Epidemiology and factors associated with Extra-pulmonary tuberculosis in a Low-prevalence area.

Background: Tuberculosis is a global public health problem. Extra-pulmonary tuberculosis accounts for an increasing proportion of cases worldwide, although information about epidemiological, clinical, or microbiological factors is lacking. Methods: We conducted a retrospective observational study of tuberculosis cases diagnosed between 2016 and 2021, classified into Pulmonary and Extra-pulmonary tuberculosis. Univariable and multivariable logistic regression models were used to investigate risk factors of Extra-pulmonary tuberculosis. Results: 20.9% of overall cases were classified as Extra-pulmonary tuberculosis, with a rising trend from 22.6% in 2016 to 27.9% in 2021. Lymphatic tuberculosis accounted for 50.6% of cases, followed by pleural tuberculosis (24.1%). 55.4% of cases belonged to foreign-born patients. Microbiological culture tested positive in 92.8% of Extra-pulmonary cases. Logistic regression analysis showed that women were more predisposed to develop Extra-pulmonary tuberculosis (aOR 2.46, 95% CI 1.45-4.20) as well as elderly patients (aged ≥ 65 years) (aOR 2.47, 95% CI 1.19-5.13) and persons with previous history of tuberculosis (4.99, 95% CI 1.40-17.82). Conclusions: Extra-pulmonary Tuberculosis have increased within our study period. A profound decline occurred in 2021 tuberculosis cases, probably due to COVID-19. Women, elderly population, and persons with previous history of tuberculosis are at higher risk of developing Extra-pulmonary tuberculosis in our setting.

Mechanotransduction in tumor dynamics modeling.

Mechanotherapy is a groundbreaking approach to impact carcinogenesis. Cells sense and respond to mechanical stimuli, translating them into biochemical signals in a process known as mechanotransduction. The impact of stress on tumor growth has been studied in the last three decades, and many papers highlight the role of mechanics as a critical self-inducer of tumor fate at the in vitro and in vivo biological levels. Meanwhile, mathematical models attempt to determine laws to reproduce tumor dynamics. This review discusses biological mechanotransduction mechanisms and mathematical-biomechanical models together. The aim is to provide a common framework for the different approaches that have emerged in the literature from the perspective of tumor avascularity and to provide insight into emerging mechanotherapies that have attracted interest in recent years.

Variabilidad interregional en el uso de tecnologías cardiovasculares (2011-2019). Correlación con índices económicos y frecuentación y mortalidad hospitalarias / Interregional variability in the use of cardiovascular technologies (2011-2019). Correlation with economic indicators, admissions, and in-hospital mortality

Introducción y objetivos La igualdad de oportunidades para acceder a avances técnicos de reconocido valor clínico debe ser una prioridad del sistema público de salud. Se analizó la variabilidad entre todas las comunidades autónomas españolas en el uso de técnicas cardiológicas con indicación ya establecida y su relación con indicadores económicos, carga de enfermedad y mortalidad hospitalaria. Métodos Se analizaron los registros de actividad de las asociaciones de la Sociedad Española de Cardiología desde 2011 a 2019 en coronariografía, intervención coronaria percutánea (ICP) general, ICP primaria, desfibrilador automático implantable (DAI), terapia de resincronización cardiaca e implante percutáneo de válvula aórtica (TAVI). Se obtuvieron índices económicos (producto interior bruto y gasto sanitario per cápita) y datos sobre frecuentación y mortalidad hospitalarias reportados en los informes RECALCAR (Recursos y Calidad en Cardiología) de la Sociedad Española de Cardiología. Se analizó el coeficiente de variación en la actividad y la correlación de esta con los índices regionales económicos, de frecuentación y la razón de mortalidad hospitalaria estandarizada por riesgo. Resultados Existe una variación notable en el uso de las tecnologías, especialmente ICP primaria (18%), DAI (22%), terapia de resincronización cardiaca (36%) y TAVI (42%). Solo se observó cierta correlación con la frecuentación de la ICP general y el DAI. No se encontró una correlación significativa entre la penetración de las técnicas y los índices económicos de riqueza y gasto. La correlación con la mortalidad hospitalaria no mostró resultados significativos, aunque es el análisis con más limitaciones, ya que estas técnicas tienen mayor impacto en la supervivencia en el medio y largo plazo. Conclusiones Los resultados del estudio, con sus limitaciones inherentes (AU)

