Patrones diferenciales entre Leishmaniasis y chagas, empleando epimastigotes de Trypanosoma cruzi / Differential patterns between leishmaniasis and chagas disease using Trypanosoma cruzi epimastigotes

En diferentes regiones de Latinoamérica la infección por T. cruzi y Leishmania se superponen, por lo cual se reportan infecciones mixtas circulantes, debido a esto; deben realizarse pruebas diagnósticas específicas para evitar reacciones cruzadas entre estas dos patologías. OBJETIVO: determinar patrones de fluorescencia que permitan la diferenciación entre Leishmaniasis, enfermedad de Chagas e infección mixta empleando epimastigotes de T. cruzi. MÉTODOS: se empleó la técnica de Inmunofluorescencia Indirecta utilizando epimastigotes de T. cruzi (TcV autóctono) como antígeno figurado frente a un panel de muestras de suero codificados como A, B, C y D correspondientes a pacientes con infección por: Leishmaniasis (A), Infección mixta por Leishmania y Chagas(B), Enfermedad de Chagas (C) y sin ninguna de las dos infecciones (D). RESULTADOS: en los cuatro paneles de muestras se observaron diferentes patrones de intensidad de fluorescencia a nivel de membrana y núcleo de los epimastigotes de T. cruzi (TcV autóctono). CONCLUSIONES: la técnica de Inmunofluorescencia (IFI) con antígenos de epimastigotes de T. cruzi a demostrado utilidad en la diferenciación entre enfermedad de Chagas, Leishmaniasis y/o infecciones mixtas por ambos parásitos en aquellas zonas donde la coexistencia de ambas es habitual

In different regions of Latin America, infection by T. cruzi and Leishmania overlap, for which mixed circulating infections are reported, due to this; Specific diagnostic tests must be performed to avoid cross reactions between these two pathologies. OBJECTIVE: to determine fluorescence patterns that allow the differentiation between Leishmaniasis, Chagas disease and mixed infection using T. cruzi epimastigotes. METHODS: the Indirect Immunofluorescence technique was used using epimastigotes of T. cruzi (autochthonous TcV) as figurative antigen against a panel of serum samples coded as A, B, C and D corresponding to patients with infection by: Leishmaniasis (A) , Mixed infection by Leishmania and Chagas (B), Chagas disease (C) and without either of the two infections (D). RESULTS: in the four sample panels, different patterns of fluorescence intensity were observed at the membrane and nucleus level of the epimastigotes of T. cruzi (autochthonous TcV). CCONCLUSIONS: the Immunofluorescence technique (IFI) with T. cruzi epimastigote antigens has proven useful in differentiating between Chagas disease, Leishmaniasis and / or mixed infections by both parasites in areas where the coexistence of both is common.

Dietary intake of advanced glycation end products (AGEs) and changes in body weight in European adults.

PURPOSE: Advanced glycation end products (AGEs) can be formed in foods by the reaction of reducing sugars with proteins, and have been shown to induce insulin resistance and obesity in experimental studies. We examined the association between dietary AGEs intake and changes in body weight in adults over an average of 5 years of follow-up. METHODS: A total of 255,170 participants aged 25-70 years were recruited in ten European countries (1992-2000) in the PANACEA study (Physical Activity, Nutrition, Alcohol, Cessation of smoking, Eating out of home in relation to Anthropometry), a sub-cohort of the EPIC (European Prospective Investigation into Cancer and Nutrition). Body weight was measured at recruitment and self-reported between 2 and 11 years later depending on the study center. A reference database for AGEs was used containing UPLC-MS/MS-measured Nε-(carboxymethyl)-lysine (CML), Nε-(1-carboxyethyl)-lysine (CEL), and Nδ-(5-hydro-5-methyl-4-imidazolon-2-yl)-ornithine (MG-H1) in 200 common European foods. This reference database was matched to foods and decomposed recipes obtained from country-specific validated dietary questionnaires in EPIC and intake levels of CEL, CML, and MG-H1 were estimated. Associations between dietary AGEs intake and body weight change were estimated separately for each of the three AGEs using multilevel mixed linear regression models with center as random effect and dietary AGEs intake and relevant confounders as fixed effects. RESULTS: A one-SD increment in CEL intake was associated with 0.111 kg (95% CI 0.087-0.135) additional weight gain over 5 years. The corresponding additional weight gain for CML and MG-H1 was 0.065 kg (0.041-0.089) and 0.034 kg (0.012, 0.057), respectively. The top six food groups contributing to AGEs intake, with varying proportions across the AGEs, were cereals/cereal products, meat/processed meat, cakes/biscuits, dairy, sugar and confectionary, and fish/shellfish. CONCLUSION: In this study of European adults, higher intakes of AGEs were associated with marginally greater weight gain over an average of 5 years of follow-up.

