Lupus eritematoso sistémico: datos sociodemográficos y su correlación clínico-analítica en un hospital universitario / Systemic Lupus Erythemathosus: sociodemographic data and clinical correlation at an university hospital

Objetivos: Analizar las características sociodemográficas y clínicas de los pacientes con Lupus Eritematoso Sistémico (LES) del Servicio de Reumatología de un Hospital Universitario de Córdoba. Pacientes y métodos: Estudio retrospectivo, descriptivo y analítico de 303 pacientes adultos con LES asistidos entre 1987-2017, que cumplían con los criterios ACR1982. Se registraron datos sociodemográficos, clínicos, de laboratorio, internaciones, óbitos y los tratamientos. Los datos fueron analizados con Excel, Infostat y SPSS 11.5 para Windows. Resultados: El 92% eran mujeres, 44% de ellas y 61% de los hombres eran mestizos. La edad promedio al diagnóstico fue de 32 años y el tiempo medio de evolución de la enfermedad de 11 años. Un tercio terminó la escuela primaria y la mayoría pertenecía al nivel socieconómico medio. Las manifestaciones del aparato locomotor y dermatológicas fueron las más frecuentes como presentación y evolución de la enfermedad. El 60% mostró compromiso renal, siendo la glomerulonefritis tipo 4 el hallazgo histopatológico prevalente. Las causas de óbito fueron septicemia y hemorragia alveolar principalmente, asociados a SLICC más alto, anti-DNA (+), leucopenia, nivel socioeconómico medio y bajo y raza mestiza como marcadores de mal pronóstico. Conclusiones: En esta serie predominaron sexo femenino, raza mestiza, nivel socioeconómico medio y nivel de instrucción primario. Los síntomas de presentación fueron osteoarticulares y dérmicos. Las causas de muerte fueron infecciones o hemorragia alveolar. Fueron factores de mal pronóstico: anti-DNA, leucopenia, etnia mestiza y bajo nivel socioeconómico

Objective: to analyze demographic and clinical characteristics in SLE patients from a university hospital in Córdoba. Patients and Methods: We analyzed retrospectively 303 adult SLE patients assisted between 1987 and 2017 who met ACR1982 SLE criteria. Demographic, clinical and laboratory data and causes of death, hospitalization and treatments were analyzed with excel, infostat and SPSS for Windows. Results: 92% were women (race: women 44% mestizo; men 61% mestizo; mean age at diagnosis: 32 years, mean time of evolution 11 years). 1/3 of them finished primary school and most of them had medium socioeconomic status. Musculoskeletal and skin involvement was most frequent as presentation symptom and during the evolution of disease. 60% had renal involvement being type 4 glomerulonephritis the most prevalent histopathological finding. Causes of death were septicemia and alveolar hemorrhage, associated with higher SLICC, anti-DNA (+), leucopenia, low socioeconomic status and mestizo race as markers of poor prognosis. Conclusion: Female gender, mestizo race, medium socioeconomic status and primary level of education predominated in this series. Presentation symptoms were musculoskeletal and skin involvement. Causes of death were infections or alveolar hemorrhage. Anti-DNA (+), leucopenia, low socioeconomic status and mestizo race were markers of poor prognosis

[Use of intravenous humana immunoglobulin in rheumatic diseases]. / Uso de inmunogtlobulina G humana endovenosa(IGEV) en enfermedades reumáticas.

