Intracraneal complications after raquis surgery. / Complicación intracraneal tras cirugía de raquis lumbar.

Intracraneal bleeding is a rare complication after raquis surgery. It is believed to occur as a drop in the intracraneal pressure after a loss of CSF secondary to an iatrogenic dural tear. We report a patient who after surgery for lumbar stenosis presented a subarachnoid haemorrhage, an intraparenchymal haematoma, and a subdural haematoma. To our knowledge, this is the first report in the literature with such complications after this type of surgery.

Histamine H3 receptor activation inhibits glutamate release from rat striatal synaptosomes.

The release of glutamate from striatal synaptosomes induced by depolarisation with 4-aminopyridine (4-AP) was studied by a method based on the fluorescent properties of the NAPDH formed by the metabolism of the neurotransmitter by glutamate dehydrogenase.Ca(2+)-dependent, depolarisation-induced glutamate release was inhibited in a concentration-dependent manner by the selective histamine H(3) agonist immepip. Best-fit estimates were: maximum inhibition 60+/-10% and IC(50) 68+/-10 nM. The effect of 300 nM immepip on depolarisation-evoked glutamate release was reversed by the selective H(3) antagonist thioperamide in a concentration-dependent manner (EC(50) 23 nM, K(i) 4 nM). In fura-2-loaded synaptosomes, the increase in the intracellular concentration of Ca(2+) ([Ca(2+)](i)) evoked by 4-AP-induced depolarisation (resting level 167+/-14 nM; Delta[Ca(2+)](i) 88+/-15 nM) was modestly, but significantly reduced (29+/-5% inhibition) by 300 nM immepip. The action of the H(3) agonist on depolarisation-induced changes in [Ca(2+)](i) was reversed by 100 nM thioperamide. Taken together, our results indicate that histamine modulates the release of glutamate from corticostriatal nerve terminals. Inhibition of depolarisation-induced Ca(2+) entry through voltage-dependent Ca(2+) channels appears to account for the effect of H(3) receptor activation on neurotransmitter release. Modulation of glutamatergic transmission in rat striatum may have important consequences for the function of basal ganglia and therefore for the control of motor behaviour.

[Clinical practice guidelines of the Spanish Society of Cardiology for surgical risk assessment in cardial patients treated with non-cardiac surgery]. / Guías de práctica clínica de la Sociedad Española de Cardiología en la valoración del riesgo quirúrgico del paciente cardiópata sometido a cirugía no cardíaca.

All patients undergoing a surgical intervention require a cardiovascular evaluation that establishes the surgical risk. On the other hand, an important proportion of the deaths that happened during the surgery are due to cardiovascular complications, many of them could be avoided with a cardiac risk screening. The surgery and the anesthesia subject the patient to stress situations during the perioperative period that forces the check upon capacity of the patient to respond to those demands, dissuading surgery if it considered that the risk is very high. The rate of major surgery in elderly patients is growing, with the increase in cardiovascular complications, mainly myocardial infarction, unstable angina and perioperative heart failure. Following we establish some recommendations for the cardiovascular assessment of the cardiac patient that will undergo noncardiac surgery.

Tyrosine phosphorylation of the p85 subunit of phosphatidylinositol 3-kinase correlates with high proliferation rates in sublines derived from the Jurkat leukemia.

A prominent tyrosine phosphorylated protein of 85 kDa (p85) was detected in highly proliferative sublines derived from the Jurkat T cell leukemia. We undertook a study to characterize the identity of this protein and its possible role in the hyperproliferative phenotypes observed. Using immunoblot and immunoprecipitation techniques, this protein was characterized as the p85 regulatory subunit of phosphatidylinositol 3-kinase. Cell proliferation and p85 tyrosine phosphorylation was not affected by tyrphostin AG-490, an inhibitor of Jak kinases, wortmannin or LY294002, inhibitors of the activity of the catalytic phosphatidylinositol 3-kinase subunit. Herbimycin-A and PPI, inhibitors of src-like protein tyrosine kinases, and genistein, a general tyrosine kinase inhibitor, inhibited p85 tyrosine phosphorylation and induced cell death in the sublines. PD98059, an inhibitor of Mek, inhibited cell growth of the sublines, but not that of the parental cells. It was concluded that tyrosine phosphorylation of p85 is associated with highly proliferative tumoral phenotypes, at least in T cell leukemias, independent of the phosphatidylinositol 3-kinase activity of the catalytic subunit.

[Does captopril possess antianginal actions? An evaluation of its effects on myocardial ischemia by stress tests in patients with stable angina and normal ventricular function]. / Posee el captopril acciones antianginosas? Valoración de sus efectos sobre la isquemia miocárdica mediante pruebas de esfuerzo en enfermos con angina estable y función ventricular normal.

INTRODUCTION: We have studied the effects of captopril on myocardial ischaemia in normotensive and hypertensive patients with coronary artery disease and stable effort-induced angina. STUDY DESIGN: A maximal treadmill effort test (Bruce modified) was obtained before and after 60 min administration of 25 mg. p.o. of captopril. In a first open pilot essay, 12 patients were studied. In a double-blind randomized, placebo-controlled, without crossover, 20 patients with the same characteristics and methodology were divided in two groups (10 in placebo and 10 in captopril group) and compared in a maximal treadmill effort test. RESULTS: In the pilot essay, the second test don't showed increments in heart rate, systolic and diastolic blood pressure showed a significant reduction at rest (p < 0.01) and at 1 mV ST segment depression (p < 0.01). Captopril increased exercise duration at 1 mV ST segment depression, time to angina and total exercise time (p < 0.01). In double-blind essay, captopril group results were similar to the pilot essay. In comparing results between placebo and captopril groups the most relevant differences were: significant increment in the time to 0.1 mV ST segment depression (p < 0.01), to angor (p < 0.05) and total exercise duration (p < 0.01). Maximal work-load sustained increased significantly with captopril (7.43 +/- 2.1 to 10.34 +/- 1.8 METS) (p < 0.01). CONCLUSIONS: We conclude that captopril used in monotherapy in patients with chronic stable angina, seems to reduce clinical and electric ischemia and to ameliorate maximal exercise duration and work-load.

[The double-orifice mitral valve. An evaluation by two-dimensional echocardiography and color echo-Doppler]. / Doble orificio de la válvula mitral. Valoración con ecocardiografía bidimensional y eco-Doppler color.

Double-orifice mitral valve is an uncommon congenital heart defect. The isolated occurrence of this anomaly is exceptional and, more often, is encountered in association with other congenital cardiac abnormalities. Principal among these are the partial and complete forms of the atrioventricular canal. In this paper, we present two cases of double-orifice mitral valve. Our first case is associated with subaortic stenosis and coarctation of aorta. The second case is an isolated one resembling a severe mitral stenosis. As we know, the diagnosis of this rare anomaly by color-Doppler technique has not been previously reported. We believe this technique provides definite anatomical and functional information about double-orifice mitral valve.