Uso de Petiveria alliacea Linn como tratamiento paliativo del dolor pulpar

Introducción: Entre las plantas de la flora cubana con propiedades medicinales se encuentra la Petiveria alliacea Linn (anamú), planta natural de la América tropical que contiene numerosos principios activos y a la cual se le atribuyen múltiples propiedades. La gran mayoría de los reportes se refieren concretamente a su acción analgésica, proveniente de sus hojas y de sus raíces. Objetivo: Evaluar el efecto terapéutico de la tintura de anamú al 20 % en la remisión del dolor pulpar en la pulpitis aguda serosa transitoria, durante el periodo de septiembre de 2020 a septiembre de 2021. Método: Se realizó un estudio de tipo cuasi-experimental en pacientes con dolor de la consulta de urgencia estomatológica del Policlínico Comunitario "Hermanos Martínez Tamayo". El universo estuvo constituido por todos los pacientes que acudieron a consulta por dolor (N꓿42) y le fue diagnosticado pulpitis aguda serosa transitoria. Los mismos fueron incluidos en el estudio mediante el método no probabilístico intencionado según el orden de recepción en la consulta estomatológica. Se trabajó con las variables: edad, tiempo de refracción del dolor y efecto terapéutico. El procesamiento estadístico de los datos se realizó mediante estadística descriptiva y como medida de resumen se utilizó el porcentaje. Resultados: En el 64,3 % de los casos estudiados se pudo lograr la remisión del dolor en los primeros 5 minutos de aplicado el fitofármaco. Conclusiones: la tintura de la Petiveria alliacea Linn (anamú) al 20 % tiene un efecto favorable en la remisión del dolor provocado por la pulpitis aguda serosa transitoria.

Introduction: Among the Cuban flora plants with medicinal properties is Petiveria alliacea Linn (anamú), a natural plant from tropical Americas that contains numerous active ingredients and to which multiple properties are attributed. The vast majority of reports refer specifically to its analgesic action, coming from its leaves and roots. Objective: To evaluate the therapeutic effect of 20% anamú tincture on the remission of pulpal pain in reversible serous acute pulpitis, during the period from September 2020 to September 2021. Method: A quasi-experimental study was carried out in patients with pain from the stomatological emergency room of the Policlínico Comunitario "Hermanos Martínez Tamayo". The population was made up of all the patients who attended the consultation for pain (No. 42) and were diagnosed with reversible serous acute pulpitis. They were included in the study using the intentional non-probabilistic method according to the order of reception in the dental office. The variables taken into account were: age, pain refraction time and therapeutic effect. The statistical processing of the data was carried out using descriptive statistics and the percentage was used as a summary measure. Results: In 64.3% of the cases studied, pain remission could be achieved in the first 5 minutes of applying the phytopharmaceutical. Conclusions: The tincture of Petiveria alliacea Linn (anamu) at 20% has a favorable effect on the remission of pain caused by reversible serous acute pulpitis.

Introdução: Entre as plantas da flora cubana com propriedades medicinais está a Petiveria alliacea Linn (anamú), uma planta natural da América tropical que contém numerosos princípios ativos e à qual são atribuídas múltiplas propriedades. A grande maioria dos relatos refere-se especificamente à sua ação analgésica, proveniente de suas folhas e raízes. Objetivo: Avaliar o efeito terapêutico da tintura de anamú 20% na remissão da dor pulpar na pulpite serosa aguda transitória, durante o período de setembro de 2020 a setembro de 2021. Método: Foi realizado um estudo quase experimental em pacientes com dor de pronto-socorro estomatológico da Policlínico Comunitario "Hermanos Martínez Tamayo". O universo foi constituído por todos os doentes que compareceram à consulta de dor (N=42) e foram diagnosticados com pulpite serosa aguda transitória. Eles foram incluídos no estudo pelo método não probabilístico intencional de acordo com a ordem de recepção no consultório odontológico. Trabalhamos com as variáveis: idade, tempo de refração da dor e efeito terapêutico. O tratamento estatístico dos dados foi realizado por meio de estatística descritiva e o percentual foi utilizado como medida sumária. Resultados: Em 64,3% dos casos estudados, a remissão da dor foi alcançada nos primeiros 5 minutos de aplicação do fitofármaco. Conclusões: A tintura de Petiveria alliacea Linn (anamu) a 20% tem efeito favorável na remissão da dor causada pela pulpite serosa aguda transitória.