INTRODUCTION: Preparations of intravenous immunoglobulin (IVIG) are used as treatment in different diseases such primary and secondary immunodeficiencies, autoimmune diseases, systemic inflammatory diseases, infectious diseases and allergic diseases among others. OBJECTIVE: to present 13 of our cases with the use of IVIG in different rheumatic diseases. PATIENTS AND METHODS: we retrospectively studied 13 patients (10 women and 3 men), mean age 29 years with different rheumatic diseases, that underwent conventional treatments without positive response. They received IVIG pulses, trying to improve or induce remission of their previous clinical situation. 6/13 patients met criteria for systemic lupus erythematosus (SLE), 2/13 had primary antiphospholipid syndrome (APL)one had polydermatomyositis (PDM), 1 juvenile arthritis, 1 panarteritis nodosa (cutaneous PAN), one Evans syndrome, and one with autoimmune uveitis. RESULTS: 7 of them had a positive response to therapy with IGEV evaluated by clinical and biochemical parameters. They remained with conventional treatments. One patient received a new IG EV pulse after 24 months, because of panniculitis reactivation. Clinical and biochemical response was poor in 4 of them, and 2 patients died. CONCLUSION: IVIg may be usefull in autoimmune rheumatic diseases when conventional therapies have failed. The therapeutic success is also limited. Only the 55 percent of our patients had a positive clinical response.

Molecular genetic and functional association of Brugada and early repolarization syndromes with S422L missense mutation in KCNJ8.

BACKGROUND: Adenosine triphosphate (ATP)-sensitive potassium cardiac channels consist of inward-rectifying channel subunits Kir6.1 or Kir6.2 (encoded by KCNJ8 or KCNJ11) and the sulfonylurea receptor subunits SUR2A (encoded by ABCC9). OBJECTIVE: To examine the association of mutations in KCNJ8 with Brugada syndrome (BrS) and early repolarization syndrome (ERS) and to elucidate the mechanism underlying the gain of function of ATP-sensitive potassium channel current. METHODS: Direct sequencing of KCNJ8 and other candidate genes was performed on 204 BrS and ERS probands and family members. Whole-cell and inside-out patch-clamp methods were used to study mutated channels expressed in TSA201 cells. RESULTS: The same missense mutation, p.Ser422Leu (c.1265C>T) in KCNJ8, was identified in 3 BrS and 1 ERS probands but was absent in 430 alleles from ethnically matched healthy controls. Additional genetic variants included CACNB2b-D601E. Whole-cell patch-clamp studies showed a 2-fold gain of function of glibenclamide-sensitive ATP-sensitive potassium channel current when KCNJ8-S422L was coexpressed with SUR2A-wild type. Inside-out patch-clamp evaluation yielded a significantly greater half maximal inhibitory concentration for ATP in the mutant channels (785.5 ± 2 vs 38.4 ± 3 µM; n = 5; P <.01), pointing to incomplete closing of the ATP-sensitive potassium channels under normoxic conditions. Patients with a CACNB2b-D601E polymorphism displayed longer QT/corrected QT intervals, likely owing to their effect to induce an increase in L-type calcium channel current (I(Ca-L)). CONCLUSIONS: Our results support the hypothesis that KCNJ8 is a susceptibility gene for BrS and ERS and point to S422L as a possible hotspot mutation. Our findings suggest that the S422L-induced gain of function in ATP-sensitive potassium channel current is due to reduced sensitivity to intracellular ATP.

Effects of cannabinoids on caffeine contractures in slow and fast skeletal muscle fibers of the frog.

The effect of cannabinoids on caffeine contractures was investigated in slow and fast skeletal muscle fibers using isometric tension recording. In slow muscle fibers, WIN 55,212-2 (10 and 5 microM) caused a decrease in tension. These doses reduced maximum tension to 67.43 +/- 8.07% (P = 0.02, n = 5) and 79.4 +/- 14.11% (P = 0.007, n = 5) compared to control, respectively. Tension-time integral was reduced to 58.37 +/- 7.17% and 75.10 +/- 3.60% (P = 0.002, n = 5), respectively. Using the CB(1) cannabinoid receptor agonist ACPA (1 microM) reduced the maximum tension of caffeine contractures by 68.70 +/- 11.63% (P = 0.01, n = 5); tension-time integral was reduced by 66.82 +/- 6.89% (P = 0.02, n = 5) compared to controls. When the CB(1) receptor antagonist AM281 was coapplied with ACPA, it reversed the effect of ACPA on caffeine-evoked tension. In slow and fast muscle fibers incubated with the pertussis toxin, ACPA had no effect on tension evoked by caffeine. In fast muscle fibers, ACPA (1 microM) also decreased tension; the maximum tension was reduced by 56.48 +/- 3.4% (P = 0.001, n = 4), and tension-time integral was reduced by 57.81 +/- 2.6% (P = 0.006, n = 4). This ACPA effect was not statistically significant with respect to the reduction in tension in slow muscle fibers. Moreover, we detected the presence of mRNA for the cannabinoid CB(1) receptor on fast and slow skeletal muscle fibers, which was significantly higher in fast compared to slow muscle fiber expression. In conclusion, our results suggest that in the slow and fast muscle fibers of the frog cannabinoids diminish caffeine-evoked tension through a receptor-mediated mechanism.

