Ginkgo biloba: Antioxidant Activity and In Silico Central Nervous System Potential.

Ginkgo biloba (GB) extracts have been used in clinical studies as an alternative therapy for Alzheimer's disease (AD), but the exact bioaction mechanism has not yet been elucidated. In this work, an in silico study on GB metabolites was carried out using SwissTargetPrediction to determine the proteins associated with AD. The resulting proteins, AChE, MAO-A, MAO-B, ß-secretase and γ-secretase, were studied by molecular docking, resulting in the finding that kaempferol, quercetin, and luteolin have multitarget potential against AD. These compounds also exhibit antioxidant activity towards reactive oxygen species (ROS), so antioxidant tests were performed on the extracts using the DPPH and ABTS techniques. The ethanol and ethyl acetate GB extracts showed an important inhibition percentage, higher than 80%, at a dose of 0.01 mg/mL. The effect of GB extracts on AD resulted in multitarget action through two pathways: firstly, inhibiting enzymes responsible for degrading neurotransmitters and forming amyloid plaques; secondly, decreasing ROS in the central nervous system (CNS), reducing its deterioration, and promoting the formation of amyloid plaques. The results of this work demonstrate the great potential of GB as a medicinal plant.

Fourth-Year Medical Students' Perceptions of Vascular Surgery: Can We Improve the Pipeline?

BACKGROUND: Since their inception, Integrated Vascular Surgery Residency (IVSR) programs have expanded widely and attracted highly competitive medical students by offering a more focused approach to learning both open surgical and endovascular techniques. However, despite substantial modifications to the training paradigm, a shortage of vascular surgeons is still projected through 2050. We aimed to gather and analyze fourth-year medical students' knowledge and perceptions of vascular surgery (VS) to further inform strategies for recruiting future vascular surgeons. METHODS: We sent anonymous electronic questionnaires to fourth-year medical students at 7 allopathic and 3 osteopathic medical schools, with questions detailing demographics, specialty preferences, and exposure to and perceptions of VS. Descriptive statistics were obtained, and responses were compared between students applying to surgical specialties (SS) and nonsurgical specialties (NSS). RESULTS: Two hundred eleven of 1,764 (12%) participants responded (56% female). 56% reported VS exposure, most commonly during the third year. 64 (30%) planned to apply to SS. 57% of respondents reported knowledge of the management of vascular disease, and 56% understood procedures performed by vascular surgeons. Ranking the importance of factors in choosing specialties, SS selected "experiences gained during medical school rotations" (P < 0.05), "types and/or variety of treatment modalities used in this field" (P < 0.001), and "interest in the pathology or disease processes treated" (P < 0.05) as highest priorities. NSS preferred "lifestyle (work-life balance) as an attending" (P < 0.001). Only 7% of all respondents believed vascular surgeons have a good work-life balance, with a larger percentage of SS (P < 0.001) agreeing. Stratified by gender, female students rated "limited ability of childbirth during residency and/or postponement of family plans" (P < 0.05), "gender-related concerns, such as discrimination at work or unfair career possibilities" (P < 0.001), and "fear of unfair competition" (P < 0.05) as potential negative aspects of VS careers. 55% of respondents believed the IVSR makes VS more appealing. CONCLUSIONS: Medical students perceive poor quality of life and work-life balance as deterring factors to a career in VS. Opportunities exist to educate students on the pathologies treated, procedures performed, and attainable quality of life available in our field. We should also continue to develop recruitment strategies to stimulate student interest and increase early exposure in VS.

A Mango Leaf Extract (Zynamite®) Combined with Quercetin Has Exercise-Mimetic Properties in Human Skeletal Muscle.

