La prescripción de opioides para el dolor crónico se ha incrementado en las últimas décadas. Sin embargo, las dudas sobre su seguridad a largo plazo, un uso inadecuado y el desarrollo de conductas aberrantes asociadas a opioides (CAAO) dificultan la toma de decisiones clínicas, provocando un tratamiento insuficiente del dolor crónico. Diversas guías prácticas han establecido recomendaciones para el control de los pacientes que reciben opioides a largo plazo. Cualquier médico debe conocer las herramientas disponibles para identificar a aquellos pacientes que presenten un riesgo elevado de mal uso de los opioides. Debe, además, saber cómo detectarlo y abordarlo sin comprometer el tratamiento óptimo del dolor en aquellos pacientes que sí pueden beneficiarse de un uso correcto de los opioides. En el presente trabajo se revisan las principales guías de práctica clínica, revisiones sistemáticas, recomendaciones y estrategias para minimizar los riesgos de los opioides en el tratamiento del dolor crónico no oncológico (AU)
Prescription of opioids for chronic pain has increased in recent decades. However, issues arise about their long-term safety, abuse and opioid-associated aberrant behaviors that hinder clinical decision-making, thereby contributing to insufficient treatment of chronic pain. Several clinical practice guidelines have established different recommendations for monitoring patients receiving long-term opioid therapies, and screening tools have been recommended to identify those at high risk. Every physician should be aware of the tools available to identify those patients requiring opioid treatment and having a high risk of addictive behaviors, knowing how to detect and treat it without compromising the optimal management of pain in those patients who can benefit from correct use of opioids. We hereby review the main clinical practice guidelines, systematic reviews, recommendations and strategies to minimize the risks of opioids in the treatment of chronic non-cancer pain (AU)
Humans , Chronic Pain/drug therapy , Analgesics, Opioid/therapeutic use , Opioid-Related Disorders/prevention & control , Patient Safety , Practice Patterns, Physicians' , Behavior, Addictive/prevention & control , Prescription Drug Misuse/prevention & control , Risk Factors
The availability of reproducible broth microdilution (BMD) methods including inter log2 antibiotic dilutions for measuring Staphylococcus aureus (SA) vancomycin minimum inhibitory concentrations (MICs) within the susceptible range is needed to elucidate the impact of vancomycin MICs on clinical outcomes of invasive SA infections. Here, we report on the development of a very precise BMD method that incorporates the following incremental antibiotic concentrations: 0.50, 0.62, 0.75, 0.87, 1.0, 1.25, 1.40, 1.50, 1.60, 1.75, and 2.0 µg/mL. The intra- and inter-assay coefficients of variation of this method were around 20%. The mean of the differences in MIC values for all isolates obtained across two independent runs performed at one center was 0.04 µg/mL [95% confidence interval (CI), 0.011-0.07 µg/mL] and that for ten isolates measured at two different centers was 0.04 µg/mL (95% CI, 0-13 µg/mL). Vancomycin MIC values differed by less than 0.1 µg/mL between runs for most isolates. Storage of isolates at -20 °C for up to 3 months had no impact on the vancomycin MIC values. The mean vancomycin MIC values obtained by the Etest using a standard inoculum (0.5 McFarland) were significantly higher (p ≤ 0.001) than those measured by BMD and the MIC values measured by the two methods correlated poorly (Rho, 0.319; p = 0.148). Nevertheless, the mean MIC values measured by the Etest using lower inocula (107 or 106 CFU/mL) and those measured by BMD were comparable and correlated significantly (p = 0.004 for 107 CFU/mL and p = 0.029 for 106 CFU/mL).