Testing for Vitamin D in High-Risk COPD in Outpatient Clinics in Spain: A Cross-Sectional Analysis of the VITADEPOC Study.

Background: Vitamin D deficiency has been associated with an accelerated deterioration in lung function and increased exacerbations in chronic obstructive pulmonary disease (COPD). 25(OH) vitamin D levels have been indicated as a potentially useful marker for adverse results related to COPD. Methods: VITADEPOC is a cross-sectional clinical study recruiting consecutive patients with high-risk COPD. The objective of our study was to investigate vitamin D determination frequency in patients with high-risk COPD in clinical practice at outpatient clinics in Spain and to describe the factors associated with vitamin D testing. We also aimed to determine the frequency of vitamin D deficiency in these patients. Results: Only 51 (44%) patients underwent vitamin D determination and 33 (28.4%) had received vitamin D supplements in clinical practice. The patients who underwent testing for vitamin D in clinical practice were more often women (58.8% vs. 26.2%, p < 0.001) with comorbidities such as osteoporosis (19.6% vs. 6.2%, p < 0.001) or chronic renal failure (7.8% vs. 0%, p < 0.001) and with exacerbator phenotype (55% vs. 32.3%, p = 0.015). A total of 63 (54.3%) patients had serum vitamin D levels <20 ng/mL at the inclusion visit. Of these, 29 (46%) had serum vitamin D levels <12 ng/mL (severe deficiency). Having a history of inhaled corticosteroids (OR 3.210, p < 0.016), being treated with a cycle of systemic corticosteroids (OR 2.149, p < 0.002), and having a lower physical activity level (OR 3.840, p < 0.004) showed a statistically significant positive association with vitamin D deficiency. Conclusion: The testing of vitamin D levels in patients with high-risk COPD treated at outpatient respiratory clinics in Spain is infrequent. However, when tested, a severe deficiency is detected in one in four patients. Efforts to optimize case detection in COPD are needed.

[Effect of adding fortifiers and protein supplements on the osmolality of donated maternal milk]. / Efecto de la adición de fortificantes y de módulo de proteínas en la osmolalidad de la leche materna donada.

INTRODUCTION AND OBJECTIVES: The fortification of maternal milk (MM) is a standard practice in order to achieve the requirements needed for the growth and development of the premature newborn. However, its osmolality could increase. According to the American Paediatrics Academy, it is recommended not to exceed 450 mOsm/kg (approximately 400 mOsm/L) in the diet of the infant, even though the safety limit is estimated to be between 400 and 600 mOsm/kg. The aim of this study is to determine the osmolality of thawed and fortified donated MM (DMM). METHOD: An analysis was performed on DMM of 6 healthy mothers, without fortifying, and with 4 levels of fortification. Measurement of the samples was carried out in triplicate at 0, 4, 9, and 24hours after their preparation. They were stored refrigerated (2-8°C) between measurements. The study groups were: (A) Non-fortified DMM; (B) DMM with vitamins added; (C) with the addition of a fortifier; (D) with the addition of a low-dose protein formula; and (E) with the addition of a high-dose protein formula. The osmolality determinations were carried out using a freezing-point osmometer. The data analysis was performed using R software (v.3.5.1). RESULTS: A total of 30 samples were analysed with 360 measurements. The osmolality of the DMM at t=0h was 301 mOsm/kg (SD 5.2) and slightly increased with time to 308.11 mOsm/kg (SD 5.21) after 24hours (t=24h), being maintained within the safety limits. The addition of vitamins (Group B) did not significantly increase the osmolality. The addition of a fortifier (C) and a low dose (D) or high dose (E) protein formula produced an increase in the baseline osmolality that increased statistically significantly in time (P=.007), but with no differences between the C, D, and E types. There were differences between the osmolality at t=0 with the fortification according to the manufacturer's data sheet (339 mOsm/l) and the findings in our laboratory (432.33 mOsm/l). CONCLUSION: The osmolality values found in the thawed DMM samples were similar to those of other studies. The fortification of the DMM samples and their storage refrigerated at 2-8°C for 24h increased the osmolality, but keeping them within the safety limits.

Complex I syndrome in striatum and frontal cortex in a rat model of Parkinson disease.

