Effect of oral calcium administration on metabolic status and uterine health of dairy cows with reduced postpartum rumination and eating time.

BACKGROUND: Hypocalcemia has detrimental effects on health and performance of dairy cows. As hypocalcemic cows show reduced feed intake, we hypothesized that cows with reduced combined rumination and eating time (CRET) may benefit from Ca supplementation. The objective was to evaluate the effect of postpartum oral Ca administration on metabolic status (Calcium [Ca], fatty acids [FA], and ß-Hydroxybutyrate [BHB] serum concentrations) and incidence of puerperal metritis (PM) in dairy cows with reduced postpartum CRET. Cows in an organic-certified dairy, diagnosed with reduced CRET (< 489 min/d; n = 88) during the first day postpartum were assigned into 1 of 2 treatments: i) Calcium administration (CA; n = 45) that received 1 Ca oral capsule (Bovikalc bolus, Boehringer Ingelheim, St. Joseph, MO) containing CaCl2 and CaSO4 (43 g of Ca) once per day, for 3 consecutive days, starting at d 1 postpartum; and ii) Control (CON; n = 43) that did not receive oral Ca. A convenience group consisting of cows with CRET ≥489 min/d was used for comparison and did not receive oral Ca (NOR; n = 96). RESULTS: At day 1 postpartum cows with reduced CRET had lower Ca serum concentrations (CA = 2.08 mmol/L; CON = 2.06 mmol/L) compared with NOR cows (2.17 mmol/L). Calcium concentrations at d 3, 5, and 12 postpartum were not different among the three groups. Serum FA concentrations at d 1, 3 and 5 postpartum were higher in both CA and CON cows compared with NOR. At d 12, only CA cows had higher FA concentrations than NOR cows. Serum BHB concentrations at d 3 were highest in CA, with no difference between CON and NOR. At d 5, BHB concentrations were higher in CA, followed by CON, and NOR. No effect was observed for Ca administration on incidence of PM and reproductive performance. CON cows had lower survival at 30 DIM (86.5%) than NOR cows (97.9%). CONCLUSIONS: The use of remote sensor technology identified cows with reduced rumination and eating time that had lower postpartum serum concentrations of calcium and altered metabolic status. However, oral calcium administration to cows with reduced CRET did not affect incidence of metabolic disorders nor reproductive health and subsequent pregnancy. Although survival at 30 days postpartum was lower for non-Ca supplemented cows, the identification of effective interventions in cows with reduced CRET requires further consideration.

Persistent urinary phosphate wasting in a patient with metastatic breast cancer: What's your diagnosis?

Tumor-induced osteomalacia (TIO) can cause severe, persistent hypo-phosphatemia due to high fibroblast growth factor-23 (FGF-23) levels, which lead to uri-nary phosphate wasting. TIO is frequently encountered in association with mesenchy-mal tumors and responds well to resection of the primary malignancy. Rarely, TIO may be seen as a paraneoplastic phenomenon with solid organ malignancies where correction of biochemical abnormalities requires ongoing phosphorus replacement. We report a case of TIO in a patient with metastatic breast cancer complicated by increased parathyroid hormone release secondary to denosumab-induced hypocalcemia. The patient required intensive intravenous and oral phosphate supplementation in addition to vitamin D repletion. A high index of clinical suspicion can yield the correct diagnosis where TIO arises in the setting of a solid organ tumor and help the clinician appropriately manage these challenging cases.

