La ética en la enseñanza de la medicina / Ethics in teaching medicine

Resumen: Se presenta el aspecto ético, esencial en la enseñanza de la medicina, la ética del profesor (educador, facilitador, maestro), del alumno (tanto como partícipe de la enseñanza o como docente) y con el paciente, una relación que debe ser holística y humanitaria. Se mencionan los errores en los que se puede caer en la enseñanza y que crean un conflicto ético entre educador y educando. Se presentan las Normas Oficiales Mexicanas que establecen y rigen la enseñanza de pregrado y postgrado (procesos todos en la formación de recursos humanos para la salud), se comenta la Norma Oficial Mexicana que rige la investigación en seres humanos y su ética, la cual es fundamental en la formación del médico.

Abstract: The important ethical aspect of medical education is presented; the ethics of the professor (educator, facilitator, teacher), of the student (both as a participant in the teaching or as a teacher) and with the patient, a relationship that should be holistic and humanitarian. Mention is made of the mistakes that can be made in teaching and that create an ethical conflict between educator and student. The Mexican Official Norms that establish and govern undergraduate and postgraduate teaching (all processes in the formation of Human Resources for Health) are presented. The Mexican Official Norm that governs research on human beings and its ethics, which is essential for the formation of the physician, is commented on.

Bioavailability, mobility and leaching of phosphorus in a Mediterranean agricultural soil (ne Spain) amended with different doses of biosolids.

The precipitation of sparingly soluble calcium phosphate in calcareous soils decreases the bioavailability of macronutrients, which makes their addition by way of fertilisers necessary. Sludge resulting from treating urban wastewater does not only provide significant amounts of phosphorus, but also helps lower the pH, thus increasing its bioavailability. The loss of part of soil nutrients due to irrigation or rain can contaminate groundwater. In order to assess the movement of phosphorus, a experiment was conducted on percolation columns, to which different doses of wastes were applied. The pH decreased by as much as 0.89 units, as well as the assimilable and soluble P, in intervals of 20 cm of depth, obtaining maximum values of 254 mg P kg-1 and 1455 µg P kg-1 respectively, and the P present in the leached water collected, which did not surpass 95 µg PL-1. The intent was to learn which was the majoritarian inorganic formed crystalline phase that immobilised the movement of phosphorus through the percolation column. The results obtained by the diffraction of X-rays are not conclusive, although they point to the formation of octacalcium phosphate. The diffractograms of the studied samples have similar diffraction lines to those of apatites.

[Ethics in teaching medicine]. / La ética en la enseñanza de la medicina.

The important ethical aspect of medical education is presented; the ethics of the professor (educator, facilitator, teacher), of the student (both as a participant in the teaching or as a teacher) and with the patient, a relationship that should be holistic and humanitarian. Mention is made of the mistakes that can be made in teaching and that create an ethical conflict between educator and student. The Mexican Official Norms that establish and govern undergraduate and postgraduate teaching (all processes in the formation of Human Resources for Health) are presented. The Mexican Official Norm that governs research on human beings and its ethics, which is essential for the formation of the physician, is commented on.

Se presenta el aspecto ético, esencial en la enseñanza de la medicina, la ética del profesor (educador, facilitador, maestro), del alumno (tanto como partícipe de la enseñanza o como docente) y con el paciente, una relación que debe ser holística y humanitaria. Se mencionan los errores en los que se puede caer en la enseñanza y que crean un conflicto ético entre educador y educando. Se presentan las Normas Oficiales Mexicanas que establecen y rigen la enseñanza de pregrado y postgrado (procesos todos en la formación de recursos humanos para la salud), se comenta la Norma Oficial Mexicana que rige la investigación en seres humanos y su ética, la cual es fundamental en la formación del médico.

Efficacy of transcutaneous perineal electrostimulation versus intracavitary anal electrostimulation in the treatment of urinary incontinence after a radical prostatectomy: randomized controlled trial study protocol.