Introduction and objectives Equal opportunities to access technical advances with recognized clinical value should be a priority of the publicly-funded health system. We analyzed variability among all the Spanish autonomous communities in the use of cardiovascular techniques with an established indication and its relationship with economic indicators, burden of disease, and hospital mortality. Method The activity registries of various Associations of the Spanish Society of Cardiology from 2011 to 2019 were analyzed for coronary angiography, overall percutaneous coronary intervention (PCI), primary PCI, implantable cardioverter-defibrillators (ICD), cardiac resynchronization therapy, and transcatheter aortic valve replacement (TAVR). Economic indices (gross domestic product and per capita health care expenditure) were obtained from public sources and data on attendance rates and mortality from the Resources and Quality in Cardiology (RECALCAR) reports of the Spanish Society of Cardiology. We analyzed the coefficient of variation for activity and the correlation of activity with regional economic indices, attendance rates, and risk-adjusted rates of in-hospital mortality. Results We identified wide variability in the use of technologies, especially for primary PCI (18%), ICD (22%), cardiac resynchronization therapy (36%), and TAVR (42%). A certain correlation with attendance rates was seen only for overall PCI and ICD. In general, no significant correlation was found between the use of the techniques and the economic indices of wealth and expenditure. The correlation with in-hospital mortality showed no significant results, although this was the analysis with the greatest limitations because the impact of these techniques on survival is exerted more in the mid- and long-term Conclusions The results of this study, despite its inherent limitations, show marked variability between autonomous communities in the use of cardiovascular technologies (AU)

The role of racial segregation in treatment and outcomes among patients with hepatocellular carcinoma.

BACKGROUND: There is a long history of segregation in the U.S.A with enduring impacts on cancer outcomes today. We evaluated the impact of segregation on racial disparities in Hepatocellular Carcinoma (HCC) treatment and outcomes. METHODS: We obtained data on black and white patients with HCC from the SEER program (2005-2015) within the 100 most populous participating counties. Our exposure was the index of dissimilarity (IoD), a validated measure of segregation. Outcomes were overall survival, advanced stage at diagnosis (Stage III/IV) and surgery for localized disease (Stage I/II). Cancer-specific survival was assessed using Kaplan-Meier estimates. RESULTS: Black patients had a 1.18 times increased risk (95%CI 1.14,1.22) of presenting at advanced stage as compared to white patients and these disparities disappeared at low levels of segregation. In the highest quartile of IoD, black patients had a significantly lower survival than white (17 months vs 27 months, p < 0.001), and this difference disappeared at the lowest quartile of IoD. CONCLUSIONS: Our data illustrate that structural racism in the form racial segregation has a significant impact on racial disparities in the treatment of HCC. Urban and health policy changes can potentially reduce disparities in HCC outcomes.

Correction to: AdNut study: effectiveness of a high calorie and protein oral nutritional supplement with ß-hydroxy-ß-methylbutyrate in an older malnourished population in usual clinical practice.

[This corrects the article DOI: 10.1007/s41999-018-0109-4.].

