Implementation of Bedaquiline, Pretomanid, and Linezolid in the United States: Experience Using a Novel All-Oral Treatment Regimen for Treatment of Rifampin-Resistant or Rifampin-Intolerant Tuberculosis Disease.

BACKGROUND: Rifampin-resistant tuberculosis is a leading cause of morbidity worldwide; only one-third of persons start treatment, and outcomes are often inadequate. Several trials demonstrate 90% efficacy using an all-oral, 6-month regimen of bedaquiline, pretomanid, and linezolid (BPaL), but significant toxicity occurred using 1200-mg linezolid. After US Food and Drug Administration approval in 2019, some US clinicians rapidly implemented BPaL using an initial 600-mg linezolid dose adjusted by serum drug concentrations and clinical monitoring. METHODS: Data from US patients treated with BPaL between 14 October 2019 and 30 April 2022 were compiled and analyzed by the BPaL Implementation Group (BIG), including baseline examination and laboratory, electrocardiographic, and clinical monitoring throughout treatment and follow-up. Linezolid dosing and clinical management was provider driven, and most patients had linezolid adjusted by therapeutic drug monitoring. RESULTS: Of 70 patients starting BPaL, 2 changed to rifampin-based therapy, 68 (97.1%) completed BPaL, and 2 of the 68 (2.9%) experienced relapse after completion. Using an initial 600-mg linezolid dose daily adjusted by therapeutic drug monitoring and careful clinical and laboratory monitoring for adverse effects, supportive care, and expert consultation throughout BPaL treatment, 3 patients (4.4%) with hematologic toxicity and 4 (5.9%) with neurotoxicity required a change in linezolid dose or frequency. The median BPaL duration was 6 months. CONCLUSIONS: BPaL has transformed treatment for rifampin-resistant or intolerant tuberculosis. In this cohort, effective treatment required less than half the duration recommended in 2019 US guidelines for drug-resistant tuberculosis. Use of individualized linezolid dosing and monitoring likely enhanced safety and treatment completion. The BIG cohort demonstrates that early implementation of new tuberculosis treatments in the United States is feasible.

Body Packer y Body Stuffer: Serie de Casos. Revisión / Body Packer y Body Stuffer: serie de casos. Revision

"Body packing", "Body pushing" y "Body stuffing" son distintas formas de transportar sustancias ilegales dentro del cuerpo humano. Frente al ingreso en la unidad de emergencias de un "Body Packer", conocido como "tragador de paquetes" con fines de contrabando o un "Body Stuffer" llamados "tragadores rápidos", quienes ingieren en forma compulsiva paquetes manufacturados para la venta de sustancias ante la posibilidad de ser sorprendidos por agentes de la ley; se plantean una serie de desafíos en cuanto al tratamiento que al día de hoy permanecen en debate. Generalmente se prefiere mantener una conducta conservadora facilitando la expulsión de los paquetes. En aquellos casos en los que los pacientes presenten paquetes atascados o rotos o no mejoren con el tratamiento conservador, se recomienda el tratamiento quirúrgico.El presente trabajo tiene por objetivo reportar una serie de casos internados por ingesta de paquetes potencialmente peligrosos que se sometieron a una evacuación farmacológica y/o quirúrgica en 8 pacientes y una revisión bibliográfica sobre el tema.

"Body packing", "Body pushing", and "Body stuffing" are different ways to use the interior of the human body to transport illegal substances. In the face of a "Body Packer" or a "Body Stuffer" known as "fast swallowers", which are those cases in which they compulsively swallow manufactured packages for the sale of substances before the possibility of being surprised by law enforcement officers, a series of challenges present themselves regarding the treatment, which is currently up for debate. Generally, a conservative conduct is preferred, facilitating the expulsion of the packages. In those cases, in which patients have stuck or broken packages or do not improve with conservative treatment, surgical treatment is recommended.The present paper aims to report a series of cases in which the patients were admitted due to an intake of potentially dangerous packages and put through a pharmacological evacuation and/or surgical evacuation of 8 patients, and a bibliographical revision on the subject.

Novel 6-Month Treatment for Drug-Resistant Tuberculosis, United States.

