Increased Systemic Cytokine/Chemokine Expression in Asthmatic and Non-asthmatic Patients with Bacterial, Viral or Mixed Lung Infection.

This study was aimed to determine the profiles of serum cytokines (IL-1ß, TNF-α, IL-4, IL-5) and chemokines (MCP-1: monocyte chemoattract protein-1 and RANTES: regulated on activation normal T cell expressed and secreted) in individuals with an asthmatic versus a non-asthmatic background with bacterial, viral or mixed acute respiratory infection. Asthmatic (n = 14) and non-asthmatic (n = 29) patients with acute viral, bacterial or mixed (bacterial and viruses) respiratory infection were studied. Patients were also analysed as individuals with pneumonia or bronchitis. Healthy individuals with similar age and sex (n = 10) were used as controls. Cytokine/chemokine content in serum was determined by ELISA. Increased cytokine/chemokine concentration in asthmatic and non-asthmatic patients was observed. However, higher concentrations of chemokines (MCP-1 and RANTES) in asthmatic patients infected by viruses, bacteria or bacteria and viruses (mixed) than in non-asthmatic patients were observed. In general, viral and mixed infections were better cytokine/chemokine inducers than bacterial infection. Cytokine/chemokine expression was similarly increased in both asthmatic and non-asthmatic patients with pneumonia or bronchitis, except that RANTES remained at normal levels in bronchitis. Circulating cytokine profiles induced by acute viral, bacterial or mixed lung infection were not related to asthmatic background, except for chemokines that were increased in asthmatic status.

[Multidisciplinary meeting on application techniques for restitution of synovial fluid in patients with knee arthritis: update]. / Reunión multidisciplinaria sobre técnicas de aplicación para la restitución de fluido sinovial en pacientes con artritis de rodilla: puesta al día.

In the degradation of articular cartilage, functional limitation and pain cardinal signs of osteoarthritis underlies, as a central factor, the quantitative and qualitative alteration of hyaluronic acid, the main component of synovial fluid and cartilage, in a pathophysiological process influenced by a wide variety of risk factors whose impact complicates the disease and radically reduces the quality of life of the patient. Conventional pharmacological management for osteoarthritis is often insufficient. Fortunately, in our days, there are viscosupplements capable of improving, replacing and promoting the endogenous production of degraded hyaluronic acid in osteoarthritis. The use of these compounds requires the adherence to a set of specific techniques, designed for the correct intra-articular infiltration of the viscosupplement without the need to inflict an additional traumatic load on the patient; these techniques with special reference to the patient affected by knee osteoarthritis (gonarthritis) are described in this article, which also highlights the criteria for choosing the ideal viscosupplement, the one most similar to hyaluronic acid native in healthy young people, and one whose therapeutic use reports greater clinical benefits in the short and long term.

En la degradación del cartílago articular, la limitación funcional y el dolor se asocian a la alteración cuantitativa y cualitativa del ácido hialurónico en un proceso fisiopatológico sobre el que influye una amplia variedad de factores cuyo impacto agrava la enfermedad y disminuye la calidad de vida del paciente. El manejo farmacológico convencional para la osteoartritis es a menudo insuficiente. Por fortuna, en el mundo actual se cuenta con viscosuplementos capaces de mejorar, restituir y promover la producción endógena del ácido hialurónico degradado en los cuadros de osteoartritis. El uso de estos compuestos exige el apego a un conjunto de técnicas específicas, diseñadas para la correcta infiltración intraarticular del viscosuplemento sin necesidad de infligir una carga traumática adicional al paciente; estas técnicas con referencia especial al paciente afectado por la osteoartritis de rodilla (gonartritis) se describen en el presente artículo, en el que además se destacan los criterios para la elección del viscosuplemento idóneo, el más semejante al ácido hialurónico nativo de personas jóvenes y sanas y aquel cuyo uso terapéutico reporta mayores beneficios clínicos a corto y a largo plazo.

Elevated levels of interleukin-2 receptor and intercellular adhesion molecule 1 in sera from a venezuelan cohort of patients with dengue.

This study evaluated the levels of soluble interleukin-2 receptor (sIL-2R) and soluble intercellular adhesion molecule-1 (sICAM-1) in patients with dengue. Sera from 17 patients with dengue fever (DF), 15 with dengue hemorrhagic fever (DHF) and 12 healthy individuals were obtained. Increased levels of sIL-2R and sICAM-1 were found in patients with DF and DHF when compared to normal; those were not correlated with leukocytes, hepatic serum enzyme levels or haemostatic parameters. Levels of sIL-2R were related to the different grades of DHF. These results suggest that increased levels of sIL-2R and sICAM-1 are a common feature of dengue.