Zynamite PX®, a mango leaf extract combined with quercetin, enhances exercise performance by unknown molecular mechanisms. Twenty-five volunteers were assigned to a control (17 males) or supplementation group (8 males, receiving 140 mg of Zynamite® + 140 mg quercetin/8 h for 2 days). Then, they performed incremental exercise to exhaustion (IE) followed by occlusion of the circulation in one leg for 60 s. Afterwards, the cuff was released, and a 30 s sprint was performed, followed by 90 s circulatory occlusion (same leg). Vastus lateralis muscle biopsies were obtained at baseline, 20 s after IE (occluded leg) and 10 s after Wingate (occluded leg), and bilaterally at 90 s and 30 min post exercise. Compared to the controls, the Zynamite PX® group showed increased basal protein expression of Thr287-CaMKIIδD (2-fold, p = 0.007) and Ser9-GSK3ß (1.3-fold, p = 0.005) and a non-significant increase of total NRF2 (1.7-fold, p = 0.099) and Ser40-NRF2 (1.2-fold, p = 0.061). In the controls, there was upregulation with exercise and recovery of total NRF2, catalase, glutathione reductase, and Thr287-CaMKIIδD (1.2-2.9-fold, all p < 0.05), which was not observed in the Zynamite PX® group. In conclusion, Zynamite PX® elicits muscle signaling changes in resting skeletal muscle resembling those described for exercise training and partly abrogates the stress kinases responses to exercise as observed in trained muscles.

Telemedicine informatics application for nutritional support surveillance of instutionalized persons in nursing homes from a hospital pharmacy service.

INTRODUCTION: Institutionalized patients who require nutrition support regularly visit the Unit of Nutrition Support of the Hospital Pharmacy  Service. During these visits, prior to establishing a nutrition regime and  followup scheme, an initial nutritional status assessment is performed.  Telemedicine and Telepharmacy have expanded in recent years for remote  monitoring of institutionalized persons. OBJECTIVE: To evaluate the implementation of a Telemedicine informatics application for nutritional support surveillance of instutionalized  persons in nursing homes from a hospital pharmacy service. Method: A multidisciplinary team led by the Hospital Pharmacy Service was  created. Data of institutionalized persons in nursing homes needing artificial  nutritional support was extracted from the SILICON prescription system and  the internal ecords of the hospital pharmacy service. Nursing homes were  selected on the basis of their previous experience using the Telemedicine  informatics application TELEA. The following nutritional  support variables were  assessed: score on Mini-Nutritional Assessment questionnaire; a 24-h  food record; pressure ulcer control; and laboratory parameters. The existing  information flow between nursing homes and hospital specialists was analyzed.  The functionalities available on TELEA were considered. RESULTS: In 2021, over 300 institutionalized persons from 28 nursing homes  were incluided for nutritional support surveillance program of the hospital  pharmacy service. The project was implemented in two nursing homes serving  38 patients, although only 13 were involved in the nutrition surveillance  program of the Nutrition Support Unit. Nutritional status assessment and  nutritional support surveillance reports were adapted to the Telemedicine  informatics application. Paper reports were replaced  with electronic data or  online questionnaires available on the informatics application. An information  flow protocol was established. An instantaneous messaging and alert system  was activated, which allowed continuous communication. Some Telepharmacy  requests were categorized as preferential when the clinical status of the patient  so required. All the information generated during the nutritional status  assessment and nutritional support surveillance process was integrated into  the electronic medical history of each patient. CONCLUSIONS: TELEA-based nutritional support surveillance facilitates the  continuum of care by enabling direct communication between nursing homes  and secondary care for institutionalized persons. This model makes it possible  to record nutrition-related data on the electronic medical history of patients  through a Telepharmacy process. This model also eliminates paper  prescriptions and medical reports, and unnecessary travels. A nutritional status  profile should also be made available to facilitate nutrition surveillance in institutionalized persons with chronic diseases. That  would be the first step for a new integrated healthcare informatics application  for frail/polymorbid elderly patients.

