Influencia del consumo de hidratos de carbono sobre el estado oxidante en mujeres con y sin diabetes mellitus gestacional / Influence of carbohydrate intake on oxidative status among women with and without gestational diabetes mellitus

RESUMEN Objetivo: Identificar la influencia del consumo de hidratos de carbono (HCO) sobre el estado oxidante en mujeres con y sin diabetes mellitus gestacional (DMG). Materiales y métodos: Se realizó un estudio transversal, observacional y comparativo a dos grupos de 21 mujeres con y sin DMG, respectivamente, en la ciudad de Toluca, México, de enero a diciembre del 2022. Para evaluar parámetros sociodemográficos, se les aplicó un cuestionario de historia clínica; en cuanto a los parámetros antropométricos, se les midió peso corporal y estatura; y respecto a los parámetros bioquímicos, colesterol total (CT) y triglicéridos (TG). Para evaluar el estado oxidante/antioxidante se cuantificaron, como marcador oxidante, el malondihaldeído (MDA), y como antioxidantes, catalasa (cat), superóxido dismutasa (SOD) y capacidad antioxidante total (CAT). Los hábitos dietéticos se evaluaron a través de un recordatorio de 24 horas, en ambos grupos de mujeres, para obtener los macronutrientes: proteínas, lípidos e HCO. A partir de los hidratos de carbono totales (HCOT), se calcularon los hidratos de carbono complejos (HCOC) e hidratos de carbono simples (HCOS) como la sacarosa. Para el cálculo de HCOS por día, se usó la lista de alimentos con contenido de sacarosa por cada 100 gramos de consumo que emplea el Sistema Mexicano de Equivalentes; para el análisis de dieta, se utilizó el programa Nutrikcal VO. Se usaron las pruebas estadísticas t de Student para muestras independientes, U de Mann-Whitney para las variables no homogéneas y se realizó la correlación de Spearman (p < 0,05) en el programa SPSS, versión 19. Resultados: Los resultados mostraron que la diferencia entre los valores de CT (p < 0,029), TG (p < 0,029), las enzimas: cat (p < 0,011), SOD (p < 0,013), así como el MDA (p < 0,039), fueron significativamente mayores en las pacientes del grupo con DMG en comparación con el grupo sin DMG. Además, el grupo con DMG consumió mayor proporción de sacarosa. Conclusiones: Las mujeres con DMG tienen un desequilibrio en el estado oxidante/antioxidante influenciado por el tipo de HCO que consumen, en particular los HCOS como la sacarosa.

ABSTRACT Objective: To identify the influence of carbohydrate (CHO) intake on oxidative status among women with and without gestational diabetes mellitus (GDM). Materials and methods: A cross-sectional, observational and comparative study was carried out with two groups of 21 women each with and without GDM in the city of Toluca, Mexico, from January to December 2022. The sociodemographic parameters were determined by administering the patients a medical history questionnaire; anthropometric parameters such as body weight and height were measured; and biochemical parameters including total cholesterol (TC) and triglycerides (TG) were calculated. The oxidant/antioxidant status was assessed as follows: malondialdehyde (MDA) as oxidative stress marker; and catalase (CAT), superoxide dismutase (SOD) and total antioxidant capacity (TAC) as antioxidants. Dietary habits were evaluated through a 24-hour reminder in both groups of women to obtain the macronutrient classes, i.e., proteins, fats and CHOs. Based on the total carbohydrates (TCHOs), complex (CCHOs) and simple carbohydrates (SCHOs) such as sucrose were calculated. SCHOs per day were measured using the list of foods with sucrose content per 100 grams according to the Mexican Food Equivalence System (SMAE). The NutriKcal VO program was used for the dietary analysis. Statistical tests such as Student's t test and Mann-Whitney U test were performed for the independent samples and nonhomogeneous variables, respectively, and Spearman's rank correlation coefficient (p < 0.05) was determined using the IBM SPSS Statistics V19. Results: The results showed that the difference between the levels of TC (p < 0.029), TG (p < 0.029), enzymes CAT (p < 0.011) and SOD (p < 0.013), as well as MDA (p < 0.039) was significantly higher among patients in the group with GDM compared to that in the group without GDM. In addition, the group with GDM consumed a higher proportion of sucrose. Conclusions: Women with GDM have an imbalance in the oxidant/antioxidant status, influenced by the type of CHO they consume, particularly SCHOs such as sucrose.