Anti-Bacterial Agents/pharmacology , Microbial Sensitivity Tests/methods , Staphylococcus aureus/drug effects , Vancomycin/pharmacology , Dose-Response Relationship, Drug , Reproducibility of Results
Experimental tests are in progress to evaluate the accuracy of the modeled iron opacity at solar interior conditions [J. E. Bailey et al., Phys. Plasmas 16, 058101 (2009)]. The iron sample is placed on top of the Sandia National Laboratories z-pinch dynamic hohlraum (ZPDH) radiation source. The samples are heated to 150-200 eV electron temperatures and 7× 10(21)-4× 10(22) cm(-3) electron densities by the ZPDH radiation and backlit at its stagnation [T. Nagayama et al., Phys. Plasmas 21, 056502 (2014)]. The backlighter attenuated by the heated sample plasma is measured by four spectrometers along ±9° with respect to the z-pinch axis to infer the sample iron opacity. Here, we describe measurements of the source-to-sample distance that exploit the parallax of spectrometers that view the half-moon-shaped sample from ±9°. The measured sample temperature decreases with increased source-to-sample distance. This distance must be taken into account for understanding the sample heating.
OBJECTIVES: Antiretroviral therapy during pregnancy is recommended to reduce the risk of mother-to-child transmission of HIV and for maternal care management. Physiological changes during pregnancy can affect pharmacokinetics, potentially altering pharmacological activity. We therefore evaluated the pharmacokinetics of twice-daily (bid) darunavir in HIV-1-infected pregnant women. METHODS: HIV-1-infected pregnant women receiving an antiretroviral regimen containing darunavir/ritonavir 600/100 mg bid were enrolled in this study. Total and unbound darunavir and total ritonavir plasma concentrations were obtained over 12 h during the second and third trimesters and postpartum. Total darunavir and ritonavir plasma concentrations were determined using a validated high-performance liquid chromatography tandem mass spectrometry assay and unbound darunavir was determined using (14) C-darunavir-fortified plasma. Pharmacokinetic parameters were derived using noncompartmental analysis. RESULTS: Data were available for 14 women. The area under the plasma concentration-time curve from 0 to 12 h (AUC12h) for total darunavir was 17-24% lower during pregnancy than postpartum. The AUC12h for unbound darunavir was minimally reduced during pregnancy vs. postpartum. The minimum plasma concentration (Cmin) of total and unbound darunavir was on average 43-86% and 10-14% higher, respectively, during pregnancy vs. postpartum. The antiviral response (< 50 HIV-1 RNA copies/mL) was 33% at baseline and increased to 73-90% during treatment; the percentage CD4 count increased over time. One serious adverse event was reported (increased transaminase). All 12 infants born to women remaining in the study at delivery were HIV-1-negative; four of these infants were premature. CONCLUSIONS: Total darunavir exposure decreased during pregnancy. No clinically relevant change in unbound (active) darunavir occurred during pregnancy, suggesting that no dose adjustment is required for darunavir/ritonavir 600/100 mg bid in pregnant women.