Bothrops alternatus snake venom induces apoptosis of skeletal muscle cells in a rabbit model / O veneno da serpente Bothrops alternatus induz apoptose nas células musculares de coelhos

Este estudo objetiva reportar a ocorrência de apoptose in vivo induzida pelo veneno da serpente Bothrops alternatus em células musculares esqueléticas. Cinco coelhos machos, adultos, receberam 150µg/kg de veneno no músculo vasto lateral, enquanto outros cinco animais receberam 0,1% de BSA diluído em PBS no mesmo local. Após 12 horas, os animais foram eutanasiados, e amostras do local de inoculação foram coletadas para análise histopatológica. Foram evidenciadas necrose e hemorragia nas células musculares. Além disso, a análise imuno-histoquímica para identificação de caspase-3 ativada revelou marcações granulares e agregadas no citoplasma das células musculares, compatíveis com o processo de apoptose. Este é o primeiro relato que confirma o veneno de B. alternatus como causador de apoptose in vivo em células musculares esqueléticas.(AU)

Effect of Enterococcus faecium SF68 on serum cobalamin and folate concentrations in healthy dogs.

OBJECTIVE: To study the effect of a 14-day administration of the probiotic Enterococcus faecium SF68 on serum concentrations of cobalamin and folate in healthy dogs. MATERIALS AND METHODS: Thirty-six healthy dogs were randomly allocated between probiotic and control groups. Enterococcus faecium SF68 was administered to the probiotic group for 14 days whereas the control group did not receive any product. A blood sample was taken from all dogs when starting the administration (day 1), when the administration ended (day 14) and 14 days later (day 28). Serum cobalamin and folate concentrations and the canine inflammatory bowel disease activity index scores were determined at each time point. RESULTS: There was a progressive reduction of mean serum cobalamin in the probiotic group during the 28-day study, with significantly lower concentration at day 28 compared to baseline and day 14 concentrations. Moderate hypocobalaminaemia was observed in eight dogs at day 28. Probiotic administration was associated with a non-significant increase in mean serum folate concentration at day 14, and a significant decrease at day 28 compared with day 1. The canine inflammatory bowel disease activity index score remained unaltered during the study. CLINICAL SIGNIFICANCE: Short-term Enterococcus faecium SF68 administration caused a significant reduction of mean cobalamin concentration and moderate hypocobolaminaemia in eight of 18 dogs. Monitoring serum folate appears unnecessary because the probiotic caused a non-significant increase that returned to baseline values after administration was discontinued.

AdNut study: effectiveness of a high calorie and protein oral nutritional supplement with ß-hydroxy-ß-methylbutyrate in an older malnourished population in usual clinical practice.

OBJECTIVE: To evaluate the effectiveness of a high calorie and protein, ß-hydroxy-ß-methylbutyrate containing oral nutritional supplement (HP-HMB-ONS), on nutritional status, activities of daily living and quality of life (QoL) in old malnourished subjects. METHODS: We conducted an observational, prospective, open label, multicenter study. Participants were > 65 years, undernourished or at nutritional risk [Nutrition Risk Score (NRS) ≥ 3] and had been included on an ONS (HP-HMB-ONS twice daily for 12 weeks) per standard of care. Visits at baseline (V1), 6 weeks (V2) and 12 weeks (V3) were performed. The primary endpoints were gain of body weight, change in body mass index (BMI) and NRS 2002 index. Data from QoL (EQ-5D-3L) and activities of daily living (Katz index) were also collected. RESULTS: A total of 235 participants were included in the study. Of these 148 took at least a 75% of the HP-HMB-ONS and were included in the analysis (per protocol); median age was 80.0 (SD:8.3) years, 65.5% (n = 97) were female, 67.6% (n = 100) had 2 or more diseases. At V3, a statistically significant increase in weight (2.1 kg; SD: 3.8) (p < 0.001) and BMI (0.8 kg/m2; SD: 1.45) were found compared to V1, whereas NRS 2002 values decreased by 0.9 (SD: 1.2). A significant (p < 0.001) improvement in Katz index (mean change = 0.3; SD:1.4) and EQ-5D scoring (mean change = 0.5; SD:1.9) compared to V1, were also reported. CONCLUSIONS: The results suggest that administration of a HP-HMB-ONS improve the nutritional status and may led to a significant improvement in patients' activities of daily living and QoL, independent of baseline BMI.