Sociocultural descriptions of febrile syndromes in rural areas of Urabá, Colombia: An exploration of "tick fever" / Descrição sociocultural de síndromes febris em áreas rurais de Antioquia Urabá: um olhar sobre a "febre do carrapato"

Abstract Introduction: In 2006 and 2008 there were two lethal outbreaks of rickettsioses in the rural areas of Urabá, characterized by the lack of immediate diagnosis and antibiotic treatment. Objective: Describe sociocultural aspects about knowledge, attitudes and practices in relation to febrile syndromes and "tick fever" in rural areas of Urabá. Materials and methods: We conducted an exploratory study using knowledge, attitudes, and practices questionnaires and semi-structured interviews about febrile syndromes and "tick fever". We surveyed 246 heads of households and interviewed nine individuals. Results: We observed that people tended to identify febrile syndromes with signs and clinical symptoms of dengue, malaria, leptospirosis and rickettsioses. A considerable proportion of individuals (32.93%) knew very little about "tick fever", thinking that is was transmitted by mosquitos. They mentioned intestinal parasitoids, malaria, dengue, and "evil eye" among the causes of febrile syndromes. "Tick fever" is linked by its name to the bite of the tick. Furthermore, the treatments for febrile syndromes mentioned by interviewees are associated to those commonly used in western medicine and medicinal plants. Conclusions: There is a need for educational programs in rural areas, to raise awareness about these potential lethal conditions that can be effectively treated.

Resumo Introdução: Nos anos de 2006 e 2008, dois surtos letais de riquetsiose foram relatados em áreas rurais de Urabá, caracterizados pela falta de atenção imediata para o diagnóstico e tratamento com antibióticos. Objetivo: Descrever aspectos socioculturais do conhecimento, atitudes e práticas de síndromes febris e "febre do carrapato" em áreas rurais de Antioquia, Urabá. Materiais e métodos: Realizou-se estudo exploratório, através de inquéritos sobre CAP (conhecimentos, atitudes e práticas) e entrevistas semiestruturadas sobre síndromes febris e "febre do carrapato", um nome que se refere às doenças das riquetsioses na área. Foram aplicados 246 inquéritos sobre a CAP foram realizadas aos chefes de agregados familiares e nove pessoas foram entrevistadas. Resultados: Observou-se que as pessoas tendem a identificar os sinais e sintomas clínicos característicos da dengue, malária, leptospirose e até riquetsiose. Um grande número de pessoas demonstra baixo conhecimento sobre "febre do carrapato" e indicou que ela é transmitida por mosquitos (32,93%). Os entrevistados indicaram que as causas das diferentes síndromes febris se devem a parasitas intestinais, malária, dengue ou, como crença cultural, ao "mau olhado". A "febre do carrapato" o associa, pelo nome, com a mordida do carrapato. Além disso, o tratamento das síndromes febris referidas pelos entrevistados está intimamente relacionado ao uso comum da medicina ocidental e ao uso de "plantas medicinais". Conclusões. É necessário ter programas de educação nessas áreas rurais para que essas entidades potencialmente letais tenham um tratamento efetivo e acessível.

Efecto de los extractos vegetales de Jatropha curcas y Anonna muricata sobre teleoginas de la garrapata común del ganado Ripichephalus (Boophilus) microplus bajo condiciones de laboratorio / Effect of plant extracts of jatropha curcas and Anonna muricata on engorged females of common cattle tick Ripichephalus (Boophilus) microplus under laboratory conditions / Efeito de extractos de plantas de Jatropha curcas e Anonna muricata em teleogines do carrapato gado comum Ripichephalus (Boophilus) microplus sob condições de laboratório

Resumen La garrapata común (Rhipicephalus (B.) microplus) del ganado es considerada el ectoparásito más importante en la ganadería. El uso repetitivo y tradicional de acaricidas comerciales se ha convertido en un serio problema en cuanto a la resistencia adquirida por esta garrapata. Por esta razón, el control biológico ha surgido como una alternativa prometedora en el control de este ectoparásito. En este estudio se evalúa el efecto de los extractos vegetales de dos plantas, J. curcas y A. muricata, sobre el índice de producción de huevos y la eficiencia reproductiva de R (B.) microplus bajo condiciones de laboratorio. Cada extracto fue evaluado a cinco concentraciones (entre 0.1 y 5%), usando controles negativo y positivo para su comparación. Ambas plantas mostraron actividad biológica, sin embargo, A. muricata tuvo un efecto mayor comparado con J. curcas, inclusive a concentraciones bajas (0,5 y 1 %). Por el contrario, J. curcas mostró solo un efecto moderado en concentraciones altas (5%). En conclusión, los resultados obtenidos en laboratorio indican que los extractos de A. muricata son promisorios para controlar la garrapata común del ganado.

