Percutaneous Left Atrial Appendage Closure in Patients with Non-Valvular Atrial Fibrillation and End-Stage Renal Disease on Hemodialysis: A Case Series.

Non-valvular atrial fibrillation (NVAF) is the most common cardiac arrhythmia in the general population, and its prevalence increases among patients with chronic kidney disease (CKD) undergoing hemodialysis. This population presents high risk of both hemorrhagic and thrombotic events, with little evidence regarding the use of oral anticoagulation treatment (OAT) and multiple complications arising from it; however, stroke prevention with percutaneous left atrial appendage closure (LAAC) is an alternative to be considered. We retrospectively describe the safety and efficacy of percutaneous LAAC in eight patients with NVAF and CKD on hemodialysis during a 12-month follow-up. The mean age was 78.8 years (range 64-86; SD ± 6.7), and seven patients were male. The mean CHA2DS2-VASC and HAS-BLED scores were high, 4.8 (SD ± 1.5) and 3.8 (SD ± 1.3), respectively. Seventy-five percent of the patients were referred for this intervention due to a history of major bleeding, with gastrointestinal bleeding being the most common type, while the remaining twenty-five percent of the patients were referred because of a high risk of bleeding. The percutaneous LAAC procedure was successfully completed in 100% of the patients, with complete exclusion of the appendage without complications or leaks exceeding 5 mm. There was one death not related to the procedure four days after the intervention. Among the other seven patients, no deaths, cardioembolic events or major bleeding were reported during the follow-up period. In our sample, percutaneous LAAC appears to be a safe and effective alternative to anticoagulation in patients with NVAF and CKD on hemodialysis.

DNA metabarcoding reveals spatial and temporal variation of fish eye fluke communities in lake ecosystems.

Eye flukes (Diplostomidae) are diverse and abundant trematode parasites that form multi-species communities in fish with negative effects on host fitness and survival. However, the environmental factors and host-related characteristics that determine species diversity, composition, and coexistence in such communities remain poorly understood. Here, we developed a cost-effective cox1 region-specific DNA metabarcoding approach to characterize parasitic diplostomid communities in two common fish species (Eurasian perch and common roach) collected from seven temperate lakes in Estonia. We found considerable inter- and intra-lake, as well as inter-host species, variation in diplostomid communities. Sympatric host species characterization revealed that parasite communities were typically more diverse in roach than perch. Additionally, we detected five positive and two negative diplostomid species associations in roach, whereas only a single negative association was observed in perch. These results indicate that diplostomid communities in temperate lakes are complex and dynamic systems exhibiting both spatial and temporal heterogeneity. They are influenced by various environmental factors and by host-parasite and inter-parasite interactions. We expect that the described methodology facilitates ecological and biodiversity research of diplostomid parasites. It is also adaptable to other parasite groups where it could serve to improve current understanding of diversity, distribution, and interspecies interactions of other understudied taxa.

Carbapenem resistance in critically important human pathogens isolated from companion animals: a systematic literature review.

This study aimed to describe the presence and geographical distribution of Gram-negativebacteria considered critical on the priority list of antibiotic-resistant pathogens publishedby the World Health Organization, including carbapenem-resistant Enterobacteriaceae,carbapenem-resistant Acinetobacter spp., and carbapenem-resistant Pseudomonas aeruginosa.A systematic review of original studies published in 5 databases between 2010 and 2021 wasconducted, including genotypically confirmed carbapenem-resistant isolates obtained fromcanines, felines, and their settings. Fifty-one articles met the search criteria. Carbapenemresistant isolates were found in domestic canines and felines, pet food, and on veterinarymedical and household surfaces. The review found that the so-called "big five"-that is, the5 major carbapenemases identified worldwide in Enterobacterales (New Delhi metallo-ßlactamase, active-on-imipenem, Verona integron-encoded metallo-ß-lactamase, Klebsiellapneumoniae carbapenemase, and oxacillin [OXA]-48-like)-and the 3 most importantcarbapenemases from Acinetobacter spp. (OXA-23-like, OXA-40-like, and OXA-58-like) hadbeen detected in 8 species in the Enterobacteriaceae family and 5 species of glucose nonfermenting bacilli on 5 continents. Two publications used molecular analysis to confirmcarbapenem-resistant bacteria transmission between owners and dogs. Isolating criticallyimportant human carbapenem-resistant Gram-negative bacteria from domestic canines andfelines highlights the importance of including these animal species in surveillance programsand antimicrobial resistance containment plans as part of the One Health approach.