Childhood systemic lupus erythematosus in Latin America. The GLADEL experience in 230 children.

To evaluate disease characteristics of childhood onset SLE in Latin America and to compare this information with an adult population in the same cohort of GLADEL. A protocol was designed as a multicenter, multinational, inception cohort of lupus patients to evaluate demographic, clinical, laboratory and serological variables, as well as classification criteria, disease activity, organ damage and mortality. Descriptive statistics, chi square, Fisher's exact test, Student's t test and multiple logistic regression were used to compare childhood and adult onset SLE. 230 patients were <18 years and 884 were adult SLE patients. Malar rash, fever, oral ulcers, thrombocytopenia and hemolytic anemia and some neurologic manifestations were more prevalent in children (p<0.05). On the other hand, myalgias, Sjögren's syndrome and cranial nerve involvement were more frequently seen in adults (p<0.05). Afro-Latin-American children had a higher prevalence of fever, thrombocytopenia and hemolytic anemia. White and mestizo children had a higher prevalence of malar rash. Mestizo children had a higher prevalence of cerebrovascular disease and cranial nerve involvement. Children met SLE ACR criteria earlier with higher mean values than adults (p: 0.001). They also had higher disease activity scores (p: 0.01), whereas adults had greater disease damage (p: 0.02). In Latin America, childhood onset SLE seems to be a more severe disease than adults. Some differences can be detected among ethnic groups.

Glucose deprivation activates diversity of potassium channels in cultured rat hippocampal neurons.

1. Glucose is one of the most important substrates for generating metabolic energy required for the maintenance of cellular functions. Glucose-mediated changes in neuronal firing pattern have been observed in the central nervous system of mammals. K(+) channels directly regulated by intracellular ATP have been postulated as a linkage between cellular energetic metabolism and excitability; the functional roles ascribed to these channels include glucose-sensing to regulate energy homeostasis and neuroprotection under energy depletion conditions. The hippocampus is highly sensitive to metabolic insults and is the brain region most sensitive to ischemic damage. Because the identity of metabolically regulated potassium channels present in hippocampal neurons is obscure, we decided to study the biophysical properties of glucose-sensitive potassium channels in hippocampal neurons. 2. The dependence of membrane potential and the sensitivity of potassium channels to glucose and ATP in rat hippocampal neurons were studied in cell-attached and excised inside-out membrane patches. 3. We found that under hypoglycemic conditions, at least three types of potassium channels were activated; their unitary conductance values were 37, 147, and 241 pS in symmetrical K(+), and they were sensitive to ATP. For K(+) channels with unitary conductance of 37 and 241, when the membrane potential was depolarized the longer closed time constant diminished and this produced an increase in the open-state probability; nevertheless, the 147-pS channels were not voltage-dependent. 4. We propose that neuronal glucose-sensitive K(+) channels in rat hippocampus include subtypes of ATP-sensitive channels with a potential role in neuroprotection during short-term or prolonged metabolic stress.

[Hyperhomocysteine like thrombocytic risk factor in patient with systemic lupus erythematous with antiphospholipid syndrome]. / Hiperhomocisteinemia como factor de riesgo trombótico en pacientes con lupus eritematoso sistémico y síndrome antifosfolípido.