BACKGROUND: Radical prostatectomy is the gold standard treatment for men with localized prostate cancer. This technique is associated with post-operative urinary incontinence. Pelvic floor physiotherapy is a conservative, painless and economical treatment for this specific situation. Kegel exercises and perineal electrostimulation are common techniques to train pelvic floor muscles. The perineal electrostimulation can be applied to the patient with surface electrodes or by an intra-cavitary anal probe. This study proposes that transcutaneous perineal electrostimulation is as effective as intra-cavitary electrostimulation in reducing urinary incontinence secondary to radical prostatectomy. The main objective is to compare the efficacy of the treatment with transcutaneous perineal electrostimulation versus the same intra-cavitary treatment to reduce the magnitude of urinary incontinence after radical prostatectomy, and the impact on the quality of life. METHODS: This single-blind equivalence randomized controlled trial will include 70 man who suffer urinary incontinence post radical prostatectomy. Participants will be randomized into surface electrodes group and intra-anal probe group. The groups will receive treatment for 10 consecutive weeks. Outcomes include changes in the 24-h Pad Test, and ICIQ-SF, SF-12 and I-QoL questionnaires. Clinical data will be collected at baseline, 6 and 10 weeks after the first session, and 6 months after the end of treatment. DISCUSSION: The results will allow us to prescribe the most beneficial perineal electrostimulation technique in the treatment of urinary incontinence derived from radical prostatectomy. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03587402. 27/06/2018.

Distinguishing Petroleum (Crude Oil and Fuel) From Smoke Exposure within Populations Based on the Relative Blood Levels of Benzene, Toluene, Ethylbenzene, and Xylenes (BTEX), Styrene and 2,5-Dimethylfuran by Pattern Recognition Using Artificial Neural Networks.

Studies of exposure to petroleum (crude oil/fuel) often involve monitoring benzene, toluene, ethylbenzene, xylenes (BTEX), and styrene (BTEXS) because of their toxicity and gas-phase prevalence, where exposure is typically by inhalation. However, BTEXS levels in the general U.S. population are primarily from exposure to tobacco smoke, where smokers have blood levels on average up to eight times higher than nonsmokers. This work describes a method using partition theory and artificial neural network (ANN) pattern recognition to classify exposure source based on relative BTEXS and 2,5-dimethylfuran blood levels. A method using surrogate signatures to train the ANN was validated by comparing blood levels among cigarette smokers from the National Health and Nutrition Examination Survey (NHANES) with BTEXS and 2,5-dimethylfuran signatures derived from the smoke of machine-smoked cigarettes. Classification agreement for an ANN model trained with relative VOC levels was up to 99.8% for nonsmokers and 100.0% for smokers. As such, because there is limited blood level data on individuals exposed to crude oil/fuel, only surrogate signatures derived from crude oil and fuel were used for training the ANN. For the 2007-2008 NHANES data, the ANN model assigned 7 out of 1998 specimens (0.35%) and for the 2013-2014 NHANES data 12 out of 2906 specimens (0.41%) to the crude oil/fuel signature category.

Antifungal treatment with echinocandins: a 10-year clinical experience.

OBJECTIVE: The number of studies evaluating the use of echinocandins, whether or not its indication meets international guidelines, in clinical practice is limited. The objective of the present study was to determine the use of echinocandins in a tertiary Spanish hospital in 10 years of clinical practice, and to evaluate its impact on prognosis. METHODS: This retrospective study involved adult nonneutropenic ill patients with suspicion of fungal invasion who started treatment with echinocandins between 2006 and 2015. RESULTS: The number of patients treated with echinocandins was 153, and candidemia was detected thereafter in 25.5%. Factors associated with in-hospital mortality in patients receiving echinocandins were: sex male, septic shock, Charlson comorbidity index, and total stay at the hospital. In-hospital mortality after 7, 30 and 90 days was 13.7%, 24.8%, and 56.8%, respectively. From patients receiving echinocandins, 98 did no show multifocal colonization, 50 had Candida score <2.5, and 49 did not meet Ostrosky-Zeichner prediction rule. A total of 19 patients did not show any of these 3 potential risk factors for candidemia. CONCLUSIONS: The use of echinocandins in 10 years of clinical practice in our tertiary hospital has been performed according to international guidelines; however, candidemia was only diagnosed thereafter in only 25.5% of cases. Furthermore, according to our results, the adequate use of echinocandins seems not to be associated with reduced mortality rates. Further studies, involving a large cohort of patients and more hospitals, are required to corroborate these results.

