Self-esteem and quality of life in patients with neurogenic dysfunction and continent urinary diversion and/or procedures for anterograde enemas.

INTRODUCTION AND OBJECTIVE: The importance of evaluating the self-esteem and quality of life of patients with a chronic disease has become increasingly relevant. The study describes self-esteem and quality of life outcomes in patients with neurogenic dysfunction and continent urinary diversions and/or antegrade enema procedures. MATERIALS AND METHODS: Cross-sectional observational study, including patients with neurogenic dysfunction who required a continent urinary diversion and/or an antegrade enema conduit during their treatment. The self-esteem evaluation was done with the Rosenberg scale and the quality of life with the KIDSCREEN-27 questionnaire. VARIABLES MEASURED: socio-demographic, clinical and economic characteristics. Descriptive statistics were applied. RESULTS: The mean age of the 9 patients was 15.6 years, the mean time elapsed from surgery to application of the questionnaires was 60.9 ±â€¯37.1 months. With a perception of improvement in 8 of the 9 patients and a normal or higher self-esteem score in all cases. In the description of physical activity and health, it was found that 7 of the 9 young people presented a perception of good health in general. A considerable reduction in the use of diapers was achieved after the intervention, going from consuming 6.2 ±â€¯1.4 diapers per day to only 1.7 ±â€¯1.3 diapers per day. CONCLUSIONS: Despite the sequelae, comorbidities and procedures, the results of self-esteem and quality of life in patients with neurogenic dysfunction are high.

[Management of patients with lymphatic diseases and lipoedema during the COVID-19 pandemic. Recommendations of the Spanish Group of Lymphology]. / La atención al paciente con patología linfática y lipedema en la pandemia COVID-19. Recomendaciones del Grupo Español de Linfología (GEL).

The COVID-19 pandemic poses a challenge to the management of non-COVID pathologies such as lymphatic diseases and lipoedema. The use of telemedicine can prevent the spread of the disease. A system is needed to help determine the clinical priority and selection of face-to-face or telemedicine options for each patient and how to carry them out during the pandemic. The Spanish Lymphology Group has drafted a consensus document with recommendations based on the literature and clinical experience, as clinical practice guidelines for the management of lymphatic abnormalities and lipoedema during the COVID-19 pandemic. These recommendations must be adapted to the characteristics of each patient, the local conditions of the centres, and the decisions of health care professionals. The document contains minimum criteria, subject to modifications according to the evolution of the pandemic, scientific knowledge and instructions from health authorities.

Efficacy assessment of an intramammary treatment with a new recrystallized enrofloxacin vs ceftiofur and parenteral enrofloxacin in dairy cows with nonsevere clinical mastitis.

A recrystallized form of enrofloxacin as dehydrate-HCl (enro-C) was assessed for bacteriological and clinical cure efficacies in Holstein-Friesian cows affected of nonsevere clinical mastitis. Treatments were enro-Csusp (n = 81), treated with a pharmaceutical suspension of enro-C/quarter; group enro-Cpd (n = 80) treated as above, but using enro-C powder suspended in water; group CF (n = 65), treated with ceftiofur HCl/quarter; and group enroR (n = 66), treated with standard enrofloxacin solution (5 mg/kg, intramuscular). Cows had a mean milk production of 31 L/day and were 2-3 lactational periods old. Treatments were administered every 24 hr for 3 days. Groups treated with enro-C exhibited statistically significant (p > .05) better clinical cure as compared to groups treated with CF or enroR (95.06%, 96.25%, 67.79%, and 57.55%, for enro-Csusp , enro-Cpd , CF, and enroR , respectively). In contrast, probability of bacteriological cure was not statistically different among treatments. Yet, the outstanding clinical and bacteriological cure rates obtained for enro-C for nonsevere cases of mastitis is superior to previously reported data for parenteral enrofloxacin and other antibacterial-intramammary treatments. Impact of using enro-C on the rate and pattern of bacterial resistance, somatic cell counts and milk electric conductivity, must be studied. Also, the use of enro-C for complicated cases of mastitis should be studied and milk withdrawal times must be accurately established.