The US Food and Drug Administration approved a 6-month regimen of pretomanid, bedaquiline, and linezolid for extensively drug-resistant or multidrug-intolerant tuberculosis after a trial in South Africa demonstrated 90% effectiveness 6 months posttreatment. We report on a patient who completed the regimen using a lower linezolid dose.

Experimental realisation of tunable ferroelectric/superconductor [Formula: see text] 1D photonic crystals in the whole visible spectrum.

Emergent technologies that make use of novel materials and quantum properties of light states are at the forefront in the race for the physical implementation, encoding and transmission of information. Photonic crystals (PCs) enter this paradigm with optical materials that allow the control of light propagation and can be used for optical communication, and photonics and electronics integration, making use of materials ranging from semiconductors, to metals, metamaterials, and topological insulators, to mention but a few. Here, we show how designer superconductor materials integrated into PCs fabrication allow for an extraordinary reduction of electromagnetic waves damping, making possible their optimal propagation and tuning through the structure, below critical superconductor temperature. We experimentally demonstrate, for the first time, a successful integration of ferroelectric and superconductor materials into a one-dimensional (1D) PC composed of [Formula: see text] bilayers that work in the whole visible spectrum, and below (and above) critical superconductor temperature [Formula: see text]. Theoretical calculations support, for different number of bilayers N, the effectiveness of the produced 1D PCs and may pave the way for novel optoelectronics integration and information processing in the visible spectrum, while preserving their electric and optical properties.

Observation of unexpected uniaxial magnetic anisotropy in La2/3Sr1/3MnO3 films by a BaTiO3 overlayer in an artificial multiferroic bilayer.

We studied in detail the in-plane magnetic properties of heterostructures based on a ferroelectric BaTiO3 overlayer deposited on a ferromagnetic La2/3Sr1/3MnO3 film grown epitaxially on pseudocubic (001)-oriented SrTiO3, (LaAlO3)0.3(Sr2TaAlO6)0.7 and LaAlO3 substrates. In this configuration, the combination of both functional perovskites constitutes an artificial multiferroic system with potential applications in spintronic devices based on the magnetoelectric effect. La2/3Sr1/3MnO3 single layers and BaTiO3/La2/3Sr1/3MnO3 bilayers using the pulsed-laser deposition technique. We analyzed the films structurally through X-ray reciprocal space maps and high-angle annular dark field microscopy, and magnetically via thermal demagnetization curves and in-plane magnetization versus applied magnetic field loops at room temperature. Our results indicate that the BaTiO3 layer induces an additional strain in the La2/3Sr1/3MnO3 layers close to their common interface. The presence of BaTiO3 on the surface of tensile-strained La2/3Sr1/3MnO3 films transforms the in-plane biaxial magnetic anisotropy present in the single layer into an in-plane uniaxial magnetic anisotropy. Our experimental evidence suggests that this change in the magnetic anisotropy only occurs in tensile-strained La2/3Sr1/3MnO3 film and is favored by an additional strain on the La2/3Sr1/3MnO3 layer promoted by the BaTiO3 film. These findings reveal an additional mechanism that alters the magnetic behavior of the ferromagnetic layer, and consequently, deserves further in-depth research to determine how it can modify the magnetoelectric coupling of this hybrid multiferroic system.

Toxicidad por ácido fluorhídrico: reporte de casos / HYdrofluoric acid toxicity

Los accidentes con ácido fluorhídrico en Argentina son un motivo de consulta infrecuente, a pesar de ser utilizado en varias actividades laborales. Es uno de los pocos cáusticos con tratamiento específico que se debe tener en cuenta. Reportamos el caso de un paciente de 35 años que estuvo en contacto con esta sustancia con posterior compromiso de miembro superior, presentando placa eritematosa en región palmar derecha y lesión ampollar con descamación posterior y sangrado en lecho ungueal. Recibió tratamiento local con gluconato de calcio al 20% en toda la extensión de la zona afectada durante 48 hs con recuperación completa a los quince días. La sospecha clínica temprana y la administración adecuada de gluconato de calcio evitan lesiones de mayor grado y extensión