Diabetes related phenotypes and their influence on outcomes of patients with corona virus disease 2019 (COVID-19).

INTRODUCTION: Diabetes mellitus (DM) is associated with severe forms of COVID-19 but little is known about the diabetes-related phenotype considering pre-admission, on-admission and data covering the entire hospitalization period. METHODS: We analyzed COVID-19 inpatients (n = 3327) aged 61.2(48.2-71.4) years attended from March to September 2020 in a public hospital. RESULTS: DM group (n = 1218) differed from Non-DM group (n = 2109) by higher age, body mass index (BMI), systolic blood pressure and lower O2 saturation on admission. Gender, ethnicity and COVID-19-related symptoms were similar. Glucose and several markers of inflammation, tissue injury and organ dysfunction were higher among patients with diabetes: troponin, lactate dehydrogenase, creatine phosphokinase (CPK), C-reactive protein (CRP), lactate, brain natriuretic peptide, urea, creatinine, sodium, potassium but lower albumin levels. Hospital (12 × 11 days) and intensive care unit permanence (10 × 9 days) were similar but DM group needed more vasoactive, anticoagulant and anti-platelet drugs, oxygen therapy, endotracheal intubation and dialysis. Lethality was higher in patients with diabetes (39.3% × 30.7%) and increased with glucose levels and age, in male sex and with BMI < 30 kg/m2 in both groups (obesity paradox). It was lower with previous treatment with ACEi/BRA in both groups. Ethnicity and education level did not result in different outcomes between groups. Higher frequency of comorbidities (hypertension, cardiovascular/renal disease, stroke), of inflammatory (higher leucocyte number, RCP, LDH, troponin) and renal markers (urea, creatinine, potassium levels and lower sodium, magnesium) differentiated lethality risk between patients with and without diabetes. CONCLUSIONS: Comorbidities, inflammatory markers and renal disfunction but not Covid-19-related symptoms, obesity, ethnicity and education level differentiated lethality risk between patients with and without diabetes.

Hepatotoxic Evaluation of N-(2-Hydroxyphenyl)-2-Propylpentanamide: A Novel Derivative of Valproic Acid for the Treatment of Cancer.

Valproic acid (VPA) is a drug that has various therapeutic applications; however, it has been associated with liver damage. Furthermore, it is interesting to propose new compounds derived from VPA as N-(2-hydroxyphenyl)-2-propylpentanamide (HO-AAVPA). The HO-AAVPA has better antiproliferative activity than the VPA in different cancer cell lines. The purpose of this study was to evaluate the liver injury of HO-AAVPA by acute treatment (once administration) and repeated doses for 7 days under intraperitoneal administration. The median lethal dose value (LD50) was determined in rats and mice (females and males) using OECD Guideline 425. In the study, male rats were randomly divided into 4 groups (n = 7), G1: control (without treatment), G2: vehicle, G3: VPA (500 mg/kg), and G4: HO-AAVPA (708 mg/kg, in equimolar ratio to VPA). Some biomarkers related to hepatotoxicity were evaluated. In addition, macroscopic and histological studies were performed. The LD50 value of HO-AAVPA was greater than 2000 mg/kg. Regarding macroscopy and biochemistry, the HO-AAVPA does not induce liver injury according to the measures of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, glutathione peroxidase, glutathione reductase, and catalase activities. Comparing the treatment with HO-AAVPA and VPA did not show a significant difference with the control group, while malondialdehyde and glutathione-reduced levels in the group treated with HO-AAVPA were close to those of the control (p ≤ 0.05). The histological study shows that liver lesions caused by HO-AAVPA were less severe compared with VPA. Therefore, it is suggested that HO-AAVPA does not induce hepatotoxicity at therapeutic doses, considering that in the future it could be proposed as an antineoplastic drug.