Validación externa de las escalas A2DS2 e ISAN para predecir la infección respiratoria asociada al ictus isquémico / External validation of the A2SD2 and ISAN scales for predicting infectious respiratory complications of ischaemic stroke

Antecedentes y objetivo: La neumonía asociada al ictus es una complicación relacionada con mal pronóstico. Las escalas A2DS2 e ISAN se han desarrollado recientemente por un grupo alemán e inglés, respectivamente, para predecir la neumonía intrahospitalaria tras un ictus agudo. Realizamos una validación externa de estas escalas en una serie consecutiva de pacientes ingresados por ictus isquémico en nuestro centro. Método: El modelo pronóstico se realiza sobre una muestra de 340 sujetos consecutivos ingresados por ictus en 2015. La discriminación se evaluó mediante el cálculo del área bajo la curva de eficacia diagnóstica (curva ROC). La calibración se evaluó mediante la realización del test de bondad de ajuste de Hosmer-Lemeshow y la representación gráfica de la curva. Se realiza un análisis de regresión logística para determinar los predictores independientes de infección respiratoria después del ictus. Resultados: La muestra final evaluada fue de 285 sujetos, entre los cuales 45 pacientes (15,8%) tuvieron infección respiratoria tras el ictus según unos criterios preestablecidos. La edad media de los pacientes fue de 71,01 (DE 12,62) años. De ellos, 177 (62,1%) fueron varones. Setenta y dos pacientes (25,3%) tenían síntomas o signos de disfagia, 42 (14,7%) tenían fibrilación auricular, 14 (4,9%) tenían situación de dependencia previa al ictus y la mediana de la puntuación NIHSS fue de 4 puntos. La puntuación media de la escala A2DS2 fue 3,25 (DE 2,54) y la de ISAN fue 6,49 (DE 3,64). El análisis muestra que por cada punto en la escala A2DS2 se incrementa el riesgo de infección respiratoria (OR = 1,576; IC 95%: 1,363-1,821), al igual que en la escala ISAN (OR = 1,350; IC 95%: 1,214-1,501). Conclusión: La puntuación alta en las escalas A2DS2 e ISAN son un fuerte predictor de infección respiratoria asociada al ictus agudo en una cohorte consecutiva de pacientes con ictus. Estas escalas son simples de usar y realizar, siendo herramientas prometedoras para la predicción de esta complicación en la práctica habitual

Background and purpose: Pneumonia as a complication of stroke is associated with poor outcomes. The A2DS2 and ISAN scales were developed by German and English researchers, respectively, to predict in-hospital stroke-associated pneumonia. We conducted an external validation study of these scales in a series of consecutive patients admitted to our hospital due to ischaemic stroke. Method: These predictive models were applied to a sample of 340 consecutive patients admitted to hospital in 2015 due to stroke. Discrimination was assessed by calculating the area under the ROC curve for diagnostic efficacy. Calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test and graphing the corresponding curve. Logistic regression analysis was performed to determine the independent predictors of respiratory infection secondary to stroke. Results: We included 285 patients, of whom 45 (15.8%) had respiratory infection after stroke according to the study criteria. Mean age was 71.01 ± 12.62 years; men accounted for 177 of the patients (62.1%). Seventy-two patients (25.3%) had signs or symptoms of dysphagia, 42 (14.7%) had atrial fibrillation, and 14 (4.9%) were functionally dependent before stroke; the median NIHSS score was 4 points. Mean scores on A2DS2 and ISAN were 3.25±2.54 and 6.49 ± 3.64, respectively. Our analysis showed that higher A2DS2 scores were associated with an increased risk of infection (OR = 1.576; 95% CI: 1.363-1.821); the same was true for ISAN scores (OR = 1.350; 95% CI: 1.214-1.501). Conclusion: High scores on A2DS2 and ISAN were found to be a strong predictor of respiratory infection associated with acute stroke in a cohort of consecutive patients with stroke. These easy-to-use scales are promising tools for predicting this complication in routine clinical practice

External validation of the A2SD2 and ISAN scales for predicting infectious respiratory complications of ischaemic stroke. / Validación externa de las escalas A2DS2 e ISAN para predecir la infección respiratoria asociada al ictus isquémico.

BACKGROUND AND PURPOSE: Pneumonia as a complication of stroke is associated with poor outcomes. The A2DS2 and ISAN scales were developed by German and English researchers, respectively, to predict in-hospital stroke-associated pneumonia. We conducted an external validation study of these scales in a series of consecutive patients admitted to our hospital due to ischaemic stroke. METHOD: These predictive models were applied to a sample of 340 consecutive patients admitted to hospital in 2015 due to stroke. Discrimination was assessed by calculating the area under the ROC curve for diagnostic efficacy. Calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test and graphing the corresponding curve. Logistic regression analysis was performed to determine the independent predictors of respiratory infection secondary to stroke. RESULTS: We included 285 patients, of whom 45 (15.8%) had respiratory infection after stroke according to the study criteria. Mean age was 71.01±12.62 years; men accounted for 177 of the patients (62.1%). Seventy-two patients (25.3%) had signs or symptoms of dysphagia, 42 (14.7%) had atrial fibrillation, and 14 (4.9%) were functionally dependent before stroke; the median NIHSS score was 4 points. Mean scores on A2DS2 and ISAN were 3.25±2.54 and 6.49±3.64, respectively. Our analysis showed that higher A2DS2 scores were associated with an increased risk of infection (OR=1.576; 95% CI: 1.363-1.821); the same was true for ISAN scores (OR=1.350; 95% CI: 1.214-1.501). CONCLUSION: High scores on A2DS2 and ISAN were found to be a strong predictor of respiratory infection associated with acute stroke in a cohort of consecutive patients with stroke. These easy-to-use scales are promising tools for predicting this complication in routine clinical practice.

Indirect three-dimensional printing: A method for fabricating polyurethane-urea based cardiac scaffolds.