In Argentina, hydrofluoric acid accidents are a rare reason for consultation, despite being a commonly used substance in laboral activities. It is one of the few caustics with a specific treatment that must be taken into account. We report the case of a 35 year old patient affected by said substance, in which we observe an impairment of the upper limb, presenting on the right palmar region, an erythematous plaque with a blister lesion with posterior scaling and bleeding of the nail bed. The importance of the early clinical suspicion and the proper administration of calcium gluconate would avoid bigger and more extensive lesions

Ex Vivo Cardiotoxicity of Antineoplastic Casiopeinas Is Mediated through Energetic Dysfunction and Triggered Mitochondrial-Dependent Apoptosis.

Casiopeinas are a group of copper-based antineoplastic molecules designed as a less toxic and more therapeutic alternative to cisplatin or Doxorubicin; however, there is scarce evidence about their toxic effects on the whole heart and cardiomyocytes. Given this, rat hearts were perfused with Casiopeinas or Doxorubicin and the effects on mechanical performance, energetics, and mitochondrial function were measured. As well, the effects of Casiopeinas-triggered cell death were explored in isolated cardiomyocytes. Casiopeinas III-Ea, II-gly, and III-ia induced a progressive and sustained inhibition of heart contractile function that was dose- and time-dependent with an IC50 of 1.3 ± 0.2, 5.5 ± 0.5, and 10 ± 0.7 µM, correspondingly. Myocardial oxygen consumption was not modified at their respective IC50, although ATP levels were significantly reduced, indicating energy impairment. Isolated mitochondria from Casiopeinas-treated hearts showed a significant loss of membrane potential and reduction of mitochondrial Ca2+ retention capacity. Interestingly, Cyclosporine A inhibited Casiopeinas-induced mitochondrial Ca2+ release, which suggests the involvement of the mitochondrial permeability transition pore opening. In addition, Casiopeinas reduced the viability of cardiomyocytes and stimulated the activation of caspases 3, 7, and 9, demonstrating a cell death mitochondrial-dependent mechanism. Finally, the early perfusion of Cyclosporine A in isolated hearts decreased Casiopeinas-induced dysfunction with reduction of their toxic effect. Our results suggest that heart cardiotoxicity of Casiopeinas is similar to that of Doxorubicin, involving heart mitochondrial dysfunction, loss of membrane potential, changes in energetic metabolites, and apoptosis triggered by mitochondrial permeability.

Enseñanza integrada de anatomía e histología en la Facultad de Odontología de la Universidad Nacional de Córdoba, Argentina / Integrated teaching of anatomy and histology in the School of Dentistry, National University of Córdoba, Argentina

INTRODUCCIÓN: Docentes de anatomía, histología y asesoría pedagógica conformaron un equipo para diseñar e implementar una experiencia de enseñanza integrada (EI) en la Facultad de Odontología, Universidad Nacional de Córdoba, Argentina. El objetivo fue promover una mayor integración entre la anatomía e histología del sistema estomatognático y guiar la transferencia a situaciones clínicas. MATERIALES Y MÉTODOS: En 2010 se rediseñó una propuesta sobre EI para su aplicación a la totalidad de alumnos y con todos los docentes, quienes participaron en ateneos interdisciplinarios para la actualización de contenidos, unificación de criterios, etc. Los alumnos realizaron cuatro clases teórico-prácticas y un trabajo práctico elaborado sobre un caso clínico, con la participación de un docente de anatomía y otro de histología. En el trabajo práctico, los alumnos efectuaron una exploración guiada de la cavidad bucal y trabajaron grupalmente para resolver preguntas sobre el caso clínico. Evaluaron cada actividad de EI, indicando aspectos positivos y a mejorar. Los docentes se expresaron a través de una encuesta. RESULTADOS: Los alumnos destacaron que el abordaje integrado les permitió una mejor comprensión y relación de los temas de las dos asignaturas; valoraron el dinamismo, las explicaciones claras y bien ilustradas de las clases, y el trabajo sobre situaciones clínicas. Los docentes consideraron que la EI es una experiencia positiva, desafiante, enriquecedora, que mejora los nexos con sus colegas y alumnos. CONCLUSIONES: La experiencia de EI permitió lograr los objetivos de aprendizaje propuestos para los alumnos y constituyó una valiosa oportunidad formativa para los docentes