Mitochondrial dysfunction named complex I syndrome was observed in striatum mitochondria of rotenone treated rats (2 mg rotenone/kg, i. p., for 30 or 60 days) in an animal model of Parkinson disease. After 60 days of rotenone treatment, the animals showed: (a) 6-fold increased bradykinesia and 60% decreased locomotor activity; (b) 35-34% decreases in striatum O2 uptake and in state 3 mitochondrial respiration with malate-glutamate as substrate; (c) 43-57% diminished striatum complex I activity with 60-71% decreased striatum mitochondrial NOS activity, determined both as biochemical activity and as functional activity (by the NO inhibition of active respiration); (d) 34-40% increased rates of mitochondrial O2•- and H2O2 productions and 36-46% increased contents of the products of phospholipid peroxidation and of protein oxidation; and (e) 24% decreased striatum mitochondrial content, likely associated to decreased NO-dependent mitochondrial biogenesis. Intermediate values were observed after 30 days of rotenone treatment. Frontal cortex tissue and mitochondria showed similar but less marked changes. Rotenone-treated rats showed mitochondrial complex I syndrome associated with cellular oxidative stress in the dopaminergic brain areas of striatum and frontal cortex, a fact that describes the high sensitivity of mitochondrial complex I to inactivation by oxidative reactions.

Late effects awareness website for pediatric survivors of acute lymphocytic leukemia.

OBJECTIVES: Every day 43 children are newly diagnosed with cancer. Fortunately, almost 90% of these childhood cancer patients will survive. However, 60-90% of these survivors will experience late effects, health problems that occur months or years after treatment has ended. Late effects could occur as a result of the disease, its treatment, and patient-related factors. The two main objectives of this research are to: 1) Examine the existence of all web-based resources for childhood cancer survivors with acute lymphocytic leukemia which focus on medical and psychological aspects of late effects, and 2) Create an innovative website specifically designed to fill this void. MATERIALS AND METHODS: A systematic literature review, followed by input from >20 different organizations, resulted in the creation of LEAP3 AHEAD (Late Effects Awareness for Patients, Physicians and the Public; Advancing Health and Eliminating All Disparities), a multi-dimensional website centering on late effects. RESULTS: An extensive review revealed 14 pediatric cancer websites, none of which focused exclusively on late effects. LEAP3 AHEAD is the first interactive website for acute lympocytic leukemia childhood cancer survivors and families, as well as physicians, and the public to: a) increase awareness about risks, detection, diagnosis, treatment, and prevention of medical and psychological late effects, b) provide suggestions to successfully reintegrate into schools, careers, and socially, and c) present opportunities including camps, scholarships, and pet therapy programs. CONCLUSION: LEAP3 AHEAD is the first national website to provide a comprehensive, accessible, affordable, and multi-dimensional resource for pediatricians, internists, nurse practitioners, psychologists, survivors and their families, as well as the public about late effects.

Ser y crear en el proceso terapéutico: arteterapia en el Hospital de Día de Leganés / To be and create in the therapeutic process: art therapy in Leganés Day Care Center

Se aborda la experiencia de trabajo en el marco de un hospital de día de Salud Mental infanto juvenil, en el que el arteterapia se integra como disciplina en el equipo multidisciplinar, ofreciendo una atención integral a los chicos y chicas. Se articula en torno a dos ejemplos que posibilitan una mirada longitudinal y muestran a través de las producciones artísticas y el relato que las acompaña, las posibilidades de dicha intervención con pacientes trastornos mentales graves. Entendiendo el marco estructural del hospital de día como espacio vivo de encuentros únicos, observamos el modo en que la intervención dialoga con el resto de las disciplinas (AU)

The communication shows the working experience in a day hospital setting with Child and Adolescent Mental Health, where art therapy is integrated in the multidisciplinary team providing an integral support to the children. It´s articulated around two examples which offer us a longitudinal look and show, through artistic productions and the narrative statement that accompanies them, the possibilities of this kind of intervention to attend patients with serious mental disorders. Understanding the structural day hospital setting as an alive space where unique meeting experiences take place, we can observe the way the art therapy intervention talks with the rest of disciplines (AU)

Vitamin D3 Supplemental Treatment for Mania in Youth with Bipolar Spectrum Disorders.