HIV Infections/metabolism , HIV Protease Inhibitors/pharmacokinetics , HIV-1 , Pregnancy Complications, Infectious/metabolism , Ritonavir/pharmacokinetics , Sulfonamides/pharmacokinetics , Adolescent , Adult , Darunavir , Drug Administration Schedule , Female , Fetal Blood/chemistry , HIV Infections/drug therapy , HIV Protease Inhibitors/administration & dosage , Humans , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Pregnancy Outcome , Ritonavir/administration & dosage , Sulfonamides/administration & dosage , Young Adult
No disponible
Female , Humans , Male , Pain Clinics/organization & administration , Pain Clinics/standards , Pain Management/methods , Pain Management/standards , Health Education/methods , Health Education/organization & administration , Health Education/standards , Fentanyl/therapeutic use , Polygalacturonase/therapeutic use , Societies, Medical/legislation & jurisprudence , Societies, Medical/standards , Opioid-Related Disorders/complications
No disponible
Humans , Female , Child , Smith-Lemli-Opitz Syndrome/chemically induced , Smith-Lemli-Opitz Syndrome/diagnosis , Fentanyl/therapeutic use , Bronchoscopy , Albuterol/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Electrocardiography , Aminophylline/therapeutic use , Dipyrone/therapeutic use
La regurgitación mitral isquémica (RMI) es una complicación común de la enfermedad arterial coronaria que produce insuficiencia cardíaca en un alto porcentaje de pacientes. Puede presentarse como una verdadera emergencia cuando es causada por un infarto del miocardio con ruptura del músculo papilar asociada a shock cardiogénico. La insuficiencia mitral isquémica crónica es una complicación frecuente trasel infarto agudo del miocardio, aparece aproximadamente en 20% de los casos y es mucho más probable en el infarto agudo del miocardio de localización inferior (38%) que en el anterior (10%). Es producida por una integración de varios mecanismos que influyen en su desarrollo y que básicamente están relacionados con remodelado local o global del ventrículo izquierdo, con disfunción y disincronía del mismo. Su evaluación adecuada y rápida puede influir en el éxito de su tratamiento y en el mejor pronóstico de los pacientes. Una indicación quirúrgica precoz, actuando sobre ventrículos menos remodelados, y la innovación en el arsenal de dispositivos y técnicas quirúrgicas permitirán una corrección exitosa y duradera con baja mortalidad hospitalaria. En este sentido, las nuevas exploraciones desarrolladas por la ecocardiografía han adquirido una gran importancia al permitir evaluar la severidad de la insuficiencia mitral, el grado de disfunción local o global del ventrículo izquierdo y el estado del aparato valvular mitral lo que ha hecho del método la exploración más confiable y necesaria en estos pacientes. Revisamos la utilidad y el papel del ecocardiograma en el estudio de la insuficienciamitral isquémica.
Ischemic mitral regurgitation is a common complication of coronary heart disease that leads to heart failure in a high percentage of patients. It can present as a real emergency when it is caused by a myocardial infarction with rupture of a papillary muscle resulting in cardiogenic shock. Chronic ischemic mitral regurgitation is a frequent complication after a myocardial infarction in 20% of cases and it is even more frequent when the myocardial infarction is localized in the inferior wall (38%) than the anterior wall (10%). This complication is the result of the interaction of several mechanisms that are related to local or global remodeling of the left ventricle and associated left ventricle dysfunction and desynchronization. Prompt and precise evaluation can be of vital importance for successful treatment and a better prognosis. Early surgery in less remodeled ventricles, and innovation in devices and surgical techniques will lead to long-lasting successful correction with low in-hospital mortality. Therefore, new developments in echocardiography have acquired substantial significance for the evaluation of the severity of mitral insufficiency, the grade of local or global dysfunction of the left ventricle and the state of the mitral valve apparatus, rendering this method more reliable and indispensable for these patients. We reviewed the utility and role of echocardiography in the evaluation ofischemic mitral regurgitation.
Humans , Echocardiography/methods , Echocardiography , Heart Failure , Myocardial Infarction/radiotherapy , Myocardial Infarction , Mitral Valve Insufficiency/radiotherapy , Mitral Valve Insufficiency , Cardiology
En continuidad con los estudios del área de Perfiles de la Cátedra de Psicología Experimental I y II, se llevó a cabo un análisis comparativo de Perfiles de Personalidad en estudiantes de psicología. La muestra fue intencional y autoseleccionada, quedó conformada por 153 estudiantes de Psicología. Se ha utilizado un diseño Descriptivo y Comparado. El instrumento utilizado fue el Inventario Multifásico de la Personalidad Minnesota-2 (MMPI-2). Los resultados reportan que existe un patrón de personalidad con similitudes muy acentuadas en los estudiantes de la carrera de psicología, independiente del curso al que pertenecen, y en comparación a los perfiles de años anteriores (n = 152, muestra 2001: n=168, muestra 2007: y n= 101 muestra 2008).