Abstract Rhipicephalus (B.) microplus or common cattle tick is considered the most important ectoparasite of livestock. Traditional and repetitive control of this tick through the use of conventional products has become a serious problem regarding tick's resistance. For this reason, biological control has emerged as a very promising alternative to control this tick. In the present study, an experiment was designed to assess the effect of plant extracts of J. curcas y A. muricata on Production eggs Index (IPH) and estimated reproduction (ER) of R (B) microplus under laboratory conditions. Each plant extract was assessed in five different concentrations (between 0.1 and 5%); a positive and negative control was used for comparison. Both plants showed biological activity, however, A. muricata showed significantly effect on engorged females of the cattle tick compared with J. curcas, even at lower concentrations (0.5, and 1 %). In conclusion, the results obtained indicate that A. muricata's seed extracts are promissory to biocontrol the common cattle tick under laboratory conditions.

Resumo O carrapato comum (Rhipicephalus (B.) microplus) do gado é considerado o ectoparasita mais importante da pecuária. O uso repetitivo e tradicional de inseticidas comerciais se converteu em um sério problema quanto a resisitência adquirida por esse carrapato. Por essa razão, o controle biológico surgiu como uma alternativa promissora no controle deste ectoparasita. Esse estudo avalia o efeito dos extratos vegetais das plantas,J. curcas e A. muricata,sobre o índice de produção de ovos e a eficiência reprodutiva deR (B.) microplussegundo condições de laboratório. Cada extrato foi avaliado em 5 concentrações (entre 0,1 e 5%), usando controles negativo e positivo para sua comparação. Ambas as plantas mostraram atividade biológica, porém,A. muricatateve um efeito maior comparado comJ. curcas,inclusive as concentrações baixas (0,5 y 1 %). Pelo contrário,J. curcasmostrou só um efeito moderado nas concentrações altas (5%). Em conclusão, os resultados obtidos no laboratório indicam que os extratos deA. muricatasão promissores para controlar o carrapato comum do gado.

Effect of oral calcium administration on the cure and reproductive performance of Holstein cows diagnosed with puerperal metritis.

Our objective was to evaluate the effect of oral calcium administration on clinical cure, survival, subsequent presentation of peripartal health disorders, and reproductive performance of Holstein cows diagnosed with puerperal metritis (PM) under certified organic management. A second objective was to evaluate the metabolic status at calving and at the time of PM diagnosis (d 0) in affected and matched healthy cows. Cows diagnosed with PM (n = 200) were assigned randomly to receive 1 of 2 treatments: (1) control received 3.75 mL of Optimum UterFlush [Van Beek Natural Science, Orange City, IA, containing yucca extract, cinnamaldehyde, thymol, and a proprietary blend of carvacrol (4-isopropyl-2-methylphenol, at 0.47 g/mL)] diluted in 117 mL of distilled water by intrauterine infusion, administered every other day for a total of 3 treatments (n = 100); (2) calcium-supplemented (CA) received the same intrauterine treatment plus 6 oral capsules providing calcium ('O' Cal-D Cap, Bio-Vet Inc., Barneveld, WI; 7.5-9.0 g of Ca/capsule) once per day, for 3 consecutive days after diagnosis of PM. All cows received hypertonic saline solution (500 mL of 7.2% solution i.v. once), dextrose (500 mL of 50% solution i.v. once), and oral aspirin (5 boluses/d for 3 d). Outcome variables included fever, presence of fetid vaginal discharge, and uterine score at d 6 and 14 after diagnosis, survival at 30 and 100 d in milk, reproductive performance, and incidence of other health disorders after PM. A group of 200 control healthy cows (CH) was matched with PM cows at d 0, and calcium and fatty acid serum concentrations were determined at calving and at the day of diagnosis of PM (d 0). Calcium status was also assessed in PM cows at d 1, 2, 3, and 6 after diagnosis. Treatment effects were tested by logistic regression, repeated measures analysis, and ANOVA. Average calcium serum concentrations at d 0 were lower in PM cows (1.57 mmol/L) compared with CH cows (2.10 mmol/L). In PM cows, calcium concentrations at d 1, 2, 3, and 6 after diagnosis were significantly higher in the CA group. Fatty acid serum concentrations at calving and at d 0 were higher in PM cows compared with CH cows (0.48 vs. 0.37 mmol/L and 0.49 vs. 0.35 mmol/L, for calving and d 0). No effect was observed for calcium administration on health and survival outcomes. However, the proportion of cows inseminated by 150 d in milk was greater for CA compared with control cows (66 vs. 55%). In conclusion, supplementing oral calcium at the time of diagnosing PM had no effect on health. High fatty acid concentrations at calving were significant risk factors for occurrence of PM. Furthermore, cows affected with PM had lower calcium and higher fatty acid concentrations than CH cows at d 0.