OBJECTIVE: We aimed to determine the effect of an open-label 8 week Vitamin D3 supplementation on manic symptoms, anterior cingulate cortex (ACC) glutamate, and γ-aminobutyric acid (GABA) in youth exhibiting symptoms of mania; that is, patients with bipolar spectrum disorders (BSD). We hypothesized that an 8 week Vitamin D3 supplementation would improve symptoms of mania, decrease ACC glutamate, and increase ACC GABA in BSD patients. Single time point metabolite levels were also evaluated in typically developing children (TD). METHODS: The BSD group included patients not only diagnosed with BD but also those exhibiting bipolar symptomology, including BD not otherwise specified (BD-NOS) and subthreshold mood ratings (Young Mania Rating Scale [YMRS] ≥8 and Clinical Global Impressions - Severity [CGI-S] ≥3). Inclusion criteria were: male or female participants, 6-17 years old. Sixteen youth with BSD exhibiting manic symptoms and 19 TD were included. BSD patients were asked to a take daily dose (2000 IU) of Vitamin D3 (for 8 weeks) as a supplement. Neuroimaging data were acquired in both groups at baseline, and also for the BSD group at the end of 8 week Vitamin D3 supplementation. RESULTS: Baseline ACC GABA/creatine (Cr) was lower in BSD than in TD (F[1,31]=8.91, p=0.007). Following an 8 week Vitamin D3 supplementation, in BSD patients, there was a significant decrease in YMRS scores (t=-3.66, p=0.002, df=15) and Children's Depression Rating Scale (CDRS) scores (t=-2.93, p=0.01, df=15); and a significant increase in ACC GABA (t=3.18, p=0.007, df=14). CONCLUSIONS: Following an 8 week open label trial with Vitamin D3, BSD patients exhibited improvement in their mood symptoms in conjunction with their brain neurochemistry.

Effect of diet on brain metabolites and behavior in spontaneously hypertensive rats.

Attention-deficit hyperactivity disorder (ADHD) is a heterogeneous psychiatric disorder affecting 5-10% of children. One of the suggested mechanisms underlying the pathophysiology of ADHD is insufficient energy supply to neurons. Here, we investigated the role of omega 3 fatty acids in altering neural energy metabolism and behavior of spontaneously hypertensive rats (SHR), which is an animal model of ADHD. To this end, we employed Proton Magnetic Resonance Spectroscopy ((1)H MRS) to evaluate changes in brain neurochemistry in the SHR following consumption of one of three experimental diets (starting PND 21): fish oil enriched (FOE), regular (RD) and animal fat enriched (AFE) diet. Behavioral tests were performed to evaluate differences in locomotor activity and risk-taking behavior (starting PND 44). Comparison of frontal lobe metabolites showed that increased amounts of omega 3 fatty acids decreased total Creatine levels (tCr), but did not change Glutamate (Glu), total N-Acetylaspartate (tNAA), Lactate (Lac), Choline (Cho) or Inositol (Ino) levels. Although behavior was not significantly affected by different diets, significant correlations were observed between brain metabolites and behavior in the open field and elevated plus maze. SHR with higher levels of brain tCr and Glu exhibited greater hyperactivity in a familiar environment. On the other hand, risk-taking exploration of the elevated plus maze's open arms correlated negatively with forebrain tNAA and Lac levels. These findings support the possible alteration in energy metabolites in ADHD, correlating with hyperactivity in the animal model. The data also suggest that omega 3 fatty acids alter brain energy and phospholipid metabolism.

Study of the antimicrobial efficacy of chlorhexidine in dental unit water: evaluation of microbial contamination in the dental office / Estudo da capacidade antimicrobiana da clorexidina na água do equipamento odontológico: avaliação de contaminação microbiana em ambiente odontológico

Objective: The aim of this study to count anaerobic bacteria before and after the use of dental equipment and to study the influence of chlorhexidine on the dental unit reservoir water. Methods: Sterile swabs were used to collect bacterial samples from the cuspidor, lights, syringes, low-and high speed handpieces and dental chairs (arms and backrest) before and after the placement of barriers. Blood agar plates were placed on the patient's and dentist's forehead and by the patient's nose and shoulder and exposed to aerosoils without (group 1) and with 0,5% (group 2) and 1,0% (group 3) chlorhexidine generated by the high speed handpiece. Ten aerosol samples were collected for each group. A sample of 1mL of the dental unit reservoir water was collected before and after the use of the high speed handpiece. The anaerobic bacterial counts were compared by the Wilcoxon and Kruskal-Wallis tests. Results: The contamination of the high speed handpiece (p=0,0431) and cuspidor (p=0,0117) increased significantly after use. Contamination in the dental unit reservoir water also increased significantly after use of the high speed handpiece. The most contaminated area was the patient's nose. Conclusion: The addition of 0,5% and 1,0% chlorhexidine in the dental office sifnificantly.