Análisis y evaluación de la efectividad de la analgesia epidural y su relación con el parto eutócico o distócico / Analysis and evaluation of the effectiveness of epidural analgesia and its relationship with eutocic or dystocic delivery

Objetivo. Numerosos estudios han demostrado mayor puntuación en la escala verbal nominal del dolor en relación con el parto distócico y la inducción médica del parto, de manera que el parto distócico y la macrosomía fetal se han relacionado con una mayor sensación de dolor durante el parto, sobre todo en el primer estadio. Incluso la analgesia epidural se ha vinculado al parto instrumentado y a la cesárea. El objetivo del estudio fue analizar y evaluar la efectividad de la analgesia epidural en el parto distócico frente al parto eutócico. Pacientes y métodos. Se diseñó un estudio observacional, analítico, longitudinal y prospectivo, en el Área Obstétrica del Hospital Universitario Dexeus. Se incluyeron 180 gestantes. Fueron incluidas todas las nulíparas o multíparas con edad gestacional superior a 36 semanas, más allá de 3cm de dilatación cervical y en trabajo de parto espontáneo o inducido. Todas las pacientes recibieron la analgesia epidural según protocolo. Resultados. Para el análisis estadístico univariante de la muestra se emplearon los métodos descriptivos básicos y para la comparación de medias entre 2 grupos, el test U de Mann-Whitney. Las correlaciones entre variables se estudiaron mediante el coeficiente de correlación de Spearman. Las diferencias consideradas estadísticamente significativas fueron aquellas cuya p<0,05. Conclusión. En nuestra población, no hubo diferencias estadísticamente significativas en la efectividad de la analgesia epidural en el parto eutócico frente al distócico. Las pacientes que recibieron la epidural que tuvieron partos distócicos presentaron la misma puntuación en la escala verbal nominal del dolor que aquellas que presentaron parto eutócico (p>0,05) (AU)

Objective. Numerous studies have demonstrated the difference in the verbal rating scale with regard to obstructed labour and induced labour, so that obstructed labour and foetal macrosomia have been related to a greater sensation of pain during labour, particularly in the first stage. Even the epidural analgesia is linked to the need for instrumented or caesarean section due to foetal obstruction. The goal of the study is to analyze and evaluate the effectiveness of epidural analgesia in normal versus obstructed labour. Patients and methods. One hundred and eighty pregnant women were included in an observational, analytical, longitudinal and prospective study, that was performed in the Obstetrics Department of the Hospital Universitario Dexeus. All the nulliparous or multiparous over 36 weeks of pregnancy, after 3cm of cervical dilatation in spontaneous or induced labor were included. All the patients were given epidural analgesia according to protocol. Results. The basic descriptive methods were used for the univariate statistical analysis of the sample and the Mann-Whitney U test was used for the comparison of means between both groups. The correlations between variables were studied by means of the Spearman coefficient of correlation. The differences regarded as statistically significant are those whose P<.05. Conclusion. In our population there were no statistically significant differences in the effectiveness of epidural analgesia in normal versus obstructed labour. Patients who got epidural analgesia and had obstructed labors have the same degree of verbal rating scale as patients that do not had obstructed labors (P>.05) (AU)

Antiproliferative activity of Haematoxylum brasiletto H. Karst.