Admittance to detect alterations in left ventricular stroke volume.

BACKGROUND: Implantable cardioverter-defibrillators monitor intracardiac electrograms (EGMs) to discriminate between ventricular and supraventricular tachycardias. The incidence of inappropriate shocks remains high because of misclassification of the tachycardia in an otherwise hemodynamically stable individual. Coupling EGMs with an assessment of left ventricular (LV) stroke volume (SV) could help in gauging hemodynamics during an arrhythmia and reducing inappropriate shocks. OBJECTIVE: The purpose of this study was to use the admittance method to accurately derive LV SV. METHODS: Ultrasonic flow probe and LV endocardial crystals were used in canines (n = 12) as the standard for LV SV. Biventricular pacing leads were inserted to obtain admittance measurements. A tetrapolar, complex impedance measurement was made between the Bi-V leads. The real and imaginary components of impedance were used to discard the myocardial component from the blood component to derive instantaneous blood conductance (Gb). Alterations in SV were measured during right ventricular pacing, dopamine infusion, and inferior vena cava occlusion. RESULTS: Gb tracks steady-state changes in SV more accurately than traditional magnitude (ie, |Y|, without removal of the muscle signal) during right ventricular pacing and dopamine infusion (P = .004). Instantaneous LV volume also was tracked more accurately by Gb than ∣Y∣ in the subset of subjects that underwent inferior vena cava occlusions (n = 5, P = .025). Finite element modeling demonstrates that admittance shifts more sensitivity of the measurement to the LV blood chamber as the mechanism for improvement (see Online Appendix). CONCLUSION: Monitoring LV SV is possible using the admittance method with biventricular pacing leads. The technique could be piggybacked to complement EGMs to determine if arrhythmias are hemodynamically unstable.

Niveles de citoquinas en suero de adictosa heroína bajo consumo activo o en terapia de mantenimiento con metadona y controles sanos en Pereira (Colombia) / Cytokine levels in serum of heroin addicts under active consumption or methadone maintenance therapy and healthy control in Pereira (Colombia)