ObjetivoO objetivo deste estudo foi quantificar as bactérias anaeróbicas, antes e após o uso deequipamentos odontológicos e estudar a influência da clorexidina na água doreservatório.MétodosOs seguintes itens foram avaliados: cuspideira, luzes, seringas, baixa e alta rotação,braço da cadeira e do encosto com coleções realizadas antes e após a colocação debarreiras. A contaminação microbiana causada pelos aerossóis de alta rotação tambémfoi avaliada: Grupo 1 (controle): (100%) de água no reservatório; Grupo 2: água noreservatório contendo 0,5% de clorexidina, Grupo 3: água no reservatório contendo1,0% de clorexidina. Dez amostras de aerossol foram recolhidos a partir de cadagrupo: placas de ágar-sangue foram colocadas na testa do paciente e do dentista e nonariz e ombro do paciente. Amostra de 1mL a partir do conteúdo da água no reservatóriofoi medida antes e após a utilização de alta rotação. Comparações entre bactériasanaeróbias foram feitas com o uso de Wilcoxon e Kruskal-Wallis teste estatístico.ResultadosVerificou-se um aumento significativo na contaminação antes e após o procedimentoutilizando alta rotação (p=0,0431) e na cuspideira (p=0,0117). Foi possível observarum aumento significativo de contaminação microbiana na água do reservatório, apósa sua utilização. O nariz do paciente era a área mais afetada.ConclusãoA adição de 0,5% e 1,0% de clorexidina no reservatório representa uma reduçãosignificativa de contaminação microbiana gerado no ambiente de um consultório odontológico.

An economic evaluation of pregabalin versus usual care in the management of community-treated patients with refractory painful diabetic peripheral neuropathy in primary care settings.

OBJECTIVE: To estimate the cost-effectiveness of pregabalin versus usual care (UC) in the management of community-treated patients with refractory painful diabetic peripheral neuropathy (pDPN) in primary care settings (PCS) in Spain. METHODS: Data was extracted from a 12-week registry study assessing costs of neuropathic pain in Spain. Pregabalin-naïve outpatients treated with UC or newly prescribed pregabalin were selected for inclusion in the cost-effectiveness analysis. Effectiveness was expressed as quality-adjusted life years (QALY) gain. Perspectives of the Spanish National Health System (NHS) and society (2006) were applied for cost calculations. Results were expressed as incremental cost-effectiveness ratio (ICER). Bootstrapping techniques (10,000 re-samples) were used to obtain the probabilistic ICER and the cost-effectiveness acceptability curve. RESULTS: A total of 189 patients were included in the economic analysis. Compared with UC, pregabalin was associated with higher QALY gain in a period of 12-weeks; 0.0406±0.0343 versus 0.0285±0.0350 (p=0.167). Overall total costs (€1368±1229 vs. €1258±1474; p=0.587) and healthcare costs (€628±590 vs. €469±420; p=0.134) were similar for both pregabalin and UC, respectively. ICERs for pregabalin varied from €5302 (95% CI: dominant; €144,105) for total costs to €14,381 (dominant; €115,648) for healthcare costs. Probabilistic sensitivity analyses showed that 79-84% of ICERs were below the threshold of €30,000/QALY. CONCLUSION: This study suggests that pregabalin may be cost-effective in the management of community-treated refractory outpatients, with pDPN when compared with usual care in the primary care setting in Spain. These findings may help policy makers when making health decision in the management of diabetes in the community.

Pain alleviation and patient-reported health outcomes following switching to pregabalin in individuals with gabapentin-refractory neuropathic pain in routine medical practice.