Biomaterial scaffolds are a key part of cardiac tissue engineering therapies. The group has recently synthesized a novel polycaprolactone based polyurethane-urea copolymer that showed improved mechanical properties compared with its previously published counterparts. The aim of this study was to explore whether indirect three-dimensional (3D) printing could provide a means to fabricate this novel, biodegradable polymer into a scaffold suitable for cardiac tissue engineering. Indirect 3D printing was carried out through printing water dissolvable poly(vinyl alcohol) porogens in three different sizes based on a wood-stack model, into which a polyurethane-urea solution was pressure injected. The porogens were removed, leading to soft polyurethane-urea scaffolds with regular tubular pores. The scaffolds were characterized for their compressive and tensile mechanical behavior; and their degradation was monitored for 12 months under simulated physiological conditions. Their compatibility with cardiac myocytes and performance in novel cardiac engineering-related techniques, such as aggregate seeding and bi-directional perfusion, was also assessed. The scaffolds were found to have mechanical properties similar to cardiac tissue, and good biocompatibility with cardiac myocytes. Furthermore, the incorporated cells preserved their phenotype with no signs of de-differentiation. The constructs worked well in perfusion experiments, showing enhanced seeding efficiency. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1912-1921, 2016.

Estudio multicéntrico de deterioro cognitivo en lupus eritematoso sistémico: ECLES / Multicenter study of cognitive decline in systemic lupus erythematousus: ECLES

Introducción: los pacientes lúpicos presentan un riesgo incrementado de deterioro cognitivo (DC) comparado con individuos sanos, el cual puede ser debido a múltiples causas. Objetivo: Describir la frecuencia y características del deterioro cognitivo en pacientes con lupus sin manifestaciones neuropsiquiátricas conocidas. Materiales y método: Se incluyeron pacientes de 16 a 55 años con diagnóstico de LES según criterios del Colegio Americano de Reumatología (ACR) de 1997. Se incluyeron test neuropsicológicos acordes a la propuesta del ACR y el cuestionario de Beck para evaluar depresión. Se definió DC a valores de <2 o más desvíos estándar comparada con la media de población normal en al menos un test. Se consideró focal cuando afectó una o más medidas de un dominio y multifocal en 2 o más dominios. Para comparar proporciones se utilizó prueba exacta de Fisher y para comparar variables numéricas se usó prueba de Kruskal-Wallis. Se consideró significativo un valor de p <0,05. Resultados: Se estudiaron 86 pacientes con lupus, el 90% de origen caucásico, 8% mestizos y 1% amerindio. El 82% alcanzó nivel secundario. La frecuencia de DC fue del 65% (56/86). Los dominios afectados: memoria 45%, funciones ejecutivas 30%, atención 29%, lenguaje 4,6%. Se detectó depresión en un 48% de los pacientes. Se analizaron diferentes factores de riesgo, sin hallar diferencias estadísticamente significativas a excepción de la etnia (p=0,02). Conclusión: Se halló una frecuencia elevada de deterioro cognitivo en pacientes con LES, los pacientes no caucásicos tuvieron mayor DC con diferencias significativas en comparación con los pacientes caucásicos.

Background: patients with systemic lupus erythematosus (SLE)have an increased risk of cognitive impairment (CI) compared tohealthy individuals and it may be due to multiple causes. Objective: To determine the frequency and characteristics of CI inlupus patients without known previous neuropsychiatric events. Methods: Patients aged 16 to 55 fulfilling the 1997 ACR criteria forSLE were included. The neuropsychological test battery proposedby the ACR was used to determine CI and Beck depression werealso assessed. CI was defined as values of ≤2 standard deviationscompared to the mean of the general population in at least one test. It was considered focal involvement if it affected one or more measuresof a single domain and multifocal if 2 or more domains wasaffected. To compare proportions, Fisher’s exact test was used andto compare numerical variables, Kruskal-Wallis. A value of p <0.05was considered significant. Results: 86 patients were evaluated, 90% were Caucasian, 8%mestizos and 1% Amerindian. 82% had high school. CI was foundin 65% of patients (56/86). The affected domains were: memory45%, executive functions 30%, attention 29% and language 4.6%. Depression was detected in 48% of patients. Different risk factorswere analyzed and found no statistically significant differences exceptfor ethnicity (p=0.02). Conclusion: A high frequency of CI was found in patients with SLE,non-Caucasian had higher CI with significant differences in comparisonwith Caucasian patients.

Evaluación del estado del Hierro y la Vitamina A en niños de la etnia Warao del estado Sucre, Venezuela / Assessing ofIronand Vitamin A status in children of Warao ethnic group of Sucre state in Venezuela

El propósito del estudio fue evaluar el estado del hierro y la vitamina A, en niños de la etnia Warao, perteneciente a las comunidades de María López y Los Barrancos, del estado Sucre. Se evaluó el consumo de alimentos,indicadores bioquímicos y antropométricos a 64 niños Warao en edades comprendidas entre los 3 y 10 años. Se encontró una adecuación deficiente del consumo de hierroen 56,8%,la mayoría provino defuentes no hem: cereales (37,8%), harina de maíz precocida fortificada (33,47%), harina de trigo (2,72%) y casabe (32,98%); el hierro hémico provino de pescados (37,49%). Se presentó déficit en la adecuación del consumo de la vitamina A en 97,3%, las fuentes fueron cereales (harina de maíz precocida), huevos y lácteos. El diagnóstico nutricional antropométrico por combinación de indicadores de dimensión corporal, arrojó que el 75,0% se encuentra en normalidad. Para los estudios bioquímicos: el 93,76% tiene deficiencia de retinol; 40,63% deficiencia severa. El 100% y 70,3% presentó niveles normales de hierro y ferritina sérica, respectivamente. La concentración de hemoglobina, reveló 70,3% de anemia. Existe prevalencia de 92,45% de parasitosis intestinal (Trichuristrichura, Ascarislumbricoides y Ancylostomideos). Se observaron diferencias estadísticamente significativas de niveles séricos de ferritina y asociaciones parasitarias. La alta prevalencia de anemia, deficiencia de vitamina A y parasitosis, indican la existencia de un déficit nutricional en cuanto al hierro y la vitamina A, que puede deberse a la baja disponibilidad de alimentos, el consumo insuficiente de nutrientes y un aprovechamiento biológico disminuido.