Introducción: Los pacientes institucionalizados que requieren soporte  nutricional artificial acuden de forma periódica a las consultas de la Unidad de  Soporte Nutricional del Servicio de Farmacia. En ellas se realiza una  valoración nutricional inicial, a partir de la cual se establece la pauta nutricional  y el plan de seguimiento. La Telemedicina y la Telefarmacia se han  expandido en los últimos años para la monitorización remota de personas  institucionalizadas. OBJETIVO: Evaluar la implementación de una aplicación informática de Telemedicina para la vigilancia del soporte nutricional de personas  nstitucionalizadas en residencias de ancianos desde un servicio de farmacia hospitalaria.Método: Se formó un equipo multidisciplinar liderado por el Servicio de Farmacia. Los datos de pacientes institucionalizados que requieren soporte nutricional artificial se obtuvieron del programa SILICON y de los  registros internos del Servicio de Farmacia. Se eligieron las primeras  residencias candidatas según la experiencia previa en el manejo de la  aplicación informática de asistencia domiciliaria. Se analizaron llas variables de  soporte nutricional necesarias para el seguimiento nutricional: Mini  Nutritional Assessment, recordatorio de ingestas de las últimas 24 horas,  control de úlceras por presión y parámetros analíticos. Se analizó el flujo de  información existente entre las residencias sociosanitarias y la atención  hospitalaria y se valoraron las opciones disponibles a través de la plataforma  tecnológica de asistencia domiciliaria. RESULTADOS: El Servicio de Farmacia realizó seguimiento nutricional a más de  300 pacientes institucionalizados en 28 residencias sociosanitarias en el año  2021. El proyecto se implantó en dos residencias sociosanitarias que cuentan  con 38 pacientes institucionalizados, aunque solo 13 pacientes estaban en  seguimiento por la Unidad de Soporte Nutricional. Todos los registros  generados en la valoración y seguimiento nutricional se adecuaron a la  aplicación informática de asistencia domiciliaria, se cambiaron los registros en  papel por información incluida en la plataforma o cuestionarios online  facilitados a través de la misma. Además, se protocolizó el flujo de información  generada y se activó un sistema de mensajería con alertas que  permite una comunicación continua. En caso de que la situación clínica  del  paciente lo requiera se puede programar una teleconsulta preferente.Toda la  información generada en el proceso de valoración y seguimientonutricional de  cada paciente se integró en la historia clínica electrónica. CONCLUSIONES: El seguimiento nutricional a través de la aplicación informática de asistencia domiciliaria facilita la continuidad asistencial por el establecimiento de una comunicación directa entre las residencias  sociosanitarias y la atención hospitalaria, permitiendo la integración de la  información nutricional de los pacientes en la historia clínica electrónica  mediante un proceso de Telefarmacia. Se han eliminado las prescripciones en  papel, informes clínicos impresos y los desplazamientos innecesarios. El  desarrollo de este perfil podría ser extensible al seguimiento nutricional de  pacientes con patologías crónicas, y ser el precedente de un nuevo programa  de cuidado integral del paciente anciano frágil o pluripatológico.

Persistent neuropathology and behavioral deficits in a mouse model of status epilepticus induced by acute intoxication with diisopropylfluorophosphate.

Organophosphate (OP) nerve agents and pesticides are a class of neurotoxic compounds that can cause status epilepticus (SE), and death following acute high-dose exposures. While the standard of care for acute OP intoxication (atropine, oxime, and high-dose benzodiazepine) can prevent mortality, survivors of OP poisoning often experience long-term brain damage and cognitive deficits. Preclinical studies of acute OP intoxication have primarily used rat models to identify candidate medical countermeasures. However, the mouse offers the advantage of readily available knockout strains for mechanistic studies of acute and chronic consequences of OP-induced SE. Therefore, the main objective of this study was to determine whether a mouse model of acute diisopropylfluorophosphate (DFP) intoxication would produce acute and chronic neurotoxicity similar to that observed in rat models and humans following acute OP intoxication. Adult male C57BL/6J mice injected with DFP (9.5 mg/kg, s.c.) followed 1 min later with atropine sulfate (0.1 mg/kg, i.m.) and 2-pralidoxime (25 mg/kg, i.m.) developed behavioral and electrographic signs of SE within minutes that continued for at least 4 h. Acetylcholinesterase inhibition persisted for at least 3 d in the blood and 14 d in the brain of DFP mice relative to vehicle (VEH) controls. Immunohistochemical analyses revealed significant neurodegeneration and neuroinflammation in multiple brain regions at 1, 7, and 28 d post-exposure in the brains of DFP mice relative to VEH controls. Deficits in locomotor and home-cage behavior were observed in DFP mice at 28 d post-exposure. These findings demonstrate that this mouse model replicates many of the outcomes observed in rats and humans acutely intoxicated with OPs, suggesting the feasibility of using this model for mechanistic studies and therapeutic screening.