Introducción: el tratamiento con metadona constituye el estándar de manejo de adictos a heroína. Durante la rehabilitación los pacientes mejoran su estado de salud y parecen volverse inmunocompetentes; hecho atribuido al abandono de prácticas de riesgo, mejor nutrición y suspensión de la heroína, cuyo efecto inmunodepresor es conocido. Pero como la metadona es también antagonista del glutamato, podría teneractividad inmunoestimulante adicional.Objetivo: comparar niveles séricos de las citoquinas FNT-α, IFN-γ e IL-10, entre adictos a heroína en consumo activo (CA=32), adictos tratados con metadona (Met=20) y controles sanos sin historia de adicción (Cont=20).Materiales y métodos: participaron 72 individuos de ambos sexos, mayores de edad, con pruebas serológicas para VIH/SIDA, hepatitis B y C negativas, que no utilizaran fármacos con efectos sobre el sistema inmune. Resultados: no hubo diferencias entre los grupos respecto a género (91,7% hombres), edad (25,2 ± 8 años) y tiempo de abuso de heroína (5,3 ± 2,9 años). Todos los adictosreportaron consumo de otras drogas ilícitas: 96% marihuana, 79 por ciento cocaína/basuco y 52 por ciento otros psicoactivos. Ningún individuo del grupo Met seguía consumiendo cocaína/basuco, pero la mayoría continuaba el consumo de marihuana. Se encontrarondiferencias significativas en los niveles de FNT-α (p=0,0004), IFN-γ (p=0,014) e IL- 10 (p=0,0001) entre los tres grupos estudiados; esta diferencia se conserva para las tres citoquinas cuando se comparan adictos con no adictos.Conclusión: se encontró un patrón de producción de citoquinas séricas diferencial entre adictos y no adictos, pero no fue posible determinar un patrón de respuesta inmune inducido por metadona.

Efficacy of a botanical preparation for the intramammary treatment of clinical mastitis on an organic dairy farm.

The objective was to evaluate the efficacy of a botanical product (PHYTO-MAST(®)) for the intra-mammary treatment of clinical mastitis (CM) in dairy cows managed in an organic system. The study involved 194 naturally occurring cases of clinical mastitis. Treatment was applied every 12 hours for 3 days and cows were evaluated for clinical cure starting on day 4. Outcomes of interest consisted of mastitis resolution at day 4, time to resolution, somatic cell score (SCS) after recovery, and bacteriological cure at 14 and 28 d after treatment. There was no significant effect on clinical mastitis resolution at day 4 for treatment compared with the control group. However, there was a faster recovery for the treatment group compared to the control group with median intervals from end of treatment to recovery of 4.6 d and 6.5 d, respectively. There was no effect on the probability of a SCS < 4 (200 000 SC/mL) after treatment. No significant effects were found for treatment on bacteriological cure at days 14 and 28.

L'efficacité du produit d'origine botanique dans le traitement, par voie intra mammaire, de la mastite clinique dans une ferme laitière organique. L'objectif de cette recherche était l'évaluation de l'efficacité du produit d'origine botanique (PHYTO-MAST®) dans le traitement, par voie intra mammaire, de la mastite clinique des vaches laitières élevées dans une exploitation biologique. La recherche comprenait 194 cas de mastite clinique développés naturellement. Les traitements furent appliqués tous les 12 heures pendant 3 jours et le degré de guérison des vaches fut évalué le 4ème jour. Les résultats d'intérêt ont compris la rémission de la mastite le 4ème jour, le temps de rémission et la guérison bactériologique au 14ème et 28ème jour après le traitement. Quand à la rémission de la mastite clinique en comparaison au groupe contrôle, il n'y a pas eu d'effet significatif le 4ème jour. Cependant, l'analyse des temps indiqua une rémission plus rapide pour le groupe en traitement en comparaison avec le groupe contrôle. Il n'y avait pas d'effet de la probabilité d'un SCC à moins de 4 (200 000 SC/mL) après le traitement. On ne trouva pas d'effet significatif pour le traitement sur la guérison bactériologique aux 14ème et 28ème jours. Il est nécessaire de réaliser des recherches plus approfondies sur l'efficacité de cette préparation botanique dans le traitement de la mastite clinique dans des fermes laitières biologiques.(Traduit par les auteurs).

A study of prevention and regression of cardiac hypertrophy with a prolactin inhibitor in a biological model of ventricular hypertrophy caused by aorto caval fistulae in rat.