Use of EDTA in the treatment of local tissue damage caused by the Bothrops alternatus venom / Utilização do EDTA no tratamento da lesão tecidual local causado pelo veneno de Bothrops alternatus

Twelve adult rabbits were distributed in three groups and received on the femoral biceps region, via intradermal injection (ID), 25µg of Bothrops alternatus venom dissolved in NaCl 0.9% and diluted in 0.25mL of phosphate buffered saline (PBS). Thirty minutes later, the group G1 received 0.25mL of phosphate buffered saline (PBS) ID while to G2 and G3 25mg of ethylenediamine tetraacetic acid (EDTA) dissolved in 0.25mL of PBS were administered via intramuscular (IM) and intravenous (IV) injection, respectively. Evaluations included local lesion and blood profile of all animals, before (time zero) and at 1, 2, 3, 4, 5, 6, 12, 18 and 24h after venom administration. All animal treated with PBS (G1) and EDTA IV (G3) presented increase of nociceptive stimuli at the site of inoculation of the venom, followed by moderate edema that persisted for 24h. Animals treated with IM EDTA (G2) only manifested increase of nociceptive stimuli at the site of injection 1h after treatment with discrete local edema between 12 and 24h. In relation to the local hemorrhagic halo no differences were found amongst the studied groups. Blood profile revealed significant decrease of segmented neutrophils in all groups. There was also increase in triglycerides and decrease in total protein and albumin in all groups. The local lesion was not altered by the treatments.(AU)

Doze coelhos adultos, distribuídos em três grupos, receberam, na região de bíceps femoral, por via intradérmica (ID), 25µg de veneno de Bothrops alternatus, dissolvidos em NaCl 09%, diluído em 0,25mL de tampão salina fosfato (PBS). Trinta minutos após o desafio, o grupo G1 recebeu 0,25mL de (PBS) ID, e os grupos G2 e G3 receberam 25mg de ácido etilenodiamino tetra-acético (EDTA), dissolvidos em mL de PBS por via intramuscular (IM) e intravenosa (IV), respectivamente. Foram avaliados lesão local e perfil sanguíneo de todos os animais, antes - tempo zero, e à uma, às duas, três, quatro, cinco, seis, 12, 18 e 24 horas após a injeção do veneno. Tanto os animais tratados com PBS (G1) como os animais tratados com EDTA IV (G3) apresentaram aumento do estímulo nociceptivo no local da administração do veneno, seguido por moderado edema, que perdurou por 24h. Os animais tratados com EDTA IM (G2) somente manifestaram aumento do estímulo nociceptivo local uma hora após tratamento e discreto edema local entre 12 e 24 horas. Em relação ao halo hemorrágico, não houve diferença entre os três grupos estudados. No perfil hematológico, observou-se diminuição significativa dos neutrófilos segmentados nos três grupos estudados. Da mesma forma, houve aumento dos triglicerídeos e diminuição da proteína total e albumina em todos os grupos. Conclui-se que a lesão local não foi alterada pelos tratamentos.(AU)

Protocolo clínico asistencial de manejo de la hipertermia maligna / Clinical protocol for the management of malignant hyperthermia

La hipertermia maligna es un síndrome hipermetabólico que ocurre en pacientes susceptibles, tras la exposición a un fármaco anestésico desencadenante (succinilcolina, anestésicos inhalatorios). En España, se presenta en uno de cada 40.000 en adultos, con una mortalidad estimada del 10%. Está inducido por una regulación anormal de los receptores de rianodina, que produce una liberación masiva del calcio del retículo sarcoplasmático del músculo. Las manifestaciones clínicas son variadas y consisten en: elevación del CO2, taquicardia e inestabilidad hemodinámica, acidosis metabólica y respiratoria, sudoración profusa, hiperpirexia, elevación de CPK, mioglobinuria, fallo renal, CID y finalmente parada cardiorrespiratoria. El tratamiento con dantroleno sódico inhibe la liberación de calcio al antagonizar los receptores de rianodina. El diagnóstico definitivo se realiza con el test de contracción de fibra muscular expuesta a cafeína y halotano. Ante este grave evento la protocolización del manejo ayuda a garantizar que el paciente reciba una atención fiable y segura (AU)