Apocynin, an NADPH Oxidase Enzyme Inhibitor, Prevents Amebic Liver Abscess in Hamster.

Amebiasis is an intestinal infection caused by Entamoeba histolytica. Amebic liver abscess (ALA) is the most common extraintestinal complication of amebiasis. In animal models of ALA, neutrophils have been shown to be the first cells to come into contact with Entamoeba histolytica during the initial phase of ALA. One of the multiple mechanisms by which neutrophils exhibit amebicidal activity is through reactive oxygen species (ROS) and the enzyme NADPH oxidase (NOX2), which generates and transports electrons to subsequently reduce molecular oxygen into superoxide anion. Previous reports have shown that ROS release in the susceptible animal species (hamster) is mainly stimulated by the pathogen, in turn provoking such an exacerbated inflammatory reaction that it is unable to be controlled and results in the death of the animal model. Apocynin is a natural inhibitor of NADPH oxidase. No information is available on the role of NOX in the evolution of ALA in the hamster, a susceptible model. Our study showed that administration of a selective NADPH oxidase 2 (NOX2) enzyme inhibitor significantly decreases the percentage of ALA, the size of inflammatory foci, the number of neutrophils, and NOX activity indicated by the reduction in superoxide anion (O2-) production. Moreover, in vitro, the apocynin damages amoebae. Our results showed that apocynin administration induces a decrease in the activity of NOX that could favor a decrease in ALA progression.

Riluzole, a Derivative of Benzothiazole as a Potential Anti-Amoebic Agent against Entamoeba histolytica.

Amoebiasis is produced by the parasite Entamoeba histolytica; this disease affects millions of people throughout the world who may suffer from amoebic colitis or amoebic liver abscess. Metronidazole is used to treat this protozoan, but it causes important adverse effects that limit its use. Studies have shown that riluzole has demonstrated activity against some parasites. Thus, the present study aimed, for the first time, to demonstrate the in vitro and in silico anti-amoebic activity of riluzole. In vitro, the results of Entamoeba histolytica trophozoites treated with IC50 (319.5 µM) of riluzole for 5 h showed (i) a decrease of 48.1% in amoeba viability, (ii) ultrastructural changes such as a loss of plasma membrane continuity and alterations in the nuclei followed by lysis, (iii) apoptosis-like cell death, (iv) the triggering of the production of reactive oxygen species and nitric oxide, and (v) the downregulation of amoebic antioxidant enzyme gene expression. Interestingly, docking studies have indicated that riluzole presented a higher affinity than metronidazole for the antioxidant enzymes thioredoxin, thioredoxin reductase, rubrerythrin, and peroxiredoxin of Entamoeba histolytica, which are considered as possible candidates of molecular targets. Our results suggest that riluzole could be an alternative treatment against Entamoeba histolytica. Future studies should be conducted to analyze the in vivo riluzole anti-amoebic effect on the resolution of amebic liver abscess in a susceptible model, as this will contribute to developing new therapeutic agents with anti-amoebic activity.

Incidence and prognosis of late readmission after percutaneous coronary intervention.