The purpose of this study was to assess the iron and vitamin A status in children of Warao ethnic group, belonging to communitiesMaríaLópez and Los Barrancos in Sucre State. We evaluated food intake, anthropometric and biochemical markers in 64 Warao children with ages between 3 and 10 years. A deficient consumption of iron was found in 56,8%, most from non-heme sources: cereals (37,8%), corn flour fortified (33,47%), wheat flour (2,72%) andcasabe (32,98%);heme iron came from fish(37,49%).In the intake of vitamin A the deficit was presented in97,3%,sources were cereals (corn flour fortified), eggs and dairy. The anthropometric-nutritional diagnosis by combination of body dimension indicators showed that 75.0% is in normality.For biochemical studies: 93.76% has retinol deficiency;40,63% severe deficiency. The 100% and 70.3% had normal levels of serum iron and ferritin, respectively. The hemoglobin concentration revealed 70.3% of anemia. There was a high prevalence (92,45%) of intestinal parasitosis (Trichuristrichura, Ascarislumbricoides y Ancylostomideos). There were statistically significant differences in serum ferritin and parasitic associations.The high prevalence of anemia, vitamin A deficiency and parasitosis,indicate the existence of nutritional deficit in iron and vitamin A,which may be due to the low availability of food, insufficient consumption of nutrients and biological utilization decreased.

Composición bromatológica de la carne de conejos suplementados con mataratón y cachaza de palma aceitera / Bromatological composition of rabbit meat supplemented with mataraton and palm-press fiber

Objetivo. Evaluar comparativamente el efecto de la suplementación del alimento balanceado comercial (ABC) con follaje de mataratón (Gliricidia sepium) y cachaza de palma aceitera (Elaeis guineensis) en la composición bromatológica de la carne de conejo. Materiales y métodos. Las muestras de carne estudiadas en el presente trabajo, provienen de una investigación previa con un diseño experimental de bloques al azar con tres tratamientos (dietas) y tres repeticiones (bloques) con muestreo de tres réplicas por repetición, donde se utilizaron 27 conejos machos mestizos durante el período postdestete divididos en tres tratamientos: uno control (T0), alimentados sólo con ABC, y dos suplementados con mataratón y cachaza de palma aceitera en proporciones de 30 y 10% (T1), y 10 y 30% (T2), respectivamente, a manera de comparar el efecto de las dietas en el valor nutricional. Resultados. Las muestras de carne provenientes de los diferentes animales en tratamiento, se evaluaron encontrando que la suplementación no afectó significativamente la composición bromatológica (p>0.05) para el contenido de humedad (70.77 a 72.42%), proteínas (19.08 a 20.34%), cenizas (1.53 a 1.68%) y lípidos (6.48 a 7.23%); indicando que indistintamente de la dieta empleada, suplementando el ABC con mataratón/fibra de palma o no, las carnes de conejo obtenidas son nutricionalmente idénticas como alimento. Conclusiones. Con base en los resultados, se sugiere que el follaje de mataratón y la fibra de palma aceitera podrían constituir una alternativa como recursos agronómicos tropicales en la producción de carne de conejo para el consumo humano.

Objective. Comparatively evaluate the effect of supplementing commercial balanced feed (BCF) withmataratón (Gliricidia sepium) foliage and palm-press fiber (Elaeis guineensis) on the bromatologiccomposition of rabbit meat. Materials and methods. The meat samples studied came from a previousresearch which used a randomized block design with three treatments (diets) and three replications(blocks) with three replays by replication sampling where 27 hybrid male rabbits during their postweaning growth period, were used in three treatments: control (T0), animals supplied only with BCF,and two supplemented treatments with mataratón foliage and palm-press fiber at 30 and 10% (T1), and10 and 30% (T2) proportions, respectively, in order to compare the nutritional value of the differentdiets. Results. The evaluation of meat samples from different animals in the treatments showed thatthe bromatological composition of the meat was not significantly affected by the supplementation(p>0.05) for humidity (70.77 to 72.42%), protein (19.08 to 20.34%), ash (1.53 to 1.68%), andlipid (6.48 to 7.23%) contents; indicating that, regardless of the diet used, supplementing CBF withmataraton/palm-press fiber or not, the rabbit meats obtained are nutritionally identical. Conclusions.Based on the results, it is suggested that the foliage of mataraton and palm-press fiber may be analternative, as a tropical agronomic resource, in the rabbit meat production for human consumption.

Cuestionario socioeconómico aplicado a grupos familiares del distrito capital para investigaciones relacionadas con la salud pública / Socioeconomic questionnaire applied to family groups of the Capital District for research related to public health

