Neuroprotection of lipoic acid treatment promotes angiogenesis and reduces the glial scar formation after brain injury.

After trauma brain injury, a large number of cells die, releasing neurotoxic chemicals into the extracellular medium, decreasing cellular glutathione levels and increasing reactive oxygen species that affect cell survival and provoke an enlargement of the initial lesion. Alpha-lipoic acid is a potent antioxidant commonly used as a treatment of many degenerative diseases such as multiple sclerosis or diabetic neuropathy. Herein, the antioxidant effects of lipoic acid treatment after brain cryo-injury in rat have been studied, as well as cell survival, proliferation in the injured area, gliogenesis and angiogenesis. Thus, it is shown that newborn cells, mostly corresponded with blood vessels and glial cells, colonized the damaged area 15 days after the lesion. However, lipoic acid was able to stimulate the synthesis of glutathione, decrease cell death, promote angiogenesis and decrease the glial scar formation. All those facts allow the formation of new neural tissue. In view of the results herein, lipoic acid might be a plausible pharmacological treatment after brain injury, acting as a neuroprotective agent of the neural tissue, promoting angiogenesis and reducing the glial scar formation. These findings open new possibilities for restorative strategies after brain injury, stroke or related disorders.

Tratamiento con Amisulpride de pacientes adictos a sustancias psicoactivas y síntomas psicóticos / Treatment with amisulpride of addicted patients to psychoactive substances and psychotic symptoms

Introducción. Cada vez disponemos de mayor información sobre la efectividad de los antipsicóticos de segunda generación en pacientes con síntomas psicóticos y trastorno por abuso de substancias. Amisulpride es un fármaco que por sus características puede considerarse una opción terapéutica válida en el manejo de estos pacientes. Objetivo. Evaluar la utilidad del Amisulpride en pacientes con Trastorno por Consumo de Sustancias y comorbilidad asociada. Método. Estudio experimental y prospectivo. Se reclutaron 97 pacientes ambulatorios que iniciaban y/o se encontraban en tratamiento en la Unidad de Conductas Adictivas de Paterna, Valencia (España). Los criterios de inclusión abarcaban a pacientes de ambos sexos con diagnostico de dependencia, según DSM-IV-TR, a una de las siguientes sustancias: alcohol, heroína, cocaína ó cannabis, que habiendo superado la fase de desintoxicación presentaban uno o varios de los síntomas siguientes: ideación paranoide, hostilidad, impulsividad ó irritabilidad marcada, sensibilidad interpersonal, alucinaciones auditivas, o alucinaciones visuales. Los pacientes que habían sido diagnosticados de dependencia a la heroína ya se encontraban en tratamiento de mantenimiento con metadona antes de ser incluidos en el estudio. Se pautó una dosis inicial de Amisulpride, estandarizada en dos rangos (100-300 mg y >/= 400 mg) que fue aumentándose paulatinamente según la respuesta clínica. El seguimiento fue de 9 meses y se realizaron 4 controles a los 3, 6 y 9 meses. Resultados. De un total de 97 pacientes seleccionados, 14 se excluyeron del análisis por violación del protocolo. Abandonaron el estudio 20 y finalizaron el seguimiento a los 9 meses un total de 63 casos. La dosis media de Amisulpride fue de 493,5±197,1 mg/día. En los pacientes que cumplieron el tratamiento, hubo mejoría global del distress psicológico, disminución del craving y mejoría de la funcionalidad psíquica y social. Conclusiones. El tratamiento con Amisulpride es efectivo en pacientes con dependencia a distintas sustancias y comorbilidad asociada, tanto a corto como a medio plazo (AU)

Introduction. There is ever more available information on the effectiveness of second-generation antipsychotic drugs used in addictive behaviour patients with psychotic symptoms. Due to its characteristics, Amisulpride is a medicine that can be considered as a valid therapeutic option to treat this group of patients. Objective. To assess the value of Amisulpride to treat patients with addictive behaviours, and the associated morbidity. Method. An experimental, prospective study was conducted. A total of 97 ambulatory patients, who were initiating, or already receiving, treatment at the Addictive Behaviours Unit in Paterna, Valencia (Spain), were selected to take part in the study. Inclusion criteria included female and male patients, diagnosed of miss using any of the following substances: alcohol, heroine, cocaine or cannabis, who having overcome the detoxification phase, presented one or more of the following symptoms: paranoidideas, hostility, severe irritative or impulsive behaviours, interpersonal sensitivity, and hearing or visual allucinations. An initial dose of Amisulpride, standardized in two ranges (100-300 mg y >/= 400 mg) was used. It was progressively increased according to the clinical response. Four assessments were conducted at months 0,3, 6 and 9. Results. Out of a total of 97 patients, 14 were excluded due to violation of the protocol. Twenty patients dropped out and 63 completed the follow-up period. Mean Amilsupride daily dose was 493.5 ± 197.1 mg In those patients who completed the treatment, an overall improvement in their psychological distress, a decreased in craving and an improvement in their psychological and social functioning were found. Conclusion. Treatment with Amisulpride seems to be effective in patients who are on different addictive substances, and its associated morbidity, both at a short and a medium period of time (AU)

