[Tissue perfusion monitoring in children with acute circulatory dysfunction: narrative review]. / Monitorización de la perfusión tisular en el niño con disfunción circulatoria aguda: revisión narrativa.

Sepsis is one of the main causes of admission to Intensive Care Units (ICU). The hemodynamic objectives usually sought during the resuscitation of the patient in septic shock correspond to macrohemodynamic parameters (heart rate, blood pressure, central venous pressure). However, persistent alterations in microcirculation, despite the restoration of macrohemodynamic parameters, can cause organ failure. This dissociation between the macrocirculation and microcirculation originates the need to evaluate organ tissue perfusion, the most commonly used being urinary output, lactatemia, central venous oxygen saturation (ScvO2), and veno-arterial pCO2 gap. Because peripheral tissues, such as the skin, are sensitive to disturbances in perfusion, noninvasive monitoring of peripheral circulation, such as skin temperature gradient, capillary refill time, mottling score, and peripheral perfusion index may be helpful as early markers of the existence of systemic hemodynamic alterations. Peripheral circulation monitoring techniques are relatively easy to interpret and can be used directly at the patient's bedside. This approach can be quickly applied in the intra- or extra-ICU setting. The objective of this narrative review is to analyze the various existing tissue perfusion markers and to update the evidence that allows guiding hemodynamic support in a more individualized therapy for each patient.

[Effect of molar incisor hypomineralization on oral health-related quality of life in children and adolescents: a systematic review]. / Efecto de la hipomineralización incisivo molar en la calidad de vida relacionada con la salud bucal de niños y adolescentes: una revisión sistemática.

Introduction: Hypersensitivity, altered dental appearance and fractures are common problems in molar incisor hypomineralization that generate functional and socio-emotional problems. Objective: to evaluate the effect of MIH on oral health-related quality of life in children and adolescents. Materials and methods: A systematic bibliographic search was carried out in electronic databases (Pubmed, Epistemonikos, Dentistry & Oral Sciences Source and Virtual Health Library). Observational studies in English or Spanish conducted between 2016-2022 that evaluated the quality of life of children and adolescents with molar incisor hypomineralization were identified. Most studies were of good methodological quality. Results: Of 96 identified studies, thirteen were included in the synthesis. The most frequent diagnostic criterion for hypomineralization of molar incisors was the index of the European Academy of Pediatric Dentistry and nine studies reported the severity of the disease. The most widely used scale to measure quality of life was the Child Perception Questionnaire (CPQ). According to the children's perception, the most affected dimensions were "Oral Symptoms" and "Emotional Well-Being", according to the parents they were "Oral Symptoms" and "Functional Limitations". Girls with molar incisor hypomineralization had worse oral health-related quality of life. Conclusions: The negative effect of molar incisor hypomineralization on children's oral health-related quality of life seems to vary between the perception of parents and children.

Safety and Effectiveness of a Single Multiallergen Subcutaneous Immunotherapy in Polyallergic Patients.

BACKGROUND: As the number of allergic sensitizations increases the severity of allergic respiratory diseases worsens. Multiple monoallergen immunotherapy can be accompanied by poor treatment adherence and high costs, single multiallergen immunotherapy needs to prove efficacy whilst maintaining a good safety profile. METHODS: Observational, retrospective, multicenter study using a 2-pollen single undiluted multiallergen subcutaneous immunotherapy (SCIT) in routine clinical practice in Spain. Patients with rhinoconjunctivitis, with/without controlled asthma, sensitized to grass, olive, Parietaria, Cupressus, plane tree and/or Salsola pollen were included. Primary and secondary clinical efficacy endpoints were quality of life (mini Rhinitis Quality of Life Questionnaire (miniRQLQ)) and visual analogue scale (VAS) respectively. All adverse events were documented. RESULTS: Ten centers included 97 patients, median age 32 years. SCIT treatment included combinations of grass mix with olive, Parietaria, Cupressus, plane tree or Salsola or olive with Parietaria, Cupressus or Salsola. The mean duration of SCIT was 1.8 years with a high treatment adherence (73%). Significant improvement in quality of life, nasal and ocular symptoms, activity limitations and practical problems (p< 0.0001) and other symptoms (p= 0.024) was observed. Most patients did not develop asthma-like symptoms and a significant improvement of all allergic symptom severity was perceived. VAS showed a significant improvement in rhinoconjunctivitis and asthma by patients and physicians. Twenty-nine patients experienced adverse reactions, 25 had local and 6 had systemic reactions. CONCLUSIONS: Single undiluted multiallergen SCIT treatment of two different pollens is efficacious and safe in both children and adults, showing that it is a suitable option for the treatment of polyallergic patients.