La evaluación de aspectos socioeconómicos en comunidades, se hace mediante el método Graffar-Méndez Castella no (1994), éste incluye cuatro variables y no refleja la realidad de la Condición Social de las familias. Se diseño el Cuestionario Condición Socioeconómica (CCSE), con variables que dibujaran una realidad adecuada de lo observado. Se aplicó desde 1996, con transformaciones: 1999, 2004 y 2005, a 959 familias. En el CCSE, se incluyeron aspectos relacionados con características del grupo familiar, ha cinamiento, dependencia, ingreso familiar, tipo y tenencia de la vivienda, número de ambientes, suministro y frecuencia con que se recibe el agua, servicios públicos en la comunidad. A cada una se le asignó un puntaje, cuya suma permitió definir cuatro categorías para la Condición Socioeconómica. Se incorporó el nivel de instrucción del jefe del hogar y de la madre, fuente de ingreso, gastos en alimentación, con el fin de comparar con Graffar, cuartos para dormir y número de servicios en el hogar. El objetivo es dar a conocer un cuestionario, para ser utilizado en investigaciones; se validó mediante formas paralelas, se utilizó el coeficiente alfa de Cronbach, haciendo uso de SPSS para Win dows. Los resultados: Confiabilidad alta (0,80< a < 0,89). Las correlaciones, para la validación, entre condición so - cioeconómica y estrato social, dieron: 2001 (r = 0,85), 155; 2004 (r = 0,70), 157 y 2005 (r = 0,93), 112 familias, to das del Área Metropolitana de Caracas. Se concluye que: el cuestionario es confiable, válido y se puede utilizar.

The evaluation of aspects socioeconomic in communities, one becomes by means of the Graffar-Méndez Castellano me thod (1994), this one includes four variables and it does not reflect reality of the Social Condition of the families. Design Questionnaire Socioeconomic Condition (QSEC), with variables that drew a reality adapted of the observed thing. It was applied from 1996, with transformations: 1999, 2004 and 2005, to 959 families. In the QSEC, they included re lated aspects with characteristics of the familiar group, overcrowding, dependency, familiar entrance, type and pos session of the house, number of atmospheres, provision and frequency whereupon the water is received, services public in the com munity. To each one a score was assigned to him, whose sum allowed to define four categories for Socioeco no mic Condition. One got up the level of instruction of the head of the home and the mother, source of entrance, ex pen ses in feeding, with the purpose of comparing with Graf far, quarters to sleep and number of services in the home. Objective it is to present a questionnaire, to be used in in vestigations; it was validated by means of parallel forms, the coefficient was used alpha of Cronbach, doing use of SPSS for Win dows. Results: High trustworthiness (0,80 < a < 0,89). The correlations, for the validation, between so cioeco nomic condition and social layer, gave: 2001 (r = 0.85), 155; 2004 (r = 0.70), 157 and 2005 (r = 0.93), 112 families, all of the Me tropolitan Area of Caracas. It concludes that: the questionnaire is reliable, valid and it is possible to be used.

Remediation of lignin and its derivatives from pulp and paper industry wastewater by the combination of chemical precipitation and ozonation.

In the present work the degradation of the lignin and its derivatives in the residual water of a paper industry by simple ozonation was investigated. The remediation of lignin was realized using the combination of the pre-treatment with chemical precipitation, using concentrated sulfuric acid (97.1%) at the pH 1 and 3, and of the simple ozonation of the filtered residual water at the pH 1, 3, 8 and 12. Since the high residues content (the initial chemical oxygen demand (COD) is 70,000 mg/L) in the experiments the diluted samples (1:10) were used. The previous precipitation has showed a significant effect on the reduction of the COD (77%) and color (96.1%). The sludge precipitated contents sulfolignin, which in the reaction with sulfuric acid was formed. In ozonation of the filtered residual water during 25 min at the pH 1, 3, 8 and 12 the follows by-products were formed: fumaric, maleic, malonic and formic acids. The biodegradability of the treated water in ozonation increases up 0.067-0.29. The effect of the precipitation and the ozonation conditions on the decolorization kinetics was evaluated.

Decomposition of toxic pollutants in landfill leachate by ozone after coagulation treatment.

This study deals with evaluation of organic matter from Mexico City waste sanitary landfill leachate of Bordo Poniente (including domestic and industrial) by ozonation after a coagulation treatment with Fe2(SO4)(3) (2.5 g/L at pH 4-5). The content of humic substances after the coagulation treatment decreases up to 70%. Then leachate obtained from a solid with initial COD=1511 mg/L and the pH 8.5 was treated by ozone. The aqueous samples by a UV-vis and HPLC technique were analyzed. The partial identification of the initial composition of the organic matter as well as of intermediates and final products was carried out after the extraction of the initial and ozonated leachate with benzene, chloroform:methanol (2:1) and hexane. Then the extracts with a gas chromatograph with mass detector and FID were analyzed. In the HPLC results we identify malonic and oxalic acids. The initial concentrations of these acids were 19 mg/L and 214 mg/L, respectively. The oxalic acid is formatted and accumulated in ozonation. The obtained results show that the color disappears (visually) at 100% during 5 min of ozonation. The organic substances, extracted with chloroform-methanol, may be destructed during 15 min of ozonation; the organic matter, extracted with benzene, destructs completely by ozone during 5 min, and the organic compounds extracted with hexane have a low ozonation rate. The toxic compounds presented in leachate decompose completely during 15 min of ozonation. The ozonation rate constants for each group of organics (as observed constants) were calculated applying simplified mathematical model and the recurrent least square method using the program MATLAB 6.5.

Circulating levels of cytokines (IL-6 and IL-1beta) in patients with intermittent claudication, at rest, after maximal exercise treadmill test and during restore phase. Could they be progression markers of the disease?