INTRODUCTION: Professors of Anatomy, Histology and from the pedagogic area formed a team with the objective of designing and carrying out an experience based on integrated teaching (IT) at the School of Dentistry, National University of Córdoba, Argentina. The main purpose was to achieve more integration between the anatomy and histology of the stomatognathic system as well to guide the transference to clinical situations. MATERIAL AND METHODS: In 2010 a new experience of IT was designed for its application to all the students and with all the professors, who participated in interdisciplinary meetings tending to content updating, criteria unification, and so on. The students attended four theoretical and practical classes and one practical activity elaborated on the basis of a clinical situation, guided by one professor of Anatomy and another of Histology. During the practical activity the students performed an oral cavity examination and worked in groups so as to answer questions referred to the clinical situation. They evaluated each IT activity, indicating positive aspects as well as those requiring adjustments. The teachers gave their opinions through an anonymous quest. RESULTS: The students remarked that the integrated approaching allowed them a better comprehension and the possibility of relating anatomical and histological contents. They also remarked the class dynamism and illustrations, clear explanations, and the activities based on clinical situations. The professors considered that the IT was a positive, defying and enriching experience that also improved the nexus with colleagues and students. CONCLUSIONS: The IT experience allowed to reach the proposed learning objectives for the students and constituted a valuable formative opportunity for the teachers

[Indicators monitoring the process of specialized nutritional support. Grupo de Nutrición de la SEFH]. / Indicadores de monitorización del proceso de soporte nutricional especializado.

OBJECTIVE: To identify and develop monitoring indicators of the process of specialized nutritional support that will allow measuring the level of adherence to the established practice standards. METHODS: Those practice standards considered to be key elements of the process were selected to develop performance indicators. The construction of these indicators combined the scientific evidence with expert opinion. Key goals were identified within each standard provided that its consecution would allow increasing the achievement of the standard. Particular improvement initiatives associated to each key goal were generated. Lastly, monitoring indicators were defined allowing undertaking a follow-up of the implementation of the improvement initiatives or either to assess the level of achievement of the key goals identified. RESULTS: Nineteen practice standards were selected representative of the critical points of the process. The strategic map for each standard has been defined, with the identification of 43 key goals. In order to achieve these key goals, a portfolio of improvements has been generated comprising 56 actions. Finally, 44 monitoring indicators have been defined grouped into three categories: 1. Numeric: they assess the level of goal achievement; 2. Dichotomic (yes/no): they inform on the execution of the improvement actions; 3. Results of the practice audits. CONCLUSIONS: We have made available monitoring indicators that allow assessing the level of adherence to the practice standards of the process of specialized nutritional support and the impact of the implementation of improvement actions within this process.

Indicadores de monitorización del proceso de soporte nutricional especializado / Indicators monitoring the process of specialized nutritional support

Objetivo: Identificar y desarrollar indicadores de monitorización del proceso de soporte nutricional especializado, que permitan medir el grado de cumplimiento de los estándares de práctica establecidos. Método: Se seleccionaron los estándares de práctica considerados aspectos clave del proceso sobre los que desarrollar indicadores de rendimiento. La construcción de indicadores combinó la evidencia científica con la opinión de expertos. Se identificaron los objetivos clave dentro de cada estándar cuya consecución permitiera incrementar el alcance del mismo. Se generaron iniciativas de mejora concretas vinculadas a cada objetivo clave. Por último, se definieron indicadores de monitorización que permitieran realizar un seguimiento de la implantación de las iniciativas de mejora, o bien valorar el grado de consecución de los objetivos clave identificados. Resultados: Se han seleccionado 19 estándares de práctica representativos de los aspectos críticos del proceso. Se ha definido el mapa estratégico de cada estándar, identificándose un total de 43 objetivos clave. A fin de alcanzar estos objetivos clave se ha generado una cartera de mejoras integrada por 56 acciones. Por último, se han definido 44 indicadores de monitorización agrupados en tres categorías: 1. Numéricos: valoran el grado de cumplimiento del objetivo; 2. Dicotómicos (si/no): Informan de la ejecución de las acciones de mejora; 3. Resultados de las auditorías de la práctica. Conclusiones: Se dispone de indicadores de monitorización que permiten evaluar el cumplimiento de los estándares de práctica del proceso de soporte nutricional especializado y el impacto de la implantación de acciones de mejora en el mismo (AU)

