Interleukin-1 gene polymorphisms and periodontal status in a Spanish population.

The aim of this study was to investigate the possible association between interleukin (IL)-1A (+4845) and/or IL-1B (+3954) gene polymorphisms and the onset and progression of chronic periodontal disease (PD), an issue that remains controversial. The relationship between IL-1ß concentration in the gingival crevicular fluid (GCF) and disease activity was also evaluated. The study was performed on 25 individuals with no gingivitis or PD and on 25 subjects with active chronic PD. Two samples of GCF were obtained from each subject and IL-1ß was determined by enzyme-linked immunoabsorbent assay. Blood samples (10 ml) were drawn from each subject to detect polymorphisms in IL-1A (+4845) and IL-1B (+3954) by polymerase chain reaction. Mean GCF IL-1ß concentrations were higher in patients with active chronic PD compared to the control group. No significant association was found in either group between GCF IL-1ß concentration and the presence of polymorphisms in IL-1A (+4845), IL-1B (+3954) or both genotypes. No significant difference was found in either group with regard to the presence of polymorphisms in IL-1A (+4845), IL-1B (+3954) or both genotypes (p=0.556). The concentration of IL-1ß in GCF was almost 2-fold higher in patients with chronic PD than in the healthy individuals. The presence of polymorphisms in IL-1A (+4845) and/or IL-1B (+3954) genotypes is not associated with IL-1ß overproduction in GCF and is not a risk factor for chronic PD. IL-1ß is considered a suitable marker of the severity and progression of chronic PD. The presence of IL-1A (+4845) and/or IL-1B +3954 gene polymorphisms does not appear to be a risk factor for chronic PD. Therefore, the IL-1A (+4845) and/or IL-1B +3954 gene polymorphisms cannot be considered genetic markers of chronic PD. Moreover, these polymorphisms do not indicate an overproduction of IL-1ß in GCF.

Prevalencia de diabetes mellitus en un servicio de medicina interna: causas de hospitalización y factores asociados a morbimortalidad / Prevalence of diabetes mellitus among patients admitted to a medical service of a general hospital

Background: Hyperglycemia among hospitalized patients is a common finding as is associated with a worse prognosis in patients with an without a history of diabetes. An optimal control of blood glucose reduces complications in these patients. Although the national prevalence of diabetes in Chile is well know, data on its prevalence among hospitalized patients is scanty. Aim: To assess the prevalence of diabetes and its association with hospital evolution among patients admitted to a medical service of a public hospital. Patients and Methods: In a prospective study from august to october of 2006 period, the cause of admission and the presence of diabetes mellitus was registered for every patient admitted to the medicine service. Among diabetics, the type of diabetes and the length of disease was recorded. Patients were followed during hospital stay, registering length of hospitalization, complications and mortality. Results: A total of 367 patients were studied and 92 (26 percent) were diabetics. Among the latter, 96 percent had type 2 diabetes and the main causes of admission were cardiovascular diseases in 38 (40 percent), infections in 18 (19 percent) and acute complications of diabetes in 13 (13 percent). Hospital mortality among diabetic and non diabetic patients was 6 and 4 percent, respectively (p = NS). Complications during hospital stay among diabetic and non diabetic patients, occurred in 15 and 9 percent, respectively (p = 0.064). The length of hospital stay was 8.8 and 9.2 days in diabetic and non diabetic patients, respectively (p = NS). Those patients with a diabetes lasting for more than 10 years had a higher rate of complications. Conclusions: The prevalence diabetes mellitus among hospitalized diabetic patients is higher than registered in national statistics. Patients with a diabetes lasting more than 10 years have more complications during hospital stay.

[Anesthetic management during removal of a giant intrathoracic mass]. / Manejo anestésico en la exéresis de un tumor intratorácico gigante.

We report the case of a young woman with a giant intrathoracic angiomyolipoma accounting for 10% of her weight and occupying 75% of the right hemithorax and 30% of the left. Before anesthetic induction, an arterial line and a central venous catheter were applied for monitoring; neck and thoracic punctures were avoided. The trachea was intubated with a double lumen tube after provision of sedation and analgesia with remifentanil-midazolam and topical anesthesia of the larynx. A rigid bronchoscope and extracorporeal circulation were available at all times and muscle relaxants were avoided. Ventilation was maintained with pressure support until the mass effect was resolved. The patient was transferred to the intensive care unit, extubated after 24 hours, and discharged 5 days after surgery. We describe the recommendations for perioperative management in cases involving this type of tumor and the complications that can develop. Recent symptoms, diagnostic images, and the results of lung function tests provide information for guiding the anesthetic approach. The obstructive ventilatory compromise caused by a giant mass depends more on location than size. Extracorporeal circulation or rigid bronchoscopy might be needed at any time during surgery.

