Prevalence, characteristics, and outcome of asthmatic patients with type 2 diseases in hospitalized patients with COVID-19 in Madrid, Spain

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Intoxicación por litio y proteinuria en rango nefrótico / No disponible

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Aislamiento, caracterización bioquímica y sensibilidad de cepas de Campylobacter sp. en diarreas agudas en el Paraguay / Isolation, biochemical characterization and sensitivity of stocks of Campylobacter sp. in acute diarrhoeas in Paraguay

Estudio de aislamiento y caracterización de Campylobacter como agente etiológico de diarreas agudas de 331 muestras de heces diarreicas obtenidas de pacientes ambulatorios e internados que fueron analizadas en el Laboratorio Central de Salud Pública en el periodo diciembre 2006 al mes de agosto de 2007

Tratamiento endovascular de estenosis venosas del acceso vascular para hemodiálisis / Endovascular treatment of venous stenoses in vascular accesses for haemodialysis

Objetivo. Evaluar los resultados obtenidos en la terapéutica endovascular de estenosis venosas del miembro del acceso vascular para hemodiálisis. Pacientes y métodos. Entre noviembre de 2001 y noviembre de 2005 se han realizado 13 procedimientos endovasculares en 11 pacientes, 46% hombres y 54% mujeres, con una edad media de 51,38 años. Las indicaciones fueron trombosis previa (38,5%), disfunción (23,1%) y primoimplante (38,5%), con clínica de edema del miembro en dos pacientes. La fístula problemática más frecuente fue humerocefálica (53,8%), y el sector tratado predominante, la vena subclavia (53,8%), seguido de la ilíaca (3) el tronco innominado (1), la humeral (1) y sólo una vena superficial (cefálica). Resultados. El éxito técnico fue del 92,3%, y el éxito funcional, del 76,9%, con una ganancia media de flujo de 112,5 mL/min en global (48,5 mL/min excluyendo primoimplantes) y un flujo medio postratamiento de 220 mL/min. Se colocó un stent en el 90,9% de las lesiones del sistema venoso central de 10 mm de diámetro medio (rango: 8-12 mm). A fecha de corte permanecen permeables el 25% de las fístulas arteriovenosas (485 días de supervivencia media postratamiento) y el 66,7% de los procedimientos endovasculares (tres fueron exitus estando permeables), con 877 días de permeabilidad media. Conclusiones. Tal como recomienda la bibliografía consultada, el tratamiento endovascular de las lesiones venosas es eficaz para aumentar la supervivencia de los accesos vasculares para hemodiálisis con una indicación adecuada. El uso de endoprótesis está indicado en grandes troncos venosos centrales, con una permeabilidad superior respecto a la angioplastia transluminal percutánea

Aim. To evaluate the results obtained in endovascular therapy of venous stenoses of the limb used for vascular access in dialysis. Patients and methods. Between November 2001 and November 2005, a total of 13 endovascular procedures were performed in 11 patients, 46% males and 54% females, with a mean age of 51.38 years. Indications were previous thrombosis (38.5%), dysfunction (23.1%) and first implant (38.5%), and two of the patients had a clinical picture of oedema in the limb. The most frequent problematic fistula was brachicephalic (53.8%) and the predominant sector treated was the subclavian vein (53.8%), followed by the iliac (3), the innominate artery (1), brachial (1) and only one superficial vein (cephalic). Results. Technical success rate was 92.3% and functional success was 76.9%, with a mean flow gain of 112.5 mL/min overall (48.5 mL/min excluding first implants) and a mean post-treatment flow of 220 mL/min. In 90.9% of the lesions in the central venous system a stent with a mean diameter of 10 mm was placed (range: 8-12 mm). At the cutoff date, 25% of the arteriovenous fistulas remained patent (average of 485 days’ survival after treatment) and 66.7% of the endovascular procedures (three died while being patent), with 877 days of average patency. Conclusions. As recommended in the literature that was consulted, the endovascular treatment of venous lesions is effective in increasing survival of vascular accesses for haemodialysis with an appropriate indication. The use of stents is indicated in large central venous trunks, with a patency that is higher than that of percutaneous transluminal angioplasty

Genotoxic and cytotoxic studies of beta-sitosterol and pteropodine in mouse.