Carbapenem resistance in critically important human pathogens isolated from companion animals:a systematic literature review

This study aimed to describe the presence and geographical distribution of Gram-negative bacteria considered critical on the priority list of antibiotic-resistant pathogens published by the World Health Organization, including carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Acinetobacter spp., and carbapenem-resistant Pseudomonas aeruginosa. A systematic review of original studies published in 5 databases between 2010 and 2021 was conducted, including genotypically confirmed carbapenem-resistant isolates obtained from canines, felines, and their settings. Fifty-one articles met the search criteria. Carbapenemresistant isolates were found in domestic canines and felines, pet food, and on veterinary medical and household surfaces. The review found that the so-called “big five”—that is, the 5 major carbapenemases identified worldwide in Enterobacterales (New Delhi metallo-β-lactamase, active-on-imipenem, Verona integron-encoded metallo-β-lactamase, Klebsiella pneumoniae carbapenemase, and oxacillin [OXA]-48-like)—and the 3 most important carbapenemases from Acinetobacter spp. (OXA-23-like, OXA-40-like, and OXA-58-like) had been detected in 8 species in the Enterobacteriaceae family and 5 species of glucose nonfermenting bacilli on 5 continents. Two publications used molecular analysis to confirm carbapenem-resistant bacteria transmission between owners and dogs. Isolating critically important human carbapenem-resistant Gram-negative bacteria from domestic canines and felines highlights the importance of including these animal species in surveillance programs and antimicrobial resistance containment plans as part of the One Health approach.

Multiple Hereditary Exostoses: Report of an EXT2 Gene Mutation in a Colombian Family.

Multiple hereditary exostoses (MHE) is a rare disease with autosomal dominant inheritance, caused by heterozygous germline mutations in the EXT1 or EXT2 genes. This disorder is characterized by the growth of prominences surrounded by cartilage in the growth plates and the long bones. Here, we report a family affected by MHE. In this family, a pathogenic variant c.544C > T (p. Arg182Ter) was identified in the EXT2 gene. This variant has been previously described in the literature, and here we are reporting the relationship with clinical findings. MHE is suspected according to the clinical manifestations; molecular research should be performed to establish the most frequent mutations. A support, diagnosis, and follow-up group should be created, and genetic counseling should be available for patients and families.

Erratum: Erratum: Multiple Hereditary Exostoses: Report of an EXT2 Gene Mutation in a Colombian Family.

[This corrects the article DOI: 10.1055/s-0038-1636998.].

Percutaneous intervention in chronic total coronary occlusions caused by in-stent restenosis: procedural results and long-term clinical outcomes in the TORO (Spanish registry of chronic TOtal occlusion secondary to an occlusive in-stent RestenOsis) multicentre registry.

AIMS: Limited data exist on the treatment and outcomes of patients with chronic total occlusions due to in-stent restenosis (CTO-ISR). We sought to evaluate results and clinical outcomes in percutaneous interventions over CTO-ISR. METHODS AND RESULTS: We conducted a registry in 16 centres involving consecutive patients undergoing attempted percutaneous intervention over CTO-ISR. A total of 233 patients were included, 192 (82.4%) with a successful acute result. The success rate was significantly lower in patients with: lesion in the circumflex artery, ostial lesions, J score >3 and no femoral access. The presence of tandem lesions (OR 0.19, 95% CI: 0.06-0.68; p=0.01) was identified as an independent predictor for outcome. After a median follow-up of 20 months, cardiac death in the successful vs. failed groups was 3% and 8.3%, respectively (p=0.09). Independent predictors for mortality were previous CABG (HR 8, 95% CI: 1.3-50; p=0.02) and multivessel disease (HR 2.3, 95% CI: 1.2-4.3; p=0.01). In the successful group, TLR was 15%, re-occlusion 6% and definite/probable stent thrombosis 1.8%. CONCLUSIONS: Percutaneous treatment of CTO due to ISR in contemporary practice shows a high success rate, resulting in good long-term results. The angiographic and procedural predictors identified may contribute to improving procedural outcome through better patient selection.

Characterization and Clinical Impact of Bloodstream Infection Caused by Carbapenemase-Producing Enterobacteriaceae in Seven Latin American Countries.

