Retrospective case review of combined local mepivacaine and steroid injections into vaginal trigger points for the management of moderate-to-severe perineal pain after childbirth.

OBJECTIVE: After an obstetric trauma, a non-negligible number of postpartum women complain of perineal pain and dyspareunia. These symptoms clearly diminish their quality of life. Many treatment options have been suggested, such as oral analgesia, local anaesthetic, or steroid injections… Regretfully, none of these have yet demonstrated their efficacy with the validated trials. The objective of this review is to retrospectively evaluate the response to vaginal infiltrations into the trigger points (where the vaginal/perineal examination sets off the maximum intensity of pain) combining local anaesthetic and corticosteroids. METHODS: Our goal is to detect women who complain of sexual disfunction and perineal pain 2 and 6 months after childbirth. All reviewed cases correspond to vaginal deliveries made between June 2016 and April 2017. Trigger points were detected through a vaginal examination. Patients with moderate-to-severe perineal pain were determined using a visual analogue score (VAS 0-10). We suggested a treatment of vaginal infiltration specifically into the trigger points. Patients underwent local injections with a combination of mepivacaine hydrochloride 2% (8 ml) and betamethasone acetate (2 ml). RESULTS: Twenty-seven women were treated with vaginal injections directly into the trigger points. Seven of them [7/27 (25.92%)] were treated 2 months after delivery and experienced complete recovery of their perineal pain 4 months after the treatment. Those who first chose conservative treatment [20/27 (74.08%)] were also assessed 6 months after giving birth. This group continued to suffer the same symptoms and they then subsequently underwent vaginal injections. As well as the first group, these women experienced complete recovery of their perineal pain after treatment. No side effects have been registered so far. CONCLUSION: Women treated with vaginal injection into the trigger points improved in a fast and effective way. It seems to be a well-tolerated and safe option for women with moderate-to-severe pain.

Immunogenicity of COVID-19 vaccines in lung cancer patients.

OBJECTIVE: Patients with lung cancer are at increased risk of SARS-CoV-2 infection and severe complications from COVID-19, but information on the efficacy of anti-SARS-CoV-2 vaccine in these patients is scarce. We aimed at evaluating the safety and immunogenicity of COVID-19 vaccines in this population. PATIENTS AND METHODS: The prospective, nationwide SOLID substudy, enrolled adults with lung cancer who were fully vaccinated against COVID-19. Serum anti-SARS-CoV-2 IgG antibody levels were quantitatively assessed two weeks and six months after receipt of the last dose using a chemiluminescent microparticle immunoassay. Multivariate odds ratios for the association between demographic and clinical factors and seronegativity after vaccination were estimated. RESULTS: 1973 lung cancer patients were enrolled. Most patients had stage IV disease (66%) and were receiving active cancer treatment (82.7%). No significant differences were found in the probability of being seronegative for anti-SARS-CoV-2 IgG antibodies after full vaccination between patients who were receiving active cancer treatment and those who were not (p = 0.396). The administration of immunotherapy or oral targeted therapy and immunization with mRNA-1273 COVID-19 vaccine were factors independently associated with increased odds of being seropositive after vaccination. From all patients, 1405 received the second dose of vaccine and high levels of antibody titers were observed in 93.6% of patients two weeks after second dose. At six months, multivariate logistic regression analysis showed that performance status ≥ 2 was independently associated with a higher probability of being seronegative after full vaccination with an OR 4.15. On the other hand, received chemotherapy or oral target therapy and vaccination with mRNA-1273 were a factor independently associated with lower odds of being seronegative after full vaccination with an OR 0.52, 0.37 and 0.34, respectively. CONCLUSIONS: Lung cancer patients can safely achieve a strong immune response against SARS-CoV-2 after full vaccination, regardless of the cancer treatment received. TRIAL REGISTRATION: NCT04407143.

Electrochemical doping for lowering contact barriers in organic field effect transistors.