Malignant hyperthermia is a hypermetabolic syndrome that appears in susceptible patients after exposure to certain anaesthetic drugs (succinylcholine, inhalation anaesthetics). Its incidence in Spain is 1 in 40,000 adults, with a 10% mortality rate. It is induced by an abnormal regulation of the ryanodine receptors, producing a massive release of calcium from the sarcoplasmic reticulum in the striate muscle. Clinical manifestations include: CO2 increase, tachycardia, haemodynamic instability, metabolic and respiratory acidosis, profuse sweating, hyperpyrexia, CPK increase, myoglobinuria, kidney failure, disseminated intravascular coagulation (DIC), and ending in cardiac arrest. Dantrolene sodium is a ryanodine receptor antagonist, and inhibits the release of intracellular calcium. Definitive diagnosis is achieved by the exposure of muscle fibres to caffeine and halothane. Protocols can help guarantee a reliable and secure management when this severe event occurs (AU)

Burden assessment in caregivers of patients with home artificial nutrition: a need and a challenge.

BACKGROUND/OBJECTIVES: Caregiving can be a stressful task with severe consequences on caregivers' health. Our aim was to evaluate the profile and the burden of caregivers of patients with home artificial nutrition (HAN) in our area. SUBJECTS/METHODS: We conducted a prospective observational study of patients who had started HAN over a period of a year (n=573) and their home caregivers (n=103). Epidemiological characteristics of the patients and the type of HAN were registered. Caregivers' profile data (gender, age and degree of kinship) and Zarit Burden Assessments were recorded. RESULTS: Care recipients had a median age of 79.0 (IQR 87) years, neurological and oncological diseases in 50% and a high rate of mobility limitations (80%). Oral supplements with high-calorie formulas were predominant (60%). The usual caregiver profile was a patient's daughter with a mean age of 53.1 (s.d. 13.4) years acting as the primary caregiver. Burden was absent in 49.5%, light in 18.4% and intense in 32% of caregivers. Intense burden was more frequent in oral over enteral nutrition (42% versus 22.6%; P=0.036). Supplementary nutrition was also associated with higher caregiver burden scores compared with complete diets. In patients with functional limitations, a tendency toward a slightly higher burden was observed. No differences in caregiver burden were detected according to other patient or caregiver characteristics. CONCLUSIONS: HAN type appears to be a factor influencing caregiver burden and therefore, evaluation of caregiver burden should be part of HAN programs.

Impact of hospital transfer on surgical outcomes of intestinal atresia.

BACKGROUND: Examine effects of hospital transfer into a quaternary care center on surgical outcomes of intestinal atresia. METHODS: Children <1 yo principally diagnosed with intestinal atresia were identified using the Kids' Inpatient Database (2012). Exposure variable was patient transfer status. Outcomes measured were inpatient mortality, hospital length of stay (LOS) and discharge status. Linearized standard errors, design-based F tests, and multivariable logistic regression were performed. RESULTS: 1672 weighted discharges represented a national cohort. The highest income group and those with private insurance had significantly lower odds of transfer (OR:0.53 and 0.74, p < 0.05). Rural patients had significantly higher transfer rates (OR: 2.73, p < 0.05). Multivariate analysis revealed no difference in mortality (OR:0.71, p = 0.464) or non-home discharge (OR: 0.79, p = 0.166), but showed prolonged LOS (OR:1.79, p < 0.05) amongst transferred patients. CONCLUSIONS: Significant differences in hospital LOS and treatment access reveal a potential healthcare gap. Post-acute care resources should be improved for transferred patients.