INTRODUCTION: Infections caused by carbapenem-resistant Enterobacteriaceae are a public health problem associated with higher mortality rates, longer hospitalization and increased healthcare costs. We carried out a study to describe the characteristics of patients with carbapenemase-producing Enterobacteriaceae (CPE) and non-CPE bloodstream infection (BSI) from Latin American hospitals and to determine the clinical impact in terms of mortality and antibiotic therapy. METHODS: Between July 2013 and November 2014, we conducted a multicenter observational study in 11 hospitals from 7 Latin American countries (Argentina, Colombia, Ecuador, Guatemala, Mexico, Peru, Venezuela). Patients with BSI caused by Enterobacteriaceae were included and classified either as CPE or non-CPE based on detection of blaKPC, blaVIM, blaIMP, blaNDM and blaOXA-48 by polymerase chain reaction. Enrolled subjects were followed until discharge or death. Demographic, microbiological and clinical characteristics were collected from medical records. Both descriptive and inferential statistics were used to analyze the information. RESULTS: A total of 255 patients with Enterobacteriaceae BSI were included; CPE were identified in 53 of them. In vitro non-susceptibility to all screened antibiotics was higher in the patients with CPE BSI, remaining colistin, tigecycline and amikacin as the most active drugs. Combination therapy was significantly more frequent in the CPE BSI group (p < 0.001). The most common regimen was carbapenem + colistin or polymyxin B. The overall mortality was 37% (94/255). Overall and attributable mortality were significantly higher in patients with CPE BSI (p < 0.001); however, we found that patients with CPE BSI who received combination therapy and those who received monotherapy had similar mortality. After multivariate adjustment, CPE BSI (adjusted odds ratio [aOR] 4; 95% confidence interval [CI] 1.7-9.5; p = 0.002) and critical illness (aOR 6.5; 95% CI 3.1-13.7; p < 0.001) were independently associated with in-hospital mortality. CONCLUSIONS: This study provides valuable data on the clinical characteristics and mortality risk factors in patients with CPE BSI. We determined that CPE infection is an independent mortality predictor and thus Latin American hospitals should perform campaigns on prevention and control of CPE BSI.

[Antimicrobial susceptibility of Salmonella enterica isolated during the pre-harvest period in swine in Colombia]. / Susceptibilidad antimicrobiana de aislamientos de Salmonellaentérica obtenidos del pre-beneficio y de porcinos en Colombia.

OBJECTIVE: To determine the antimicrobial susceptibility of isolates of Salmonella enterica isolated from animals and during the pre-slaughter period. METHOD: Antimicrobial susceptibility tests were performed using the agar diffusion method on 333 isolates of Salmonella enterica obtained from the pre-harvest period represented by transport trucks and pens. From the animals, isolates were obtained from the animals' feces in transport trucks and pens, mesenteric lymph nodes, and cecal content. The specimens were obtained from four slaughtering facilities. RESULTS: The antimicrobial susceptibility tests were performed obtaining the following results: 99.6 % (n=332) of isolates showed resistance to at least one antimicrobial agent. The following resistance percentages were found: amoxicillin-clavulanic acid 15.9 % (n=53), ampicillin 33.9 % (n=113), ceftiofur 41.4 % (n=138), ciprofloxacin 9 % (n=30 ), chloramphenicol 19.2 % (n=64), florfenicol 33 % (n=110), gentamicin 22.8 % (n=76), sulfamethoxazole-trimethoprim 24.9 % (n=83), tetracycline 93.1 % (n=310) and tilmicosin 73.8 % (n=246). CONCLUSION: The results show that it is essential to reinforce containment measures to prevent the development of antimicrobial resistances and improve training of the operators, workers, and veterinarians in Colombia involved in the primary production, product processing, distribution, and sale to the consumer, thereby guaranteeing a safe food product and the effectiveness of antimicrobial agents in human and veterinary medicine.

Susceptibilidad antimicrobiana de aislamientos de Salmonellaentérica obtenidos del pre-beneficio y de porcinos en Colombia / Antimicrobial susceptibility of Salmonella enterica isolated during the pre-harvest period in swine in Colombia

Objetivo Determinar la susceptibilidad antimicrobiana de aislamientos de Salmonella enterica obtenidos durante la etapa de prebeneficio y de animales. Método Se realizaron pruebas de susceptibilidad antimicrobiana con el método de difusión en agar a 333 aislamientos de Salmonella enterica obtenidos del prebeneficio de camiones de transporte y de corrales. Se obtuvieron heces en camión, heces en corral, nódulos linfáticos mesentéricos y contenido cecal. Los especímenes fueron obtenidos en cuatro plantas de beneficio porcino. Resultados El 99,6 % (n=332) de las aislamientos mostró resistencia frente al menos un antimicrobiano. Se encontraron los siguientes porcentajes de resistencia: amoxacilina-ácido clavulánico 15,9 % (n=53), ampicilina 33,9 % (n=113), ceftiofur 41,4 % (n=138), ciprofloxacina 9 % (n=30), cloranfenicol 19,2 % (n=64), florfenicol 33 % (n=110), gentamicina 22,8 % (n=76), sulfametoxazol-trimetroprim 24,9 % (n=83), tetraciclina 93,1 % (n=310) y tilmicosina 73,8 % (n=246). Conclusiones Los resultados muestran que es indispensable reforzar las medidas de contención para prevenir el desarrollo de resistencias antimicrobianas y fortaleciendo la capacitación de operarios, trabajadores y médicos veterinarios en la producción primaria durante el procesamiento del producto, durante la distribución y venta hasta el consumidor, garantizando un alimento inocuo.