Objective: To identify and develop monitoring indicators of the process of specialized nutritional support that will allow measuring the level of adherence to the established practice standards. Methods: Those practice standards considered to be key elements of the process were selected to develop performance indicators. The construction of these indicators combined the scientific evidence with expert opinion. Key goals were identified within each standard provided that its consecution would allow increasing the achievement of the standard. Particular improvement initiatives associated to each key goal were generated. Lastly, monitoring indicators were defined allowing undertaking a follow-up of the implementation of the improvement initiatives or either to assess the level of achievement of the key goals identified. Results: Nineteen practice standards were selected representative of the critical points of the process. The strategic map for each standard has been defined, with the identification of 43 key goals. In order to achieve these key goals, a portfolio of improvements has been generated comprising 56 actions. Finally, 44 monitoring indicators have been defined grouped into three categories: 1. Numeric: they assess the level of goal achievement; 2. Dichotomic (yes/no): they inform on the execution of the improvement actions; 3. Results of the practice audits. Conclusions: We have made available monitoring indicators that allow assessing the level of adherence to the practice standards of the process of specialized nutritional support and the impact of the Implementation of improvement actions within this process (AU)

Comparison of fat mass and fat-free mass between Anthropometry, BIA and DEXA in young females: are methods really interchangeable?

The aim of this study was to check the degree of consistency and agreement between three methods for the estimation of body composition, fat mass and fat-free mass after their application to a group of young women. A transverse observation study was performed. Fifty-nine women aged between 18 and 28 years old were included. Each woman was subjected to three assessments of body composition: anthropometry, dual-energy x-ray absorptiometry and bio-impedance analysis. Pearson’s r coefficient and the Cronbach α were calculated. To check the degree of agreement, analysis of variance was implemented for repeated measurements and Bland and Altman plot was used. Differences were observed among the four assessment methodologies, the results of the General Durnin & Womersley Formula departing from those of the others, such that it was left out. In contrast, the consistency of the Specific Durnin & Womersley Formula was better in fat mass. Regarding the level of agreement between pairs of methods, a homogenous pattern was observed, with low bias, although broad 95% agreement limits were observed. These results indicate that different methods of body composition assessment provide different estimations in a sample of healthy young women. Dual-energy x-ray absorptiometry and anthropometry (Specific Durnin & Womersley Formula) have high levels of consistency, with low bias ranges (AU)

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An energy-based detection algorithm of epileptic seizures in EEG records.

A simple algorithm to automatically detect segments with epileptic seizures in long EEG records has been developed. The main advantages of the proposed method are: the simple algorithm used and the lower computational cost. The algorithm measures the energy of each EEG channel by a sliding window and calculates some features of each patient signal to detect the epileptic seizure. It is also able to distinguish between seizures and noise artifacts. Nine invasive EEG records acquired by Epilepsy Center of the University Hospital of Freiburg were analyzed in this work. In 90 segments studied (39 with epileptic seizures) the sensitivity obtained with the method is 87.18 %. The algorithm is appropriate to detect epileptic seizures, with high sensitivity, in long EEG records to decrease the time used by physicians and specialists in visual inspections.

DeltaTAp73 upregulation correlates with poor prognosis in human tumors: putative in vivo network involving p73 isoforms, p53, and E2F-1.