AIM: Inflammation is considered to be one of the main mechanisms for the development and progression of peripheral arterial disease (PAD). Many studies have demonstrated that maximal exercise enhances the acute inflammatory response in claudicant patients, but no one has assessed the duration of this acute inflammatory activation. The aim of this study was to assess of the inflammatory pattern in claudicants and of the inflammatory response after maximal exercise and during the recovery from calf pain. METHODS: Eleven patients with moderate claudication (MC) (age: 60.5+/-5.8 years; body mass index [BMI]: 27.5+/-4.6; absolute claudication distance [ACD]: 165.4+/-38), 10 patients with severe claudication (SC) (age: 60.3+/-5 years; BMI: 27+/-4.5; ACD: 91+/-11.3) and 8 healthy subjects (age: 59.4+/-6.8; BMI: 28.7+/-4.16) underwent to maximal treadmill test (speed 2.5 km/h, slope 15%). At rest, just after stop of the exercise (appearance of calf pain in patients, and 6 min of treadmill in controls) the circulating levels of interleukin (IL)-1beta and IL-6 have been measured. STATISTICAL ANALYSIS: variance of mean values, Bonferroni t-test, split plot variance model, variance of d stop-before and stop-recovery have been utilized. P<0.05 has been considered the significant cut-off of the differences. RESULTS: The maximal exercise excited significant (P<0.01) inflammatory activation in all patients: MC (rest IL-1beta: 1.55, 3.3 at stop; rest IL-6: 5.97, 8.38 at the stop); SC (rest IL-1beta: 2.97, 5.72 at stop; rest IL-6: 6.98, 9.99 at the stop). During recovery, MC showed a reduction of the inflammatory activation, whilst SC showed further increase (IL-1beta: 7.55; IL-6: 11.94). CONCLUSION: The study confirms the higher inflammatory activation in claudicants and its enhancement after maximal exercise. During recovery, we found two kinds of response: type 1 (controls and MC), in which inflammation subsides, and type 2 (SC) characterized by further inflammatory increase. This trend is not univocal: 3 MC showed a type 2 response and 2 SC showed a type 1. In conclusion, inflammatory activation may depend not only on the degree of endothelial damage, but also on the individual inflammatory attitude, better assessed after maximal exercise than baseline values. This individual inflammatory responsiveness, considering the role of the rest measurement of markers of inflammation recently discussed, could be a useful marker for aggressive PAD.

Evaluación genotóxica del extacto acuoso liofilizado de Solanum sessiflorum Dunal, cocona en células Germinales de Ratón / Genotoxic evaluation extact lyophilised aqueous sessiflorum Dunal Solanum, cocona mouse germ cell

Se ha realizado la evaluación del potencial genotóxico del extracto acuoso liofilizado de los frutos de Solanum sessilifloum Dunal, mediante el método de anomalías de la cabeza de espermatozoides del ratón. Se utilizaron un total de 21 ratones albinos machos de la cepa Balb/c-53, distribuidos aleatoriamente en tres grupos experimentales con 7 animales por grupo: Solanum sessilifloum Dunal , a dosis de 2000 mg/kg p.c, ciclofosfamida a dosis de 50 mg/kg p.c (control positivo) y solución salina al 0.9 por ciento (control negativo). Se administró el extracto y la solución salina por vía oral y ciclofosfamida por vía intraperitoneal durante 5 días consecutivos. A los 35 días, después de la primera administración, se sacrificaron los animales, se extrajeron los epidídimos, se preparó una solución con tripsina, se coloreó con eosina y se procedió a la extensión de la muestra en láminas y porta objetos para su posterior lectura. Se clasificaron los espermatozoides siguiendo el criterio de Wyrobex y Bruce, basado en cabezas normales, amorfas, bananas y sin gancho. No se encontraron diferencias significativas entre el grupo tratado con Solanum sessiliflorum Dunal y el grupo control negativo, por lo que se puede concluir que el extacto acuoso liofilizado de Solanum sessiliflorun Dunal, no posee acción genotóxica a nivel de células germinales.

The genotoxin potential of the aquosus extract lyophilized of frutis Solanum sessiliflorum Dunal, by means of method head anomaly of spermatozoid mouse was evaluated. A total of 21 albino mice males of the cepa Balb/c-53 were used. Tree group experimentals with 7animals for group: Solanum sessilifloum Dunal to dose 2000 mg/kg, ciclofosfamide to dose 50mg//kg (positive control) and saline solution 0.9 per cent (negative control we established. the aqueous extract and saline solution were administer route oral and ciclofosfamide route intraperitoneal during 5 days consecutives. After 35 days o the first administration, the animals were sacrifices; epididimes extracted and prepared a solution with tripsine, coloured with eosine and procedured to extend in lamina slide (2 lamina for animal) for the later recount. The spermatozoids were classified following the criterion of Wyrobex and Bruce, based in normal heads, amorphous, bananas and ahook. Solanum sessiliflonum Dunal not presented significants diference o amorphous spermatozoids in relation to negative control, for the that may to conclude extract not endowed genotoxic action to level germinals cells.

Evaluación genotóxica del extracto acuoso liofilizado de Solanum sessiliflorum Dunal, cocona en células germinales del ratón / Genotoxic evaluation of the lyophilized aqueous extract of Solanum sessiliflorum Dunal, cocona in mouse germ cells

Se ha realizado la evaluación del potencial genotóxico del extracto acuoso liofilizado de los frutos de Solanum sessiliflorum Dunal, mediante el método de anomalías de la cabeza de espermatozoides del ratón. Se utilizaron un total de 21 ratones albinos machos de la cepa Balb/c-53, distribuidos aleatoriamente en tres grupos experimentales con 7 animales por grupo: Solanum sessiliflorum Dunal a dosis de 2000 mg/Kg p.c, ciclofosfamida a dosis de 50 mg/kg p.c. (control positivo) y sohteión salina al 0.9% (control negativo). Se administró el extracto y la solución salina por vía oral y ciclofosfamida por vía intraperitoneal durante 5 días consecutivos. A los 35 días, después de la primera administración, se sacrificaron los animales, se extrajeron los epidídimos, se preparó una solución con tripsina, se coloreó con eosina y se procedió a la extensión de la muestra en láminas porta objetos para su posterior lectura. Se clasificaron los espermatozoides siguiendo el criterio de Wyrobex y Bruce, basado en cabezas normales, amorfas, bananas y sin gancho. No se encontraron diferencias significativas entre el grupo tratado con Solanum sessiliflorum Dunal y el grupo control negativo, por lo que se puede concluir que el extracto acuoso liofilizado de Solanum sessiliflorum Dunal, no posee acción genotóxica a nivel de células germinales.