Objective To determine the antimicrobial susceptibility of isolates of Salmonella enterica isolated from animals and during the pre-slaughter period. Method Antimicrobial susceptibility tests were performed using the agar diffusion method on 333 isolates of Salmonella enterica obtained from the pre-harvest period represented by transport trucks and pens. From the animals, isolates were obtained from the animals' feces in transport trucks and pens, mesenteric lymph nodes, and cecal content. The specimens were obtained from four slaughtering facilities. Results The antimicrobial susceptibility tests were performed obtaining the following results: 99.6 % (n=332) of isolates showed resistance to at least one antimicrobial agent. The following resistance percentages were found: amoxicillin-clavulanic acid 15.9 % (n=53), ampicillin 33.9 % (n=113), ceftiofur 41.4 % (n=138), ciprofloxacin 9 % (n=30 ), chloramphenicol 19.2 % (n=64), florfenicol 33 % (n=110), gentamicin 22.8 % (n=76), sulfamethoxazole-trimethoprim 24.9 % (n=83), tetracycline 93.1 % (n=310) and tilmicosin 73.8 % (n=246). Conclusion The results show that it is essential to reinforce containment measures to prevent the development of antimicrobial resistances and improve training of the operators, workers, and veterinarians in Colombia involved in the primary production, product processing, distribution, and sale to the consumer, thereby guaranteeing a safe food product and the effectiveness of antimicrobial agents in human and veterinary medicine.

Actividad antiinflamatoria y analgésica de un extracto orgánico del alga roja Galaxaura rugosa (J. Ellis & Solander) J.V. Lamouroux / Anti-inflammatory and analgesic activity of an organic extract from the red alga Galaxaura rugosa (J. Ellis & Solander) J.V. Lamouroux

Introducción: el alga roja Galaxaura rugosa (J. Ellis & Solander) J.V. Lamouroux (Galaxauraceae) es una de las especies más abundantes en la plataforma rocosa del arrecife coralino del archipiélago cubano, sin embargo, poco se conoce de sus propiedades farmacológicas. Objetivos: evaluar la actividad antiinflamatoria y analgésica del extracto en diclorometano del alga roja G. rugosa, así como la composición fitoquímica de esta especie. Métodos: las algas se colectaron en el litoral norte de La Habana. La caracterización fitoquímica del alga se realizó según el Método de Chabra. Para la preparación del extracto se sometió la muestra a extracción Soxhlet con diclorometano a 40 ºC. La actividad antiinflamatoria tópica se estudió en el modelo de edema de la oreja inducido por aceite de Croton en ratones machos OF-1, a las dosis de 10*10-3; 0,125; 0,25; 0,5; 1 y 2 mg/oreja. Se evaluó también la actividad analgésica del extracto en el modelo de contorsiones inducidas por ácido acético al 0,8 por ciento, por vía intraperitoneal (i.p.), a las dosis de 3; 6; 12,5; 25 y 100 mg/kg. Resultados: G. rugosa presentó en su composición fitoquímica compuestos grasos, lactónicos, triterpénicos y/o esteroidales y carbohidratos. El extracto en diclorometano de G. rugosa a partir de la dosis de 0,125 mg/oreja presenta una potente actividad antiinflamatoria (superior al 40 por ciento). El extracto logró reducir las contorsiones en más de un 75 por ciento a partir de la dosis de 6 mg/kg. Conclusiones: los resultados presentados demuestran que el extracto en diclorometano del alga roja G. rugosa está constituido por una mezcla de compuestos capaces de inhibir con una elevada eficacia farmacológica la respuesta inflamatoria aguda y el dolor inducido por agentes químicos(AU)