PURPOSE: Although full-length TAp73 variants largely mimic p53 suppressor activities, the transactivation-deficient transcripts DeltaTAp73 exert an oncogenic effect by inactivating p53 and TAp73 suppressor properties. Additionally, DeltaTAp73 may cooperate with oncogenic RAS to induce cell transformation, confer drug resistance, and induce the phosphorylation of phosphorylated Rb. Here, we study the expression of TAp73 and DeltaTAp73 variants and assess possible associations with E2F-1, p53 and K-ras status. We address the possible clinical relevance of alterations in these genes. PATIENTS AND METHODS: We determine in 113 colon and 60 breast cancer patients (a) the expression levels of TAp73, DeltaTAp73 (DeltaEx2p73, DeltaEx2/3p73, and DeltaNp73), and E2F-1 transcripts by quantitative real-time reverse transcriptase polymerase chain reaction (PCR); (b) mutations in the first exon of K-ras by PCR-single-stranded confirmational polymorphism; and (c) p53 status by immunohistochemistry. Tumor characteristics were examined in each patient. RESULTS: Both suppressor and oncogenic isoforms of TP73 were significantly coupregulated in tumor tissues. Associations were observed between (a) p53 wild type status and upregulation of some TP73 variants; (b) overexpression of E2F-1 and some TP73 forms; and (c) upregulation of DeltaTAp73 variants and advanced pathologic stage, lymph node metastasis, vascular invasion, presence of polyps, and tumor localization. CONCLUSION: Overexpression of TP73 variants in tumor tissues indicates that they may be involved in colon and breast carcinogenesis. The association between upregulation of DeltaTAp73 isoforms and poor prognosis features, specifically advanced tumor stage, suggests that they may be of practical clinical prognostic value. Interestingly, the in vivo associations identified here may indicate a functional network involving p73 variants, p53, and E2F-1.

Concordance between qualitative and quantitative cultures in burned patients. Analysis of 2886 cultures.

OBJECTIVE: To determine the concordance between superficial cultures (SC) and quantitative cultures (QC) in the diagnosis of wound infection in burn patients. SAMPLE: All SC and QC taken from the same patient, site and during the same surgery were analysed. VARIABLES: On the SC, the microorganism (MO) and its amount defined subjectively by the microbiologist was recorded (negative, very low, low, regular and abundant). On the QC, the MO and its amount were expressed as colony forming units per gram of tissue (CFUs/g). STATISTICS: Kappa index of agreement beyond chance; Wilcoxon and Kruskall-Wallis for continuous variables and chi(2) for categorical variables were used with a p<0.05 indicating statistical significance. RESULTS: One thousand four hundred and forty three pairs of cultures were analyzed. The concordance between SC and QC (Kappa index) was 52%. On the SC, only when the microbiologist subjectively informed "abundant" MOs there was a significant difference (p<0.0001). There were 6.1% of QCs with more than 10(5) CFUs/g and the most frequent MOs isolated were: S. aureus (27.9%), E. coli (11.6%), P. aeruginosa (11.6%), E. faecalis (11.6%) and S. epidermidis (7.0%). CONCLUSIONS: SC has a moderate concordance with the QC showing a low reliability between the two methods. The subjective information given by the microbiology technician in the SC is not precise. A study in which the two methods be compared blindly against the reference standard, in a prospective cohort of patients, it is needed to discriminate which of two methods it is the most accurate one determining sensitivity and specificity.

[The environment and its impact on health: old risks, new risks]. / El medio ambiente y su impacto en la salud: riesgos tradicionales, nuevos riesgos.

The objective of this article is to investigate three representative elements of environmental health from a geographical perspective taking the Autonomous Community as the unit of analysis: legionnaire's disease, chemical safety and food safety. Legionnaire's disease is a pathology with a specific epidemiological profile; males, adults, and with previous chronic pathologies and habits. The official response, with regard to recent outbreaks and the increase in the incidence of legionnaire's disease, has differed between autonomous communities due to peculiarities and different organizational cultures. Both the sinking of the ship Prestige and the accident at the oil refinery at Puertollano (Ciudad Real) have increased concern in the population about chemical substances, so familiar in our environment. However it is not only the big accidents which are relevant: it is surprising to learn that most of the registered poisonings are due to domestic cleaning goods. The pending challenge from the Public Health point of view is to elaborate the Report on Human Exposure to Environmental Chemical Agents which, undoubtedly, will help to establish differences between type and class. Finally, the number of outbreaks of food poisoning continues to be of concern; this should lead us to think about the effectiveness of food safety programmes and to focus on the home, being place where most of the outbreaks occur. The General Sanitary Inspection of Food ought to be a good tool to help improve food safety.