Cannabinoid Effects on Experimental Colorectal Cancer Models Reduce Aberrant Crypt Foci (ACF) and Tumor Volume: A Systematic Review.

OBJECTIVE: Colorectal cancer represents a heavy burden for health systems worldwide, being the third most common cancer worldwide. Despite the breakthroughs in medicine, current chemotherapeutic options continue to have important side effects and may not be effective in preventing disease progression. Cannabinoids might be substances with possible therapeutic potential for cancer because they can attenuate the side effects of chemotherapy and have antiproliferative and antimetastatic effects. We aim to determine, through a systematic review of experimental studies performed on animal CRC models, if cannabinoids can reduce the formation of preneoplastic lesions (aberrant crypt foci), number, and volume of neoplastic lesions. MATERIALS AND METHODS: A systematic, qualitative review of the literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, and Scopus databases were searched. We use the following Medical Subject Headings (MESH) terms in PubMed: "colorectal neoplasms," "colonic neoplasms," "colorectal cancer," "polyps," "rimonabant," "cannabidiol," "cannabinoids," "azoxymethane," "xenograft," and "mice." Only studies that met the eligibility criteria were included. RESULTS: Eight in vivo experimental studies were included in the analysis after the full-text evaluation. Seven studies were azoxymethane (AOM) colorectal cancer models, and four studies were xenograft models. Cannabidiol botanical substance (CBD BS) and rimonabant achieved high aberrant crypt foci (ACF) reduction (86% and 75.4%, respectively). Cannabigerol, O-1602, and URB-602 demonstrated a high capacity for tumor volume reduction. Induction of apoptosis, interaction with cell survival, growth pathways, and angiogenesis inhibition were the mechanisms extracted from the studies that explain cannabinoids' actions on CRC. CONCLUSIONS: Cannabinoids have incredible potential as antineoplastic agents as experimental models demonstrate that they can reduce tumor volume and ACF formation. It is crucial to conduct more experimental studies to understand the pharmacology of cannabinoids in CRC better.

Metabolic alkalosis is related to delayed response to treatment of hypokalemia in non-surgical critically ill patients.

Background: Potassium (K+) homeostasis is closely related to acid - base disorders. The aim of this study is to analyze the possible causes of hypokalemia non-surgical critically ill patients including acid - base disorders and its relationship with response to K+ supplementation. Methods: We performed a retrospective cohort study of 122 consecutive non-surgical patients admitted to the Intensive Care Unit during July 2016 Patients were classified according to the presence of hypokalemia or not. Demographic data, morbidities associated with hypokalemia, with emphasis in acid-base disorders and response to treatment were described and analyzed. Results: Hypokalemia was observed in 32,7% (n = 40) of the patients included. Hypokalemic group had a higher value of base excess (median of -0.65 [IQR -3.3-5.2] Vs -3.2 [IQR -5.1--1.4]; p < 0.001). The patients with hypokalemia that achieved normal serum K+ in more than 25 h had a higher value of excess base than those who did so in less than 24 h (median of 4.3 [IQR -2.1-5.5] vs -1.9 [IQR -4.8-3]; p < 0.05). Neither the degree of hypokalemia, the time to development, route of administration or solution concentration, speed of infusion, the amount of K+ administered per day per kg of weight were related with the response of treatment. Conclusions: Hypokalemia is a common disorder in non-surgical critically ill patients. Hypokalemic patients had a higher incidence of metabolic alkalosis. Patients with hypokalemia and metabolic alkalosis needed a higher amount of potassium administration and higher time to achieve correction.

Culture and Dehydration: A Comparative Study of Caída de la Mollera (Fallen Fontanel) in Three Latino Populations.