Introduction: the red alga Galaxaura rugosa (J. Ellis & Solander) J.V. Lamouroux (Galaxauraceae) is one of the most abundant species on the rocky platform of the Cuban coral reef. However, little is known about its pharmacological properties. Objectives: evaluate the anti-inflammatory and analgesic activity of a dichloromethane extract from the red alga G. rugosa and determine the phytochemical composition of the species. Methods: the algae were collected from the northern coast of Havana. Phytochemical characterization of the alga was performed using Chabra's method. The extract was obtained with a Soxhlet device with dichloromethane at 40 ºC. Topical anti-inflammatory activity was studied with the croton oil ear edema test model in male OF-1 mice at doses of 10*10-3, 0.125, 0.25, 0.5, 1 and 2 mg/ear. The analgesic activity of the extract was evaluated on a model of writhing induced by 0.8 percent acetic acid administered intraperitoneally (i.p.) at doses of 3, 6, 12.5, 25 and 100 mg/kg. Results: phytochemical analysis of G. rugosa revealed the presence of fatty, lactonic, triterpenic and/or steroidal compounds, as well as carbohydrates. The dichloromethane extract of G. rugosa at the dose of 0.125 mg/ear displayed a potent anti-inflammatory activity (above 40 percent). The extract reduced writhing by more than 75 percent with a dose of 6 mg/kg. Conclusions: results show that dichloromethane extract of the red alga G. rugosa is composed of a mixture of compounds capable of inhibiting the acute inflammatory response and the pain induced by chemical agents with a high pharmacological efficacy(AU)

Actividad antiinflamatoria y analgésica de un extracto orgánico del alga roja Galaxaura rugosa (J. Ellis & Solander) J.V. Lamouroux / Anti-inflammatory and analgesic activity of an organic extract from the red alga Galaxaura rugosa (J. Ellis & Solander) J.V. Lamouroux

INTRODUCCIÓN: el alga roja Galaxaura rugosa (J. Ellis & Solander) J.V. Lamouroux (Galaxauraceae) es una de las especies más abundantes en la plataforma rocosa del arrecife coralino del archipiélago cubano, sin embargo, poco se conoce de sus propiedades farmacológicas. OBJETIVOS: evaluar la actividad antiinflamatoria y analgésica del extracto en diclorometano del alga roja G. rugosa, así como la composición fitoquímica de esta especie. MÉTODOS: las algas se colectaron en el litoral norte de La Habana. La caracterización fitoquímica del alga se realizó según el Método de Chabra. Para la preparación del extracto se sometió la muestra a extracción Soxhlet con diclorometano a 40 ºC. La actividad antiinflamatoria tópica se estudió en el modelo de edema de la oreja inducido por aceite de Croton en ratones machos OF-1, a las dosis de 10*10-3; 0,125; 0,25; 0,5; 1 y 2 mg/oreja. Se evaluó también la actividad analgésica del extracto en el modelo de contorsiones inducidas por ácido acético al 0,8 %, por vía intraperitoneal (i.p.), a las dosis de 3; 6; 12,5; 25 y 100 mg/kg. RESULTADOS: G. rugosa presentó en su composición fitoquímica compuestos grasos, lactónicos, triterpénicos y/o esteroidales y carbohidratos. El extracto en diclorometano de G. rugosa a partir de la dosis de 0,125 mg/oreja presenta una potente actividad antiinflamatoria (superior al 40 %). El extracto logró reducir las contorsiones en más de un 75 % a partir de la dosis de 6 mg/kg. CONCLUSIONES: los resultados presentados demuestran que el extracto en diclorometano del alga roja G. rugosaestá constituido por una mezcla de compuestos capaces de inhibir con una elevada eficacia farmacológica la respuesta inflamatoria aguda y el dolor inducido por agentes químicos.

INTRODUCTION: the red alga Galaxaura rugosa (J. Ellis & Solander) J.V. Lamouroux (Galaxauraceae) is one of the most abundant species on the rocky platform of the Cuban coral reef. However, little is known about its pharmacological properties. OBJECTIVES: evaluate the anti-inflammatory and analgesic activity of a dichloromethane extract from the red alga G. rugosa and determine the phytochemical composition of the species. METHODS: the algae were collected from the northern coast of Havana. Phytochemical characterization of the alga was performed using Chabra's method. The extract was obtained with a Soxhlet device with dichloromethane at 40 ºC. Topical anti-inflammatory activity was studied with the croton oil ear edema test model in male OF-1 mice at doses of 10*10-3, 0.125, 0.25, 0.5, 1 and 2 mg/ear. The analgesic activity of the extract was evaluated on a model of writhing induced by 0.8 % acetic acid administered intraperitoneally (i.p.) at doses of 3, 6, 12.5, 25 and 100 mg/kg. RESULTS: phytochemical analysis of G. rugosa revealed the presence of fatty, lactonic, triterpenic and/or steroidal compounds, as well as carbohydrates. The dichloromethane extract of G. rugosa at the dose of 0.125 mg/ear displayed a potent anti-inflammatory activity (above 40 %). The extract reduced writhing by more than 75 % with a dose of 6 mg/kg. CONCLUSIONS: results show that dichloromethane extract of the red alga G. rugosa is composed of a mixture of compounds capable of inhibiting the acute inflammatory response and the pain induced by chemical agents with a high pharmacological efficacy. composed of a mixture of compounds capable of inhibiting the acute inflammatory response and the pain induced by chemical agents with a high pharmacological efficacy.