Clinical protocol for the management of malignant hyperthermia. / Protocolo clínico asistencial de manejo de la hipertermia maligna.

Malignant hyperthermia is a hypermetabolic syndrome that appears in susceptible patients after exposure to certain anaesthetic drugs (succinylcholine, inhalation anaesthetics). Its incidence in Spain is 1 in 40,000 adults, with a 10% mortality rate. It is induced by an abnormal regulation of the ryanodine receptors, producing a massive release of calcium from the sarcoplasmic reticulum in the striate muscle. Clinical manifestations include: CO2 increase, tachycardia, haemodynamic instability, metabolic and respiratory acidosis, profuse sweating, hyperpyrexia, CPK increase, myoglobinuria, kidney failure, disseminated intravascular coagulation (DIC), and ending in cardiac arrest. Dantrolene sodium is a ryanodine receptor antagonist, and inhibits the release of intracellular calcium. Definitive diagnosis is achieved by the exposure of muscle fibres to caffeine and halothane. Protocols can help guarantee a reliable and secure management when this severe event occurs.

Perfil hematológico de éguas Quarto de Milha alimentadas com feno ou haylage de Tifton-85 ( Cynodon spp. ) / Hematological panel of Quarter Horse mares fed Tifton 85 (Cynodon spp. ) hay and haylage

RESUMO O capim Tifton-85 (Cynodon spp.) vem sendo utilizado na alimentação de equinos na forma de pré-secado (haylage) e feno, todavia não existem estudos conclusivos a respeito da influência da haylage sobre o estado de saúde dessa espécie. Portanto, esta pesquisa objetivou avaliar o perfil sanguíneo como indicador de higidez de éguas Quarto de Milha alimentadas com haylage e feno de Tifton-85. A gramínea utilizada foi cortada com 30 dias de crescimento. Para produção da haylage, a planta cortada permaneceu no campo até atingir 70% de matéria seca, quando foi colhida. Foram utilizadas 12 éguas Quarto de Milha, com idade entre oito e 12 anos e com peso vivo médio inicial de 451,6kg. Os animais foram distribuídos aleatoriamente em dois grupos (n=6), sendo o grupo 1 alimentado com feno e o grupo 2 alimentado com haylage, por um período de 28 dias. Foram realizadas cinco coletas de sangue em intervalos de uma semana, para a determinação do perfil hematológico. Em relação ao eritrograma, observou-se discreta diminuição da concentração de hemoglobina, do hematócrito e do volume globular médio (VGM) em ambos os grupos. No leucograma, houve aumento dos leucócitos totais nas coletas iniciais em ambos os grupos, mas sem significado clínico. Conclui-se que éguas adultas Quarto de Milha, após a ingestão de feno e haylage de Tifton-85, não apresentaram alterações no perfil hematológico que indicassem prejuízos à saúde.(AU)

ABSTRACT Tifton-85 grass (Cynodon spp) has been used in equine nutrition in the form of pre-dried (haylage) and hay, however, there are no conclusive studies about the influence of haylage on blood profile of this species. Therefore, the aim of this study was to evaluate the blood profile as health indicators of Quarter Horse mares were fed haylage and Tifton-85 hay. The used grass was cut at 30 days of growth. For the production of haylage, this plant remained cut in the field until it had 70% of dry matter, when it was collected. Twelve Quarter Horse mares, aged 8-12 years, with average weight of 451.58kg were used. The animals were distributed randomly into two groups (n= 6), group 1 fed hay and group 2 fed haylage, both for 28 days. Blood samples were collected at one week intervals each for determining the hematological parameters. In the erythrogram, a decrease in the hemoglobin concentration, packed cell volume and mean cell volume after the administration in both groups were detected. The white blood count increased in both groups, but the values remained within normal limits without clinical significance. In conclusion, adult Quarter Horse mares fed Tifton-85 hay and haylage showed no alterations in hematology.(AU)

In vivo dual-delivery of glucagon like peptide-1 (GLP-1) and dipeptidyl peptidase-4 (DPP4) inhibitor through composites prepared by microfluidics for diabetes therapy.