BACKGROUND: The possibility of decreasing or reverting left ventricular hypertrophy and, therefore, cardiac hypertrophy (CH) is an important medical issue. The aim of the present study was to evaluate these two possibilities with a 3-week daily dose of captopril, losartan, or bromocriptine in a preventive or corrective model. METHODS: After aorto caval fistulae (ACF) surgery on adult male Wistar rats to induce CH, animals were assigned to the preventive protocol (drug treatment began immediately after surgery) or corrective protocol (hypertrophy was allowed to develop before drug treatment). After treatments, isoproterenol was administered to half of the animals to further induce CH. The groups included the passive control, the sham-operated animals, those with ACF surgery but without drug treatment, and the 3-week treatments with captopril, losartan, or the low or high dose of bromocriptine. RESULTS: Three treatments, with captopril, losartan, or the high dose of bromocriptine, significantly impeded/reverted an increase in CH-related parameters in the preventive/corrective model compared to the surgically treated group without drug treatment. The same effect was found after isoproterenol administration. The present results show an avoidance/reversion of CH with these three treatments. Better results were found with the angiotensin converting enzyme inhibitor (captopril) than with the prolactin inhibitor (bromocriptine). CONCLUSIONS: Treatments with captopril, losartan, and the high dose of bromocriptine were effective in preventing/reversing the manifestation of CH in the preventive/corrective rat models. Further studies are needed to identify the initial mediator, the key component, and the molecular events involved in the pathogenesis of CH.

Búsqueda de úlcera de Buruli en el Urabá Chocoano y Antioqueño, Colombia 2006 / Search of Buruli in Choco and Antioquia, Uraba Colombia, 2006

Introducción: en Colombia no se ha reportado ningún caso de úlcera de Buruli (UB), aún teniendo regiones con características similares a zonas endémicas. En nuestro medio, la proximidad geográfica y las condiciones ambientales similares con los países de Sur y Centro América donde se han reportado casos, motivan a buscar activamente pacientes sospechosos de UB, y aplicar técnicas de laboratorio moleculares específicas para brindar un adecuado diagnóstico. Objetivo: buscar casos de úlcera de Buruli (UB) en Urabá chocoano y antioqueño, (Colombia) durante el año 2006. Materiales y métodos: se estudiaron casos provenientes de las áreas de estudio, para establecer la causa etiológica de las lesiones utilizando métodos de diagnóstico clínico, microbiológico, histopatológico y molecular. Resultados: en cinco pacientes (6%) no se pudo establecer la causa etiológica de la úlcera (leishmaniosis, micosis, úlceras venosas o arteriales, cáncer). El examen clínico de estos pacientes no fue concluyente de UB, sin embargo debido a la falta de documentación de casos en Colombia, se procesó biopsia de la lesión para detectar ADN de Mycobacterium ulcerans por reacción en cadena de la polimerasa (PCR). Todas las pruebas de PCR fueron negativas para ADN de Mycobacterium ulcerans. Conclusiones: debido a indicadores epidemiológicos que señalan a Colombia con condiciones geográficas y ambientales similares a las que se presentan en regiones endémicas, como Perú, Guyana Francesa, México, Surinam, es necesario continuar con su búsqueda.

Introduction: in Colombia there are no reported cases of Buruli ulcer (BU), however the geographic and environmental characteristics are similar to endemic regions, and the proximity to other countries in South and Central America where there are reported cases, makes it an important issue to search for them, using molecular techniques specific for BU diagnostic. Objectives: to search for Buruli ulcer (BU) at the Urabá region of Chocó and Antioquia in Colombia, during 2006. Materials and methods: patients with skin ulcer from the study region were tested to establish the etiologic cause of the lesions, using clinical, microbiological, pathological and molecular methods. Results: Five patients were tested for BU using PCR test, since other etiologic causes of the ulcer (leishmaniosis, mycosis, venous or arterial ulcer, others) were not determined. Clinical examination of the patients was not conclusive of BU; but due to the lack of documented cases in Colombia, biopsies were taken from patients for detection of M. ulcerans by PCR. All the samples samples tested negative for DNA of Mycobacterium ulcerans. Conclusions: due to the epidemiological indicators that show that Colombia has the geographic and environmental conditions similar to endemic regions, as Perú, French Guyana, México and Surinam it is necessary to continue with the search.