BACKGROUND: It has been suggested that peripheral neuropathic pain (PNP) may affect up to 3% of the general population. PNP has a substantial negative impact on patient functioning and quality of life, including reduced productivity and increased consumption of healthcare resources. OBJECTIVE: The objective of this study was to analyse changes in pain and patient-reported health outcomes following switching to pregabalin treatment in patients with gabapentin-refractory PNP as part of routine clinical practice in Spanish primary-care settings. METHODS: This was an open-label, non-randomized, post hoc analysis of a 12-week, multicentre, non-interventional cost-of-illness study. The study involved primary-care physicians and was carried out between September 2005 and April 2006. Patients were aged at least 18 years and had chronic, treatment-refractory PNP. The analysis included all pregabalin-naïve patient switches that had previously shown an inadequate response to gabapentin. The following variables were assessed before and after pregabalin therapy: pain (Short-Form McGill Pain Questionnaire [SF-MPQ]), disability level (Sheehan Disability Scale [SDS]), symptoms of anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), self-perceived sleep quality and quantity (Medical Outcomes Study [MOS] Sleep Scale), and health-related quality of life (EuroQol [EQ] five-dimension [5D] questionnaire). RESULTS: A total of 174 patients with an inadequate response to gabapentin switched to pregabalin at the beginning of the study. After 12 weeks of pregabalin therapy, alone or in combination with other analgesic drugs, significant and clinically relevant improvements were observed in pain severity [mean (SD) SF-MPQ change: -31.9 (22.1) points; 42.5% being responders (pain reduction ≥50%)], disability [SDS score: -7.5 (6.2) vs baseline], affective symptoms [HADS depression: -4.5 (3.9); HADS anxiety: -4.1 (3.7)], sleep [MOS summary index: -17.2 (16.6)], and health status [EQ-5D visual analogue scale (VAS): 27.3 (18.2)], with an overall gain of 0.040 (0.031) quality-adjusted life-years. CONCLUSION: These findings suggest that pregabalin could be a valid treatment alternative for the management of patients with gabapentin-refractory peripheral neuropathic pain in primary-care settings under real-life conditions of care. Our data show that patients who were switched to pregabalin, either as monotherapy or in combination with other analgesics, showed substantial and clinically relevant improvements in relieving pain and related symptoms.

Diagnosis and treatment of grass pollen-induced allergic rhinitis in specialized current clinical practice in Spain.

Allergic rhinitis (AR) is the leading cause of consultation at the allergy specialist's office, but detailed, reliable, and validated clinical data on this condition are limited. This study was designed to define the clinical features, diagnostic methods, and therapeutic approaches of patients with AR induced by grass pollen in Spain. Two hundred twelve specialists participated in a multicenter, observational, epidemiologic, questionnaire-based study. Each investigator had to recruit at least two patients consulting for the first time and with a diagnosis of AR induced by grass pollen. Five hundred twenty-four patients (52% men; mean age, 29.3 years) with grass pollen-induced rhinitis (mean disease duration, 8.7 years) were recruited. Just 18.4% of patients reported that their symptom status had improved since the beginning of the condition, 89.4% had moderate-severe rhinitis (Allergic Rhinitis and Its Impact on Asthma classification) and 35.1% had concomitant bronchial asthma. For 52.1% of patients, control of symptoms with previous drug treatment was poor. Most of the patients were polysensitized to other pollens (sensitization to olive tree pollen, 57.1%). Oral antihistamines (97.3%) and nasal corticosteroids (82.3%) were the most frequently prescribed drugs and 43.1% of patients received specific immunotherapy. The clinical profile for the majority of Spanish patients consulting an allergy specialist for AR induced by grass pollen corresponds to a young adult with a lengthy moderate-severe rhinitis, often accompanied by bronchial asthma. Their symptoms progressively worsen and rhinitis is poorly controlled by symptomatic treatment. Oral antihistamines and nasal corticosteroids are the most frequently used therapeutic approaches and less than one-half receive specific immunotherapy.

Epidemiology of allergic rhinitis caused by grass pollen or house-dust mites in Spain.

BACKGROUND: Although the prevalence of allergic rhinitis (AR) is increasing, relatively little is known about patient characteristics in Spain. The aim of this study was to investigate the clinical profile and therapeutic strategies in patients attending Spanish specialists for AR caused by grass pollen or house-dust mites (HDMs). METHODS: This was a multicenter cross-sectional epidemiological study of consecutive patients aged ≥5 years with confirmed diagnosis of AR caused by grass pollen or HDMs attending allergy specialists throughout Spain. Demographic and clinical data and information on treatment were collected. RESULTS: Data from 1043 patients were analyzed (524 with grass pollen allergy and 519 with HDM allergy; mean age, 27.1 years). Three-quarters had persistent AR as per the Allergic Rhinitis and Its Impact on Asthma (ARIA) definition, with disease duration of >2 years in 94.3% of those with pollen allergy and 85.5% of those with HDM allergy. Approximately 38% had concurrent asthma. Over one-half of the patients were considered to have gotten worse since the first onset of symptoms. In total, 51.5% did not achieve good disease control with pharmacotherapy and 47.7% were treated with immunotherapy (52.2% of HDM allergic patients and 43.2% of grass pollen-allergic patients). CONCLUSION: The duration of AR in patients attended for the first time by specialists is long and, in general, the disease does not improve over time and is often not well controlled with pharmacologic interventions. Less than one-half of patients receive allergen-specific immunotherapy that is more often prescribed in HDM allergy.