Manejo anestésico en la exéresis de un tumor intratorácico gigante / Anesthetic management during removal of a giant intrathoracic mass

Se describe el caso de una mujer joven con un angiomiolipomagigante intratorácico correspondiente al 10%de su peso, que ocupaba 75% del hemitórax derecho y30% del izquierdo. Previo a la inducción anestésica semonitorizó a la paciente de forma invasiva, evitando losaccesos centrales en cuello o tórax. La intubación se realizócon tubo de doble luz izquierdo, previa sedaciónanalgesiacon remifentanilo-midazolam y anestesia tópicasobre las estructuras laríngeas. Se mantuvodisponibilidad permanente de broncoscopio rígido y circulaciónextracorpórea y se evitó el uso de relajantesmusculares manteniendo la ventilación con soporte depresión hasta que el efecto de masa fue resuelto. Lapaciente fue trasladada a UCI, extubada a las 24 horas ydada de alta a los 5 días del postoperatorio. Se describenlas recomendaciones perioperatorias en este tipo detumores y los posibles tipos de complicaciones.Al enfrentarnos a este tipo de pacientes, la sintomatologíareciente y la evaluación mediante imágenes y pruebasfuncionales nos guiarán en el enfoque anestésico. Elcompromiso obstructivo generado por estas masasgigantes depende principalmente de su localización másque de su tamaño. Cualquier momento del intraoperatoriopuede requerir la necesidad de circulación extracorpóreao broncoscopia rígida

We report the case of a young woman with a giantintrathoracic angiomyolipoma accounting for 10% of herweight and occupying 75% of the right hemithorax and30% of the left. Before anesthetic induction, an arterialline and a central venous catheter were applied for monitoring;neck and thoracic punctures were avoided. Thetrachea was intubated with a double lumen tube afterprovision of sedation and analgesia with remifentanilmidazolamand topical anesthesia of the larynx. A rigidbronchoscope and extracorporeal circulation were availableat all times and muscle relaxants were avoided. Ventilationwas maintained with pressure support until themass effect was resolved. The patient was transferred tothe intensive care unit, extubated after 24 hours, and discharged5 days after surgery. We describe the recommendationsfor perioperative management in cases involvingthis type of tumor and the complications that can develop.Recent symptoms, diagnostic images, and the resultsof lung function tests provide information for guiding theanesthetic approach. The obstructive ventilatory compromisecaused by a giant mass depends more on locationthan size. Extracorporeal circulation or rigid bronchoscopymight be needed at any time during surgery

Modulation of renal kallikrein by a high potassium diet in rats with intense proteinuria.

Injury of the renal tubulointerstitial compartment is recognized to play an important role in hypertension. Its damage may in turn, impair the activity of vasodepressor systems, like the kallikrein-kinin, in blood pressure regulation. The overload proteinuria model induces tubulointerstitial injury with activation of the renin-angiotensin system, but renal kallikrein and the development of hypertension have not received special attention. Sprague-Dawley rats received seven intraperitoneal doses of bovine serum albumin (BSA) 2 g/day under normosodic diet and were hydrated ad libitum. A second group received a high potassium diet to stimulate kallikrein production during the previous four weeks and while under BSA administration. A third one received potassium and BSA in the same schedule, but with the kinin B2 receptor antagonist, HOE140, added during the protein load phase. A control group received seven saline injections. Kallikrein protein was detected by immune labeling on renal sections and enzymatic activity in the urine. The BSA group showed massive proteinuria followed by intense tubulointerstitial damage. Blood pressure increased after the third dose in BSA animals, remaining elevated throughout the experiment, associated with significant reductions in renal expression and urinary activity of kallikrein, compared with controls. An inverse correlation was found between blood pressure and immunohistochemistry and urinary activity of kallikrein. Potassium induced a significant increase in both urinary activity and renal kallikrein expression, associated with significant reduction in blood pressure. The HOE140 antagonist blunted the antihypertensive effect of kallikrein stimulation in proteinuric rats. Loss of renal kallikrein, produced by tubulointerstitial injury, may participate in the pathogenesis of the hypertension observed in this model.