By electrochemically p-doping pentacene in the vicinity of the source-drain electrodes in organic field effect transistors the injection barrier for holes is decreased. The focus of this work is put on the influence of the p-doping process on the transistor performance. Cyclic voltammetry performed on a pentacene based transistor exhibits a reversible p-doping response. This doped state is evoked at the transistor injection electrodes. An improvement is observed when comparing transistor characteristics before and after the doping process apparent by an improved transistor on-current. This effect is reflected in the analysis of the contact resistances of the devices.

In situ resonance Raman spectroscopy of polyazulene on aluminum.

Polyazulene (PAz) has been electrochemically deposited on different electrode substrates. The films were characterized with Raman and UV-vis spectroscopy. The spectroelectrochemical studies were performed in situ during p- and n-doping (electrochemical oxidation and reduction, respectively). The focus of this work was mainly on the charging and discharging reactions of PAz on Al substrates. The results were compared to the corresponding results obtained from PAz on Pt substrates. Three different excitation wavelengths (514, 633, and 780 nm) were used in the Raman experiments and the resonance enhancement effect was observed when changing the wavelength of the excitation line. The vibrational behavior of PAz deposited on Al was very similar to that of PAz deposited on Pt during p-doping. Furthermore, it was found that the vibrational responses during p- and n-doping are different indicating that the electronic structure of PAz is not the same during positive and negative charging. It was concluded that PAz is not reversibly n-doped on Al. The n-doping on Pt was shown to be more reversible. In this paper, the important correlation between UV-vis and Raman spectroscopy is discussed as well as the correlation between doping-induced infrared active bands and Raman bands of neutral PAz.

Raman and in situ FTIR-ATR characterization of polyazulene films and its derivate.

Polymers from azulene (A) and 2-[(E)-2-azulen-1-ylvinyl]thiophene (B) electrochemically synthesized are materials with a broad absorbance in the UV-vis spectral region. An experimental approach to correlate the Raman and in situ FTIR spectra from azulene based polymers according to the effective conjugation coordinate theory (ECC) is presented. Film characterization was made by Raman and Fourier transform infrared attenuated total reflectance, FTIR-ATR spectroscopy. Throughout the whole work A was used as a model compound. The polymers were synthesized at different polymerization potentials in order to create different structures. Polyazulene showed a divergent Raman response upon change in excitation wavelength, lambda(exc)= 514 nm and lambda(exc)= 780 nm, in comparison to common conducting polymers. The FTIR-ATR measurements were made during charging-discharging of the polymers. The IR spectra of the conducting state show new doping induced infrared active vibrations (IRAV) in the region between 1600 and 700 cm(-1) and a broad electronic absorption in the high energy range (4000-8000 cm(-1)). Two different structures of the polymer from B are formed, and both follow the trends for conducting polymers upon charging.

Efectos protectores de las proantocianidinas a nivel intestinal frente a estrés termooxidativo por ingestión de aceite de girasol utilizado en fritura / Protective effects of proanthocyanidins at the intestinal levelagainst thermooxidative stress due to ingestion of sunflower oil used in frying

La fritura repetida de alimentos produce termooxidación y polimerización, potencialmente negativas para la salud. Se desconoce cómo reacciona el sistema gastrointestinal frente a estos compuestos. Las proantocianidinas poseen propiedades antioxidantes e hipolipemiantes. Hipotetizamos que un extracto de algarrobo rico en proantocianidinas (CFE) mejora la defensa del intestino frente a la agresión termooxidativa. Se estudió, en el aceite de girasol, la termooxidación producida por la fritura repetida de pescado y, en ratas Wistar, el efecto de administrar conjuntamente aceite de fritura y CFE sobre: la digestión de los compuestos termooxidados, la lipemia postprandial, las proteínas implicadas en la absorción de lípidos, y la actividad y expresión antioxidante y de hemo-oxigenasa-1 en intestino delgado. Doce ratas Wistar, macho, de 200-250 g fueron canuladas durante una semana con la mezcla del aceite termooxidado-CFE o con aceite termooxidado. Se cuantificó la alteración termooxidativa en el aceite de fritura y en la grasa post-prandial del lumen gastrointestinal, la lipemia postprandial, las proteínas NPC1L1, ACAT-2 y MTP, y el estado antioxidante en duodeno, yeyuno e íleon. Se encontraron niveles elevados de compuestos de polimerización y triglicéridos oxidados en el aceite de girasol y en la grasa del lumen gastrointestinal. La administración de aceite de girasol termooxidado-CFE disminuye la digestibilidad del aceite y de los compuestos poliméricos/termooxidados, aminora la lipemia postprandial, eleva NPC1L1, ACAT-2 y MTP, y mejora el estado antioxidante intestinal y la excreción de polímeros fecales. El empleo de CFE reduce la lipemia postprandial y garantiza un estado antioxidante intestinal adecuado frente a lípidos termooxidados.(AU)