BACKGROUND: Haematoxylum brasiletto is a tree that grows in Central America, commonly known as "Palo de Brasil," which is used in the traditional medicine for the treatment of cancer and gastric ulcers. OBJECTIVE: The aim of this study was to isolate the compounds responsible for antiproliferative activity of H. brasiletto. MATERIALS AND METHODS: A bioassay-guided fractionation of ethanol extract of H. brasiletto was performed using 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide cell proliferation assay to measure the antiproliferative activity on six human cancer cell lines (A549, LS180, HeLa, SiHa, MDA-MB-231, and NCI-H1299) and one human noncancer cell line (ARPE-19). The ethanol extract was partitioned with hexane, dichloromethane, and ethyl acetate. The active dichloromethane fraction was fractioned by silica-column chromatography, and active subfractions were separated using preparative-thin layer chromatography. The chemical structure of an isolated compound was elucidated with different chemical and spectroscopic methods. RESULTS: The flavonoid brazilin (1) was isolated from the heartwood of H. brasiletto. The measurement of antiproliferative activity showed that brazilin can inhibit the growth of SiHa, MDA-MB-231, A549, and NCI-H1299 cell lines by 50% at doses of 44.3, 48.7, 45.4, and 48.7 µM, respectively. Furthermore, the flavonoid showed a high antiproliferative activity on LS 180 and HeLa with IC50 values of 62.2 and 71.9 µM, respectively. Brazilin also exhibited a high antiproliferative activity on the human noncancer cell line ARPE-19 with an IC50 value of 37.9 µM. CONCLUSIONS: Brazilin: (6aS, 11bR)-7,11b-Dihidro-6H-indeno[2,1-c] cromeno-3,6a, 9,10-tetrol was isolated; this compound demonstrated antiproliferative activity against several human cancer cell lines. This work demonstrated that brazilin, a flavonoid isolated and characterized of H. brasiletto, has antiproliferative activity against cancer cell lines. SUMMARY: The flavonoid brazilin was isolated from the heartwood of H. brasilettoBrazilin is able to inhibit the growth of SiHa, MDA-MB-231, A549 and NCI- H1299 cancerous cell linesBrazilin exhibited a moderate antiproliferative activity on the human non-cancer cell line ARPE-19Brazilin demonstrated to have antiproliferative activity against human cancer cell lines and could be a potential source of anticancer agents. Abbreviations used: MTT: [3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium]; FBS: Fetal bovine serum; TLC: Thin layer chromatography.

Diseño y validación de contenido de un cuestionario sobre Pérdida de Peso en Deportes de Combate (PPDC) / Projeto e conteúdo validação de um questionário sobre a perda de peso no Combat Sports (PPDC) / Design and content validation of a questionnaire on Weight Loss in Combat Sports (PPDC)

El sistema de categorías por peso que rige los deportes de combate fomenta en estos atletas la puesta en práctica de determinados métodos y estrategias para reducir su masa corporal antes del pesaje oficial, así como otros hábitos y protocolos de rápida rehidratación y rellenado de las reservas energéticas en el lapso de tiempo (6-20 h) que separa este pesaje oficial del comienzo del torneo. El objetivo de este trabajo fue diseñar y validar por primera vez un instrumento que permita estudiar los hábitos que están llevando a cabo los deportistas de combate durante las fases de pérdida de peso y su posterior recuperación antes del torneo. Tras el diseño original del cuestionario, se verificó la validez de contenido y la validez estructural del instrumento a través del acuerdo y consenso de 12 jueces expertos. En segundo lugar, se realizó un estudio de la validez de compresión de los ítems que compone el instrumento con una muestra de 46 deportistas de combate experimentados. Así mismo, se calculó la fiabilidad mediante la aplicación de la prueba test-retest en una muestra de 28 deportistas. Los resultados indicaron que el cuestionario sobre pérdida de peso en deportes de combate presenta óptimos niveles de validez de contenido así como de reproducibilidad en las respuestas para identificar y monitorizar los métodos, las frecuencias y las estrategias con las que estos deportistas acometen las fases de pérdida de peso antes del pesaje y su posterior recuperación antes del comienzo del torneo (AU)