Effectiveness and safety of a glutaraldehyde-modified, L-tyrosine-adsorbed and monophosphoryl lipid A-Adjuvanted allergen immunotherapy in patients with allergic asthma sensitized to olive pollen: A retrospective, controlled real-world study.

BACKGROUND: Allergy to olive pollen is one of the primary causes of allergic asthma in Spain. Even though allergen immunotherapy (AIT) has shown clinical benefits in patients sensitized to different allergens, studies in asthmatic patients sensitized to olive pollen are insufficient. OBJECTIVE: To assess the effectiveness and safety of an ultra-short course of AIT with an L-tyrosine-adsorbed and monophosphoryl lipid A-adjuvanted olive pollen and olive/grass pollen extract (Pollinex Quattro®) in patients with allergic asthma in the real-world setting. METHODS: Retrospective, controlled study including patients with asthma, with and without allergic rhinitis, caused by sensitization to olive pollen from 11 centers in Spain. Patients received out-of-season (October-March) treatment with AIT in addition to their pharmacological treatment (active group) or pharmacological treatment (control group). Effectiveness variables, including unscheduled visits to the healthcare center, emergency room admissions, symptoms of asthma and rhinitis (following GEMA and ARIA classifications, respectively), and use of medication to treat asthma and rhinitis during the subsequent pollen season were compared between treatment groups. RESULTS: Of 131 study patients, 42 were treated with their usual asthma medication (control group) and 89 were treated with AIT (active group), either Pollinex Quattro® 100% olive pollen (n = 43, 48.3%) or 50% olive pollen/50% grass pollen (n = 46, 51.7%). Patients' demographic and clinical characteristics were similar between groups. The mean (SD) number of unscheduled visits to a healthcare center and emergency room admissions due to allergy symptoms was 2.19 (1.40) and 0.43 (0.63) in the control group, and 1.09 (1.25) and 0.11 (0.51) in the active group (P = 0.001 and P = 0.006, respectively). Severity and control of asthma symptoms remained unchanged (P = 0.347 and P = 0.179, respectively), rhinitis type improved (P = 0.025), and severity remained unchanged in the active compared to the control group. The use of short-acting beta-agonists and inhaled corticosteroids to treat asthma symptoms decreased in the active vs. the control group (P = 0.001 and P = 0.031, respectively). Twelve (13.5%) and two (2.2%) patients in the active group experienced local adverse reactions (edema, swelling, erythema, hives, pruritus, and heat), and systemic adverse reactions (hypertensive crisis and low-grade fever) to AIT, respectively; none was serious. CONCLUSION: AIT with Pollinex Quattro® specific for olive pollen and olive/grass pollens resulted in reduced visits to the healthcare center and emergency room and the use of asthma medication during the pollen season, indicating that this treatment was safe and effective in treating asthma in patients sensitized to these pollens.

Dermatophyte colonization in rabbits kept in pet stores of Santiago of Chile / Colonización por dermatofitos en conejos mantenidos en tiendas de mascotas de Santiago de Chile

ABSTRACT Objective. The dermatophytes are keratinophilic fungi, of importance in public health because of their anthropozoophilic nature. Given the increasing acquisition of exotic animals as pets and the scarce studies on the state of colonization by dermatophytes on these animals; we raised the objective of determine the presence of dermatophytes in clinically healthy rabbits (Oryctolagus cuniculus) from pet stores in Santiago, Chile. Materials and Methods. 42 clinically healthy rabbits were studied. Clinical specimens were obtained from the hairy mantle and cultivated on Sabouraud glucose agar and dermatophyte test medium (DTM™); the identification of the fungal isolates was performed using classic mycological procedures that included direct microscopic examination and the analysis of micromorphological features on culture. Results. Of the total number of rabbits studied, three (7.1%) presented colonization by dermatophytes, being more frequent in males and in those animals that coexisted with Guinea Pigs. The species identified in all three cases was Trichophyton mentagrophytes. Conclusions. This study evidence colonization by dermatophytes in domestic rabbits, important information for veterinarians and owners of pets, at the time of being in contact with this animal species.