Tratamiento con plasma autólogo rico en plaquetas en una paciente estéril con un endometrio refractario / Treatment with rich platelets autologous plasma in a sterile patient with suspected refractory endometrium

Paciente de 36 años con esterilidad primaria de 2 años. Tras estudio completo se decide donación de ovocitos. En los controles se observa un grosor endometrial adelgazado. Con el diagnóstico de endometrio refractario, se realiza un tratamiento con estrógenos a altas dosis, vitamina E y pentoxifilina durante 3 meses. Como el grosor endometrial no aumenta, asociamos AAS. Finalmente se administra intraútero plasma autólogo rico en plaquetas. A las 96 horas se observa un endometrio de 7,3 mm, transfiriéndose dos embriones vitrificados, resultando en un aborto bioquímico. Discusión: El tratamiento médico del endometrio refractario constituye un reto. Existen numerosas opciones terapéuticas, hormonales y no hormonales. Sin embargo, la mayoría de estas opciones están escasamente evaluadas por lo que se requieren de estudios mejor diseñados y con mayor tamaño muestral (AU)

36 years old patient with primary sterility of 2 years. An oocyte donation was decided after the study. An endometrial thickness slimmed was observed in different visits. With the diagnosis of refractory endometrium, a treatment was performed with high-dose estrogen, vitamin E and pentoxifylline for 3 months. As the endometrial thickness did not increase, we associated AAS. Finally intrauterine platelet-rich autologous plasma was administered. At 96 hours 7.3 mm of endometrium was observed, two vitrified embryos transferred, resulting in a biochemical abortion. Discussion: The medical treatment of refractory endometrium is a challenge. There are many therapies, hormonal and nonhormonal options. However, most of these options are poorly evaluated so they require better designed studies and larger sample size (AU)

Ixodicide activity of Eysenhardtia polystachya against Rhipicephalus (Boophilus) microplus.

The objective of this study was to evaluate the acaricidal effect of 2 compounds extracted from Eysenhardtia polystachya in vitro, namely coatlines and matlalines. Each extract was obtained by aqueous extraction in a nitrogen atmosphere. Engorged adult females of an amitraz-resistant strain of Rhipicephalus (Boophilus) microplus were used to produce larvae and to carry out the adult immersion test (AIT), while larvae were assayed using the larval packet test (LPT). After exposure to coatlines or matlalines, the mortality of larvae and engorged females, as well as the reproductive parameters of adult ticks were assessed. Coatlines were not lethal against larvae and did not decrease reproductive parameters. Conversely, matlalines showed a 90 to 100% efficacy against adults and larvae at all concentrations tested and a reduction of 76.41 to 80.64% oviposition and a 48.02 to 54.86% reduction in egg hatchability. Therefore, the acaricidal activity of matlalines was more efficient. Further studies are required to elucidate both the mode of action of matlalines as well the structure-activity relationships responsible for the observed differential efficacy between these 2 related isoflavans against the cattle tick.

Three nucleus-encoded subunits of mitochondrial cytochrome c oxidase of the whiteleg shrimp Litopenaeus vannamei: cDNA characterization, phylogeny and mRNA expression during hypoxia and reoxygenation.

The mitochondrial cytochrome c oxidase (COX) catalyzes the reduction of oxygen to water playing a key role in the respiratory chain and ATP synthesis. The nucleus-encoded COX subunits do not participate in catalysis, but some are known to play a role in the expression, assembly and activity of the enzyme. Since hypoxia continuously affects the shrimp environment, it is important to study COX to understand their ability to deal with low oxygen levels. The goal of this research was to characterize the complementary DNA (cDNA) sequences of three nucleus-encoded subunits -coxIV, coxVa, and coxVb- and to evaluate the shrimp COX response to hypoxia by measuring their gene expression. The cDNA sequence of coxIV consisted of 532bp, which encodes a 17.47kDa protein, while coxVa cDNA consisted of 460bp and coded a protein of 17.11kDa, and the coxVb coding sequence consisted of 364bp encoding a 13.74kDa protein. Shrimp subunits do not have isoforms, and they are not differentially expressed during hypoxia, as observed in mammals. Coordinated changes were detected in the mRNA amounts of nuclear and mitochondrial subnits; these changes, at the transcriptional level, are suggested to be controlled through transcriptional factors Sp1 and NRF2.