Evaluación preliminar del bioensayo para la detección de antimicrobianos en músculo bovino / Preliminary evaluation of the bioassay for the detection of antimicrobial in bovine muscle

Antecedentes: En Colombia, la vigilancia del cumplimiento de los Límites Máximos de Residuos LMRs de antimicrobianos veterinarios en carne bovina es exigua, debido a que la capacidad analítica es insuficiente para monitorear un gran número de muestras y un amplio rango de antibióticos. El bioensayo es un método microbiológico desarrollado por la agencia de salud pública (FSIS) del Departamento de Agricultura de Estados Unidos, para la detección, identificación y semicuantificación de residuos antimicrobianos. Objetivos: Se evaluó preliminarmente el bioensayo para determinar su uso como prueba de detección cualitativa para el monitoreo y vigilancia de residuos de cuatro antimicrobianos en músculo bovino, como contribución al sistema de gestión de inocuidad en el marco del Acuerdo sobre la aplicación de Medidas Sanitarias y Fitosanitarias, bajo lineamientos de la Comisión Europea, Decisión 2002/657/CE. Métodos: El protocolo de experimentación usó tejidos fortificados con diferentes concentraciones de penicilina G potásica, oxitetraciclina, eritromicina y estreptomicina, como representantes de cuatro familias de antibióticos de uso veterinario en Colombia. Para el establecimiento de los criterios de funcionamiento del bioensayo se prepararon seis repeticiones de cada uno de los niveles o concentraciones probadas por antimicrobiano, incluyendo un nivel sin fortificación y cinco niveles de concentraciones antibióticas menores, iguales y superiores al Límite Máximo de Residuos LMRs de cada uno de los antimicrobianos analizados. Resultados: Se establecieron preliminarmente los criterios de funcionamiento del método (especificidad, límites de detección y estabilidad). La técnica mostró excelente especificidad (ningún falso-positivo); los límites de detección se determinaron para los cuatro antibióticos con relación a sus respectivos LMRs: Betalactámicos (penicilina G =LMR), tetraciclinas (oxitetraciclina =LMR), macrólidos (eritromicina =LMR) y aminoglucósidos (estreptomicina >4 LMR); sin embargo, la sensibilidad del bioensayo para estreptomicina no fue satisfactoria. La estabilidad de los analitos en la matriz fortificada al límite de detección, resultó adecuada durante el período de tiempo evaluado. Conclusiones: El método del bioensayo preliminarmente evaluado es aplicable a la detección de una amplia gama de residuos antimicrobianos en músculo bovino, a concentraciones iguales a los LMRs.

Background: In Colombia, the vigilance of the Maximum Residue Limits MRLs of veterinary antimicrobials in cattle meat is limited, because the analytical capacity is insufficient to monitor a large number of samples and a wide range of antibiotics. The bioassay is a microbiological method developed by the health public agency (FSIS) of the United States Department of Agriculture (USDA) for the detection, identification and semiquantification of antimicrobial residues in cattle muscle. Objective: It was evaluated preliminary the bioassay for use as a test for the qualitative detection for monitoring and surveillance of four antimicrobials in cattle muscle, as contribution to the inocuity management system within the agreement framework about the application of Sanitary and Phytosanitary Measures; using some guidelines of the European Decision 2002/657/EC. Methods: The experimental protocol used fortified tissues with varying concentrations of penicillin G potassium, oxytetracycline, erythromycin and streptomycin, as representatives of the four important families of veterinary antibiotics used in Colombia. To establish the performance criteria of the bioassay were prepared six replicates of each of the levels or concentrations tested for antimicrobial, including a level without fortification and five levels of lower antibiotic concentrations, equal and above MRL Maximum Residue Limit for each one of the tested antimicrobials. Results: The performance characteristics of method were preliminarily determined (specificity, detection limits and stability). The test showed excellent specificity (no false positive); detection limits were determined for the four antibiotics in relation to their respective Maximum Residue Limit MRLs: Beta-lactams (penicillin G =MRL), tetracyclines (oxytetracycline =MRL), macrolides (erythromycin =MRL) and aminoglycosides (streptomycin >4 MRL); however, the sensitivity of bioassay for the streptomycin was unsatisfactory. Stability of the analytes in the matrix was adequate during the period evaluated. Conclusions: The preliminary bioassay method evaluated is applicable to the detection of a broad range of antimicrobial residues in bovine muscle at concentrations at the MRLs.