BACKGROUND: Early readmission (< 30 days) after percutaneous coronary intervention (PCI) is associated with a worse prognosis, but little is known regarding the causes and consequences of late readmission. The aim of the present study was to determine the incidence, causes, and prognosis of patients readmitted > 1 < 12-months after PCI (late readmission). METHODS: Single-center retrospective cohort study of 743 consecutive post-PCI patients. Patient characteristics and follow-up data were collected by reviewing their electronic medical records and from standardized telephone interviews performed at 1 year and at the end of follow-up. RESULTS: Of the 743 patients, 224 (30.14%) were readmitted 1-12 months after PCI, 109 due to chest pain (48.66%), and 115 for other reasons (51.34%). Hospital readmission was associated with lower survival rates of 77.6% vs. 98.3% at 24 months and 73.5% vs. 97.6% at 36 months (p < 0.001). Univariate predictors for late readmission were hypertension, older age, chronic kidney disease, lower left ventricular ejection fraction, and lower baseline hemoglobin concentration. Only baseline hemoglobin concentration was an independent predictor of late readmission (odds ratio: 0.867, 95% confidence interval: 0.778-0.966, p = 0.01). Readmission for chest pain portrayed a lower mortality rate compared to other causes, with survival rates of 90.2% vs. 50% at 36 months (p < 0.001). CONCLUSIONS: Late hospital readmission after PCI is associated with a worse prognosis and is related to patient comorbidities. Readmission for chest pain is common and portrayed a more favorable prognosis, similar to patients not readmitted. A readily available parameter, baseline anemia, was the main predictor of late readmission.

Highly Diverse Arenaviruses in Neotropical Bats, Brazil.

We detected arenavirus RNA in 1.6% of 1,047 bats in Brazil that were sampled during 2007-2011. We identified Tacaribe virus in 2 Artibeus sp. bats and a new arenavirus species in Carollia perspicillata bats that we named Tietê mammarenavirus. Our results suggest that bats are an underrecognized arenavirus reservoir.

Cholecystokinin Outcome on Markers of Intestinal IgA Antibody Response.

Cholecystokinin 8 (CCK8) is an entero-octapeptide that participates in crosstalk with components of intestinal immunity via the CCK receptor (CCKR), but its role in modulation of the IgA response is not fully known under physiological conditions. Male eight-week-old BALB/c mice each were intraperitoneally injected once during 7 days with CCK8, devazapide (CCKR1 antagonist), L365,260 (CCKR2 antagonist) or vehicle (sham group). In intestinal lavages, total and secretory IgA (SIgA) were determined by ELISA; in lamina propria, IgA+ B lymphocytes and IgA+ plasma cells were analyzed by flow cytometry; mRNA levels of polymeric immunoglobulin receptor (pIgR) in epithelial cells and α chain, interleukins (ILs) in lamina propria cells were assessed by qRTPCR. Regarding the sham conditions, IgA+ plasma-cell percentage and IL-2, IL-5, IL-10 and transforming growth factor-ß (TGF-ß) mRNA levels were either increased by CCK8 or decreased by both CCKR antagonists. For IgA/SIgA responses, IL-4/IL-6 mRNA levels were decreased by all drugs and pIgR mRNA was increased by CCK8 and reduced by L365,260. IgA+ B cell percentage and α chain mRNA levels were elicited by CCK8 and L365,260. Data suggested a presumable differential role of CCK/CCKR on the IgA-response; outcome of L365,260 on the elicitation of IgA+ B cells and α chain mRNA needs further examination.

Medical Theatre as an Innovative Pedagogical Strategy in Medical Simulation.

Medical education has overshadowed the importance for interpersonal abilities in modern medicine practice. In this work, we report an innovative strategy to teach, practice, and evaluate communication and empathy abilities, based on medical theater. This approach was based on interdisciplinary effort between Medicine, Performing Arts, and Bioethics Faculty. Development and first pilot experience results are here reported. A multidisciplinary team was established with the objective to structure the methodology where simulated clinical consultations were performed: two interviews took place, each with one medical student as physician and one performing arts student as simulated patient. Thirty students and 7 Faculty members participated as spectators. Students received immediate feedback and they qualitatively evaluated the global experience. We conclude that medical theater methodology is a developmental strategy that could promote integral acquisition of communication competences. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01551-8.

Ascorbic Acid Ameriolates Liver Damage by Myeloperoxidase Oxidative Products in a Hamster Model of Amoebic Liver Abscess.