Serum and tissue concentrations of doxycycline in broilers after the sub-cutaneous injection of a long-acting formulation.

1. The antibacterial agent doxycycline hyclate (Dox) is usually administered to broilers in drinking water or as a feed supplement. Parenteral injection is not the usual route for administration, so a long-acting formulation (Dox-LA) was tested to evaluate if serum concentrations can achieve the pharmacokinetic/pharmacodynamic (PK/PD) ratios regarded as adequate for the drug. 2. A poloxamer-based matrix was used to provide Dox-LA. Serum and tissue concentrations of Dox vs time were determined in two day-old broilers after subcutaneous (SC) injection of Dox-LA or oral administration of a single bolus of aqueous Dox (Dox-PO), at a dose of 20 mg/kg. Weight gain, feed conversion rate, haematological variables, aspartate aminotransferase and alanine aminotransferase activities, blood urea and creatinine were determined and compared for Dox-LA with Dox-PO and non-medicated controls. 3. Dox-LA had a high relative bioavailability (1200%). Maximum serum concentrations were not statistically different (5·1 ± 1·1 µg/ml for Dox-LA and 6·1 ± 1.4 µg/ml for Dox-PO), but half-life of Dox-LA was much greater than the value obtained for Dox-PO (73·0 ± 0·9 h and 2·0 ± 0·02 h, respectively). Tissue concentrations were higher, and stayed higher for longer periods in the Dox-LA group. 4. In conclusion, considering the minimum effective serum concentration against Mycoplasma spp is 0·5 µg/ml, a dose-interval of 180 h can be achieved with Dox-LA, but only for 24 h after Dox-PO. Better PK/PD ratios for Dox-LA should result in improved clinical outcomes compared with Dox-PO.

Pharmacokinetics of disodium fosfomycin in broilers and dose strategies to comply with its pharmacodynamics versus Escherichia coli.

The objective of this study was to determine, in broilers, which modality of disodium fosfomycin (DF) administration and at what dose the best pharmacokinetic (PK) profile could be obtained, taking as reference a 110 field bacterial strains of Escherichia coli minimum inhibitory concentration survey. The DF was administered via drinking water either ad libitum or at a higher concentration having 1 h of water restriction to build up thirst in the birds (loading dose). Dosages tested were 10, 20, 40, and 80 mg/kg per administration, either once or twice daily. Birds included were 24-d-old Cornish broilers randomly assigned to 16 groups of 200 birds per group and 3 replicates per group. The PK of DF was determined after ad libitum administration of either a single- or double-loading dose or after an initial loading dose followed by ad libitum medication. Also, PK after i.v. administration was studied in separate groups. Serial blood samplings were performed in all groups. Serum obtained was analyzed for DF and a possible active metabolite by means of a microbiological agar diffusion assay. The DF showed a short elimination half-life (approximately 2 h after oral loading administration) with a rapid clearance (1.23 to 1.42 mL/kg per h). Apparent volume of distribution-area under the curve values were also low (10 and 80 mg/kg=0.25 L/kg and 0.22 L/kg, respectively). Considering a minimum inhibitory concentration level that inhibited 90% of total strains of 8 µg/mL for E. coli, it is concluded that single-loading administration at 10, 20, 40, and 80 mg/kg complies poorly with sustained serum concentrations over a dosing interval of 24 h. Doses of 10 and 20 mg/kg twice a day also were insufficient to attain therapeutic concentrations. Useful serum concentrations of DF to treat outbreaks of susceptible E. coli require an initial loading dose of 40 mg/kg, followed by an ad libitum medication of 40 mg/kg 8 h later (80 mg/kg per d).