Anti-inflammatory and antinociceptive activities of methanolic extract from red seaweed Dichotomaria obtusata

The aim of the present work was to investigate the anti-inflammatory and antinociceptive effects of methanolic extract from D. obtusata using classic models in mice (croton oil-induced ear edema and acetic acid-induced writhing) and a phospholipase A2 activity test. Qualitative analysis of the chemical composition of seaweed was also determined by extraction with solvents of increasing polarity and precipitation and color tests. Results of qualitative chemical study showed the presence of lactonic and phenolic compounds, reduced carbohydrates, other sugars, flavonoids, fatty compounds, triterpenes and steroids. The extract inhibited mouse ear edema in a dose-dependent manner with an efficacy higher than 90% and a mean effective dose of 4.87µg/ear, while intraperitoneal administration presented a moderate activity. The extract did not inhibit phospholipase A2 activity. In the writhing test, the intraperitoneal administration of the extract showed a strong antinociceptive activity (80.2%), while the oral route showed a lower efficacy. In conclusion, this study demonstrated the anti-inflammatory and antinociceptive effects of methanol extract of D. obtusata in experimental models, suggesting its therapeutic potential in the treatment of peripheral painful and/or inflammatory pathologies.

O objetivo do presente trabalho foi investigar os efeitos antiinflamatórios e antinociceptivos de um extrato metanólico de D. obtusata, utilizando modelos clássicos em ratos (teste do edema de orelha induzido por óleo de cróton e teste de contorções induzidas por ácido acético) e um teste de atividade de fosfolipase A2. A análise qualitativa da composição química das algas foi também determinada através de extração com solventes de polaridade crescente e testes de precipitação e cor. Os resultados do estudo de química qualitativa mostraram a presença de compostos lactônicos e fenólicos, hidratos de carbono reduzidos e outros açúcares, flavonoides, compostos graxos, triterpenos e esteroides. O extrato inibiu o edema de orelha dos ratos de um modo dependente da dose com eficácia superior a 90% e dose média efetiva de 4.87µg/orelha, enquanto a administração intraperitoneal apresentou atividade moderada. O extrato não inibiu a atividade da fosfolipase A2. No teste de contorção, a administração intraperitoneal do extrato mostrou forte atividade antinociceptiva (80,2%), enquanto a administração oral mostrou menor eficácia. Em conclusão, este estudo demonstrou os efeitos antiinflamatórios e antinociceptivos do extrato metanólico de D. obtusata em modelos experimentais, sugerindo seu potencial terapêutico no tratamento de patologias dolorosas periféricas e/ou inflamatórias.

Immediate efficacy of diode laser application in the treatment of dentine hypersensitivity in periodontal maintenance patients: a randomized clinical trial.

BACKGROUND: To evaluate the immediate efficacy in the reduction of dentine hypersensitivity (DH) when applying an 810 nm diode laser (DL), and a 10% potassium nitrate bioadhesive gel (NK10%). MATERIAL AND METHODS: Forty-five consecutive periodontal maintenance patients of both sexes, with a DH >or= 2 on the verbal rating scale (VRS) in one or more teeth, were randomly allocated into three equal groups: 15 patients received DL and placebo gel; 15 patients were tested with a placebo laser and NK10%; and the remaining 15 received a placebo laser and placebo gel. The DH was evaluated at the start of the study, 15 and 30 min. after the laser application, and on days 2, 4, 7, 14, 30 and 60 by a blind examiner. RESULTS: After 15 min., observations showed a reduction in DH after an evaporative stimulus (ES) of 36.9% (0.86), three times greater than that of the control group (0.23) (p=0.008). After 14 days, this effect was even greater [DL 71.7% (1.67)/NK10% 36.3% (1.73)/control 28.1% (0.73); p=0.004], and lasted until day 60 [65.7% (1.53)/30.4% (0.73)/25.8% (0.67); p=0.01]. CONCLUSIONS: The DL and NK10% gel were proven effective in the treatment of DH. A significantly greater immediate response was observed with DL.

Coronary aneurysms after drug-eluting stent implantation: clinical, angiographic, and intravascular ultrasound findings.