The weight classes system established for most of the combat sports promotes the implementation of methods and strategies to reduce the athletes´ body mass before the official weigh-in, and other habits and protocols of fast rehydration and fill the energy reserves in the period of time (6-20 h) that separate the official weigh-in and the beginning of the tournament. The aim of this study was to design and validate for the first time a questionnaire to assess the habits that are conducting by the combat sport athletes during the phases of weight loss and the subsequent recovery. After the original design of the questionnaire, we verified the construct validity and structural validity of the instrument through agreement and consensus of 12 expert judges. Second, we conducted a study of the compression validity and reliability of the items that compose the instrument using a sample of 46 experienced combat athletes. The results indicated that the weight loss in combat sports questionnaire provides optimal levels of content validity, as well as reliability in their answerers that allows researchers and coaches to identify and monitor the methods, frequencies and strategies that these kind of athletes carry out during the rapid weight loss phases before the official weigh-in and the subsequent recovery phases before the start of the tournament (AU)

Sistema de categorias por peso que rege os esportes de combate promove nestes atletas que colocar em prática certos métodos e estratégias para reduzir a sua massa corporal antes da pesagem oficial, bem como outros hábitos e protocolos de hidratação rápida e acolchoado das reservas energia no lapso de tempo (6-20 h) que separa esta pesagem oficial do início do torneio. Objetivo deste trabalho foi o projeto e validar pela primeira vez, um instrumento que permitem estudá-los hábitos que levam para fora os atletas de combate durante as fases de perda de peso e sua posterior recuperação antes do torneio. Após o desenho original do questionário, verificou-se a validade de conteúdo e a validade estrutural do instrumento através de acordo e consenso dos 12 juízes especializados. Em segundo lugar, um estudo da validade da compressão dos itens compondo o instrumento com uma amostra de 46 experientes atletas de combate. Da mesma forma, foi calculada através da aplicação de teste de confiabilidade teste-reateste em uma amostra de 28 atletas. Os resultados indicaram que o inquérito sobre a perda de peso em esportes de combate apresenta os níveis ideais de validade de conteúdo, bem como a reprodutibilidade em respostas para identificar e monitorar estratégias que estes atletas realizar estágios de perda de peso antes da pesagem e sua subsequente recuperação antes do início do torneio, frequências e métodos (AU)

Muscle contraction velocity, strength and power output changes following different degrees of hypohydration in competitive olympic combat sports.

BACKGROUND: It is habitual for combat sports athletes to lose weight rapidly to get into a lower weight class. Fluid restriction, dehydration by sweating (sauna or exercise) and the use of diuretics are among the most recurrent means of weight cutting. Although it is difficult to dissuade athletes from this practice due to the possible negative effect of severe dehydration on their health, athletes may be receptive to avoid weight cutting if there is evidence that it could affect their muscle performance. Therefore, the purpose of the present study was to investigate if hypohydration, to reach a weight category, affects neuromuscular performance and combat sports competition results. METHODS: We tested 163 (124 men and 39 woman) combat sports athletes during the 2013 senior Spanish National Championships. Body mass and urine osmolality (UOSM) were measured at the official weigh-in (PRE) and 13-18 h later, right before competing (POST). Athletes were divided according to their USOM at PRE in euhydrated (EUH; UOSM 250-700 mOsm · kgH2O(-1)), hypohydrated (HYP; UOSM 701-1080 mOsm · kgH2O(-1)) and severely hypohydrated (S-HYP; UOSM 1081-1500 mOsm · kgH2O(-1)). Athletes' muscle strength, power output and contraction velocity were measured in upper (bench press and grip) and lower body (countermovement jump - CMJ) muscle actions at PRE and POST time-points. RESULTS: At weigh-in 84 % of the participants were hypohydrated. Before competition (POST) UOSM in S-HYP and HYP decreased but did not reach euhydration levels. However, this partial rehydration increased bench press contraction velocity (2.8-7.3 %; p < 0.05) and CMJ power (2.8 %; p < 0.05) in S-HYP. Sixty-three percent of the participants competed with a body mass above their previous day's weight category and 70 of them (69 % of that sample) obtained a medal. CONCLUSIONS: Hypohydration is highly prevalent among combat sports athletes at weigh-in and not fully reversed in the 13-18 h from weigh-in to competition. Nonetheless, partial rehydration recovers upper and lower body neuromuscular performance in the severely hypohydrated participants. Our data suggest that the advantage of competing in a lower weight category could compensate the declines in neuromuscular performance at the onset of competition, since 69 % of medal winners underwent marked hypohydration.