Psychosocial and Clinical Characteristics and Psychiatric Co-morbidity Among Men and Women with HIV/AIDS under Medical Treatment at a Tertiary Health Care Center in Cali, Colombia

Introduction: Better understanding of psychosocial and health care needs of complex HIV/AIDS patients may facilitate disease management and virologic control. Objectives: To examine the behavioral, psychosocial, and co-morbid characteristics of HIV/AIDS illness in men and women being followed at a tertiary health care center in Colombia. Methods: A sample of HIV+ patients, 114 men and 29 women, was selected for review of clinical records. Results: Men were older (40 vs. 32 yrs.) and more likely to be employed (83 vs. 50%). Of those reporting sexual preference, 33% of men and 100% of women indicated being heterosexual. A higher percentage of men (34%) had CD4 count < 200 cells/mm2 when compared with the women (21%). More men than women had opportunistic infections (75 vs. 48%) and more men tended to be on complex medication regimens (68 vs. 48%). Viral load data was available for 53% of the cases, half of which had > 400 copies/ml. Only 40% of patients attended every scheduled 3-month visit. Less than one-quarter (22%) of the sample was diagnosed by a psychiatrist with a mental disorder and only a small proportion (one-fifth) had a psychiatric follow-up. Conclusions: Our study reveals several important findings among this sample of HIV patients attending a tertiary care private hospital in Cali: (1) the epidemic is rising among women, (2) undetected and under-treated psychiatric illness is highly prevalent, and (3) adherence to scheduled clinical visits is low among patients with a viral load >400 copies/ml. Thus, integrating psychosocial care with behavioral interventions to improve adherence is warranted to counteract these critical issues. An important weakness of this study was that clinical records did not include complete documentation of all variables...

Introducción: Una mejor comprensión de las necesidades psicosociales y de salud de pacientes con VIH/sida de mayor complejidad puede facilitar su manejo y control virológico. Objetivo: Estudiar las características de comportamiento, psicosociales y de comorbilidad en la enfermedad por VIH/sida en hombres y mujeres de un centro de atención nivel tres en Colombia. Método: Revisión de una muestra de pacientes con VIH+ de 114 hombres y 29 mujeres y de sus historias clínicas. Resultados: Los hombres eran de mayor edad (40 vs. 32 años) y estaban empleados (83% vs. 50%). En los que reportaron preferencia sexual, 33% de los hombres y 100% de las mujeres refirieron heterosexualidad. Un mayor porcentaje de hombres (34%) que de mujeres (21%) tuvo un recuento de CD4 <200 células/mm2. Más hombres tenían infecciones oportunistas (75% vs. 48%) y estaban en tratamientos médicos de mayor complejidad (68% vs. 48%). Datos de carga viral estaban disponibles en el 53% de los casos. Solamente 40% asistieron a cada una de las citas trimestrales. El 22% tenía un diagnóstico de enfermedad mental realizado por un psiquiatra, y sólo una quinta parte, seguimiento por psiquiatra. Conclusiones: Nuestro estudio revela tres hallazgos importantes para la población que acude a un hospital privado de nivel tres en la ciudad de Cali: (i) la epidemia está aumentando en mujeres, (ii) la enfermedad psiquiátrica no detectada y no tratada es altamente prevalente y (iii) la adherencia a las visitas programadas fue baja en los pacientes con carga viral >400 copias/ml. Por lo tanto, para mejorar adherencia es prioritario integrar el cuidado psicosocial con las intervenciones sobre el comportamiento y así controlar estos críticos aspectos...