Beta-sitosterol (BS) and pteropodine (PT) are constituents of various plants with pharmacological activities potentially useful to man. The chemicals themselves possess biomedical properties related to the modulation of the immune and the nervous systems, as well as to the inflammatory process. Therefore, safety evaluation of the compounds is necessary in regard to their probable beneficial use in human health. The present study evaluates their genotoxic and cytotoxic potential by determining the capacity of the compounds to induce sister chromatid exchanges (SCE), or to alter cellular proliferation kinetics (CPK) and the mitotic index (MI) in mouse bone marrow cells. Besides, it also determines their capacity to increase the rate of micronucleated polychromatic erythrocytes (MNPE) in peripheral mouse blood, and the relationship polychromatic erythrocytes/normochromatic erythrocytes (PE/NE) as an index of cytotoxicity. For the first assay, four doses of each compound were tested: 200, 400, 600, and 1000 mg/kg in case of BS, and 100, 200, 300, and 600 mg/kg for PT. The results in regard to both agents showed no SCE increase induced by any of the tested doses, as well as no alteration in the CPK, or in the MI. With respect to the second assay, the results obtained with the two agents were also negative for both the MNPE and the PE/NE index along the daily evaluation made for four days. In the present study, the highest tested dose corresponded to 80% of the LD(50) obtained for BS and to 78% in the case of PT. The results obtained establish that the studied agents have neither genotoxic nor cytotoxic effect on the model used, and therefore they encourage studies on their pharmacological properties.

In vitro genotoxic evaluation of three alpha-asarone analogues.

alpha-Asarone has shown a significant capacity to reduce the level of lipids, including cholesterol. However, several toxic and genotoxic studies have determined that its use may pose a risk to human health. Therefore, a series of compounds structurally analogous to alpha-asarone were prepared in order to maintain the same pharmacological properties but with low toxicity. In this study we evaluated the potential of three alpha-asarone analogues to induce mutagenicity using the Ames test (strains TA98 and TA100 in the presence of metabolic activation), as well as the induction of sister chromatid exchanges (SCE) in cultured human lymphocytes. The tested compounds were: 1-(2,4,5-trimethoxyphenyl)propan-1-one (D1), 1-(2-chloro-4,5-dimethoxyphenyl)propan-1-one (D2), and 1-(4,5-dimethoxy-2-nitrophenyl)propan-1-ol (D3). The results in the first assay showed no mutagenic effect for the three tested analogues; in the TA100 strain, certain cytotoxicity did appear in the case of D2 and D3 only at high concentrations. In regard to the SCE assay, compounds D1 and D2 presented no statistical differences in comparison with the control culture values; however, the high dose of D3 (300 microg/ml) produced a significant increment in SCE (68% above the control value). With respect to the mitotic index and the cellular proliferation kinetics, we observed a reduction when compounds D2 and D3 were used at the higher concentrations. Our results encourage further preclinical studies of these compounds in both in vitro and in vivo models (particularly for analogues D1 and D2), to determine their toxicological profile and establish the possibility of using them in humans.

Neutral endopeptidase and angiotensin I converting enzyme insertion/deletion gene polymorphism in humans.

Neutral endopeptidase (NEP) hydrolyses angiotensins (Ang) I and II and generates angiotensin-(1-7) [Ang-(1-7)]. In humans, the insertion/deletion (I/D) angiotensin-I converting enzyme (ACE) gene polymorphism determined plasma ACE levels by 40%. In rats, a similar polymorphism determines ACE levels which are inversely associated to NEP activity. The objective of this study is to evaluate the relationship between ACE expression and plasma NEP activity in normotensive subjects and in hypertensive patients. In total, 58 consecutive patients with hypertension, evaluated in our Hypertension Clinic, were compared according to their ACE I/D genotypes with 54 control subjects in terms of both plasma ACE activity and NEP activities. Plasma ACE activity was elevated 51 and 70% in both DD ACE groups (normotensives and hypertensives) compared with their respective ID and II ACE groups (P<0.001). A significant effect of the ACE polymorphism and of the hypertensive status on ACE activity was observed (P<0.001). In normotensive DD ACE subjects, NEP activity was 0.30+/-0.02 U/ml, whereas in the normotensive II ACE and in the normotensive ID ACE subjects NEP activity was increased 65 and 48%, respectively (P<0.001). In the hypertensive DD ACE patients, NEP activity was 0.47+/-0.03 U/mg. An effect of the I/D ACE genotypes on NEP activity (P<0.04) and an interaction effect between the I/D ACE genotype and the hypertensive status were also observed (P<0.001). These results are consistent with a normal and inverse relationship between the ACE polymorphism and NEP activity in normotensive humans (as is also observed in rats). This normal relationship is not observed in hypertensive patients.