[Are blood lipids a risk factor for age-related macular degeneration?]. / Los lípidos séricos, factor de riesgo de la degeneración macular asociada a la edad?

PURPOSE: To study the levels of lipids in serum, in patients with age-related macular degeneration (AMD), and to establish its pathogenic relevance in the disease. METHODS: The serums of a total of 40 patients, distributed in a AMD group (25 patients) and a control group (15 patients, with similar ages and without ocular affectation) were studied, correlating the biochemical findings with the clinical examination of these patients. RESULTS: We have observed a mean level of serum total cholesterol statistically superior in AMD patients (control= 200.18+/-18.89 mg/dL; AMD= 227.28+/-5.46 mg/dL; p<0.01). These significant differences are repeated for different lipoproteins (triglycerides, LDL, VLDL and apolipoprotein B), not appearing for the HDL and apolipoprotein A-1. We have not found correlations of these concentrations with the clinical or functional stage of the AMD. CONCLUSIONS: Serum lipids could take part in the pathogenic mechanism of AMD, either by their relation with arteriosclerosis, which would diminish the choroidal flow, or by direct deposit in the Bruch's membrane. However, more longitudinal studies are needed to understand the relation of serum lipids and AMD, and to establish therapeutic approaches on the matter.

Los lípidos séricos ¿Factor de riesgo de la degeneración macular asociada a la edad? / Cholesterol ¿A risk factor for age-related macular degeneration?

Objetivo: Estudiar el patrón de los lípidos séricos en los pacientes con degeneración macular asociada a la edad (DMAE), y establecer su importancia patogénica. Material: Se han estudiado los sueros de un total de 40 pacientes distribuidos en un grupo DMAE (25 pacientes) y un grupo control (15 sujetos sin afectación ocular) del mismo rango de edad, correlacionándose los hallazgos bioquímicos con la exploración clínica de estos enfermos. Resultados: Hemos observado una concentración media de colesterol total sérico en los pacientes con DMAE estadísticamente superior que la hallada en el grupo control (control= 200,18ñ18,19 mg/dL; DMAE= 227,28ñ5,46 mg/dL; p<0,01). Estas diferencias significativas se repiten para las distintas lipoproteínas (triglicéridos, LDL, VLDL y apolipoproteína B), no apareciendo para la HDL y la apolipoproteína A-1. No hemos encontrado correlaciones de estas concentraciones con el estadio clínico o funcional de la DMAE. Conclusiones: Los lípidos séricos podrían intervenir en la patogenia de la DMAE, bien por su relación con la arteriosclerosis, que disminuiría el flujo coroideo, o bien por depósito directo en la membrana de Bruch. No obstante, se necesitan más estudios longitudinales para comprender la relación de los lípidos séricos y la DMAE, y establecer conductas terapéuticas al respecto. (AU)

[Sterilization of catheters used for intermittent bladder emptying using a domestic microwave oven]. / Esterilización de catéteres empleados para vaciado vesical intermitente con microondas casero.

In contemporary urology it is increasingly frequent the indication of intermittent catheterization. Patients undergoing this type of therapy use several non-standardized methods to make catheterization as clean as possible. Microwave sterilization has been successfully used for certain materials and biological residues. For this reason and because it is a rather inexpensive system, we tried to demonstrate that sterilization of catheters used by our patients for intermittent catheterization using domestic microwave ovens at home is a convenient, inexpensive and clean alternative that should be taken into account. The catheters used were those employed in our hospitalized patients for a minimum of 4 days, which involves a high percentage of contamination. In 15 cases, the catheter was treated in a 800 W domestic microwave oven after having washed it with water so as to eliminate macroscopic organic residues, and in another 15 cases they were thoroughly washed before microwave treatment. In either case, the treatment was done for over 6 minutes at maximum power with the precautions described in the text. In all instances, the catheter's sterility was confirmed except for one case where contamination occurred during post-treatment handling.