OBJECTIVES: to detect the prevalence of hyperhcy in SLE patients with and without antiphospholipid syndrom; to compare the Hcy levels between those patients and healthy controls and to determine the correlation between hyperhcy and antiphospholipid antibodies. PATIENTS AND METHODS: we studied 44 SLE patients: 17 had antiphospholipid syndrom and 27 didn't have it, and we compared them to 24 healthy controls. All of them where checked clinically and with laboratory tests like anticardiolypin antibodies, lupus anticoagulant and Hcy. Hcy > 9 was considered abnormal. Patient who had hyperhcy were treated with folic acid+vitB6+vitB12 a month along. STATISTICAL ANALYSIS: cualytative variables: chi square or Fischer's; cuantitative variables: Student's T test or Mann-Whitney's test. RESULTS AND CONCLUSIONS: there were 35 trombotic manifestations in 44 patients. Hyperhcy was present in 27 SLE patients (61,4%), 12 of them had antiphospholipid syndrom. Hcy concentrations patients vs.controls was statisticaly different (p=0,002). There was also stastisticaly different the hcy concentration from SLE patients with SAF vs controls (p=0,003) and without SAF vs controls (p= 0,015). From 33 SLE patients, 20 (33%) were aCL(+). 15(75%) of them had hiperhcy.

[Function of flow cytometry on the dosage of antibodies against double stranded DNA in systemic lupus erythematosus]. / Función de la citometría de flujo en el dosaje de anticuerpos anti-DNA de doble cadena en el lupus eritematoso sistémico.

BACKGROUND: Among the diverse number of antibodies observed in systemic lupus erythematosus, antibodies against double stranded DNA (anti-dsDNA) represent important serologic markers for the disease diagnosis and the follow-up of the disease activity. OBJECTIVE: To evaluate the role of a new quantitative methodology to detect antibodies against double stranded DNA in systemic lupus erythematosus and its association with the disease activity. MATERIAL AND METHODS: The performance of the indirect immunofluorescence flow cytometry with Crithidia luciliae as substrate was compared with the Crithidia luciliae indirect immunofluorescence assay and the ELISA technique in order to detect antibodies against double stranded DNA in 54 sera from 47 patient with systemic lupus erythematosus and 100 sera from normal controls. RESULTS: The new method showed a sensitivity of 78% and a specificity of 81% when the Crithidia luciliae indirect immunofluorescence assay was the gold standard. Compared with the ELISA technique, the flow cytometry showed a sensitivity of 78% and a specificity of 86%. No correlation was found among antibodies against double stranded DNA values detected with flow cytometry and the MEX-SLEDAI activity scores. However, the flow cytometry showed a sensitivity of 70% and a specificity of 42% to distinguish patients with systemic lupus erythematosus with and without activity (MEX-SLEDAI score > or = 5). The Rho intra-observer coefficient was 0.61 (p < 0.0001). CONCLUSIONS: In spite of the fact that this new method might represent an interesting advance for antibodies against double stranded DNA quantitative testing, a clear superiority does not emerge when it was compared with more traditional assays. Difficulties related with its reproducibility might represent a limitation in the routine use of this new method.

[Hyperhomocystinemia as a thrombotic risk factor in patients suffering from systemic lupus erithematosus and antiphospholipid syndrome]. / Hiperhomocisteinemia como factor de riesgo trombótico en pacientes con lupus eritematoso sistémico y síndrome antifosfolípido.

