods resulted in an increase in high-density-lipoprotein (HDL) cholesterol (7% for the olive oil diet and 4% for the sunflower oil diet) and in apolipoprotein (apo) A-I (9% for both) compared with the NCEP-I diet. Low-density-lipoprotein (LDL) cholesterol and apo B concentrations (x +/- SEM) were lower (P < 0.05) during the sunflower oil diet (2.40 +/- 0.11 mmol/L, 0.85 +/- 0.04 mg/L) than during the olive oil diet (2.64 +/- 0.15 mmol/L, 0.93 +/- 0.05 mg/L). No significant differences were observed in these variables between the sunflower oil and NCEP-I (2.48 +/- 0.13 mmol/L, 0.89 +/- 0.04 mg/L) diets.(ABSTRACT TRUNCATED AT 250 WORDS)