Defining the user role in infection control.

BACKGROUND: Health policy initiatives continue to recognize the valuable role of patients and the public in improving safety, advocating the availability of information as well as involvement at the point of care. In infection control, there is a limited understanding of how users interpret the plethora of publicly available information about hospital performance, and little evidence to support strategies that include reminding healthcare staff to adhere to hand hygiene practices. AIM: To understand how users define their own role in patient safety, specifically in infection control. METHODS: Through group interviews, self-completed questionnaires and scenario evaluation, user views of 41 participants (15 carers and 26 patients with recent experience of inpatient hospital care in London, UK) were collected and analysed. In addition, the project's patient representative performed direct observation of the research event to offer inter-rater reliability of the qualitative analysis. FINDINGS: Users considered evidence of systemic safety-related failings when presented with hospital choices, and did not discount hospitals with high ('red' flagged) rates of meticillin-resistant Staphylococcus aureus. Further, users considered staff satisfaction within the workplace over and above user satisfaction. Those most dissatisfied with the care they received were unlikely to ask staff, 'Have you washed your hands?' CONCLUSION: This in-depth qualitative analysis of views from a relatively informed user sample shows 'what matters', and provides new avenues for improvement initiatives. It is encouraging that users appear to take a holistic view of indicators. There is a need for strategies to improve dimensions of staff satisfaction, along with understanding the implications of patient satisfaction.

Comparison of pollen levels between 2 pollen traps in Salamanca, Spain

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Antibacterial and antioxidant activities in extracts of fully grown cladodes of 8 cultivars of cactus pear.

The antimicrobial and antioxidant activities of some cultivars of the nopal cactus have not been determined. In this study, 8 cultivars of nopal cacti from Mexico were assayed for phenolic content, antioxidant activities, and antimicrobial activities against Campylobacter Jejuni, Vibrio cholera, and Clostridium Perfringens. Plant material was washed, dried, and macerated in methanol. Minimum bactericidal concentrations (MBCs) were determined using the broth microdilution method. Antioxidant activities were quantitatively determined using spectrophotometric methods. The MCBs of the nopal cacti ranged from 1.1 to 12.5 mg/mL for c. jejuni, 4.4 to 30 mg/mL for V. cholera, and 0.8 to 16 mg/mL for C. perfringens in the cultivars Cardon Blanco, Real de Catorce, and Jalpa, respectively. High quantities of total phenols and total flavonoids were found in the Jalpa cacti (3.80 mg of gallic acid equivalent GAE/g dry weight [DW] and 36.64 mg of quercetin equivalents [QE]/g DW, respectively). 2,2-Diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activities (RSA) were correlated to bioactive compound contents. The Villanueva cacti had the highest %RSA at 42.31%, and the lowest activity was recorded in Copena V1 at 19.98%. In conclusion, we found that some of the 8 cactus pear cultivars studied may be used for their antioxidant compounds or antimicrobials to control or prevent the contamination of foods.

Evaluación preclínica y estudio de estabilidad de extractos a partir del follaje de Momordica charantia Lin / Obtaining and characterizing the Momordica charantia Linn leaf extracts

El objetivo del presente trabajo fue la evaluación preclínica y el estudio de estabilidad de extractos a partir del follaje de Momordica charantia Lin. Se obtuvieron extractos acuoso e hidroalcohólico para los cuales se establecieron las especificaciones de calidad mediante la evaluación de tres lotes y se estudió su estabilidad por el método de vida de estante durante 12 meses. A los extractos se le evaluó el potencial genotóxico mediante ensayos de micronúcleos en médula ósea de ratón y aberraciones cromosómicas en linfocitos de sangre periférica. La actividad hipoglicemiante oral fue evaluada en animales con hiperglicemia temporal inducida por carga de glucosa. Como resultados se establecieron las especificaciones de calidad de los extractos acuoso e hidroalcohólico, los mismos mostraron estabilidad por 6 meses para el extracto acuoso y 12 meses para el extracto hidroalcohólico. No mostraron efecto genotóxico en los ensayos evaluados y mostraron efecto hipoglicemiante oral a la dosis de 450 mg/kg.