RESUMEN Objetivo. Los dermatofitos son hongos queratinofílicos, de importancia en salud pública por su rol antropozoofílico. Dado el aumento en la adquisición de animales exóticos como mascotas y los escasos estudios sobre el estado de colonización por dermatofitos en estos animales, nos planteamos el objetivo de determinar la presencia de dermatofitos en conejos (Oryctolagus cuniculus) clínicamente sanos procedentes de tiendas de mascotas en Santiago de Chile. Materiales y Métodos. Se estudiaron 42 conejos clínicamente sanos. Las muestras clínicas se obtuvieron desde el manto piloso y cultivadas en agar Sabouraud glucosado y dermatophyte test medium (DTM®). La identificación del agente aislado fue realizada por procedimientos micológicos clásicos que incluyeron examen microscópico directo y cultivo. Resultados. Del total de conejos estudiados, tres (7,1%) presentaron colonización por dermatofitos, siendo más frecuente en machos y en aquellos animales que convivían con cuyes. La especie identificada en los tres casos fue Trichophyton mentagrophytes. Conclusiones. Este estudio evidencia la colonización por dermatofitos en conejos domésticos, información importante para médicos veterinarios y propietarios de mascotas, al momento de estar en contacto con esta especie animal.

Componentes alimentarios vegetales y microbianos potencialmente útiles en el tratamiento y control de la giardiasis / Potentially useful in the treatment plant and microbial food components and control of giardiasis

La giardiasis es una infección intestinal de amplia distribución mundial, que presenta manifestaciones clínicas con variaciones desde la infección asintomática, a la enfermedad aguda o crónica asociada con diarrea prolongada y severa y malabsorción de nutrientes. Su agente etiológico es el protozoario Giardia lamblia. La infección se inicia por la ingestión de quistes del parásito, presentes en agua y/o alimentos contaminados o por contacto orofecal directo. Los mecanismos a través de los cuales G. lamblia causa le enfermedad permanecen aún en discusión, pero los principales postulados incluyen tanto alteraciones morfológicas como funcionales de la mucosa intestinal a causa de la adhesión de los trofozoítos a las células epiteliales mediante el disco ventral o suctorio, que afectaría la absorción de nutrientes. El principal tratamiento es la administración de drogas antiparasitarias, muchas de las cuales han demostrado tener un amplio rango de efectos secundarios desagradable, lo cual sumado a la ocurrencia de resultados clínicos insatisfactorios y al surgimiento de cepas resistentes, ha impulsado la búsqueda de nuevas estrategias terapéuticas. Es por ello que el objetivo de esta tesis doctoral fue evaluar la actividad antigiardiásica de componentes alimentarios de origen vegetal y microbiano, como así también la interacción de los mismos con drogas antiparasitarias de uso común.

ABSTRACT: Giardiasis is an intestinal infection of worldwide distribution, presenting with clinical manifestations ranging from asymptomatic infection to acute or chronic disease associated with prolonged and severe diarrhea and malabsorption of nutrients, Its etiologic agent is the protozoan Giardia lamblia. Infection is initiated by ingestion of parasite cysts present in contaminated water and food or by direct fecal-oral contact The mechanisms through which G. lamblia causes disease will remain still under discussion, but the main tenets include both mechanical obstruction as morphological and functional alterations of the intestinal mucosa because of the adherence of trophozoites to epithelial cells by ventral disk that affect nutrient absorption. The main treatment is the administration of antiparasitic drugs, many of which have been shown to have a wide range of unpleasant side effects, which added to the occurrence of unsatisfactory clinical results and the emergence of resistant strains, has prompted the search for new therapeutic strategies.

Beneficial effect of Berberis buxifolia Lam, Ziziphus mistol Griseb and Prosopis alba extracts on oxidative stress induced by chloramphenicol.