A sunken soft-spot or fontanel is a sign for dehydration in infants. Around the world, folk illnesses, such as caída de la mollera in some Latin American cultures, often incorporate this sign as a hallmark of illness, but may or may not incorporate re-hydration therapies in treatment strategies. This report describes a study of lay descriptions of causes, symptoms, and treatments for caída de la mollera in three diverse Latin American populations. A mixed-methods approach was used. Representative community-based samples were interviewed in rural Guatemala, Guadalajara, Mexico, and Edinburgh, Texas, with a 132 item questionnaire on the causes, susceptibility, symptoms, and therapies for caída de la mollera. Cultural consensus analysis was used to estimate community beliefs about caída. Interviews conducted in rural Guatemala (n = 60), urban Mexico (n = 62), and rural Texas on the Mexican border (n = 61) indicated consistency in thematic elements within and among these three diverse communities. The high degree of consistency in the illness explanatory models indicated shared beliefs about caída de la mollera in each of the communities and a core model shared across communities. However, an important aspect of the community beliefs was that rehydration therapies were not widely endorsed. The consistency in explanatory models in such diverse communities, as well as the high degree of recognition and experience with this illness, may facilitate communication between community members, and health care providers/public health intervention planners to increase use of rehydration therapies for caída de la mollera. Recommendations for culturally informed and respectful approaches to clinical communication are provided.

Factores relacionados con el consumo de alimentos funcionales en la provincia de Las Palmas / Factors related to functional food consumption in the province of Las Palmas

Fundamento: Cuando se analiza la actitud de los consumidores ante los alimentos funcionales se debe tener en cuenta cómo se insertan éstos en la alimentación y en las percepciones de los individuos. El principal objetivo de este trabajo es analizar las creencias y actitudes, ante los alimentos funcionales, desarrolladas por los consumidores, en la provincia de Las Palmas. Métodos: Se ha realizado un estudio, descriptivo, transversal y aleatorizado. Se han utilizado fuentes de información primarias, mediante encuestas personales, en el que se recogen datos sociodemográficos, hábitos alimentarios generales y consumo y frecuencia de alimentos funcionales. Resultados: La mayoría de las personas entrevistadas muestran una actitud positiva hacia los alimentos funcionales, con una opinión óptima sobre el beneficio de los mismos, concluyendo que la mayor preocupación por parte de la población, respecto a la alimentación y la mayor disponibilidad de alimentos funcionales, plantea la necesidad de revisar los enfoques educacionales en materia alimentaria (AU)

Background: The analysis of consumer attitudes to functional foods requires to consider how they are inserted in individuals perceptions and food choice behaviour. The main objective of this study is to analyze the beliefs and attitudes to functional foods, developed by consumers in the province of Las Palmas. Methods: Using a descriptive, crossectional and randomized study design, data were collected from primary sources by means of personal interviews.Data collected included sociodemographic issues, general dietary habits and consumption and frequency of functional foods. Results: Most respondents had a positive attitude toward functional foods, including an optimal opinion of their benefit. Conclusions: The greater concern of the population about food and the ?way of eating? as well as an increased availability of functional foods, requires an adequate educational approach regarding food (AU)

Office-based ultrasound in sports medicine practice.

Increasing knowledge, interest, and visibility in the field of sports medicine has equipped clinicians in the field with a novel array of diagnostic and therapeutic options but has also provided a higher level of complexity in patient care. True understanding of the vast spectrum of radiographic technology available to the sports clinician has become more critical than ever. Advances particularly in the areas of magnetic resonance imaging, diagnostic office ultrasound, and 3-dimensional reconstruction computed tomography, as well as nuclear medicine, offer the clinician a myriad of diagnostic options in patient evaluation. As these advances accumulate, the challenge to optimize care, contain cost, and interpret the extensive data generated becomes even more difficult to manage. Improving technology, education, and application of office ultrasound offers an interesting new tool for the bedside evaluation in real time of dynamic motion and pathology of sports-related injuries. As studies continue to validate ultrasound's effectiveness in diagnosing injuries to the upper and lower extremities compared with more costly magnetic resonance imaging and more invasive exploratory surgery, its promise as a cost-effective diagnostic tool is growing. A particularly promising development in the care of sports injuries is the expansion of injection therapies, and in-office ultrasound provides assurance that prolotherapy, platelet-rich plasma, dry needling, corticosteroid, and viscosupplementation are delivered accurately and safely. Communication with patients continues to increase in complexity because a greater understanding of the presence of radiographic abnormalities irrelevant to the current complaint is gained. All the accumulated data must then be interpreted and communicated to the patient with a firm understanding of not only the patient history and physical examination but also the availability, indications, contraindications, sensitivity, specificity, and even the cost implications of the spectrum of diagnostic options.