The objective of this investigation was the preclinical evaluation and the stability study of the Momordica charantia Linn hydroalcoholic and aqueous leaf extracts. The hydroalcoholic and aqueous extracts were obtained and the quality specifications were determined by evaluating three lots. The stability of the extracts was evaluated for 12 months. The genotoxic potential of the extracts was evaluated by mouse bone marrow micronucleus test and chromosome aberration test. The hypoglycemic effect was determined by oral glucose tolerance test. As results, the quality specifications were established and the aqueous extract was stable for 6 months and the hydroalcoholic extract for 12 months. A genotoxic effect was not observed in both extracts and the hypoglycemic effect was observed at the oral dose of 450 mg/kg of body weight.

Efficacy of fish oil on serum of TNF α , IL-1 ß , and IL-6 oxidative stress markers in multiple sclerosis treated with interferon beta-1b.

UNLABELLED: Multiple sclerosis (MS) is a chronic inflammatory disease, which leads to focal plaques of demyelination and tissue injury in the central nervous system. Oxidative stress is also thought to promote tissue damage in multiple sclerosis. Current research findings suggest that omega-3 polyunsaturated fatty acids (PUFAs) such as eicosapenta-enoic acid (EPA) and docosahexaenoic acid (DHA) contained in fish oil may have anti-inflammatory, antioxidant, and neuroprotective effects. The aim of the present work was to evaluate the efficacy of fish oil supplementation on serum proinflammatory cytokine levels, oxidative stress markers, and disease progression in MS. 50 patients with relapsing-remitting MS were enrolled. The experimental group received orally 4 g/day of fish oil for 12 months. The primary outcome was serum TNF α levels; secondary outcomes were IL-1 ß 1b, IL-6, nitric oxide catabolites, lipoperoxides, progression on the expanded disability status scale (EDSS), and annualized relapses rate (ARR). Fish oil treatment decreased the serum levels of TNF α , IL-1 ß , IL-6, and nitric oxide metabolites compared with placebo group (P ≤ 0.001). There was no significant difference in serum lipoperoxide levels during the study. No differences in EDSS and ARR were found. CONCLUSION: Fish oil supplementation is highly effective in reducing the levels of cytokines and nitric oxide catabolites in patients with relapsing-remitting MS.

Use of hyperbaric oxygenation in neonatal patients: a pilot study of 8 patients.

This article presents a pilot study to determine the value of hyperbaric oxygenation (HBO2) in the acute management of neonatal hypoxia (hypoxic ischemic encephalopathy) and necrotizing enterocolitis. Neonates with hypoxic-ischemic encephalopathy and NE were treated in a Sechrist monoplace chamber. Electroencephalogram, evoked potential, ophthalmic evaluation, ultrasonograph, laboratory exams, and radiographs were obtained before and after HBO2. Treatment protocol was 2.0 atm abs/45 minutes. Preventive myringotomies were conducted in all patients. A follow-up was done at 3 and 6 months. All patients (n = 8) were ventilator-dependent and required bag-valve-mask ventilation by a neonatologist during the treatment. All showed a resolution after HBO2. There was also a dramatic improvement (P < .05) in hemoglobin, hematocrit, total proteins, serum sodium, triglycerides, and pH. There were favorable changes in all other studies although they did not meet statistical significance. There was a marked reduction of the morbidity and mortality. There were no adverse effects on the ophthalmologic or Central Nervous System. When used promptly, HBO2 can modify the local and systemic inflammatory response caused by intestinal inflammation or cerebral or systemic hypoxia. It helps to preserve the marginal tissue and recover the ischemic and metabolic penumbra. This pilot study suggests that HBO2 could be a safe and effective treatment in the acute management of neonatal necrotizing enterocolitis or hypoxic ischemic encephalopathy. There is a need for a prospective, randomized, controlled, and double-blinded study to determine the real use of HBO2 in these cases.

Increased resolution in neutral atom microscopy.