OBJECTIVES: to detect the prevalence of hyperhcy in SLE patients with and without antiphospholipid syndrom; to compare the Hcy levels between those patients and healthy controls and to determine the correlation between hyperhcy and antiphospholipid antibodies. PATIENTS AND METHODS: we studied 44 SLE patients: 17 had antiphospholipid syndrom and 27 didn't have it, and we compared them to 24 healthy controls. All of them where checked clinically and with laboratory tests like anticardiolypin antibodies, lupus anticoagulant and Hcy. Hcy > 9 was considered abnormal. Patient who had hyperhcy were treated with folic acid+vitB6+vitB12 a month along. STATISTICAL ANALYSIS: cualytative variables: chi square or Fischer's; cuantitative variables: Student's T test or Mann-Whitney's test. RESULTS AND CONCLUSIONS: there were 35 trombotic manifestations in 44 patients. Hyperhcy was present in 27 SLE patients (61,4%), 12 of them had antiphospholipid syndrom. Hcy concentrations patients vs.controls was statisticaly different (p= 0,002). There was also stastisticaly different the hcy concentration from SLE patients with SAF vs controls (p=0,003) and without SAF vs controls (p= 0,015). From 33 SLE patients, 20 (33%) were aCL(+). 15(75%) of them had hiperhcy.

Hiperhomocisteinemia como factor de riesgo trombótico en pacientes con Lupus Erimatoso Sistémico y Síndrome Antifosfolipido / Hyperhomocystinemia as a thrombotic risk factor in patients suffering from systemic lupus erithematosus and antiphospholipid syndrome

Objetivos: Determinar la prevalencia de hiperhomocisteinemia (hiperhcy) en pacientes con lupus eritematoso sistémico (LES) con y sin síndrome antifosfolípido (SAF); comparar los niveles de homocisteína (Hcy) entre pacientes con LES (con y sin SAF asociado) y un grupo de controles sanos y determinar la correlación entre hiperhcy y la presencia de anticuerpos antifosfolípidos. Pacientes y métodos: Se estudiaron 44 ptes con LES, portadores o no de SAF. Se los dividió en 2 grupos: 17 con LES y SAF y 27 con LES sin SAF y se compararon con 24 controles sanos. A todos se les realizó interrogatorio, examen físico y pruebas de laboratorio: anticuerpos anticardiolipinas (aCL), anticoagulante lúpico y Hcy. Se consideró hiperhcy a valores superiores a 9. A los ptes con hiperhcy se los trató con ácido fólico + B6 + B 12 durante un mes. Análisis estadístico: variables cualitativas: Chi cuadrado o Exacta de Fischer y cuantitativas: test T de Student o MannWhitney test. Resultados y conclusiones: Hubo 35 manifestaciones trombóticas en los 44 pacientes. Se encontró Hiperhcy en 27 ptes con LES (61,4%), de los cuales 12 tenían SAF. La diferencia entre los valores de Hcy de los pacientes con o sin SAF no fue significativa (p=0,42). Comparando las concentraciones de Hcy entre pacientes y controles, la diferencia fue muy significativa (p=0,002).También tuvo significación estadística la diferencia entre las concentraciones de Hcy de los pacientes con LES sin SAF vs. controles (p=0,015) y LES con SAF vs. controles (p=0,003). A 33 ptes se les dosó aCL: 20 (60,6%) fueron (+). De estos, 15 (75%) tenían hiperhcy. De los 27 pacientes con LES que tenían hiperhcy, sólo 18 cumplieron con el mes de tratamiento con a.fólico+B6+B12. 16 de 18 (88,8%) normalizaron o disminuyeron la Hcy.(AU)

Objectives: to detect the prevalence of hyperhcy in SLE patients with and without antiphospholipid syndrome; to compare the Hcy levels between those patients and healthy controls and to determine the correlation between hyperhcy and antiphospholipid antibodies. Patients and methods: we studied 44 SLE patients: 17 had antiphospholipid syndrome and 27 didnt have it, and we compared tbem to 24 healthy controls. All of them where checked clinically and with laboratory tests like anticardiolypin antibodies, lupus anticoagulant and Hcy. Hcy > 9 was considered abnormal. Patient who had hyperhcy were treated with folic acid+vitB6+vitBI2 a month along. Statistical analysis: qualitative variables: chi square or Fischers; quantitative variables: Students T test or Mann-Whitneys test. Results and conclusions: there were 35 trombotic manifestations in 44 patients. Hyperhcy was present in 27 SLE patients (61,4%), 12 of them had antiphospholipid syndrome. Hcy concentrations patients vs. controls was statisticaly different (p=0,002). There was also statistically different the hcy concentration from SLE patients with SAF vs controls (p=0,003) and without SAF vs controls (p= 0,015). From 33 SLE patients, 20 (33%) were aCL( +). 15(75%) of them had hiperhcy.(AU)