In continuity with the studies of the area of Profiles of the Professorship of Experimental Psychology I and II, a comparative analysis of Profiles of Personality in students of psychology was carried out. The sample was intentional and autoseleccionada, remained conformed by 153 (166) students of Psychology. A Descriptive design has been utilized and Compared. The instrument utilized was the Polyphase Inventory of the Personality Minnesota-2 (MMPI-2). The results report that a boss of personality with similarities exists very accentuated in the students of the career of psychology, independent of the course to which they belong, and in comparison to the profiles of previous years (n = 152 sample 2001; n = 168, sample 2007 and n = 101 sample 2008).
It has been postulated that chronic administration of antidepressant drugs induces delayed structural and molecular adaptations at glutamatergic forebrain synapses that might underlie mood improvement. To gain further insight into these changes in the cerebral cortex, rats were treated with fluoxetine (flx) for 4 weeks. These animals showed decreased anxiety and learned helplessness. N-methyl-d-aspartate (NMDA) and alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA) receptor subunit levels (NR1, NR2A, NR2B, GluR1 and GluR2) were analysed in the forebrain by both western blot of homogenates and immunohistochemistry. Both methods demonstrated an upregulation of NR2A, GluR1 and GluR2 that was especially significant in the retrosplenial granular b cortex (RSGb). However, when analysing subunit content in postsynaptic densities and synaptic membranes, we found increases of NR2A and GluR2 but not GluR1. Instead, GluR1 was augmented in a microsomal fraction containing intracellular membranes. NR1 and GluR2 were co-immunoprecipitated from postsynaptic densities and synaptic membranes. In the immunoprecipitates, NR2A was increased while GluR1 was decreased supporting a change in receptor stoichiometry. The changes of subunit levels were associated with an upregulation of dendritic spine density and of large, mushroom-type spines. These molecular and structural adaptations might be involved in neuronal network stabilization following long-term flx treatment.
Antidepressive Agents/pharmacology , Fluoxetine/pharmacology , Gene Expression Regulation/drug effects , Glutamic Acid/physiology , Neuronal Plasticity/drug effects , Prosencephalon/drug effects , Receptors, AMPA/biosynthesis , Receptors, N-Methyl-D-Aspartate/biosynthesis , Animals , Anxiety/drug therapy , Behavior, Animal/drug effects , Dendritic Spines/drug effects , Dendritic Spines/metabolism , Helplessness, Learned , Intracellular Membranes/drug effects , Intracellular Membranes/metabolism , Male , Microsomes/drug effects , Microsomes/metabolism , Neurons/drug effects , Neurons/metabolism , Neurons/ultrastructure , Post-Synaptic Density/drug effects , Post-Synaptic Density/metabolism , Prosencephalon/metabolism , Rats , Rats, Sprague-Dawley , Receptors, AMPA/genetics , Receptors, N-Methyl-D-Aspartate/genetics , Synaptic Membranes/drug effects , Synaptic Membranes/metabolism
Spectroscopic and colorimetric analysis of a representative set of Dugès watercolor paintings was performed. These paintings were the result of scientific studies carried out by the zoologist Alfredo Dugès, who recorded the fauna of the Mexican Republic between 1853 and 1910. Micro-Raman spectroscopy, with an excitation wavelength of 830 nm, and colorimetric techniques were employed in order to understand if different colors with the same hue were reproduced using the same pigments. The color coordinates of the measured areas were obtained in the CIEL*a*b* color space. Raman analysis showed that, in some cases, to reproduce colors with the same hue the pigment employed was not the same. Pigments identified in the watercolors were vermilion, carbon-based black, lead white, gamboge and chrome yellow, Prussian and ultramarine blue. Some of these pigments have been used since ancient times, others as Prussian blue, chrome yellow and synthetic ultramarine blue arrived to the market at the beginning of the 18th and 19th centuries, respectively. Furthermore, regarding the white color, instead of left the paper unpainted, lead white was detected in the eye of a bird. The green color was obtained by mixing Prussian blue with chrome yellow. The results of this work show the suitability of using Raman spectroscopy for watercolor pigment analysis and colorimetric techniques to measure the color of small areas (246 microm x 246 microm) that was the case for the lead white pigment.