Inhibitory effect of chlorophyllin on the frequency of micronuclei induced by sodium nitrite in mice.

In this report the potency of chlorophyllin (CHL) was evaluated to prevent two types of damage produced by nitrite in mice: the increase of micronucleated polychromatic erythrocytes (MNPE) and the bone marrow toxicity, measured as the index of polychromatic erythrocytes/normochromatic erythrocytes (PE/NE). The study was done in eight groups of male mice. The first three groups were administered orally for 4 days with sodium nitrite (10, 15 and 20 mg/kg), the daily administration with nitrite was followed by an intraperitoneal administration of CHL (4 mg/kg), three more groups were administered with the same amounts of nitrite, a seventh group of mice was treated with distilled water while another was treated with CHL (4 mg/kg). Our study produced two main results: (a) no bone marrow injury was induced by any of the tested chemicals, as indicated with the PE/NE index, and (b) CHL protected (as high as 44%) the MNPE produced in nitrite treated mice.

Effects of chlorophyllin on acetaldehyde: lack of modulation of the rate of sister-chromatid exchanges in mouse bone marrow, and of complex formation in aqueous solution.

Acetaldehyde (Ace) is a reactive compound widely found in natural and industrialized products. On the other hand, chlorophyllin (Chl) is a chloropyll derivative which has shown DNA modulatory effects in several models. The first aim of the present study was to determine the capacity of Ace to increase the rate of sister-chromatid exchanges (SCEs) in mouse bone marrow cells in vivo, as well as to determine its capacity to modify the mitotic index (MI) and the average generation time (AGT). For this experiment we tested four dosages of Ace by the i.p. route (0.4, 4.0, 40.0 and 400 mg/kg), and found a genotoxic effect with the two highest dosages (more than double the basal level was observed with 400 mg/kg). We also found that none of the doses tested modified the MI or the AGT. A second objective was to explore the potential of Chl to modulate the genotoxicity of Ace in the same model. We evaluated whether an oral administration of Chl (2.0, 6.0 and 10.0 mg/kg), given 1 h before an i.p. administration of Ace (100 mg/kg), could modulate the SCEs produced by the mutagen. The result showed a similar SCE rate in both, the Ace-treated mice and those administered with the two chemicals, indicating that Chl was not a modulatory chemical on the genotoxicity of Ace. No modifications were observed concerning the MI or the AGT either. A third objective was to determine whether the two compounds (Ace and Chl) may form a molecular complex in aqueous solution. In agreement with the lack of modulatory effect by Chl, a reversed HPLC and a spectrophotometric analysis showed that the two compounds were unable to form a complex. This report confirms the importance of the specificity concerning the interaction mutagen/antimutagen.

Modelación matemática de epidemias simples / Mathematic modelling of simple epidemics

En este artículo se muestra la utilidad de los paquetes matemáticos en la modelación de epidemias simples en forma determinística y estocástica, así como en el cálculo de la tasa de contacto o infección y simulación del desarrollo de dichas epidemias. Para cada tema se presentan los programas hechos en el paquete Mathematica 3.0 que permiten calcular numéricamente los parámetros de relevancia epidemiológica, como número de susceptibles y de infectados, proporción de susceptibles, velocidad de infección, probabilidad de tener un determinado número de susceptibles en un tiempo determinado, gráficas de las curvas epidémicas, cálculo de la tasa de infección cuando estPara explicar la aplicación de la teoría y utilización de los programas, se presenta a manera de ejemplo el caso de un brote de parotiditis en la vereda Santa Marta de Matanza, Santander, en 1996. Por información directa se sabe que la población susceptible el 14 de julio era de 102 personas y hasta el 5 de octubre había 49 infectados. Se estimó la tasa de infección por medio de simulación, un valor fue 0,0053. Se aplicó el modelo determinístico y los resultados obtenidos fueron: duración promedio de la epidemia: 173 días; tiempo promedio de ocurrencia de una nueva infección: 1,6; velocidad máxima de contacto: 1,4 personas por día a los 84,7 días, instante en que el número de susceptibles y de infectados era de 51,5 personas, valor muy cercano a los 49 que había realmente a los 84 díasa es desconocida y simulación del proceso epidémico.Para explicar la aplicación de la teoría y utilización de los programas, se presenta a manera de ejemplo el caso de un brote de parotiditis en la vereda Santa Marta de Matanza, Santander, en 1996. Por información directa se sabe que la población susceptible el 14 de julio era de 102 personas y hasta el 5 de octubre había 49 infectados. Se estimó la tasa de infección por medio de simulación, un valor fue 0,0053. Se aplicó el modelo determinístico y los resultados obtenidos fueron: duración promedio de la epidemia: 173 días; tiempo promedio de ocurrencia de una nueva infección: 1,6; velocidad máxima de contacto: 1,4 personas por día a los 84,7 días, instante en que el número de susceptibles y de infectados era de 51,5 personas, valor muy cercano a los 49 que había realmente a los 84 días