El polimorfismo de la IL-1 y su eventual asociación con la enfermedad periodontal crónica. Una revisión de la literatura (II) / The association between the IL-1 polymorphism and chronic periodontal disease. A literature review (II)

El propósito de esta revisión es describir el papel que desempeña el polimorfismo de los genes de la IL-1 en la aparición y evolución de la enfermedad periodontal. A lo largo de ella, se observa una falta de homogeneidad en los resultados obtenidos por los diferentes autores. Incluso los estudios más recientes tienden a desestimar la relación que pudiera existir entre la presencia de polimorfismos en los genes de la IL-1 y la enfermedad periodontal. De igual manera, la presencia de estos polimorfismos parece no influir en el fracaso implantario ni en las técnicas de regeneración tisular guiada (AU)

The aim of this bibliographic review is describing the role of the polymorphism in IL-1 genes in the appearance and evolution of the periodontal disease. Through the review, it’s observed a lack of homogeneity in the results obtained by different authors. Despite of this, more recent articles tend to have a low opinion of the relationship that could exist between the presence of polymorphism in IL-1 genes and periodontal disease. In the same way, the presence of theses polymorphisms seems not to influence in the implant failure nor in the guided tissue regeneration techniques (AU)

Desafiando la realidad laboral: programa de capacitación laboral para personas con discapacidad intelectual / Labor program for the congnitive disabled: defying laboral reality

Este artículo se propone presentar el Programa de Capacitación Laboral para Personas con Discapacidad Intelectual que se lleva a efecto en la Escuela Gabriela Mistral. Su objetivo es favorecer la integración sociolaboral de los alumnos en la comunidad. Se intenta demostrar que, aunque los recursos sean escasos, un equipo de trabajo interdisciplinario logra establecer redes que acojan a este sector de la sociedad y le permitan acceder al mundo laboral en buenas condiciones.

This paper presents a Labor Program for the Intelectual Disability that is taking place at the Escuela Gabriela Mistral. Its goal is to favor the sociolaboral integration of its students inside the community. It tries to demonstrate that, even with low resources, an interdisciplinary working group may establish nets that will accept this people, thus allowing them to join the labor world in good conditions.

La IL-1 y su eventual asociación con la enfermedad periodontal crónica. Una revisión de la literatura (I) / The association between IL-1 and chronic periodontal disease. A literature review (I)

El propósito de esta revisión bibliográfica es describir las acciones que protagonizan las interleuquinas, con especial interés la IL-1 en el desarrollo de la enfermedad periodontal crónica, así como su presencia en el fluido gingival crevicular (FGC). La mayoría de los estudios revisados muestran una fuerte asociación entre los niveles aumentados de esta citoquina y el estado periodontal del paciente. La IL-1 puede ser un excelente marcador para detectar la severidad y progresión de la enfermedad periodontal crónica (AU)

The aim of this bibliographic review is describing the actions played by the interleukins, especially IL-1 in development of chronic periodontal disease and it’s presence in gingival crevicular fluid (GCF). Most of the reviewed articles show a strong relationship between high levels of these cytokines and the periodontal status of the patient. Thus, IL-1 becomes in an excellent marker for detecting the severity and progression of chronic periodontal disease (AU)

Tratamiento de la incontinencia con el cabestrillo sin tensión en forma económica / Treatment of the incontinence with the tension sling in economic form

La incontinencia de esfuerzo tiene una alta prevalencia en las mujeres y puede condicionar problemas sociales. Una amplia variedad de técnicas se han usado, pero en la actualidad los expertos han determinado que el procedimiento con mejores resultados a largo plazo son los sling. Los cuales se han realizado con materiales como la fascia aponeurótica autologa, pero con cierta morbilidad de las zonas dadoras. En los últimos años los materiales sintéticos y de ellos el polipropilene como cintas sin tensión (TVT) han demostrado durabilidad, menos morbilidad. pero su inconveniente ha sido que los set comercialmente disponibles tienen un costo de aproximadamente 800 dólares por paciente. Nosotros presentamos nuestra experiencia en 42 pacientes con incontinencia de esfuerzo, en el servicio de urología del Hospital Nacional Guillermo Almenara Irigoyen, con el uso de estas mallas de polipropilene auto fabricadas con un costo promedio de 20 dólares por paciente, desde enero del 2000 a enero del 2002. Describimos nuestra técnica, así como el modo de fabricación de las cintas para el cabestrillo o sling, demostrando su fácil reproducibilidad en cualquier centro de EsSALUD. Todas nuestras pacientes tuvieron estudios urodinámicos, valoración de cistoceles asociados, cistoscopía y en los casos de inestabilidad patrón miccional diario. El tiempo promedio de cirugía fue de 38 minutos, el seguimiento promedio fue de 16 meses y el resultado exitoso en 41 pacientes (97.3 por ciento). La técnica de cabestrillo sin tensión a bajo costo para la realidad de nuestro país es factible, eficaz, reproducible y significará un ahorro para la institución sin disminuir la calidad de atención a nuestras pacientes.