Hiperhomocisteinemia como factor de riesgo trombótico en pacientes con lupus eritematoso sistémico y síndrome antifosfolípido. / [Hyperhomocysteine like thrombocytic risk factor in patient with systemic lupus erythematous with antiphospholipid syndrome]

OBJECTIVES: to detect the prevalence of hyperhcy in SLE patients with and without antiphospholipid syndrom; to compare the Hcy levels between those patients and healthy controls and to determine the correlation between hyperhcy and antiphospholipid antibodies. PATIENTS AND METHODS: we studied 44 SLE patients: 17 had antiphospholipid syndrom and 27 didnt have it, and we compared them to 24 healthy controls. All of them where checked clinically and with laboratory tests like anticardiolypin antibodies, lupus anticoagulant and Hcy. Hcy > 9 was considered abnormal. Patient who had hyperhcy were treated with folic acid+vitB6+vitB12 a month along. Statistical analysis: cualytative variables: chi square or Fischers; cuantitative variables: Students T test or Mann-Whitneys test. RESULTS AND CONCLUTIONS: there were 35 trombotic manifestations in 44 patients. Hyperhcy was present in 27 SLE patients (61,4

), 12 of them had antiphospholipid syndrom. Hcy concentrations patients vs.controls was statisticaly different (p=0,002). There was also stastisticaly different the hcy concentration from SLE patients with SAF vs controls (p=0,003) and without SAF vs controls (p= 0,015). From 33 SLE patients, 20 (33

) were aCL(+). 15(75

) of them had hiperhcy.

Hiperhomocisteinemia como factor de riesgo trombótico en pacientes con Lupus Erimatoso Sistémico y Síndrome Antifosfolipido / Hyperhomocystinemia as a thrombotic risk factor in patients suffering from systemic lupus erithematosus and antiphospholipid syndrome

Objetivos: Determinar la prevalencia de hiperhomocisteinemia (hiperhcy) en pacientes con lupus eritematoso sistémico (LES) con y sin síndrome antifosfolípido (SAF); comparar los niveles de homocisteína (Hcy) entre pacientes con LES (con y sin SAF asociado) y un grupo de controles sanos y determinar la correlación entre hiperhcy y la presencia de anticuerpos antifosfolípidos. Pacientes y métodos: Se estudiaron 44 ptes con LES, portadores o no de SAF. Se los dividió en 2 grupos: 17 con LES y SAF y 27 con LES sin SAF y se compararon con 24 controles sanos. A todos se les realizó interrogatorio, examen físico y pruebas de laboratorio: anticuerpos anticardiolipinas (aCL), anticoagulante lúpico y Hcy. Se consideró hiperhcy a valores superiores a 9. A los ptes con hiperhcy se los trató con ácido fólico + B6 + B 12 durante un mes. Análisis estadístico: variables cualitativas: Chi cuadrado o Exacta de Fischer y cuantitativas: test T de Student o MannWhitney test. Resultados y conclusiones: Hubo 35 manifestaciones trombóticas en los 44 pacientes. Se encontró Hiperhcy en 27 ptes con LES (61,4%), de los cuales 12 tenían SAF. La diferencia entre los valores de Hcy de los pacientes con o sin SAF no fue significativa (p=0,42). Comparando las concentraciones de Hcy entre pacientes y controles, la diferencia fue muy significativa (p=0,002).También tuvo significación estadística la diferencia entre las concentraciones de Hcy de los pacientes con LES sin SAF vs. controles (p=0,015) y LES con SAF vs. controles (p=0,003). A 33 ptes se les dosó aCL: 20 (60,6%) fueron (+). De estos, 15 (75%) tenían hiperhcy. De los 27 pacientes con LES que tenían hiperhcy, sólo 18 cumplieron con el mes de tratamiento con a.fólico+B6+B12. 16 de 18 (88,8%) normalizaron o disminuyeron la Hcy.