The repeated frying of food in sunflower oil produces thermo-oxidation and polymerization, potentially negative for health. The reaction of the gastrointestinal system to these compounds is unknown. Proanthocyanidins have antioxidant and lipid-lowering properties. We hypothesize that a carob-fruit extract rich in proanthocyanidins (CFE) improves the defense of the intestine against thermo-oxidative aggression. In sunflower oil, the thermo-oxidation produced by repeated frying of fish was studied while, in Wistar rats, the effect of jointly administering altered sunflower oil and CFE on: the digestion of thermo-oxidized compounds, postprandial lipaemia, proteins involved in lipid absorption, antioxidant and hemoxygenase-1 activity and expression in the small intestine. Twelve male Wistar rats, 200-250 g were cannulated for one week with the mixture of the thermo-oxidized oil-CFE or the thermo-oxidized oil. Thermo-oxidation was determined in sunflower oil and in the postprandial-fat of the gastrointestinal lumen, postprandial lipaemia, the proteins NPC1L1, ACAT-2 and MTP, and the antioxidant status in the duodenum, jejunum and ileum. High thermo-oxidation and polymerization levels were found on sunflower oil and fat in the gastrointestinal lumen. The administration of thermo-oxidized sunflower oil-CFE decreases the digestibility of the oil and the polymeric/thermo-oxidized compounds, reduces postprandial lipaemia, increases NPC1L1, ACAT-2, and MTP, and improves the intestinal antioxidant status and excretion of fecal polymers. The use of CFE reduces postprandial lipaemia and guarantees an adequate intestinal antioxidant status against thermo-oxidized lipids.(AU)

A randomized phase II study to compare oxaliplatin plus 5-fluorouracil and leucovorin (FOLFOX4) versus oxaliplatin plus raltitrexed (TOMOX) as first-line chemotherapy for advanced colorectal cancer.

INTRODUCTION: The aim of this study was to compare TOMOX versus FOLFOX4 as first-line treatment of advanced colorectal cancer (CRC). MATERIALS AND METHODS: 191 chemotherapy-naïve patients were randomized to receive TOMOX or FOLFOX4. Patients were evaluated every 3 months and chemotherapy was continued until disease progression or unacceptable toxicity. Overall response rate was the primary endpoint. RESULTS: 183 patients were included in the intent-to-treat analysis (92 TOMOX and 91 FOLFOX4). Overall response rate was 45.6 and 36.3 % (p = 0.003) for TOMOX and FOLFOX4, respectively. No statistically significant differences were observed in overall survival (15.6 and 17.2 months; p = 0.475); progression-free survival (7.7 and 8.7 months; p = 0.292), and response duration (6.4 and 7.6 months; p = 0.372) for TOMOX and FOLFOX4, respectively. Grades 3 and 4 neutropenia (p < 0.0001) and leukopenia (p = 0.028) were more common with the FOLFOX4 regimen, while hepatic disorders and asthenia were higher in TOMOX group (p = ns). There were two treatment-related deaths in the FOLFOX4 arm and one in the TOMOX arm. Quality of life analysis based on the SF-36 revealed differences between the two regimens for physical and mental composite scores after 6 weeks, and for body pain and emotional role functioning after 6 and 12 weeks; all of these favored the FOLFOX4 arm (p ≤ 0.05). CONCLUSIONS: TOMOX and FOLFOX4 seem to have similar efficacy and are well tolerated in the first-line treatment for advanced CRC with different profiles of toxicity. The convenient TOMOX regimen may offer an alternative to fluoropyrimidine-based regimens.