Entamoeba histolytica is a protozoan-pathogen-causing amoebic liver abscess (ALA). After amoeba establishment in the liver, it causes abundant infiltrate of neutrophils. Liver tissue damage by neutrophils results in part from anti-amoebic oxidative intermediates, including reactive oxygen species (ROS), reactive nitrogen species (RNS), and hypochlorous acid (HOCl), derived from the myeloperoxidase (MPO) enzyme. Ascorbic acid (ASC) is an antioxidant that acts as a scavenger for ROS and NOS-derived free radicals. No previous information regarding the effect of ASC concerning the participation of MPO in an experimental model of ALA in hamsters has been reported. Thus, the aim of the present work was to analyze the effect of ASC on acute ALA development and to measure the activity and gene expression of the MPO enzyme. Hamsters were treated with ASC (800 mg/kg) and then intrahepatically inoculated with E. histolytica trophozoites. Animals were sacrificed at 3, 6, and 12 h post-inoculation (p.i.), and liver samples were collected. The percentage of lesions, amoeba in situ count, MPO activity, and mpo gene expression were ascertained. Compared to ALA hamsters without ASC treatment as the control group (CT), the ALA group treated with ASC had a significant decrease in liver lesions (all p.i. hours) and viable amoeba count (12 h p.i.) and an increase in MPO activity (12 h p.i.) and mpo gene expression (6 h/12 h p.i.). These data suggest that ASC ameliorated liver damage caused by oxidizing products via modulation of mpo expression and activity.

Muscarinic receptors control markers of inflammation in the small intestine of BALB/c mice.

Muscarinic-acetylcholine-receptors (mAChRs) modulate intestinal homeostasis, but their role in inflammation is unclear; thus, this issue was the focus of this study. BALB/c mice were treated for 7 days with muscarine (mAChR/agonist), atropine (mAChR/antagonist) or saline. Small-intestine samples were collected for histology and cytofluorometric assays in Peyer's patches (PP) and lamina propria (LP) cell-suspensions. In LP, goblet-cells/leukocytes/neutrophils/MPO+ cells and MPO/activity were increased in the muscarine group. In PP, IFN-γ+/CD4+ T or IL-6+/CD4+ T cell numbers were higher in the muscarine or atropine groups, respectively. In LP, TNF-α+/CD4+ T cell number was higher in the muscarine group and lower in the atropine.

Maestras de preescolar: características reconocidas en niños y niñas con aptitudes sobresalientes / Preschool teachers: recognized characteristics in gifted children / Professores de pré-escolar: características reconhecidas em meninos e meninas excepcionais

Resumen (analítico) El presente trabajo tuvo como objetivo identificar las características que las profesoras de preescolar reconocían en las niñas y los niños con aptitudes sobresalientes. Es una investigación cuantitativa, transversal y exploratoria. Participaron 58 profesoras de preescolar. Se empleó la técnica de redes semánticas naturales modificadas a través de cuatro preguntas estímulo: qué características tienen los niños con aptitud sobresaliente en el área cognitiva, en el área crea-tiva, en el área psicomotriz y área socioemocional. Los resultados mostraron que las profesoras lograron reconocer algunos rasgos de los niños sobresalientes que coinciden con lo reportado en la litera-tura, lo que sugiere que ellas pueden ser un elemento clave en la detección de la población si se les proporcionan los instrumentos apropiados con las características del alumnado sobresaliente.

Abstract (analytical) This study had the objective of identifying characteristics that preschool teachers recognize in gifted boys and girls through a quantitative, cross-sectional and exploratory investigation. A total of 58 preschool teachers participated in the research. A modified natural semantic networks technique was used by asking four stimulus questions: What characteristics do gifted children have in the cognitive area?; in the creative area?; in the psychomotor area; and in the socio-emotional area. The results showed that the teachers were able to recognize some characteristics of gifted children that coincide with what is reported in scientific literature. This suggests that they may be a key element in detec-ting the population of gifted children if they are provided with the appropriate instruments outlining the characteristics of outstanding students.