Objectives: to detect the prevalence of hyperhcy in SLE patients with and without antiphospholipid syndrome; to compare the Hcy levels between those patients and healthy controls and to determine the correlation between hyperhcy and antiphospholipid antibodies. Patients and methods: we studied 44 SLE patients: 17 had antiphospholipid syndrome and 27 didn't have it, and we compared tbem to 24 healthy controls. All of them where checked clinically and with laboratory tests like anticardiolypin antibodies, lupus anticoagulant and Hcy. Hcy > 9 was considered abnormal. Patient who had hyperhcy were treated with folic acid+vitB6+vitBI2 a month along. Statistical analysis: qualitative variables: chi square or Fischer's; quantitative variables: Student's T test or Mann-Whitney's test. Results and conclusions: there were 35 trombotic manifestations in 44 patients. Hyperhcy was present in 27 SLE patients (61,4%), 12 of them had antiphospholipid syndrome. Hcy concentrations patients vs. controls was statisticaly different (p=0,002). There was also statistically different the hcy concentration from SLE patients with SAF vs controls (p=0,003) and without SAF vs controls (p= 0,015). From 33 SLE patients, 20 (33%) were aCL( +). 15(75%) of them had hiperhcy.

Ischemic preconditioning in the hippocampus of a knockout mouse lacking SUR1-based K(ATP) channels.

BACKGROUND AND PURPOSE: ATP-sensitive K+ (K(ATP)) channels have been implicated in the mechanism of neuronal ischemic preconditioning. To evaluate the role of neuronal/beta-cell-type K(ATP) channels, SUR1 null (Sur1KO) mice lacking (K(IR)6.x/SUR1)(4) K(ATP) channels were subjected to a preconditioning protocol with the use of double carotid occlusion. METHODS: Wild-type C57BL/6 and Sur1KO mice were subjected to a double carotid block for 40 minutes with or without a 20-minute preconditioning block. After a 10-day reperfusion period, damage was assessed histologically in the hippocampal CA1, CA2, and CA3 areas and in the dentate gyrus. The neuroprotective effects of intracerebroventricular injections of diazoxide, which selectively affects mitochondria versus opening SUR1-type K(ATP) channels, and 5-hydroxydecanoate, a selective blocker of mitoK(ATP) channels, were evaluated with the same protocol. RESULTS: Neurons in the CA1 region of both Sur1KO and wild-type animals subjected to a 20-minute ischemic insult were protected equally from neuronal damage produced by a subsequent 40-minute ischemic period. Pretreatment with diazoxide protected both Sur1KO and wild-type neurons, while 5-hydroxydecanoate augmented neurodegeneration in both strains of animals when administered before a 20-minute bout of ischemia. CONCLUSIONS: SUR1-based K(ATP) channels are not obligatory for neuronal preconditioning or augmentation of neurodegeneration by 5-hydroxydecanoate.

[Semester direct cost by rheumatoid arthritis in patients in a university hospital]. / Costo directo semestral por artritis reumatoidea en pacientes que concurren a un hospital universitario.

INTRODUCTION: There are no medical publications with economic analysis of rheumatoid arthritis patients (RA) from Argentina are lacking. The objective of the present study is to determine the direct cost and its breakdown in patients with RA. MATERIAL AND METHODS: Fifty-two patients who met the American College of Rheumatology RA criteria were included. Direct cost was calculated over a follow-up period of 6 months during year 2001. Variables were analyzed with Student's T test, Mann-Whitney U Test, c' or ANOVA as corresponded. P values < 0.05 were considered significant. RESULTS: The mean monthly home income was $426.6 SD 272. The mean half-yearly direct costs was $677.5 SD 376.2. The components of the direct cost were identified and the mean for medication cost was $606.7 (89%), for lab tests was $45.5 (7%), for medical attention $12.5 (2%) and other costs $2.4. No differences in total cost or in medication cost were found when compared considering age, evolution time of RA or HAQ scores. CONCLUSION: Half-yearly direct cost in RA is excessively high considering the monthly mean income of the patients being analyzed. The cost of medication was the principal component of the direct cost.