The neutral atom microscope uses a beam of thermal noncharged atoms or molecules to probe an atomic surface with very low interaction energies (<70 meV). Continued optimization of the 'pinhole' neutral atom microscope has improved resolution to 0.35 µm. Recent images are presented demonstrating resolution and the contrast mechanisms identified so far. The future potential for sub-100 nm resolution is discussed.

Ginkgo biloba extract (EGb 761) modulates the expression of dopamine-related genes in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced Parkinsonism in mice.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) causes nigrostriatal dopaminergic neurotoxicity and behavioral impairment in rodents similar to Parkinson's disease. The MPTP mouse model is widely used to evaluate new protective agents. EGb 761 is a well-defined mixture of active compounds extracted from Ginkgo biloba leaves according to a standardized procedure. We have shown that EGb 761 attenuates the loss of striatal dopamine levels and prevents the neurodegeneration of the nigrostriatal pathway induced by MPTP. This finding shows that neuroprotective effects of EGb 761 act, in part, on the dopamine system. Therefore, this study investigates whether EGb 761 exerts dopaminergic neuroprotection through the regulation of dopamine-related gene expression in MPTP-induced Parkinsonism. Male C57BL/6J mice were injected with MPTP (30 mg/kg, i.p.) for 5 days and later with EGb 761 (40 mg/kg, i.p.) daily for 18 days. The expression of selected genes was evaluated in the striatum and midbrain by quantitative PCR. The genes for tyrosine hydroxylase (Th), vesicular monoamine transporter 2 (Vmat2), dopamine transporter (Dat), dopamine D2 receptor (Da-d2r), and transcription factors (Pitx3 and Nurr1) related to dopamine neurotransmission were selected for the analysis. EGb 761 administration to MPTP-treated mice protected Th (41%), Vmat2 (15%), Dat (102%), Da-d2r (46%), Pitx3 (63%), and Nurr1 (148%) mRNA levels in the midbrain, all of which were up-regulated. However, EGb 761 partially reversed the MPTP effect exclusively for Th (48%) and Nurr1 (96%) mRNA in the striatum. Only Th and Nurr1 mRNA and protein levels were regulated by EGb 761 in both regions of the nigrostriatal pathway. This result could be related to the regulation of their transcription. Our results suggest that EGb 761-associated neuroprotection against MPTP neurotoxicity is related to the regulation of the dopamine genes. Moreover, this neuroprotection also involves the regulation of transcription factors such as Nurr1 that are important for the functional maintenance of dopaminergic neurons.

Increased expression of the mineralocorticoid receptor in the brain of spontaneously hypertensive rats.

The mineralocorticoid receptor (MR) has been considered as both neuroprotective and damaging to the function of the central nervous system. MR may be also involved in central regulation of blood pressure. In the present study, we compared the expression of MR and the glucocorticoid receptor (GR) in the hippocampus and hypothalamus of 16-week-old spontaneously hypertensive rats (SHR) and normotensive control Wistar Kyoto (WKY) rats. In the hippocampus, MR expression was studied by in situ hybridization (ISH), quantitative polymerase chain reaction (PCR) and immunohistochemistry, whereas GR expression was analysed using the latter two procedures. Hypertensive animals showed an increased expression of MR mRNA in the whole hippocampus according to qPCR data and also in CA3 by ISH. Immunocytochemical staining for MR of the dorsal hippocampus, however, did not reveal differences between SHR and WKY rats. SHR showed elevated hypothalamic MR mRNA by qPCR, as well as an increased number of MR immunopositive cells in the magnocellular paraventricular region, compared to WKY rats. By contrast, expression levels of GR mRNA or protein in the hippocampus and hypothalamus of SHR were similar to those of WKY rats. Furthermore, we investigated the role of MR in the hypertensive rats by i.c.v. injection of the MR antagonist RU-2831. This compound produced a significant drop in blood pressure for SHR. In conclusion, MR expression is increased in the hippocampus and hypothalamus of SHR. We suggest that pathological MR overdrive may take responsibility for up-regulation of blood pressure and the encephalopathy of hypertension.