Resumo (analítico) O presente trabalho teve como objetivo identificar ases características que professores de pré-escola reconhecem em meninos e meninas com habilidades destacadas. É uma investigação quantitativa, transversal e exploratória. Participaram 58 professores de pré-escola, foi utilizada a técnica de redes semânticas naturais modificadas por meio de quatro questões-estímulo: Quais são as características das crianças com aptidão destacada na área cognitiva, na área criativa, na área psicomotora e na área socioemocional. Os resultados mostraram que os professores conseguiram reconhecer algumas características das crianças destacadas que coincidem com o que foi relatado na literatura, o que sugere que podem ser um elemento fundamental no detecção da população se lhes forem fornecidos os instrumentos adequados com as características dos alunos destacados.

Serological Surveillance of Rabies in Free-Range and Captive Common Vampire Bats Desmodus rotundus.

The control of vampire bat rabies (VBR) in Brazil is based on the culling of Desmodus rotundus and the surveillance of outbreaks caused by D. rotundus in cattle and humans in addition to vaccination of susceptible livestock. The detection of anti-rabies antibodies in vampire bats indicates exposure to the rabies virus, and several studies have reported an increase of these antibodies following experimental infection. However, the dynamics of anti-rabies antibodies in natural populations of D. rotundus remains poorly understood. In this study, we took advantage of recent outbreaks of VBR among livestock in the Sao Paulo region of Brazil to test whether seroprevalence in D. rotundus reflects the incidence of rabies in nearby livestock populations. Sixty-four D. rotundus were captured during and after outbreaks from roost located in municipalities belonging to three regions with different incidences of rabies in herbivores. Sixteen seropositive bats were then kept in captivity for up to 120 days, and their antibodies and virus levels were quantified at different time points using the rapid fluorescent focus inhibition test (RFFIT). Antibody titers were associated with the occurrence of ongoing outbreak, with a higher proportion of bats showing titer >0.5 IU/ml in the region with a recent outbreak. However, low titers were still detected in bats from regions reporting the last outbreak of rabies at least 3 years prior to sampling. This study suggests that serological surveillance of rabies in vampire bats can be used as a tool to evaluate risk of outbreaks in at risk populations of cattle and human.

Randomized study comparing 3D virtual reality and conventional 2D on-screen teaching of cerebrovascular anatomy.

OBJECTIVE: Performing aneurysmal clipping requires years of training to successfully understand the 3D neurovascular anatomy. This training has traditionally been obtained by learning through observation. Currently, with fewer operative aneurysm clippings, stricter work-hour regulations, and increased patient safety concerns, novel teaching methods are required for young neurosurgeons. Virtual-reality (VR) models offer the opportunity to either train a specific surgical skill or prepare for an individual surgery. With this study, the authors aimed to compare the spatial orientation between traditional 2D images and 3D VR models in neurosurgical residents or medical students. METHODS: Residents and students were each randomly assigned to describe 4 aneurysm cases, which could be either 2D images or 3D VR models. The time to aneurysm detection as well as a spatial anatomical description was assessed via an online questionnaire and compared between the groups. The aneurysm cases were 10 selected patient cases treated at the authors' institution. RESULTS: Overall, the time to aneurysm detection was shorter in the 3D VR model compared to 2D images, with a trend toward statistical significance (25.77 ± 37.26 vs 45.70 ± 51.94 seconds, p = 0.052). No significant difference was observed for residents (3D VR 24.47 ± 40.16 vs 2D 33.52 ± 56.06 seconds, p = 0.564), while in students a significantly shorter time to aneurysm detection was measured using 3D VR models (26.95 ± 35.39 vs 59.16 ± 44.60 seconds, p = 0.015). No significant differences between the modalities for anatomical and descriptive spatial mistakes were observed. Most participants (90%) preferred the 3D VR models for aneurysm detection and description, and only 1 participant (5%) described VR-related side effects such as dizziness or nausea. CONCLUSIONS: VR platforms facilitate aneurysm recognition and understanding of its spatial anatomy, which could make them the preferred method compared to 2D images in the years to come.