La suplementación con hierro y el aumento del estrés oxidativo en el embarazo: una paradoja poco discutida / Iron supplementation and oxidative stress in pregnancy: a little-discussed paradox

La suplementación con hierro a las mujeres embarazadas es una recomendación ampliamente aceptada en la práctica médica. Sin embargo, el hierro participa en los fenómenos de iniciación y propagación de reacciones de generación de especies reactivas de oxígeno e hidroperóxidos lipídicos, los cuales juegan un papel importante en la fisiopatología de enfermedades como diabetes gestacional y preeclampsia. Aparece una paradoja: suplementar con hierro disminuye el riesgo de anemia y complicaciones, pero esta podría favorecer el desarrollo de otras enfermedades. Esta paradoja se discute en el texto y se sugieren estudios que se deben realizar para aclarar cuáles son las condiciones de mayor seguridad para suplementar con hierro a las mujeres gestantes.

Impairment of smooth muscle function of rat thoracic aorta in an endothelium-independent manner by long-term administration of N(G)-nitro-L-arginine methyl ester.

In this study, we aimed to elucidate whether the daily hypertensive dose of long-term N(G)-nitro-l-arginine methyl ester (l-NAME) treatment, could make a difference between endothelial and smooth muscle functions in rat thoracic aorta. We test the hypothesis that high-dose, long-term l-NAME treatment has a depressive effect on vascular smooth muscle contractile activity which is not related with nitric oxide (NO) synthesis inhibition. After 14 days of treatment, isometric tension and (45)Ca(2+) influx were measured in aortic tissues isolated from l-NAME(10) and l-NAME(100) hypertensive (10 and 100 mg/kg/day, systolic blood pressures 167 +/- 7 and 172 +/- 10 mmHg, respectively) and control normotensive rats (132 +/- 7 mmHg). In l-NAME(10)- and l-NAME(100)-treated rats, acetylcholine-induced relaxation in aortic rings was suppressed with no significant difference between the treatments. l-NAME(100) (but not l-NAME(10)) treatment, significantly inhibited contractile responses to phenylephrine, angiotensin II, and K(+) (80 mm) in endothelium-intact tissues. The effect of l-NAME(100) on phenylephrine-induced contractile responses was not observed after 3 days of treatment. In endothelium-denuded aortic tissues of l-NAME(100) (but not l-NAME(10))-treated rats, phenylephrine (1 x 10(-6) m)- and K(+) (80 mm)-induced contractions and (45)Ca(2+) influxes were significantly reduced. In Ca(2+)-free medium (0.1 mm EDTA), on the contrary, the transient contractions obtained by either phenylephrine (1 x 10(-6) m) or caffeine (1 x 10(-2) m), or the sustained contractions induced by 12-o-tetradecanoylphorbol-13-acetate (1 x 10(-6) m; a protein kinase C activator) in endothelium-denuded aortic rings, were not modified by both l-NAME treatments. These results indicate that in aortic rings from l-NAME hypertensive rats, low and high doses, long-term l-NAME administration may be associated with equivalent inhibition in NO-dependent vasodilator tone (corresponding to equivalent hypertension values); whereas only high-dose, long-term l-NAME administration produces an endothelium-independent decrease in vasocontrictor activity, at least partly explained by a reduction in extracellular Ca(2+) influx.

Medidas radiográficas y corporales para diagnosticar relaciones de clase II utilizando análisis estadístico multivariado / Radiographic and body measurements to diagnose class II relationships using a multivariate statistical analysis

Para el diagnóstico en ortodoncia se han utilizado más de 40 variables dependiendo de los autores. De ellas, algunas aportan información para realizar el diagnóstico de las relaciones de clase II. Cuando se tienen tantas variables es necesario utilizar un método que permita identificar las más representativas y eliminar las redundantes. Para el logro de este objetivo se utilizó el análisis estadístico multivariado (análisis de componentes principales, análisis de factor, análisis de agrupamiento y análisis discriminante), con el cual se identificaron las variables: ángulo de Lande, ánguilo de la convexidad y la distancia del punto A a la perpendicular de FH; igualmente, se identificaron los subgrupos y los factores (constructor) por género; por último, se obtuvo la función discriminante para identificar las relaciones clase II. Con el análisis multivariado se logró reducir el número de variables utilizadas para el diagnóstico.