[Aortic valve multiple papillary fibroelastoma complicated with a cerebrovascular accident: Report of one case]. / Fibroelastoma papilar múltiple de válvula aórtica complicado de accidente vascular encefálico embólico. Caso clínico.

The echocardiographic identification of cardiac tumors as cause of embolic episodes is infrequent, and the finding of multiple papillary fibroelastoma is even less common. We report a 70 years old female with a history of a rheumatic mitral valve lesion, subjected to a commissurotomy in 1970. She was admitted with a cerebrovascular accident and the transesophageal echocardiogram revealed the presence of a multiple papillary fibroelastoma in the aortic valve. The patient was operated and the tumor excised, the pathological analysis confirmed the diagnosis. The patient was discharged in good conditions and after 8 months of follow up, she has no neurological abnormality and is in functional class I.

Synthesis and hypolipidemic activity of modified side chain alpha-asarone homologues.

A series of homologues of alpha-asarone (1), containing variable size and functionality on the side chain attached to the aromatic ring, has been subjected to a study of structure-activity relationship. For most of the prepared derivatives, either with a carbonyl (8a-8e), a hydroxy group (9a-9e), or with a conjugated double bond (10a-10d), significant effects on serum lipoprotein cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were displayed. The results showed an enhancement of the hypocholesterolemic activity as the length of the chain is decreased. Theoretical conformational and electrostatic potential analyses of I and olefins 10 suggest unfavorable steric interactions in the bulky superior side-chain homologues as the deactivating biological effect.

Induction of sister chromatid exchanges by 2,4-dichlorophenoxyacetic acid in somatic and germ cells of mice exposed in vivo.

2,4-dichlorophenoxyacetic acid (2,4-D) is one of the most widely used selective herbicides throughout the world; however, the studies that have been conducted to establish its genotoxic potential have given conflicting results. The aim of this investigation was to determine whether the herbicide increases the frequency of sister chromatid exchanges (SCEs) in bone marrow and spermatogonial cells of mice exposed in vivo. The experiment included an oral administration of 2,4-D to three groups of mice (50,100 and 200 mg/kg), as well as to a control group of animals administered with distilled water, pH 10.5 and another group injected with cyclophosphamide (50 mg/kg). In somatic cells, the results showed a significant SCE increase with the two high doses tested, a response that was manifested in a dose-dependent manner. With regard to the mitotic index and the cell proliferation kinetics, there were no modifications exerted by 2,4-D; however, cyclophosphamide induced cytotoxic damage and a cell-cycle delay. With respect to the germ cells, the genotoxic results were similar to those described earlier; that is, there was a significant SCE increase induced by the two high 2,4-D doses tested and a higher genotoxic damage was observed in the animals treated with cyclophosphamide. Our investigation established that 2,4-D is a moderate genotoxicant in mice treated in vivo with high doses, and suggests a minor hazard for humans in the present conditions of its use.

[Treatment of advanced heart failure by heart transplantation]. / Tratamiento de la insuficiencia cardíaca avanzada mediante transplante de corazón.