Occurrence and diversity of Sarcocystidae protozoa in muscle and brain tissues of bats from São Paulo state, Brazil.

Studies on infectious and emerging diseases caused by bats have been increasing worldwide due to their well-recognised status as a reservoir species for various infectious agents as well as their close relationship to humans and animals. This study reports the molecular frequency and diversity of the parasites belonging to the Sarcocystidae family in bats in São Paulo state, Brazil. A total of 2892 tissue samples (brain and pectoral muscle/heart homogenates) from 1921 bats belonging to 36 species were collected, and the Sarcocystidae protozoan 18S ribosomal RNA encoding genes (18S rDNA) were detected by nested PCR and Sanger sequencing. The relative prevalence of Sarcocystidae species was 4.7% (91/1921) among 16 bat species, including insectivorous (n = 65), frugivorous (n = 13) and nectarivorous (n = 11) bats. From 66 sequenced positive samples, 50 were found to be suitable for analysis. Ten samples from insectivorous and nectarivorous bats showed 100% similarity with Neospora caninum (n = 1), Hammondia hammondi (n = 1), Cystoisospora canis (n = 1), Nephroisospora eptesici (n = 1), Sarcocystis (Frenkelia) glareoli (n = 1), and Toxoplasma gondii (n = 5). The 45 non-T. gondii samples revealed 15 different 18S rDNA alleles with identities varying from 96.1 to 100% with several Sarcocystidae species, which might suggest that bats can harbour a large variety of Sarcocystidae organisms. From the five T. gondii-positive tissue samples, three samples from two different bat specimens of the insectivorous Eumops glacinus were characterised using 11 PCR-restriction fragment length polymorphism (RFLP) markers, revealing the non-archetypal ToxoDB genotypes #6 (type BrI), which is one of the most prevalent in different hosts and regions from Brazil, and #69. We recommend the inclusion of T. gondii as a differential diagnosis for rabies and other neurological syndromes in bats.

Protective Role of Glutathione and Nitric Oxide Production in the Pathogenesis of Pterygium.

OBJECTIVE: In the pathogenesis of pterygium, the protective role of glutathione and nitric oxide production is unclear. These are important factors for homeostasis in the redox state of cells. The aim of this study was to determine the levels of these and related parameters in pterygium tissue. Patients and Methods. The study sample consisted of 120 patients diagnosed with primary or recurrent pterygium. Five groups of tissue samples were examined: control, primary pterygium, recurrent pterygium, and two groups of primary pterygium given a one-month NAC presurgery treatment (topical or systemic). The levels of endothelial nitric oxide synthase (eNOS), nitric oxide (NO), 3-nitrotyrosine (3NT), reduced and oxidized glutathione (GSH and GSSG), and catalase (CAT) were evaluated in tissue homogenates. RESULTS: Compared with the control, decreased levels of eNOS, NO, and 3-nitrotyrosine as well as the degree of oxidation of GSH (GSSG%) were observed in primary and recurrent pterygium. 3-Nitrotyrosine and GSSG% were reduced in the other pterygium groups. GSH and CAT were enhanced in recurrent pterygium and systemic-treated primary pterygium but were unchanged for topical-treated primary pterygium. There was a strong positive correlation of eNOS with NO and 3NT, GSSG% with NO and 3NT, and GSH with GSSG and CAT. Women showed a higher level of GSH and catalase in primary pterygium, whereas a lower level of GSH and a higher level of NO in recurrent pterygium. CONCLUSION: The results are congruent with the following proposed sequence of events leading to a protective response of the organism during the pathogenesis of primary pterygium: a decreased level of eNOS provokes a decline in the level of NO in pterygium tissue, which then leads to reduced S-nitrosylation of GSH or other thiols and possibly to the modulation of the intracellular level of GSH through synthesis and/or mobilization from other tissues.