Recuperación y reinfusión de hematíes durante el postoperatorio / No disponible

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

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

El expendedor de plantas de la ciudad de Medellín: su caracterización social y su saber en salud bucal / The medicinal plant salespersons in the city of Medellín: their social characterization and knowledge of oral health

Introducción: la presente investigación permite la caracterización del expendedor como portador de un saber y una cultura ancestral, da cuenta de su tradición y permanencia en el tiempo. La descripción de sus conocimientos se da a través de la clasificación y sistematización de cada una de las plantas recomendadas por él, según su uso en cavidad bucal, la descripción de sus características botánicas y formas de uso; además de poder referenciar el valor potencial medicinal científico de dichas plantas. Métodos: se realizó una investigación cualitativa de corte etnográfico que permitió comprender el fenómeno, con el propósito de describir una práctica empírica arraigada en un grupo social, los expendedores de plantas de la ciudad de Medellín. Resultados: puede afirmarse que el expendedor de plantas de Medellín se constituye en una figura insertada en un sistema médico, el cual posee coherencia interna para el contexto, por su rol y elementos identificados en su conocimiento, como: adquisición, transmisión y ejercicio, los cuales, conforman el corpus y praxis de los sistemas médicos tradicionales como cabeza médica. Conclusiones: la transmisión de los mismos se da como legado, entre generaciones, en condición de “un don” que la naturaleza humana les otorga. Su ejercicio se da en los circuitos comerciales de la ciudad moderna, en el sector tradicional de las plazas de mercado y en los nuevos sectores del empleo informal: avenidas, calles y bulevares. El expendedor interactúa con los distintos sectores, su conocimiento y están enmarcados dentro de una lógica general de sincretismo cultural producto de sus concepciones sobre salud bucal.

Magnetic characterisation of rat muscle tissues after subcutaneous iron dextran injection.

Ex vivo freeze-dried rat muscle tissues, collected at different times t after a single dose of subcutaneously injected iron dextran, have been magnetically characterised. The AC susceptibility of the tissues shows an overall superparamagnetic behaviour and the dependence on t of, especially, the out-of-phase component is remarkably systematic despite the fact that each tissue originates in a different rat individual. The experiments show that the akaganéite (beta-FeOOH) nanoparticles contained in the injected drug are progressively degraded in the living tissue and, at times of the order of 1 month and for all the analysed rat individuals, converge to a magnetically well-defined species with much narrower magnetic activation energy distribution than iron dextran. Thorough transmission electron microscopy experiments of the same tissues indicate the presence of oxyhydroxide particles, whose size decreases for increasing t in agreement with the interpretation of the magnetic susceptibility. The conclusions drawn from the magnetic study do well correspond to the properties of the whole tissue since no biochemical extraction work has been done. The AC susceptibility appears to be a valuable and complementary tool in pharmacological studies of iron-containing drugs.

[Neuropsychological and behavioural impairments resulting from bilateral thalamic infarct]. / Alteraciones neuropsicológicas e infarto talámico bilateral.

The neuropsychological characteristics of a patient with a bilateral thalamic infarct in the posterior communicating artery territory due to basilar artery thrombosis are described. MRI examination showed bilateral thalamic acute ischemic lesions in the zone anterior to the tuberothalamic branches. In the cognitive exploration, the patient showed verbal and visual memory disorders, impairment of the executive functions including inability to generate and make decisions and behavioural disorders including lack of inhibition, euphoria, and occasional aggressiveness. Two months later the patient had improved in the neuropsychological test scores but still suffered from severe recent memory loss, and certain behavioural disorders including lack of inhibition and euphoria. Other cases on thalamic infarcts with cognitive and behavioural impairments due to disconnection of the front subcortical pathways have been described in the literature.

Antisense transgenesis of tobacco with a flax pectin methylesterase affects pollen ornamentation.

Antisense transgenesis of tobacco (Nicotiana tabacum) with a partial flax (Linum usitatissimum L.) pectin methylesterase (Lupme3) cDNA sequence yielded plants with altered pollen content. Moreover, the characteristically sculptured cell wall surrounding the pollen grains was modified in transgenic tobacco plants: the wavy ornamentation was dramatically reduced, suggesting the involvement of the demethylation of pectin in the pollen cell wall-specific structure. Germination of pollen was decreased and the pollen tube surface aspect was also different in transgenic plants.