High doses of vitamin E improve mitochondrial dysfunction in rat hippocampus and frontal cortex upon aging.

Rat aging from 4 to 12 mo was accompanied by hippocampus and frontal cortex mitochondrial dysfunction, with decreases of 23 to 53% in tissue and mitochondrial respiration and in the activities of complexes I and IV and of mitochondrial nitric oxide synthase (mtNOS) (P < 0.02). In aged rats, the two brain areas showed mitochondria with higher content (35-78%) of oxidation products of phospholipids and proteins and with higher (59-95%) rates of O(2)(-) and H(2)O(2) production (P < 0.02). Dietary supplementation with vitamin E (2.0 or 5.0 g/kg of food) from 9 to 12 mo of rat age, restored in a dose-dependent manner, the decreases in tissue and mitochondrial respiration (to 90-96%) and complexes I and IV and mtNOS activities (to 86-88%) of the values of 4-mo-old rats (P < 0.02). Vitamin E prevented, by 73-80%, the increases in oxidation products, and by 62-68%, the increases in O(2)(-) and H(2)O(2) production (P < 0.05). High resolution histochemistry of cytochrome oxidase in the hippocampal CA1 region showed higher staining in vitamin E-treated rats than in control animals. Aging decreased (19%) hippocampus mitochondrial mass, an effect that was restored by vitamin E. High doses of vitamin E seem to sustain mitochondrial biogenesis in synaptic areas.

Ambient Assisted Nutritional Advisor for elderly people living at home.

Nutrition is a critical aspect when getting older because bad nutrition habits can accelerate the process of degradation of the physical condition of the old person. In order to mitigate this problem, an Ambient Assisted Living service has been developed. Research with this service is focused on demonstrating that with an Ambient Intelligence systems it is possible to make the nutritional management much more effective by influencing the user, by automatically and seamlessly monitoring and by facilitating tools for nutritional management for people that want to be autonomous. In this paper both requirement acquisition and development processes are described as well.

Brain mitochondrial dysfunction in aging.

Aging of mammalian brain is associated with a continuous decrease of the capacity to produce ATP by oxidative phosphorylation. The impairment of mitochondrial function is mainly due to diminished electron transfer by complexes I and IV, whereas inner membrane H+ impermeability and F1-ATP synthase activity are only slightly affected. Dysfunctional mitochondria in aged rodents show decreased rates of respiration and of electron transfer, decreased membrane potential, increased content of the oxidation products of phospholipids and proteins, and increased size and fragility. In aging mice, the activities of brain mitochondrial enzymes (complexes I and IV and mtNOS) are linearly correlated with neurological performance (tightrope and T-maze tests) and with median life span and negatively correlated with the mitochondrial content of lipid and protein oxidation products. Conditions that increased mice median life span, such as moderate exercise, vitamin E supplementation, caloric restriction, and high spontaneous neurological activity; also improved neurological performance and mitochondrial function in aged brain. The diffusion of mitochondrial NO and H2O2 to the cytosol is decreased in the aged brain and may be a factor for reduced mitochondrial biogenesis.

Outcomes of planned home birth: an integrative review.

Current evidence indicates the critical importance of several factors that contribute to improved perinatal outcomes: a facilitating environment at the place of birth, skilled birth attendance, and the continuum of perinatal care for women and newborns. This level of care is often referred to as "first-level" care, and is most readily provided in birthing centers and primary level health facilities. However, there is a body of evidence that has been compiled over the past several decades that addresses the safety of planned home birth, under circumstances that emulate these elements of "first-level" care. These studies demonstrate a remarkable consistency in the generally favorable results of maternal and neonatal outcomes, both over time and among diverse population groups. These outcomes are also favorable when viewed in comparison to various reference groups (birth center births, planned hospital births, and vital statistics). These data should influence policy in support of planned home birth, including policy that endorses building or sustaining a home birth infrastructure in parallel to the efforts to build capacity for facility-based birth. Such public policy would also be in keeping with the fundamental right of women to have choice in childbirth, particularly when options are equally good.

Cellular mechanisms involved in the melatonin inhibition of HT-29 human colon cancer cell proliferation in culture.