Presence of impaired insulin secretion and insulin resistance in normoglycemic male subjects with family history of type 2 diabetes.

In order to demonstrate the effect of family history (FH) coexisting with obesity in insulin resistance (IR) and secretion in subjects at risk for type 2 diabetes, fasting and 2 h post-glucose load serum glucose and insulin concentrations were measured in 143 individuals, 66 men and 77 women, ages ranging from 18 to 68 years, who were considered at risk but were normoglycemic following ADA criteria. Insulin resistance was estimated using HOMA(IR), basal hyperinsulinemia and I(0)/G(0) ratio. Insulin secretion was estimated by means of HOMA(beta-cell), DeltaI(30-0)/DeltaG(30-0) ratio and the insulin concentration at 30 min post-glucose load (I(30)). Disposition index (DI) was calculated to verify if insulin secretion compensate IR. Obesity in males produced an increase in all the parameters indicative of IR in both groups of individuals, with (FH(+)) or without (FH(-)) family history of diabetes, increase that was more pronounced in those FH(-). This effect was not observed in women. The parameters indicative of insulin secretion showed that only in males the presence of FH(+) was responsible for a significant decrease in insulin secretion, mainly expressed as lower values of HOMA(beta-cell) in obese as well as in non-obese. The I(30) and the ratio DeltaI(30-0)/DeltaG(30-0), although lower, did not reach statistical significance. The DI showed that only when obesity and FH were associated the decrease in insulin secretion was not a compensatory response to the IR present in those individuals. In conclusion, normoglycemic obese and non-obese male subjects of Hispanic (Latinos) origin with a family history of type 2 diabetes present not only IR but impaired insulin secretion, having the obese FH(+) and additional risk like low DI.

Avaliação sensorial e instrumental de ovos de galinhas alimentadas com rações suplementadas com óleo de linhaça e antioxidantes / Sensorial and instrumental evaluation of eggs from hens fed flaxseed oil and antioxidants

O objetivo deste estudo foi avaliar a qualidade sensorial de ovos de galinhas alimentadas com dietas contendo ácidos graxos polinsaturados ômega-3 (AGPI `ômegaï-3) e antioxidantes naturais e sintéticos. Galinhas poedeiras foram alimentadas, durante 30 dias, com dietas constituídas de 0 (zero) e 5 por cento de óleo de linhaça. Foram definidos 9 tratamentos: 4 grupos com5 por cento de óleo de linhaça (controle/sem antioxidante; BTA+BHT, 100+100 ppm; orégano, 200 ppm; alecrim, 200 ppm) e 4 grupos sem óleo de linhaça mas utilizando os mesmos antioxidantes. Foram incluídos os ovos de galinhas alimentadas até o começo do experimento com uma ração comercial (sem óleo de linhaça), (grupo controle)...

El paciente geriátrico: su manejo anestésico

El avance en las técnicas quirúrgicas, los cuidados intensivos y el conocimiento más profundo del proceso del envejecimiento y enfermedades concurrentes, tienden a favorecer la disminución de la morbimortalidad perioperatoria del paciente geriátrico, siendo mínima por demás la contribución que a la misma da la anestesia. Sin señalar una técnica anestésica ideal para estos pacientes, puesto que no existe, este artículo enfoca la anestesia geriátrica basado en el análisis de unas implicaciones que se derivan de los cambios fisiológicos y que son importantes para el anestesiólogo. Hacer énfasis en que los buenos resultados se logran mediante una cuidadosa evaluación perioperatoria, la monitoría fisiológica adecuada, el reconocimiento de las alteraciones en la farmacología clínica, la técnica quirúrgica cuidadosa y la aplicación de medidas que disminuyen el estrés y las alteraciones hemodinámicas y ácido-base durante el período intra y postoperatorio. Establece además una serie de recomendaciones universales para el manejo y prevención de ciertas complicaciones frecuentes