Oral delivery of proteins is still a challenge in the pharmaceutical field. Nanoparticles are among the most promising carrier systems for the oral delivery of proteins by increasing their oral bioavailability. However, most of the existent data regarding nanosystems for oral protein delivery is from in vitro studies, lacking in vivo experiments to evaluate the efficacy of these systems. Herein, a multifunctional composite system, tailored by droplet microfluidics, was used for dual delivery of glucagon like peptide-1 (GLP-1) and dipeptidyl peptidase-4 inhibitor (iDPP4) in vivo. Oral delivery of GLP-1 with nano- or micro-systems has been studied before, but the simultaneous nanodelivery of GLP-1 with iDPP4 is a novel strategy presented here. The type 2 diabetes mellitus (T2DM) rat model, induced through the combined administration of streptozotocin and nicotinamide, a non-obese model of T2DM, was used. The combination of both drugs resulted in an increase in the hypoglycemic effects in a sustained, but prolonged manner, where the iDPP4 improved the therapeutic efficacy of GLP-1. Four hours after the oral administration of the system, blood glucose levels were decreased by 44%, and were constant for another 4 h, representing half of the glucose area under the curve when compared to the control. An enhancement of the plasmatic insulin levels was also observed 6 h after the oral administration of the dual-drug composite system and, although no statistically significant differences existed, the amount of pancreatic insulin was also higher. These are promising results for the oral delivery of GLP-1 to be pursued further in a chronic diabetic model study.

Peritoneal tuberculosis due to Mycobacterium caprae.

The incidence of tuberculosis in humans due to Mycobacterium caprae is very low and is almost confined to Europe. We report a case of a previously healthy 41-year-old Moroccan with a 6 month history of abdominal pain, weight loss, fatigue and diarrhea. A diagnosis of peritoneal tuberculosis due to M. caprae was made.

Effects of different extracts of the mushroom Agaricus blazei Murill on the hematologic profile of mice with Ehrlich tumor / Efeitos de diferentes extratos do cogumelo Agaricus blazei Murill sobre o perfil hematológico de camundongos com tumor de Ehrlich

The aim of this study was to investigate the effect of the mushroom Agaricus blazeii Murril (ABM) extracts on the hematological profile of Swiss mice bearing an Ehrlich solid tumor. Three fractions (total extract, polysaccharides, and supernatant) of ABM extracts obtained by four methods (ultrasonic or water bath, at pH 4 or pH 7) were administered to mice over 21 days. Polysaccharide solutions were analyzed by gas and liquid chromatography that showed both mannose and glucose concentrations. The method of extraction influenced the degree of glucose polymerization and the mannose/glucose relationship. The treatment with ABM supernatant at pH 7 and water bath was associated with reduced concentrations of leukocytes and lymphocytes and altered the percentage of CD4+ and CD8+ lymphocytes in Ehrlich tumor-bearing mice. The treatment with the ABM extract in water bath and ultrasound at pH 4 resulted in lower lymphocyte counts, regardless of tumor presence, and greater granulocyte values in mice with Ehrlich tumor than in controls. We concluded that different fractions and methods of extraction of A. blazei produced differing blood profiles in mice inoculated with the Ehrlich tumor.