Phase behavior of an intact monoclonal antibody.

Understanding protein phase behavior is important for purification, storage, and stable formulation of protein drugs in the biopharmaceutical industry. Glycoproteins, such as monoclonal antibodies (MAbs) are the most abundant biopharmaceuticals and probably the most difficult to crystallize among water-soluble proteins. This study explores the possibility of correlating osmotic second virial coefficient (B(22)) with the phase behavior of an intact MAb, which has so far proved impossible to crystallize. The phase diagram of the MAb is presented as a function of the concentration of different classes of precipitants, i.e., NaCl, (NH4)2SO4, and polyethylene glycol. All these precipitants show a similar behavior of decreasing solubility with increasing precipitant concentration. B(22) values were also measured as a function of the concentration of the different precipitants by self-interaction chromatography and correlated with the phase diagrams. Correlating phase diagrams with B(22) data provides useful information not only for a fundamental understanding of the phase behavior of MAbs, but also for understanding the reason why certain proteins are extremely difficult to crystallize. The scaling of the phase diagram in B(22) units also supports the existence of a universal phase diagram of a complex glycoprotein when it is recast in a protein interaction parameter.

Impacto clínico y económico de las intervenciones farmacéuticas / Clinical and economic impact of pharmaceutical interventions

Se realizó un estudio retrospectivo durante el periodo comprendido entre noviembre del 2008 y abril del 2009 a partir del sistema de distribución de medicamentos en dosis unitarias, con el objetivo de documentar el valor de la intervención farmacéutica, tanto en datos descriptivos como en datos económicos y de eficiencia, mediante el empleo de un programa de equivalentes terapéuticos. Las intervenciones farmacéuticas se agruparon en dosis/intervalo, sustitución, vía de administración, interacciones, alergias y otros. En cuanto al impacto económico, los valores de precios se obtuvieron a partir de los precios de compra de los medicamentos y del catálogo de especialidades farmacéuticas. Se realizaron un total de 297 intervenciones repartidas en 50 dosis/intervalo, 174 sustituciones, 34 de vía, 25 de interacciones, 3 de alergia y 11 en el apartado de otros. El ahorro real calculado supuso 18 146,39 euros. El registro de las intervenciones se valora como beneficioso para la detección de problemas prioritarios y áreas de actuación, además de constituir una herramienta útil para poder demostrar el coste/efectividad de las acciones.

A retrospective study was conducted from November 2008 to April 2009 in the unit-dose drug distribution system. The objective was to document the value of the pharmaceutical intervention both in descriptive and economic/efficiency data by using a program of therapeutic equivalences. The pharmaceutical interventions were grouped into dose/interval, substitutions, route of administration, interactions, allergies and others. Regarding the economic impact, the values of prices were derived from the drug purchase prices and the catalogue of pharmaceutical specialties. Two hundred ninety seven interventions were performed and distributed as follows: 50 dose / interval, 174 substitutions, 34 routes of administration, 25 interactions, 3 allergies and 11 of other types. Actual estimated savings amounted to 18 146.39 euros. The record of interventions is considered advantageous for the detection of priority problems and areas for action, in addition to being a useful tool to prove the cost-effectiveness of actions. Key words: Pharmaceutical intervention, clinical impact, economic impact.

Mantenimiento y cuidado de catéteres intravasculares. La importancia de la heparinización / No disponible

No disponible

Seguridad y utilidades de Zaleplon en operaciones aéreas / No disponible

resumen

abstract