Descompresión suboccipital percutánea como alternativa en el tratamiento del dolor secundario a la neuralgia del nervio occipital: serie de casos / Suboccipital decompression as an alternative in the treatment of pain secundary to occipital neuralgia: a case series

INTRODUCCIÓN: La neuralgia occipital es una entidad con componentes bien definidos, pero ocasionalmente subdiagnosticada, que tiende a mantener un comportamiento insidioso y generar cierta resistencia al tratamiento médico, manteniendo una buena respuesta al manejo intervencionista con un mínimo índice de complicaciones asociadas y un alivio del dolor satisfactorio y prolongado. DESCRIPCIÓN DEL CASO: Presentamos 5 casos de pacientes con criterios definidos para neuralgia occipital por la (IHS), los cuales fueron manejados mediante descompresión suboccipital percutánea, evaluados por la escala numérica análoga y escala verbal análoga durante un periodo de 90 días. Los procedimientos se realizaron sin complicaciones ni eventos adversos. El resultado fue un alivio satisfactorio para el paciente del dolor crónico, con una adecuada especificidad del sitio del padecimiento, así como mejoría en la calidad de vida, el estado de ánimo, el consumo de medicamentos y la satisfacción de la paciente. CONCLUSIONES: Consideramos que el uso de la descompresión percutánea del nervio occipital mayor vía suboccipital puede ser tomada como una alternativa en pacientes con neuralgia occipital, con una alta probabilidad de obtener un beneficio analgésico y una baja probabilidad de presentar algún efecto adverso o complicación

INTRODUCTION: Occipital neuralgia is an entity with welldefined components, but occasionally underdiagnosed that tends to maintain insidious behavior and generate some resistance to medical treatment, maintaining a good response to interventional management with a minimum rate of associated complications and pain relief. Satisfactory and prolonged. CASE DESCRIPTION: We present 5 cases of patients with defined criteria for occipital neuralgia by (IHS) which were managed by suboccipital decompression, evaluated by the analog numerical scale and analogous verbal scale over a period of 90 days. The procedures were performed without complications or adverse events. The result was a satisfactory relief for the patient of chronic pain, with adequate specificity of the site of the condition; as well as improvement in the quality of life, mood, medication consumption and patient satisfaction. CONCLUSIONS: We consider that the use of decompression of the major occipital nerve via suboccipital route can be taken as an alternative in patients with occipital neuralgia, with a high probability of obtaining an analgesic benefit and a low probability of presenting some adverse effect or complication

Restraint stress increased the permeability of the nasal epithelium in BALB/c mice.

Stress seems to affect the onset and evolution of diverse illnesses with an inflammatory substrate. Whether physiological or psychological, stress increases epithelial permeability. In the mucosa of the nasal cavity and upper respiratory tract, the epithelial barrier is regulated in large part by bicellular and tricellular tight junctions (bTJs and tTJs, respectively). The junctional complexes are composed of multiple membrane proteins: claudins, tight-junction-associated MARVEL proteins (TAMs: occludin, tricellulin and marvelD3), and scaffolding proteins such as ZO-1, -2 and -3. The aim of the present study was to examine the possible modification of nasal permeability and TJ protein expression in a mouse model of acute psychological stress (a 4-h immobility session). Serum corticosterone was quantified from plasma samples to verify the onset of stress. Evaluation was made of the relative concentration of key proteins in nasal mucosa by using Western blot, and of changes in permeability by analyzing FITC-Dextran leakage from the nose to the blood. Compared to the control, the stressed group showed a greater epithelial permeability to FITC-Dextran, a reduced expression of occludin and tricellulin, and an elevated expression of ZO-2 and claudin-4. This evidence points to increased paracellular flow of large molecules through an altered structure of tTJs. Apparently, the structure of bTJs remained unchanged. The current findings could provide insights into the relation of stress to the onset/exacerbation of respiratory infections and/or allergies.