The antiproliferative and proapoptotic properties of melatonin in human colon cancer cells in culture were recently reported. To address the mechanisms involved in these actions, HT-29 human colon cancer cells were cultured in RPMI 1640 medium supplemented with fetal bovine serum at 37 degrees C. Cell proliferation was assessed by the incorporation of [(3)H]-thymidine into DNA. Cyclic nucleotide levels, nitrite concentration, glutathione peroxidase and reductase activities, and glutathione levels were assessed after the incubation of these cells with the following drugs: melatonin membrane receptor agonists 2-iodo-melatonin, 2-iodo-N-butanoyl-5-methoxytryptamine, 5-methoxycarbonylamino-N-acetyltryptamine (GR-135,531), and the antagonists luzindole, 4-phenyl-2-propionamidotetralin, and prazosin; the melatonin nuclear receptor agonist CGP 52608, and four synthetic kynurenines analogs to melatonin 2-acetamide-4-(3-methoxyphenyl)-4-oxobutyric acid, 2-acetamide-4-(2-amino-5-methoxyphenyl)-4-oxobutyric acid, 2-butyramide-4-(3-methoxyphenyl)-4-oxobutyric acid and 2-butyramide-4-(2-amino-5-methoxyphenyl)-4-oxobutyric acid. The results show that the membrane receptors are not necessary for the antiproliferative effect of melatonin and the participation of the nuclear receptor in this effect is suggested. Moreover, the antioxidative and anti-inflammatory actions of melatonin, counteracting the oxidative status and reducing the production of nitric oxide by cultured HT-29 cells seem to be directly involved in the oncostatic properties of melatonin. Some of the synthetic kynurenines exert higher antiproliferative effects than melatonin. The results reinforce the clinical interest of melatonin due to the different mechanisms involved in its oncostatic role, and suggest a new synthetic pathway to obtain melatonin agonists with clinical applications to oncology.

The mitochondrial energy transduction system and the aging process.

Aged mammalian tissues show a decreased capacity to produce ATP by oxidative phosphorylation due to dysfunctional mitochondria. The mitochondrial content of rat brain and liver is not reduced in aging and the impairment of mitochondrial function is due to decreased rates of electron transfer by the selectively diminished activities of complexes I and IV. Inner membrane H(+) impermeability and F(1)-ATP synthase activity are only slightly affected by aging. Dysfunctional mitochondria in aged rodents are characterized, besides decreased electron transfer and O(2) uptake, by an increased content of oxidation products of phospholipids, proteins and DNA, a decreased membrane potential, and increased size and fragility. Free radical-mediated oxidations are determining factors of mitochondrial dysfunction and turnover, cell apoptosis, tissue function, and lifespan. Inner membrane enzyme activities, such as those of complexes I and IV and mitochondrial nitric oxide synthase, decrease upon aging and afford aging markers. The activities of these three enzymes in mice brain are linearly correlated with neurological performance, as determined by the tightrope and the T-maze tests. The same enzymatic activities correlated positively with mice survival and negatively with the mitochondrial content of lipid and protein oxidation products. Conditions that increase survival, as vitamin E dietary supplementation, caloric restriction, high spontaneous neurological activity, and moderate physical exercise, ameliorate mitochondrial dysfunction in aged brain and liver. The pleiotropic signaling of mitochondrial H(2)O(2) and nitric oxide diffusion to the cytosol seems modified in aged animals and to contribute to the decreased mitochondrial biogenesis in old animals.

Brain mitochondrial dysfunction in aging: conditions that improve survival, neurological performance and mitochondrial function.

Mice with (a) high spontaneous neurological activity, or subjected to (b) moderate exercise or (c) dietary supplemented with high doses of vitamin E from 28 weeks of age to senescence (76 wk of age), showed an increased survival and a retardation in the development of the neurological deficits associated to aging. During aging there was an increase in dysfunctional brain mitochondria, characterized by an increased content of oxidation products and by a diminished functional activity. The mitochondrial oxidative damage observed in adult (52 wk) and senescent mice (76 wk) was partially ameliorated in the groups of animals subject to the mentioned experimental conditions, and this decrease in mitochondrial oxidative damage was related to the improvement in neurological performance. In brain mitochondria, the activities of enzymes that are critical for mitochondrial function (mtNOS, NADH-dehydrogenase, and cytochrome oxidase) decreased progressively during aging and constituted aging markers. Usual clinical recommendations for aged humans, such as increased neurological activity, moderate exercise, and vitamin E supplementation, proved to be effective in increasing mice survival and neurological performances, along with a better mitochondrial function and a lower content of oxidation products.