A method to study global spatial patterns related to sensory perception in scalp EEG.

Prior studies of multichannel ECoG from animals showed that beta and gamma oscillations carried perceptual information in both local and global spatial patterns of amplitude modulation, when the subjects were trained to discriminate conditioned stimuli (CS). Here the hypothesis was tested that similar patterns could be found in the scalp EEG human subjects trained to discriminate simultaneous visual-auditory CS. Signals were continuously recorded from 64 equispaced scalp electrodes and band-pass filtered. The Hilbert transform gave the analytic phase, which segmented the EEG into temporal frames, and the analytic amplitude, which expressed the pattern in each frame as a feature vector. Methods applied to the ECoG were adapted to the EEG for systematic search of the beta-gamma spectrum, the time period after CS onset, and the scalp surface to locate patterns that could be classified with respect to type of CS. Spatial patterns of EEG amplitude modulation were found from all subjects that could be classified with respect to stimulus combination type significantly above chance levels. The patterns were found in the beta range (15-22 Hz) but not in the gamma range. They occurred in three short bursts following CS onset. They were non-local, occupying the entire array. Our results suggest that the scalp EEG can yield information about the timing of episodically synchronized brain activity in higher cognitive function, so that future studies in brain-computer interfacing can be better focused. Our methods may be most valuable for analyzing data from dense arrays with very high spatial and temporal sampling rates.

Biocatalytic transformation of petroporphyrins by chemical modified cytochrome C.

A semi-synthetic biocatalyst was prepared by a double chemical modification of cytochrome c. Free amino groups were modified with poly(ethylene glycol) while free carboxylic groups were alkylated to form methyl esters. The double chemically modified protein, PEG-Cyt-Met, oxidized synthetic porphyrins in a ternary solvent mixture composed by methylene chloride, methanol, and phosphate buffer. The highest activity was found in the ternary systems with low water content (5%). The use of relatively hydrophobic peroxides, such as tert-butyl and cumene hydroperoxides, extended the operational life of the biocatalyst, which, in turn, resulted in an extended oxidation of the substrates tested. PEG-Cyt-Met is able to transform asphaltenes, a highly recalcitrant petroleum fraction. The huge energetic resource found as asphaltene-rich deposits is the driving force to investigate and to innovate upgrading technologies, including biotechnological strategies.

La electrocoagulacion endoscopica como metodo de control de la hemorragia digestiva activa en la infancia / Electrocoagulation endoscopy as method of control of active digestive hemorrhage in infancy

Dentro de las nuevas tecnicas desarrolladas para el tratamiento de la hemorragia digestiva, se encuentra la electrocoagulacion endoscopica. Se electrocoagularon 8 casos con gastritis aguda erosiva, ulcera gastrica y ulcera duodenal lograndose una hemostasia permanente en 7 de ellos, habiendo resangrado un caso portador de ulcera duodenal que tuvo necesidad de ser intervenido quirurgicamente. La electrocoagulacion endoscopica es un metodo efectivo, seguro, que permite ser usado al lado de la cama del enfermo y que controla el sangramiento en la mayoria de los casos. La electrocoagulacion endoscopica es una alternativa para la cirugia de urgencia teniendo dentro de sus beneficios el evitar transfusiones de sangre con el riesgo que estos conllevan.