Coloring Agents/analysis , Paintings , Spectrum Analysis, Raman , Animals , Birds , Color
OBJECTIVES: We sought to evaluate the association between ischemic times, cytokines-interleukin (IL)-6, IL-1b, tumor necrosis factor-alpha, sIL-2r, IL-8, and IL-10-and alterations in gaseous exchange. MATERIALS AND METHODS: This prospective study of 42 orthotopic liver transplantation (OLT) recipients examined ischemic times and respiratory variables measured as alterations in intrapulmonary shunt and in the Po(2)/Fio(2) ratio. Centrifuged blood samples were frozen at -80 degrees C for storage. The Inmulite-One system (Euro/Dpc, Gwynedd, UK) was used to determine the concentration of cytokines. For statistical analysis, we used the Pearson correlation coefficient. RESULTS: The average cold ischemic time was 478 minutes (range, 35-929) and warm ischemic time was 69.58 minutes (range, 20-180). The warm ischemic time affected the degree of shunt at the end of the operation (P < .027) and the levels of IL-10 (P < .018) and IL-6 (P < .000). The final degree of shunting and IL-10 (P < .044) showed a correlation. The cold ischemic time affected IL-1 (P < .046) and IL-8 levels (P < .023). The reperfusion syndrome was correlated with the final levels of IL-10 (P < .064) and of IL-8 (P < .066). CONCLUSION: Warm and cold ischemic times affect the final cytokine levels and the degree of intrapulmonary shunt.
Cytokines/blood , Ischemia/immunology , Liver Transplantation/immunology , Reperfusion Injury/immunology , Humans , Inflammation/blood , Interleukin-1/blood , Interleukin-10/blood , Interleukin-6/blood , Interleukin-8/blood , Ischemia/blood , Liver Circulation/immunology , Oxygen/blood , Oxygen Consumption , Partial Pressure , Portal Vein/physiology , Reperfusion , Reperfusion Injury/blood
BACKGROUND: The present study sought to identify whether there were higher inflammatory cytokine levels in blood samples drawn from the pulmonary artery, radial artery, portal vein, or reperfused graft during each transplantation phase to determine the best site. METHODS: We examined 39 consecutive patients undergoing liver transplantation for their blood cytokine levels at various sites. Comparison of levels permitted us to select the best blood sample draw site, considering the best site to be the one showing the highest cytokine levels. RESULTS: During hepatectomy and neohepatic phases, the best site was the radial artery; during the anhepatic phase, the portal vein; and during reperfusion, the reperfused graft. CONCLUSIONS: The radial artery constituted, an optimal sample draw site, considering the best one to show the highest cytokine levels.
Blood Chemical Analysis/methods , Blood Specimen Collection/methods , Liver Transplantation , Cytokines/blood , Female , Humans , Inflammation/blood , Interleukin-1beta/blood , Interleukin-2/blood , Interleukin-6/blood , Male , Middle Aged , Monitoring, Intraoperative , Portal Vein , Pulmonary Artery , Radial Artery , Reperfusion , Tumor Necrosis Factor-alpha/blood
INTRODUCTION: The interindividual variability in cardiorespiratory function during liver transplantation (OLT) has been attributed to various factors, including polymorphisms in immunity genes known to affect the circulation levels of cytokines. AIM: To evaluate polymorphisms of genes encoding for interleukin-6 (IL6) and tumor necrosis factor (TNF) in association with cardiorespiratory function in OLT. DESIGN: Prospective observational study. PATIENTS AND METHODS: We studied 62 consecutive patients who had OLT performed in our hospital between 2004 and 2005. Polymorphisms at positions -308 and -409 of TNF gene, as well as those at -174 and -574 of IL6 gene were determined in all patients by means of PCR-RFLPs. Associations were carried out using chi-square tests and analysis of variance. A bilateral P < .05 was accepted as significant. RESULTS: No statistically significant associations were observed. CONCLUSIONS: A relationship between the polymorphisms studied and respiratory function in OLT was lacking. These results must be interpreted with caution due to the limited sample size.