Costo directo semestral por artritis reumatoidea en pacientes que concurren a un hospital universitario / Semester direct cost by rheumatoid arthritis in patients in a university hospital

INTRODUCTION: There are no medical publications with economic analysis of rheumatoid arthritis patients (RA) from Argentina are lacking. The objective of the present study is to determine the direct cost and its breakdown in patients with RA. MATERIAL AND METHODS: Fifty-two patients who met the American College of Rheumatology RA criteria were included. Direct cost was calculated over a follow-up period of 6 months during year 2001. Variables were analyzed with Students T test, Mann-Whitney U Test, c or ANOVA as corresponded. P values < 0.05 were considered significant. RESULTS: The mean monthly home income was $426.6 SD 272. The mean half-yearly direct costs was $677.5 SD 376.2. The components of the direct cost were identified and the mean for medication cost was $606.7 (89 per cent), for lab tests was $45.5 (7 per cent), for medical attention $12.5 (2 per cent) and other costs $2.4. No differences in total cost or in medication cost were found when compared considering age, evolution time of RA or HAQ scores. CONCLUSION: Half-yearly direct cost in RA is excessively high considering the monthly mean income of the patients being analyzed. The cost of medication was the principal component of the direct cost. (AU)

Costo directo semestral por artritis reumatoidea en pacientes que concurren a un hospital universitario. / [Semester direct cost by rheumatoid arthritis in patients in a university hospital]

INTRODUCTION: There are no medical publications with economic analysis of rheumatoid arthritis patients (RA) from Argentina are lacking. The objective of the present study is to determine the direct cost and its breakdown in patients with RA. MATERIAL AND METHODS: Fifty-two patients who met the American College of Rheumatology RA criteria were included. Direct cost was calculated over a follow-up period of 6 months during year 2001. Variables were analyzed with Students T test, Mann-Whitney U Test, c or ANOVA as corresponded. P values < 0.05 were considered significant. RESULTS: The mean monthly home income was $426.6 SD 272. The mean half-yearly direct costs was $677.5 SD 376.2. The components of the direct cost were identified and the mean for medication cost was $606.7 (89

), for lab tests was $45.5 (7

), for medical attention $12.5 (2

) and other costs $2.4. No differences in total cost or in medication cost were found when compared considering age, evolution time of RA or HAQ scores. CONCLUSION: Half-yearly direct cost in RA is excessively high considering the monthly mean income of the patients being analyzed. The cost of medication was the principal component of the direct cost.

Costo directo semestral por artritis reumatoidea en pacientes que concurren a un hospital universitario / Semester direct cost by rheumatoid arthritis in patients in a university hospital

INTRODUCTION: There are no medical publications with economic analysis of rheumatoid arthritis patients (RA) from Argentina are lacking. The objective of the present study is to determine the direct cost and its breakdown in patients with RA. MATERIAL AND METHODS: Fifty-two patients who met the American College of Rheumatology RA criteria were included. Direct cost was calculated over a follow-up period of 6 months during year 2001. Variables were analyzed with Student's T test, Mann-Whitney U Test, c' or ANOVA as corresponded. P values < 0.05 were considered significant. RESULTS: The mean monthly home income was $426.6 SD 272. The mean half-yearly direct costs was $677.5 SD 376.2. The components of the direct cost were identified and the mean for medication cost was $606.7 (89 per cent), for lab tests was $45.5 (7 per cent), for medical attention $12.5 (2 per cent) and other costs $2.4. No differences in total cost or in medication cost were found when compared considering age, evolution time of RA or HAQ scores. CONCLUSION: Half-yearly direct cost in RA is excessively high considering the monthly mean income of the patients being analyzed. The cost of medication was the principal component of the direct cost.