La oxigenación hiperbarica en el tratamiento de diferentes afecciones clinicoquirúrgicas

Se describe la labor asistencial desarrollada por el Servicio de Oxigenación Hiperbárica (OHB) del ISMM Dr Luis Díaz Soto en el término de un año, referida a pacientes de perfil clínico-quirúrgico en general y afecciones varias del sistema nervioso. Se esboza brevemente el desarrollo contemporáneo del método y su mecanismo de acción básica. El equipamiento del departamento y 1a técnica de administración de la OHB se describen particularizando los regímenes de presión y tiempo utilizados según las características de los pacientes. Los resUltados obtenidos se presentan en tablas, agrupados según el tipo de trastorno, considerándose como criterio de mejoría cualquier cambio favorable en la evolución de la enfermedad a partir de la instauración del tratamiento. Se concluye que la experiencia optenida hasta el presente se corresponde con lo reportado por numerosos autores, confirma el valor de la OHB como tratamiento específico o coadyuvante en múltiples afecciones, y justifica la conveniencia de su extensión y desarrollo(AU)

Experiencias preliminares sobre el empleo de la oxigenación hiperbárica en afecciones de perfil clínico

Se presentan los primeros resultados obtenidos de la aplicación de la oxigenación hiperbárica (OHB) en el tratamiento de afecciones pertenecientes a diferentes especialidades clínicas, tales como: medicina interna, cardiología, gastroenterología, hematología, nefrología y endocrinología. Los pacientes fueron tratados en cámaras hiperbáricas individuales del Servicio de OHB del ISMMb Dr. Luis Díaz Soto. Los regímenes de presión, así como la duración y frecuencia de las sesiones se ajustaron a las características particulares de cada paciente, así como a su respuesta al tratamiento. La OHB ha sido efectiva en el tratamiento de la enfermedad isquémica cardíaca, arritmias hepatopatías, úlcera péptica, sicklemia, insuficiencia renal, dibetes mellitus y otras, se discuten los efectos terapéuticos del método particularmente sus acciones antihipóxica, hipoglicemiante y normalizadora del metabolismo y del equilibrio ácido-básico(AU)

Manometria anorrectal en niños con constipación crónica / Anorectal manometry in children with chronic constipation

Se estudian 40 pacientes con constipación crónica cuyas edades fluctuaron entre 8 meses y 14 años, agrupándose en un primer grupo de 37 pacientes cuya frecuencia de evacuación de las heces era de más de 2 días, y en un segundo grupo de 3 pacientes con colostomía por sospecha de megacolon agangliónico, con la introducción por primera vez en nuestro país de la manometría anorrectal (MAR). Se realiza la MAR previo enema evacuante y sedación, introduciéndose un sistema de catéteres en recto y esfínter anal interno, conectados a un sistema de registro poligrafico y colocándose un balón en el recto superior para la estimulación de éste. Se expresa que de los 37 pacientes del primer grupo, 33 presentaron el reflejo rectoanal inhibitorio, por lo que en el 89

Manometria anorrectal en niños con constipación crónica / Anorectal manometry in children with chronic constipation

Se estudian 40 pacientes con constipación crónica cuyas edades fluctuaron entre 8 meses y 14 años, agrupándose en un primer grupo de 37 pacientes cuya frecuencia de evacuación de las heces era de más de 2 días, y en un segundo grupo de 3 pacientes con colostomía por sospecha de megacolon agangliónico, con la introducción por primera vez en nuestro país de la manometría anorrectal (MAR). Se realiza la MAR previo enema evacuante y sedación, introduciéndose un sistema de catéteres en recto y esfínter anal interno, conectados a un sistema de registro poligrafico y colocándose un balón en el recto superior para la estimulación de éste. Se expresa que de los 37 pacientes del primer grupo, 33 presentaron el reflejo rectoanal inhibitorio, por lo que en el 89% de los casos se descartó la existencia de megacolon agangliónico. Se comprueba la elevación de la presión esfinteriana después de la estimulación, así como la relación entre el volumen distensor y la respuesta de relajación del esfínter interno. Se observa que todos los pacientes del segundo grupo presentan un volumen crítico de respuesta esfinteriana elevado en comparación con los del primer grupo