OBJECTIVES: This study sought to assess clinical, angiographic, and intravascular ultrasound (IVUS) findings in patients developing coronary aneurysms (CANs) after drug-eluting stent (DES) implantation. BACKGROUND: The long-term safety of DES remains unsettled. METHODS: This study analyzed 1,197 consecutive patients with late angiographic evaluation after DES implantation. In 15 patients (1.25%, 95% confidence interval: 0.58 to 1.93), CANs developed at follow-up. Analyses included quantitative angiography and volumetric IVUS. RESULTS: DES developing CANs were more frequently implanted during acute myocardial infarction and were longer than those without this outcome. The elapsed time from DES implantation to CAN diagnosis was 313 +/- 194 days. Angiographically, maximal CAN diameter measured 5.1 +/- 1.2 mm. On IVUS, CAN external elastic lamina area was 32 +/- 13.1 mm(2) and incomplete apposition area was 12.1 +/- 8.6 mm(2). Two patients presented with acute myocardial infarction secondary to DES thrombosis. Four additional patients presented with unstable angina and underwent CAN aggressive dilation (3 were also treated for concomitant in-stent restenosis). Dual antiplatelet therapy was recommended in the remaining 9 patients who were asymptomatic at CAN diagnosis, but 1 of them eventually died of cardiogenic shock after a CAN-related myocardial infarction. After a mean follow-up of 399 +/- 347 days, the 1-year event-free survival was 49 +/- 14% and was related to CAN size on IVUS. In 2 patients, CANs disappeared at repeated late angiography and IVUS showed abluminal CAN thrombosis. CONCLUSIONS: After DES implantation, CANs are rare and may be detected in asymptomatic patients. However, CANs are frequently associated with adverse clinical events as a result of DES restenosis and DES thrombosis. Further studies are required to determine the implications of this distinct new entity.

Long-term clinical benefit of sirolimus-eluting stents in patients with in-stent restenosis results of the RIBS-II (Restenosis Intra-stent: Balloon angioplasty vs. elective sirolimus-eluting Stenting) study.

OBJECTIVES: We sought to assess the long-term effectiveness and safety of sirolimus-eluting stents (SES) in patients with in-stent restenosis (ISR). BACKGROUND: Treatment of patients with ISR remains a challenge. The long-term outcome of patients with ISR treated with SES remains unknown. METHODS: The RIBS-II (Restenosis Intra-stent: Balloon angioplasty vs. elective sirolimus-eluting Stenting) study was a randomized trial conducted in 150 patients with ISR (76 SES, 74 balloon angioplasty [BA]). The long-term (>1 year) clinical outcome and pre-specified subgroup analyses were pre-defined secondary study end points. RESULTS: At 1 year, the event-free survival (death, myocardial infarction, target vessel revascularization [TVR]) was better in the SES group (88% vs. 69%, p < 0.005). Additional long-term (>3 years) clinical follow-up was obtained in 97% of patients (median 3.3 years). After the first year, 3 patients died (1 SES, 2 BA), 5 suffered myocardial infarction (4 SES, 1 BA), and 7 required TVR (4 SES, 3 BA). At last follow-up, definitive/probable/possible stent thrombosis was similar in both groups (2/2/1 SES vs. 1/0/3 BA, p = NS). At 4 years, the event-free survival was 76% in the SES arm and 65% in the BA arm (p = 0.019). On multivariate analysis, SES implantation was an independent predictor of event-free survival. Subgroup analyses were consistent with the main outcome measure. CONCLUSIONS: In patients with ISR, SES implantation remains effective and safe at very long-term clinical follow-up.

Diagnosis and treatment of coronary stent entanglement complicated by extreme stent distortion.

A 2.5 x 32 mm Taxus Libert e stent was deployed at high pressure in the proximal right coronary artery (RCA) of a 71-year-old male patient, but the distal part of the lesion remained uncovered. A second stent (Driver 2.5 x 12 mm) could not be advanced through the first one and was withdrawn. The pullback traction resulted in dislodgement of the stent from its delivery balloon. Fluoroscopic examination suggested that the missing stent had traveled to the ascending aorta. Transesophageal echocardiography disclosed a dense, linear, mobile structure in the ascending aorta arising from the right coronary ostium. A 64-multislice computed tomographic scan revealed that both stents were entangled, with the first stent (Taxus 32 mm) elongated (approximately 90 mm in length), and the second one (Driver 12 mm) attached to the tail of the Taxus stent in the aorta. Stent retrieval was performed with a 15 mm snare loop catheter through a 7 Fr femoral sheath. Examination of the retrieved material revealed elongation of the Taxus stent entangled with the Driver stent. This case illustrates the potential for serious complications derived from stent entanglement, even with modern stent platforms, and how integrating noninvasive imaging modalities can provide crucial information regarding the cause of the complication and its solution.