The sesquiterpene lactone dehydroleucodine reversibly inhibits Allium cepa L. root growth.

Here, we prove that dehydroleucodine, a sesquiterpene lactone, at low concentrations (25-100 microM) slowed down the Allium cepa L root growth by 22-70% respectively neither affecting cell viability nor cell size. Removal of the drug after 24 h incubation restored the normal growth rate of the roots. Higher concentrations (200 microM) of dehydroleucodine were deleterious for the roots. As cell size did not change, it is most likely that dehydroleucodine affected some event of cell division cycle making it longer. Thus, dehydroleucodine could be a useful tool to slow down cell proliferation.

A peptide that mimics the C-terminal sequence of SNAP-25 inhibits secretory vesicle docking in chromaffin cells.

Excitation-secretion uncoupling peptides (ESUPs) are inhibitors of Ca2+-dependent exocytosis in neural and endocrine cells. Their mechanism of action, however, remains elusive. We report that ESUP-A, a 20-mer peptide patterned after the C terminus of SNAP-25 (synaptosomal associated protein of 25 kDa) and containing the cleavage sequence for botulinum neurotoxin A (BoNT A), abrogates the slow, ATP-dependent component of the exocytotic pathway, without affecting the fast, ATP-independent, Ca2+-mediated fusion event. Ultrastructural analysis indicates that ESUP-A induces a drastic accumulation of dense-core vesicles near the plasma membrane, mimicking the effect of BoNT A. Together, these findings argue in favor of the notion that ESUP-A inhibits ATP-primed exocytosis by blocking vesicle docking. Identification of blocking peptides which mimic sequences that bind to complementary partner domains on interacting proteins of the exocytotic machinery provides new pharmacological tools to dissect the molecular and mechanistic details of neurosecretion. Our findings may assist in developing ESUPs as substitute drugs to BoNTs for the treatment of spasmodic disorders.

Los resultados iniciales de un programa de autocontrol para bebedores problema en México / Initial results of an autocontrol program for problem alcoholics in Mexico

La búsqueda de modelos de tratamiento efectivos para problemas relacionados con el consumo excesivo del alcohol, ha sido preocupación creciente de las autoridades de salud a nivel internacional, ante la evidencia reciente ineficacia de los modelos tradicionales de abordaje a esta problemática. En el presente estudio, se presentan los resultados iniciales de la aplicación de un programa de tratamiento de auto control dirigido de consulta externa a una muestra de 108 bebedores problema en la ciudad de México. Este programa de tratamiento de corte cognoscitivo-conductal, se caracteriza por ser una intervención brevé, en la cual el usuario elige su meta de tratamiento sea ésta, moderación o abstinencia, y donde la responsabilidad para el cambio se centra en el propio bebedor. La comparación entre el patrón de consumo de este grupo de bebedores durante el periodo previo al tratamiento y durante la fase de tratamiento, muestra un incremento en los días en que éstos permanecen abstemios, y una reducción tanto en el número de copas que consumen en días que beben, como en las ocasiones de consumo excesivo. Estos resultados son similares a los que se reportan en otros países, utilizando el mismo de la necesidad de modificar políticas de salud pública que reflejen una concepción contemporánea y científica del fenómeno del alcoholismo, y que impulsen acciones de prevención y tratamiento dirigidas al núcleo de la población muestra la mayor proporción de problemas relacionados con el consumo del alcohol y una mayor probabilidad de responder con éxito al tratamiento: los bebedores problema

Reforzamiento muscular respiratorio en un paciente con síndrome de Guillain Barre durante el proceso de desconección del ventilador mecánico / Respiratory muscle reinforcement in a patients with Guillain Barre syndrome during the desconexion process of the mechanical ventilator

Se presenta la historia y evolución clínica de un paciente afectado del síndrome del Guillain Barré, también se analiza y discute un programa de entrenamiento graduado de los músculos respiratorios que conduce a un retiro definitivo de la ventilación mecánica