Effects of elastic stocking on quality of life of patients with chronic venous insufficiency. An Italian pilot study on Triveneto Region.

AIM: Even though compression therapy is the most recommended treatment for chronic venous insufficiency (CVI) in the national and international guidelines, its application, at least in Italy, is lower than the estimated need from the prevalence of CVI in the epidemiological studies. Since we believe that the measurement of the impact of compression therapy on quality of life (QoL) could improve the compliance for this precious treatment, we carried out this study on 50 patients with CVI. METHODS: Fifty patients (23 CEAP C2 and 27 C(3-4-5), selected within a larger study on QoL in CVI), received a prescription for compression therapy. Before treatment and 4 months afterwards, the patients received the instrument for QoL assessment (MOS SF-36; CIVIQ-2; Euro-QoL 5D and a visual analogue scale). The score scales have been adjusted to poorest QoL as 0 and best QoL as 100. RESULTS: Baseline QoL of patients in class C2 did not show significant difference with the healthy Italian Population, except for the physical role item. The patients in class C(3-4-5) showed significant reduction of QoL. After 4 months all the items of the utilized instrument showed significant improvement (from P<0.01 to P<0.04 for SF-36; from P<0.099 to P<0.006 for other instruments) in all CEAP classes. CONCLUSIONS: The study unquestionably shows that the compression therapy improves the QoL of patients with CVI, and should be included in the CVI treatment covered by the Public National Health Insurance. Finally, the QoL measurement could be utilized as the scientific method to assess the effectiveness and efficacy of different therapeutic devices.

[Rate of serological markers of hepatitis B and C viruses in first-time users of the hemodialysis program at Hospital Nacional Cayetano Heredia (HNCH)]. / Frecuencia de marcadores serológicos de hepatitis viral B y C en pacientes que ingresan por primera vez al programa de hemodiálisis en el Hospital Nacional Cayetano Heredia.

PURPOSE: Determine the rate of markers of hepatitis B (HBV) and C (HCV) viruses in patients with terminal chronic kidney failure (TCKF) prior to the start of a chronic hemodialysis program (CHD), and assess the time relation between infection and epidemiological history. MATERIALS AND METHODS: This was a prospective and analytical study. The study population was composed of the entire group of TCKF patients using the CHD program for the first time at the HNCH, Lima, from June 2002 to September 2003. HbsAg and HBV Anti-HBc, and HCV anti-VHC markers were assessed. RESULTS: 86 patients were studied, 45 female (52.3%) and 41 male (47.7%). During the study, the total rate of HBV markers was 20.9%, HBsAg(+) was 2.3%, and anti-HBcT(+) was only 18.7%. Anti-HCV rate was 4.65%. Related factors for potential carriers of only anti-HBcT(+) were: elder age, sexual intercourse with prostitutes OR=6.1 (1.5-25.3), food consumption at restaurants OR=5.2 (1.6-16.4), or being born in the jungle area OR=6.7 (1.5-30.5). Multi-variance analysis showed that only elder age OR=1.03 (1.00-1.06), being born in the jungle area OR=13.1 (1.8-91.1), and food consumption in restaurants OR=5.0 (1.4-18.0) were related to total anti-HBc count. CONCLUSIONS: The study results suggest a low rate of serological markers of HBV and HCV in TCKF patients using chronic hemodialysis treatment for the first time at HNCH.

Frecuencia de marcadores serológicos de hepatitis viral B y C en pacientes que ingresan por primera vez al programa de hemodiálisis en el Hospital Nacional Cayetano Heredia / Rate of serological markers of hepatitis B and C viruses in first-time users of the hemodialysis program at Hospital Nacional Cayetano Heredia

Objetivo: Determinar la frecuencia de marcadores de hepatitis viral B (VHB) y C (VHC) en pacientes con insuficiencia renal crónica terminal (IRC-T) antes de ingresar a un programa de hemodiálisis crónica (HDC) y evaluar la relación temporal de la infección con antecedentes epidemiológicos. Materiales y métodos: Se realizó un estudio de serie de casos prospectivo y analítico. La población se conformó por la totalidad de pacientes nuevos con IRC-T que ingresaron por primera vez al programa de HDC del HNCH-Lima, desde Junio del 2002 hasta Setiembre del 2003, se evaluaron los marcadores HBsAg y anti-HBcTotal del VHB y anti-VHC del VHC. Resultados: Se estudiaron 86 pacientes , 45 (52.3 por ciento) fueron mujeres y 41 (47.7 por ciento) varones. En el periodo de estudio se halló una frecuencia total de marcadores de VHB del 20.9 por ciento, siendo 2.3 por ciento HBsAg(+) y 18.7 por ciento sólo anti-HBcT(+). En tanto la frecuencia de anti-VHC fue de 4.65 por ciento. Los factores relacionados para ser portador de sólo anti-HBcT(+) fueron: edad avanzada, relaciones sexuales con prostitutas OR=6.1 (1.5-25.3), ingerir alimentos en restaurantes OR=5.2(1.6-16.4) y haber nacido en la Selva OR=6.7 (1.5-30.5). En el análisis multivariado solo la edad avanzada OR=1.03 (1.00-1.06), haber nacido en la Selva OR=13.1 (1.8-91.1) e ingerir alimentos en restaurantes OR=5.0 (1.4-18.0), se relacionaron con la presencia de anti-HBcTotal. Conclusión: Los resultados de este estudio sugieren baja frecuencia de los marcadores serológicos de VHB y VHC en pacientes con IRCT que ingresan por primera vez al tratamiento de HDC en el HNCH.