O objetivo deste estudo foi investigar o efeito de diferentes extratos do cogumelo Agaricus blazeii Murril (ABM) sobre o perfil hematológico de camundongos Swiss portadores de tumor de Ehrlich sólido. Três frações (extrato total, polissacarídeos e sobrenadante) dos extratos de ABM foram obtidas por quatro métodos (sonificador, banho-maria, em pH 4 ou pH 7) e administradas para camundongos durante 21 dias. Soluções de polissacarídeos foram analisadas por cromatografia gasosa e líquida, que mostraram concentrações de glucose e manose. O método de extração influenciou o grau de polimerização da glicose e a relação manose/glucose. O tratamento com o sobrenadante de ABM (em pH 7 e banho-maria) estava associado com reduzidas concentrações de leucócitos e linfócitos, além de alterar a porcentagem de linfócitos CD4+ e CD8+ em camundongos portadores de tumor sólido de Ehrlich. O tratamento com extratos de ABM, obtidos tanto em banho-maria como no sonificador em pH 4, resultou nas mais baixas contagens de linfócitos, independentemente da presença do tumor, e nos maiores valores de granulócitos em camundongos com tumor de Ehrlich. Conclui-se que os diferentes métodos de extração com as respectivas frações de A. blazei são capazes de intereferir no perfil hematológico de camundongos com tumor sólido de Ehrlich.

SPECT, angio-TC coronaria, coronariografía invasiva e imágenes de fusión en la cardiopatía isquémica estable / SPECT, coronary angio-CT, invasive coronary angiography and fusion images in stable coronary disease

Objetivos: Valorar la información de la SPECT, de la angio-TC coronaria y de las imágenes híbridas de fusión en los pacientes con cardiopatía isquémica estable en los que se practica una coronariografía invasiva (CI). Material y métodos: Se ha incluido en forma prospectiva a 46 pacientes (65,98 ± 8,3 años) con enfermedad coronaria, valorándose la información de dichas técnicas en el diagnóstico de la enfermedad multivaso, en la detección del vaso culpable y en el manejo de los pacientes. Resultados: En la CI, 29 de los 46 pacientes (63%) presentaban enfermedad multivaso: la SPECT la diagnosticó en un 48,2% y la angio-TC en un 89,6%. La concordancia entre la angio-TC y la CI en el diagnóstico del vaso culpable fue del 77% (kappa 0,6) y entre la SPECT y la CI del 73% (kappa 0,56). Las imágenes híbridas obtenidas después del cateterismo no habrían aportado nueva información a la ya obtenida mediante la SPECT y la CI de cara al manejo terapéutico. Conclusiones: La angio-TC destaca en el diagnóstico de la enfermedad multivaso y en la detección del vaso culpable respecto a la CI. La SPECT resulta un buen complemento funcional de la CI en la detección del territorio más isquémico. No obstante, en los pacientes con cardiopatía isquémica estable en los que se ha realizado una SPECT como primer estudio no invasivo, si la decisión de practicar posteriormente una CI es clara, la realización de una angio-TC y la obtención de imágenes de fusión SPECT-TC no parecen indicadas, ya que no cambiaría el manejo terapéutico que se adopta sobre la base de la información de la SPECT y la CI (AU)

Objectives: To evaluate the usefulness of the information obtained with SPECT, coronary angio-CT and fusion images, in patients with stable ischemic disease who need invasive coronary angiography (IA). Material and methods: Forty-six patients (65.98 ± 8.3 years) with coronary disease were prospectively included. The fusion images generated after undergoing IA were used to evaluate the performance of these techniques in the diagnosis of multi-vessel coronary disease, the detection of the culprit vessel and the therapeutic management of these patients. Results: In the IA, 29 of the 46 patients (63%) had multi-vessel disease. SPECT could detect it in 48.2% and coronary angio-CT could detect it in 89.6%. Concordance between coronary angio-CT and IA in the diagnosis of the culprit vessel was 77% (kappa 0.6), and between SPECT and IA it was 73% (kappa 0.56). Although fusion images could have been obtained prior to IA, they would not have changed the therapeutic approach derived from SPECT and IA. Conclusions: Coronary angio-CT has a high ability for the diagnosis of multi-vessel disease and the culprit lesion, and SPECT is a good functional complement of the IA in the detection of the most ischemic territory. However, the performance of fusion images in patients with stable ischemic disease, who have undergone a SPECT as the first non-invasive study and need IA, does not seem indicated because they would not have changed the therapeutic management derived from SPECT and IA information (AU)