[Evaluation of immunity against Venezuelan equine encephalitis virus and dengue in the human population of San Carlos, the Almirante Padilla Island Municipality, Zulia State, Venezuela. 1996]. / Evaluación de la inmunidad contra los virus de encefalitis equina venezolana y dengue en la población humana de San Carlos, Municipio Insular Almirante Padilla, Estado Zulia, Venezuela. Año 1996.

The Insular Municipality of Almirante Padilla, historically, has been affected by Venezuelan Equine Encephalitis (VEE) epidemics, that have occurred cyclically in the Paez, Mara and Almirante Padilla Municipalities of the State of Zulia. During the last epidemic outbreak (1995), the studies reported a great number of cases of VEE in humans, based on epidemiologic-clinical diagnosis; occupying this municipality, the first place in the attack rate by the virus. At the same time, Dengue has been defined as an endemic illness affecting different regions, whose etiologic agent has previously circulated in the studied zone. In order to evaluate the immunity acquired against these viruses, a serological study was conducted in San Carlos Island. Two hundred and ten blood samples were obtained at random, among individuals of an age range between < 1 and 69 years, with and without antecedents of viral illness symptomatology at the moment of the epidemic outbreak, occurred in 1995. The samples were classified according to sex and age, and analyzed through the test of ELISA for specific IgG antibodies against the VEE and Dengue viruses. From the total of the samples processed, 116 (55.2%) were positive for VEE, affecting uniformly all age-groups with a slight masculine predominance. Likewise, 88 cases (41.9%) were determined positive for Dengue virus, affecting mainly the group ranging from 10 to 19 years. These results let us suggest that the epidemic outbreak occurred in 1995 at the Almirante Padilla Insular Municipality, had a double nature with both viruses being involved in the etiology of febrile cases.

Monitorización de niveles plasmáticos de fenitoína / Phenytoin plasma levels monitoring

La fenitoína es un fármaco utilizado ampliamente en la práctica clínica para el tratamiento de la epilepsia mayor, de las crisis convulsivas parciales y convulsiones tónico-clónicas generalizadas y menos frecuentemente para otros trastonos como las arritmias cardiacas o las neuralgias del trigémino. Es uno de los fármacos que más frecuentemente se monitorizan por el laboratorio clínico debido a varios motivos: 1. posee un margen terapeútico estrecho con un índice terapeútico bajo; 2. la relación entre la dosis y el nivel plasmático puede resultar impredecible debido a la gran variación interindividual; 3. la cinética de metabolismo es saturable dentro del rango terapeútico, lo que significa que pequeñas variaciones de la dosis pueden producir grandes aumentos de niveles plasmáticos. Las indicaciones de su monitorización son las sospechas de falta de cumplimiento terapéutico o de intoxicación y la presentación de convulsiones. En este trabajo revisamos las propiedades farmacológicas de la fenitoína estudiando especialmente la farmacocinética, las reacciones adversas debidas a sobredosis y los métodos analíticos empleados en el laboratorio para su medida (AU)

[Viral agents in patients with infectious processes of the central nervous system]. / Agentes virales en pacientes con procesos infecciosos del Sistema Nervioso Central.

Local statistics report a great number of cases of neurological diseases of unidentified cause. The purpose of this research was to determine the presence of viral agents in patients with affection of the central nervous system, in Zulia State, Venezuela. In different health centers throughout the state, we collected 129 randomized samples of cerebrospinal fluid (CSF) and serum from patients ranging from 1 day to 41 years of age, showing symptoms of CNS disease and whose bacteriological test resulted negative. The serum/CSF albumin ratio was determined to exclude contaminated CSF samples, thus 54 optimal samples were obtained for the research. We determined serum IgM and CSF IgG specific for Venezuelan equine encephalomyelitis (VEE), Herpes simplex (HSV), Epstein Barr (EBV), Dengue, Rubella and Measles virus, through ELISA and indirect immunofluorescence techniques. Of the 54 samples studied, 33 (61.11%) were positive. %). The etiological agents implicated were VEE 14 cases (42.42%); HSV 11 cases (33.33%); EBV 5 cases (15.15%) and Dengue 3 cases (9.09%). We did not detect Rubella o Measles. Regarding the age distribution, the most affected group was that of children under 12 (83.34%). We analyzed the clinical manifestations and the CSF characteristics and did not find differences suggestive of an specific etiological diagnosis, even though certain signs could be considered early indications of CNS alterations due to viral causes. Our study shows that a large percentage of CNS affections of unknown etiology are produced by viral agents, indicating that in our region, most of this cases are not registered.