Heart Function Tests , Interleukin-6/genetics , Liver Transplantation/physiology , Polymorphism, Genetic , Promoter Regions, Genetic , Respiratory Function Tests , Tumor Necrosis Factor-alpha/genetics , Analysis of Variance , Chi-Square Distribution , Humans , Length of Stay , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , Retrospective Studies , Treatment Outcome
Seven of 50 Enterobacter cloacae strains from clinical isolates produced small turbid zones of hemolysis in horse and sheep blood agar plates, and the culture supernatants were also positive for hemolytic activity. The hemolysin was partially purified from the culture supernatant of E. cloacae by ultrafiltration (PM-10 membrane) and extraction with acetone. Semipurified hemolysin was stable to heating (100 degrees C, 30 min) and was soluble in organic solvents (acetone, ethanol, and methanol). The toxin showed no loss of biological activity after treatment with trypsin and was stable to acid treatment at pH 2.0 but not at a pH greater than 7.0. In the rat intestinal loop assay, the hemolysin caused hemorrhagic fluid accumulation and severe histological alterations. These findings indicate that this hemolysin may be a putative virulence factor in E. cloacae infections.
Enterobacter cloacae/pathogenicity , Hemolysin Proteins , Intestines/drug effects , Agar , Animals , Enterobacter cloacae/metabolism , Hemolysin Proteins/biosynthesis , Hemolysin Proteins/chemistry , Hemolysin Proteins/isolation & purification , Hemolysin Proteins/toxicity , Hemolysis , Horses , Humans , Molecular Weight , Rats , Sheep , Virulence
AIMS: Potential virulence factors produced by culture filtrates of Plesiomonas shigelloides isolated from water were investigated. METHODS AND RESULTS: Culture filtrates of P. shigelloides strains were assayed for cytotoxic activity in CHO (Chinese hamster ovary), Vero (African green monkey kidney), HeLa (human cervix), HT29 (human epithelial intestinal) and SK6 (swine epithelial kidney) cells. Microscopic analyses revealed intensive cytoplasmic vacuolation including cell rounding and swelling, with gradual destruction of the monolayer in filtrate-treated cells. Neutral red assays showed that CHO, HeLa and Vero cells were the most sensitive to the vacuolating activity, which was evident within 30 min of culture filtrate exposure. This activity was inactived by heating at 56 degrees C for 15 min and partially neutralized by antiserum to the cytotoxin of Aeromonas hydrophila. All P. shigelloides strains had a cell-associated haemolysin in the agar plate assay. Three isolates were found to produce a cell-free haemolytic activity at 37 degrees C. In the suckling mouse test, two P. shigelloides culture supernatants were positive for enterotoxic activity. CONCLUSIONS: P. shigelloides culture filtrates isolated from aquatic environment cause intracellular vacuolation on mammalian cells, and produce haemolytic and enterotoxic activities. SIGNIFICANCE AND IMPACT OF THE STUDY: This work revealed the presence of putative virulence factors that could be associated with human infections involving Plesiomonas strains.