The chemiluminescence of luminol, a measure of oxidative stress, increased immediately as a consequence of reactive oxygen species (ROS) stimulated by this antibiotic. The effect of Ch was dose dependent with maximum stimulus at 8 mg/ml (Vmax); above this concentration the cells began to reduce the production of ROS. The oxidative injury of Ch was counteracted by water extracts of Berberis buxifolia lam, Zizyphus mistol Griseb and Prosopis alba, indigenous fruits from Argentina. The relatively light units (RLU) emitted decreased immediately as a consequence of a protective effect exerted by the extracts of these fruit extracts on blood cells. The three indigenous fruit extracts reduced to a different extent the oxidative injury caused by Ch. B.buxifolia lam exhibited the highest antioxidant capacity followed by Z.mistol Griseb. Water extracts of both fruit extracts were the most effective against the oxidative stress, while P.alba presented better antioxidant capacity in the ethanolic fraction obtained. Hexane extracts showed low protective action on blood cells, with little reduction of area under curve (AUC) of RLU plotted versus time. Leukocytes remained viable in blood samples incubated for 3h with Ch and water extracts of B. buxifolia lam or Z. mistol Griseb (97.1% and 92.5% viability by Trypan blue exclusion, respectively); whereas with Ch only the cells were stressed and viability decreased to 30%. The three fruit extracts protected the viability of leukocytes in parallel with the decrease of ROS. Erythrocytes were not lysed in the presence of Ch.

Beneficial effect of Berberis buxifolia Lam, Ziziphus mistol Griseb and Prosopis alba extracts on oxidative stress induced by chloramphenicol / Efecto benéfico de extractos de Berberis buxifolia Lam, Zizyphus mistol Griseb y Prosopis alba sobre el estrés oxidativo inducido por cloramfenicol

The chemiluminescence of luminol, a measure of oxidative stress, increased immediately as a consequence of reactive oxygen species (ROS) stimulated by this antibiotic. The effect of Ch was dose dependent with maximum stimulus at 8 mg/ml (Vmax); above this concentration the cells began to reduce the production of ROS. The oxidative injury of Ch was counteracted by water extracts of Berberis buxifolia lam, Zizyphus mistol Griseb and Prosopis alba, indigenous fruits from Argentina. The relatively light units (RLU) emitted decreased immediately as a consequence of a protective effect exerted by the extracts of these fruit extracts on blood cells. The three indigenous fruit extracts reduced to a different extent the oxidative injury caused by Ch. B.buxifolia lam exhibited the highest antioxidant capacity followed by Z.mistol Griseb. Water extracts of both fruit extracts were the most effective against the oxidative stress, while P.alba presented better antioxidant capacity in the ethanolic fraction obtained. Hexane extracts showed low protective action on blood cells, with little reduction of area under curve (AUC) of RLU plotted versus time. Leukocytes remained viable in blood samples incubated for 3h with Ch and water extracts of B. buxifolia lam or Z. mistol Griseb (97.1% and 92.5% viability by Trypan blue exclusion, respectively); whereas with Ch only the cells were stressed and viability decreased to 30%. The three fruit extracts protected the viability of leukocytes in parallel with the decrease of ROS. Erythrocytes were not lysed in the presence of Ch.

Se estudió el efecto antioxidante de tres extractos de frutas autóctonas, Berberis buxifolia lam (michay), Zizyphus mistol Griseb (mistol) and Prosopis alba (algarrobo). Las células sanguíneas humanas sufrieron estrés oxidativo por acción de cloramfenicol (Ch), con un aumento inmediato de especies reactivas del oxígeno (ERO), que fue determinado por quimioluminiscencia con luminol. La respuesta fue dependiente de la dosis, con un máximo a 8 mg/ml. Los extractos de frutas autóctonas de la Argentina fueron capaces de contrarrestar el estrés generado por el antibiótico. El michay y el mistol resultaron más efectivos en la fase acuosa, y el algarrobo fue más antioxidante en extractos etílicos, mientras que las fracciones obtenidas con hexano no fueron activas. La viabilidad de los leucocitos se mantuvo elevada con Ch en presencia de extractos, entre 92.5 y 97.1%, cayendo hasta un 30% con Ch solo. Tanto los eritrocitos como los leucocitos fueron protegidos del efecto estresante por la capacidad antioxidantes de los extractos de las tres frutas investigadas, lo que podría ser importante a considerar en la dieta de niños, y pacientes en general, sometidos a Ch u otras terapias causantes de estrés oxidativo.