Influencia del alojamiento conjunto en la lactancia humana en madres cesareadas. Estudio randomizado. Hospital Regional del Cusco. 1994 / Influence of the joint precocious housing in the human lactation in mothers cesareans. I study randomizado. Regional hospital of the Cusco. 1994

Los partos por cesárea representan al 9 por ciento del total de partos. Las madres cesareadas tienen dificultades en el inicio y establecimiento de la lactancia por prácticas hospitalarias inadecuadas. Es un estudio comparativo en el primer grupo el alojamiento conjunto y amamantamiento, se inician dentro de las tres horas posparto y en el grupo control a las 12 horas del mismo. Se hace seguimiento por cuatro días midiendo la frecuencia de tetadas y al cuarto día se mide el volúmen de secreción láctea por el método de la doble pesada. El grupo en alojamiento conjunto precoz tuvo mayor frecuencia de tetadas al día (11,3 vs. 7,3) en los 4 días de seguimiento y mayor volúmen de secreción láctea al cuarto día (230 ml vs. 158ml). El alojamiento conjunto precoz en cesareadas es posible y es aceptado por las madres, induce mayor frecuencia de tetadas y mayor volúmen de secreción láctea lo cual facilita el establecimiento de la lactancia humana.

Incidence and studies on antigenic specificities of antineutrophil-cytoplasmic autoantibodies (ANCA) in poststreptococcal glomerulonephritis.

Sera from 210 patients with Acute Poststreptococcal Glomerulonephritis (APSGN) and 14 patients with streptococcal impetigo without glomerular disease were tested for the presence of IgG-ANCA using an indirect immunofluorescence assay (IIF) on ethanol fixed normal human neutrophils. In the group of nephritic patients, ANCA were detected by IIF in 9% (18 out of 210 cases) in an atypical diffuse cytoplasmic pattern (a-ANCA) in 14 cases and in a (p-ANCA) perinuclear staining in the remaining 4 cases. Longitudinal studies performed on six IIF positive patients, showed persistence of the phenomenon for up to six months, without relationship with activity of disease. No patient with streptococcal impetigo showed positivity on the IIF assay. Positive sera were analyzed on ELISA plates for their IgG reactivity against specific purified ANCA antigens: Proteinase-3 (PR3), Myeloperoxidase (MPO). Cathepsin-G and Bactericidal/Permeability Increasing Protein (BPI). Anti-MPO antibodies were present in 4 cases (3 a-ANCA and 1 p-ANCA). No reactivity was identified against PR-3, BPI and Catepsin-G in any of the samples. The presence of ANCA was significantly associated with a more severe glomerular disease as assessed by the serum creatinine and the crescents formation. Further studies are required to identify other antigenic specificities of these autoantibodies. Their absence in the streptococcal impetigo control group might suggest that their presence in APSGN could play some pathogenic role in kidney disease.

[Antineutrophil cytoplasmic antibodies and nonspecific ulcerative colitis]. / Anticuerpos anticitoplasma de neutrófilos y colitis ulcerosa inespecífica.

We studied the presence of antineutrophil cytoplasmic antibodies in 16 patients with idiopathic ulcerative colitis, using an indirect immunofluorescence technique and specific ELISA for myeloperoxidase and proteinase 3. Twelve patients had an active disease and in ten, antineutrophil cytoplasmic antibodies were positive, with a predominantly perinuclear distribution and without specificity for myeliperoxidase or proteinase 3. These antibodies were negative in the four patients with inactive disease. It is concluded that antineutrophil cytoplasmic antibodies could be serologic indicators of disease activity in patients with ulcerative colitis.