Purpose: Determine the rate of markers of hepatitis B (HBV) and C (HCV) viruses in patients with terminal chronic kidney failure (TCKF) prior to the start of a chronic hemodyalisis program (CHD), and assess the time relation between infection and epidemiological history. Materials and Methods: This was a prospective and analytical study. The study population was composed of the entire group of TCKF patients using the CHD program for the first time at the HNCH, Lima, from June 2002 to September 2003. HbsAg and HBV Anti-HBc, and HCV anti-VHC markers were assessed. Results: 86 patients were studied, 45 female (52.3 per cent) and 41 male (47.7 per cent). During thestudy, the total rate of HBV markers was 20.9 per cent, HBsAg(+) was 2.3 per cent, and anti-HBcT(+) was only 18.7 per cent. Anti-HCV rate was 4.65 per cent. Related factors for potentialcarriers of only anti-HBcT(+) were: elder age, sexual intercourse with prostitutes OR=6.1 (1.5-25.3), food consumption at restaurants OR=5.2 (1.6-16.4), or being born in the jungle area OR=6.7 (1.5-30.5). Multi-variance analysis showed that only elder age OR=1.03 (1.00-1.06), being born in the jungle area OR=13.1 (1.8-91.1), and food consumption in restaurants OR=5.0 (1.4-18.0) were related to total anti-HBc count. Conclusions: The study results suggest a low rate of serological markers of HBV and HCV in TCKF patients using chronic hemodyalisis treatment for the first time atHNCH.

Quality of life in chronic venous insufficiency. An Italian pilot study of the Triveneto Region.

AIM: Chronic venous insufficiency (CVI) is a chronic disease, whose disability has not been appreciated clearly, and several treatment costs are not covered by Public Health Service, probably because its any social impact is not well known. The aim of the study was to assess the impact of CVI on quality of life (QoL), and to compare the sensitivity of more diffused instruments for QoL assessment. METHODS: One hundred and four patients with CVI received the Italian version of four QoL assessment instruments (MOS SF-36; CIVIQ-2; Euro-QoL 5D and a visual analogical scale). The poorest QoL was adjusted as 0, the best as 100. After filling the questionnaires, patients underwent a clinical and instrumental examination to assess the diagnosis according to the CEAP classification. RESULTS: The QoL is progressively impaired from CEAP class C1 to class C5-6. The SF-36 showed a normal QoL in patients of CEAP class C1 and C2. Class C3 showed a significant (P<0.0018) reduction of QoL (physical role and bodily pain), and the decline was more significant (P<0.0001) in class C4, involving all physical items and several mental ones. Class C5-6 showed very low scores of physical and social functioning, general health and vitality. Physical and emotional scores were better than C4 patients. CONCLUSIONS: QoL is progressively impaired in CVI, involving primarily the physical items and the emotional role, with worsening of mental items only in advanced stages. This early involvement of physical items underlines how CVI is not an esthetic problem, but, a disease. Its impact on the lifestyle and QoL is similar to that of other chronic diseases (diabetes, cancer, chronic pulmonary disease), reaching in the class C5-6 the poorest level, similar to heart failure.

DOTS implementation in a middle-income country: development and evaluation of a novel approach.

BACKGROUND: DOTS is widely accepted as the most cost-effective strategy for tuberculosis (TB) control. However, there is little published information regarding methods for implementation in middle-income countries. METHODS: Over 3 years, the Canadian Lung Association assisted the Ecuadorian TB programme to implement DOTS for over half the nation's total population. A multilevel strategy developed by a team of Ecuadorian health professionals provided initial, in-service, replica and reinforcement training at the local level, and training at national level for specialist physicians, specialist societies and medical schools. Evaluation was based on international guidelines for case finding, treatment and laboratory quality control, and costs of all implementation activities. RESULTS: By January 2004, DOTS training had been provided to 1954 health professionals and 199 smear microscopy technicians, and DOTS was implemented in all 496 health facilities. Case detection activities at the local level increased substantially. Cure and treatment completion improved to 83% of new cases. Overall concordance of laboratory quality control readings was 98.7%. The total cost of DOTS implementation was US dollar 3 049 585. CONCLUSIONS: To achieve international targets for TB control, DOTS implementation in a middle-income country required intensive training at the local level and at multiple other levels.

Antioxidant and free radical scavenging activities of 5,7,3'-trihydroxy-3,6,4'-trimethoxyflavone from Brickellia veronicaefolia.

The antioxidant and antiradical activities of 5,7,3'-trihydroxy-3,6,4'-trimethoxyflavone or centaureidin isolated and characterized from Brickellia veronicaefolia were elucidated by heat-induced oxidation in a beta-carotene and linoleic acid system and by the 1,1-diphenyl-2-picrylhydrazyl decoloration test. The centaureidin (32.1%) exhibited antioxidative activity less than that of BHT (95.5%) and alpha-tocopherol (95.9%) on oxidation in a beta-carotene and linoleic acid system. A moderate antiradical effect (47.6%) compared with BHT (96.7%) and alpha-tocopherol (94.6%) in DPPH decoloration test was found.