BACKGROUND: Heart transplantation currently provides the most effective treatment for advanced heart failure. However, medical therapy for this condition has also improved, heart donors are scarce and the cost of the procedure is high. Therefore the indications and management of these patients need reevaluation. AIM: To analyze the results of 24 patients submitted to heart transplantation for end-stage heart failure needing repeated hospitalizations and i.v. inotropes for compensation. PATIENTS AND METHODS: The group was comprised by 21 men and 3 women with a mean age of 36.8 years, mean left ventricular ejection fraction 19 +/- 4.5%, mean systolic pulmonary artery pressure 48 +/- 13 mmHg (24-70) and mean pulmonary vascular resistance 2.6 Wood Units (1-5). Fourteen patients (58%) had a previous median sternotomy. Immunosuppression did not include induction therapy and steroids were discontinued early. RESULTS: Operative mortality was 4% at 30 days. Actuarial survival at one year was 90% and at 5 years 72%. Freedom from rejection at one year was 76% and at 5 years 50%. Freedom from infection was 70% at one year and 56.5% at five years. All patients with more than 3 months of follow-up were in functional class I. CONCLUSIONS: These results justify the proposed modifications for transplantation protocols.

Lead induces endothelium- and Ca2+-independent contraction in rat aortic rings.

The contractile effect of lead on rat aortic rings was examined. Lead (0.1-3.1 mM) elicited concentration-dependent but endothelium-independent contractions, which were unaffected by prazosin (1 microM). The contractile effects of lead were similar when the aortic rings were bathed either in the absence or presence of external Ca2+. Lanthanum (1 mM) but not verapamil (I pM) inhibited the lead contractions; hence non-L-calcium channels are involved in such effect. In addition, lead induced contractions on aortic rings incubated in Ca2+-free EGTA-containing solution for 70 min., an experimental condition in which intracellular Ca2+-stores are depleted. Finally, the contractile effect of lead was not modified by calphostin C (an inhibitor of protein kinase C). In conclusion, the present results suggest that in rat aorta, the lead-induced contraction is independent of extra- and intracellular calcium stores. In addition, the effect of lead is independent of either catecholamines or protein kinase C. It is likely that in rat aorta, lead enters into the smooth muscle cells through non-L-calcium channels, and when acting like calcium on the contractile machinery it produces contraction. The differences observed between our results and those obtained by other authors may indicate that the mechanism of the contractile effect of lead varies among the different blood vessels.

[Infective endocarditis: short and long-term results in 261 cases managed by a multidisciplinary approach]. / Endocarditis infecciosa: análisis de 261 casos y resultados del tratamiento con un enfoque multidisciplinario.

BACKGROUND: Early diagnosis, an effective treatment and prompt recognition of complications are essential to improve the prognosis of infective endocarditis (IE). AIM: To report the results of a multidisciplinary approach to diagnosis and management of patients with IE at the Universidad Católica de Chile Hospital. PATIENTS AND METHODS: The clinical history, diagnosis, treatment and outcome of 261 episodes (Duke criteria) of IE admitted between January 1980 and January 1999 were analyzed. These included 185 episodes of native, 73 of prosthetic valve and 3 of nonvalvular IE. RESULTS: Sixty nine percent of patients were men and the mean age was 49 +/- 16 years. Seventy five percent had a definite diagnosis of IE (Duke). S. viridans, staphylococci and enterococci together constituted 85% of the isolated bacterial strains. Twenty seven had culture-negative IE, related to a high incidence of antibiotic therapy prior to diagnosis. Transesophageal echocardiography was performed in 102 cases and it detected vegetations in 91% of aortic and 96% of mitral IE, rupture or prosthesis dehiscence in 67% of aortic and 52% of mitral IE and abscesses in 51% of aortic and 15% of mitral IE. Fifty one percent developed heart failure and 34% had embolic events. S. aureus IE was associated to a higher incidence of embolic events, complications which contraindicated surgery and increased mortality rate (27%). Of all patients, 40% were treated exclusively with antibiotics, 52% were operated on and 8% had surgical indication but were nonoperable because of serious complications. The overall mortality was 16.3%: 13% in the medical, 9% in the surgical and 81% in the non-operable groups. The type of treatment and mortality rates did not differ between IE of native valves and prosthetic valves. Long term follow up showed survival rates of 73% at 5 years and 66% at 10 years. CONCLUSION: A multidisciplinary approach may be very helpful to improve the prognosis of IE.