[Rapidly progressive glomerulonephritis without immune deposits: detection of neutrophil anticytoplasmic antibodies]. / Glomerulonefritis rápidamente progresiva sin depósitos inmunes: detección de anticuerpos anticitoplasma de neutrófilos.

Antineutrophil cytoplasmic autoantibodies (ANCA), are serologic markers of disease in rapidly progressive glomerulonephritis without immune deposits (pauci-immune) and vasculitis, and could play a pathogenic role in these diseases. We communicate 5 patients with pauci-immune rapidly progressive glomerulonephritis; four of them in the evolution of necrotizing systemic vasculitis (Wegener's granulomatosis and microscopic polyarteritis) and one case with lesions limited to the kidney. All of them were associated with the presence of ANCA. The immunofluorescence pattern (cytoplasmic and perinuclear) and the antigenic specificity of ELISA assay, [antiproteinase-3 (PR-3) and antimyeloperoxidase (MOP)], are useful laboratory tools for the diagnosis and clinical management of these patients.

Antineutrophil-cytoplasmic-autoantibodies in poststreptococcal nephritis.

Sera from 210 patients with APSGN, were tested for the presence of ANCA (IgG-isotype). Indirect immunofluorescence (IF) on ethanol fixed human PMNs was used, and for those positive sera, ELISA kits for PR3 (Proteinase 3) and MPO (Myeloperoxidase) was performed. ANCA were detected in 9% (18 out of 210 cases) in a predominantly diffuse cytoplasmic staining pattern in 14 cases (77%), and in a perinuclear pattern in the remaining 4 cases (22%). Anti-MPO was found in 4 cases (C-ANCA 3; P-ANCA 1) and anti-PR3 was always negative. The presence of ANCA was significantly associated with a more severe glomerular disease as assessed by the serum creatinine value and the crescents formation. Longitudinal studies performed in 11 cases have shown that raised levels of these autoantibodies may persist for at least six months, without relationship with disease activity. Further studies are required to dilucidate the specificity of these autoantibodies, and if its presence is either an epiphenomenon of the heterogeneous humoral immune response in streptococcal infection, or they play some pathogenic role in APSGN.

[Peptic pharyngitis]. / Faringitis péptica.

The AA. suggest the diagnosis of peptic Pharyngitis for those patients with normal ENT exploration but enduring sore throat associated to acidopeptic disorders.

Laser-induced autofluorescence of human arteries.

A new technique for imaging the intimal surface of arteries through optic fibers has been devised. With the aid of an optical multichannel analyzer, we recorded in real time fluorescence spectra during excitation of the arterial surface with an argon ion laser. Spectral parameters were used to detect atherosclerotic plaques and to discriminate normal tissue from lipid rich and calcified atheromas. By digitizing relative intensity values and the ratios of the peak at 550 nm to that at 520 nm into a gray scale, we generated pseudocolor maps of the arterial wall of 10 human aortas. Specific color distributions were congruent with the distribution of calcified tissue visualized by soft x-ray radiography and the distribution of lipid delineated by staining with Sudan IV. Thus, bidimensional maps obtained by laser spectroscopy can be used to identify the presence and composition of atherosclerotic lesions. Fluorescence imaging may prove to be an important application of laser techniques for the diagnosis and treatment of atherosclerosis.

Adenovirus isolates from urine of patients with acquired immunodeficiency syndrome.

13 adenoviruses (Ad) from the urine of 10 patients with acquired immunodeficiency syndrome (AIDS) were characterised by haemagglutination inhibition and restriction endonuclease analysis of their DNA. The haemagglutinin (HA) for 6 of these isolates was found to be that of Ad34/35. 3 other isolates were found to have Ad7 HA and the remaining 4 viruses were found to have both phenotypes. In contrast, the restriction patterns were more homogeneous than anticipated from the serological analysis. 11 isolates had a SmaI-restriction pattern identical to Ad35, and 2 isolates, which lacked one of the 9 Ad35 SmaI-restriction sites, were identical to Ad34. Analyses with other restriction enzymes reinforced the conclusion that the genomes of all isolates resemble that of Ad35 (and Ad34) more than they resembled the previously isolated Ad7 subtypes. The discrepancy between the restriction endonuclease and the serological analyses is best explained by assuming that some of these new isolates are recombinants between a small part (less than 10%) of the Ad7 genome coding for HA and greater than 90% of the Ad35 genome. It is therefore important to characterise both the genotype and the HA for this potentially important group of pathogens in AIDS patients.