Plesiomonas/pathogenicity , Water Microbiology , Animals , Cell Line , Cell Survival/drug effects , Culture Media, Conditioned/toxicity , Cytotoxins/biosynthesis , Cytotoxins/toxicity , Hemolysin Proteins/biosynthesis , Hemolysis , Humans , Vacuoles/drug effects , Virulence
The cytotoxic enterotoxin produced by Aeromonas hydrophila is considered to be the main virulence factor in gastrointestinal infections mediated by this pathogen. In this study, we examined the morphological and apoptotic effects of this toxin on HT29 cells, using light and electron microscopy in situ, as well as agarose gel electrophoresis of cell DNA. Cells treated with the cytotoxic enterotoxin became round and lost their polarity as well as their adhesion to each other and to the substrate. Cytoplasmic blebbing and nuclear condensation also occurred. DNA fragmentation was detected by TUNEL labelling and agarose gel electrophoresis. These results show that the cytotoxic enterotoxin of A. hydrophila can induce apoptosis in human intestinal cells in culture.
Aeromonas hydrophila/pathogenicity , Apoptosis/drug effects , Bacterial Proteins , Enterotoxins/toxicity , Intestinal Mucosa/microbiology , Aeromonas hydrophila/metabolism , Dose-Response Relationship, Drug , HT29 Cells , Humans , In Situ Nick-End Labeling , Intestinal Mucosa/pathology , Intestinal Mucosa/ultrastructure , Microscopy, Electron
OBJECTIVES/HYPOTHESIS: Laryngeal pseudosulcus is an accurate prognostic indicator of laryngopharyngeal reflux (LPR) disease. STUDY DESIGN: Prospective study of 20 consecutive patients with laryngeal pseudosulcus. Pseudosulcus is infraglottic laryngeal edema that is thought to be secondary to LPR. All patients were evaluated with dual-channel pH probe 24-hour monitoring to evaluate for the presence of laryngopharyngeal reflux. METHODS: Twenty patients identified with laryngeal pseudosulcus on routine physical examination were included in the study. Each patient underwent a 24-hour dual-channel pH probe. The data were analyzed and compared with previously published normative data. The data included the total number of reflux episodes and the percentage of time the pH dropped below 4 at the proximal probe. RESULTS: Eighteen of the 20 patients with laryngeal pseudosulcus were found to have LPR. The mean number of reflux episodes at the proximal probe was 29.4 (range, 3-82). The mean percentage of time the pH dropped below 4 was 1.15%. In the upright position the mean value was 1.59% and in the supine position it was 0.19%. This gives pseudosulcus a positive predictive value for LPR of 90%. CONCLUSION: This study shows laryngeal pseudosulcus to be an accurate predictor of laryngopharyngeal reflux disease.
Esophagitis, Peptic/diagnosis , Laryngeal Edema/diagnosis , Laryngitis/diagnosis , Pharyngitis/diagnosis , Adult , Aged , Diagnosis, Differential , Female , Gastric Acidity Determination , Humans , Laryngoscopy , Male , Middle Aged , Monitoring, Ambulatory , Prognosis
Anopheles mosquitoes captured in Andoas, Peru, a Plasmodium vivax-endemic area in the Peruvian Amazon region, contained both VK210 and VK247 P. vivax circumsporozoite (CS) proteins. Approximately 0.9% of the 4,403 mosquitoes tested by enzyme-linked immunosorbent assay were positive; 28% and 72% of the positive mosquitoes contained VK210 and VK247 CS proteins, respectively. These findings correlate strongly with a recent report of the presence of antibodies in residents of this area that recognize the VK210 and VK247 repeats, clearly indicating that both P. vivax CS protein polymorphs are common in the region.
Anopheles/parasitology , Plasmodium vivax/chemistry , Protozoan Proteins/analysis , Animals , Peru , Plasmodium vivax/isolation & purification
A mosquito capture program was initiated to study mosquito species and their potential for arboviral transmission in the Peruvian Amazon. More than 35,000 mosquitoes of 13 different genera and at least 25 species were captured in urban and sylvan sites in the Iquitos area. These findings represent the first published list of Peruvian mosquitoes since 1971 and the first such list from the Peruvian Amazon.
Culicidae/classification , Insect Vectors/classification , Animals , Arbovirus Infections/transmission , Peru
