Revisión sistemática con metaanálisis. Iodo povidona / Systematic Review with Meta-Analysis. Povidone Iodine

Introducción: La descontaminación preoperatoria de la piel es parte de la práctica quirúrgica estándar. La infección del sitio quirúrgico implica un gasto adicional a los sistemas de salud y un incremento en la morbilidad y mortalidad de los pacientes sometidos a cirugía. El iodo povidona es un desinfectante muy utilizado para eliminar la carga bacteriana cutánea. Objetivo: Constatar si el iodo povidona es mejor que otros desinfectantes cutáneos en la reducción de las infecciones del sitio quirúrgico. Métodos: Se realizó una búsqueda en Google Académico, PubMed y Embase utilizando los términos Mesh; iodo povidona, infección del sitio quirúrgico, cirugía, antisépticos locales, unidos por el operador booleano AND y los filtros Adultos, desde 2015, y ensayos clínicos controlados. Se aplicó la escala de Jadad para riesgo de sesgos y el Consort 2010 y la lista de chequeo PRISMA para determinar la calidad del estudio. El riesgo relativo fue la medida de efecto para un IC95 y un error de 0,05. Se incluyeron 8 ensayos clínicos controlados, n= 4800 casos, con la distribución de eventos en los grupos experimental 140/2402 y control 141/2398, para una diferencia no significativa p=0,444. La heterogeneidad fue I2=62,57 por ciento. Conclusiones: No existieron diferencias entre el iodo povidona y el resto de los desinfectantes para disminuir el porcentaje de infecciones del sitio quirúrgico en este estudio(AU)

Introduction: Preoperative skin decontamination is part of standard surgical practice. Surgical site infection implies an additional cost to health systems and an increase in morbidity and mortality of patients undergoing surgery. Povidone iodine is a widely used disinfectant to eliminate the bacterial load on the skin. Objective: To verify if povidone iodine is better than other skin disinfectants in reducing surgical site infections. Methods: A search of articles and controlled clinical trials published since 2015 was carried out in Google Scholar, PubMed and Embase and using terms of the Mesh such as povidone iodine, surgical site infection, surgery, local antiseptics, joined by the Boolean operator AND in addition to Adult filters. The Jadad scale for risk of bias and Consort 2010 and PRISMA checklist were applied to determine the quality of the study. Relative risk was the measure of effect for CI95 and an error of 0.05. Eight controlled clinical trials were included, n= 4800 cases, with the distribution of events in the experimental groups 140/2402 and control 141/2398, for a non-significant difference p=0.444. Heterogeneity was I2=62.57 percent. Conclusions: There were no differences between povidone iodine and the rest of the disinfectants to reduce the percentage of surgical site infections in this study(AU)

Enriched-biochar application increases broccoli nutritional and phytochemical content without detrimental effect on yield.

BACKGROUND: Soil fertility is a major concern during vegetable production. Conventional versus organic fertilization has been studied in order to conserve soil properties. While some reports point out an increase in food nutritional properties, the loss of crop yield under organic conditions continues to be a problem. Thus, an experiment with broccoli in the field was carried out, comparing crop management under conventional fertilization (CF) and two soil amendment treatments: manure pellet (M) and an enriched-biochar (EB) supplemented by an organic fertilizer (AND) applied alone (M + CF; EB+AND) or in combination (M + EB + AND). Crop yield and the nutritional properties in the flowering heads (mineral content, phenolic compounds and glucosinolates (GSLs)), were determined. RESULTS: Enriched-biochar and manure as a standalone amendment resulted in higher crop yield regarding CF, but not when they were applied in combination. The number of flowering heads with no-commercial characteristics was lower after enriched-biochar soil application. Finally, enriched-biochar treatment enhanced NO3 - , PO4 3- and SO4 2- levels in the flowering heads, and some of the ion contents can be associated with mineral changes in the soil after the biochar amendment. Also, the contents of phenolic compounds and indole GSLs were higher after enriched-biochar application compared with the other treatments, GSL increase being due to the higher percentage of sulfur in the plant rather that an adequate N/S ratio. CONCLUSION: Application of enriched-biochar amendment in the cultivation of broccoli is appropriate, since there are no losses of yield and an increase in nutritional compounds in the flowering heads. © 2022 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Esfinterotomía lateral interna vs. toxina botulínica como tratamiento de la fisura anal / Lateral Internal Sphincterotomy versus Botulinum Toxin as Treatment of Anal Fissure

Introducción: La fisura anal crónica es una entidad frecuente que produce molestias durante y después de la defecación, su fisiopatología no es clara y su manejo es variado. La esfinterotomia lateral interna es una de las técnicas más utilizadas, aunque su elevado porcentaje de incontinencia no es aceptado y la inyección de toxina botulínica es una alternativa tentadora. Objetivo: Comparar los resultados de la inyección de toxina botulínica tipo A con la esfinterotomia lateral interna para tratamiento de la fisura anal en cuanto a dolor postoperatorio, recurrencia, curabilidad e incontinencia. Métodos: Se realizó un estudio tipo cohorte. A un grupo de 40 pacientes se trató con inyección de 50 UI de Toxina Botulínica tipo A y el otro grupo de 42 pacientes se le realizó esfinterotomia lateral interna. Los resultados se comparan estadísticamente para CI95 y error de 0,05. Resultados: La esfinterotomia vs toxina botulínica, resultó en cuanto a curabilidad en un 85,4 por ciento de los casos contra un 77,5 por ciento. Las recidivas se presentaron en 4,8 por ciento / 12,5 por ciento, la incontinencia ocurrió en 9,5 por ciento / 2,5 por ciento y el dolor posoperatorio estuvo presente en el 14,8 por ciento / 5,0 por ciento. Conclusiones: La esfinterotomia resultó mejor en cuanto a curabilidad y recidivas, mientras la aplicación de la toxina botulínica presentó mejores resultados en la incontinencia fecal y el dolor posoperatorio(AU)

Introduction: Chronic anal fissure is a frequent entity that produces discomfort during and after defecation. Its pathophysiology is not clear and its management is varied. Lateral internal sphincterotomy is one of the most used techniques, although its high percentage of incontinence is not accepted; botulinum toxin injection is therefore a tempting alternative. Objective: To compare the results of botulinum toxin type A injection or lateral internal sphincterotomy for treatment of anal fissure in terms of postoperative pain, recurrence, healing and incontinence. Methods: A cohort study was carried out. One group of 40 patients were treated with injection of 50 IU of botulinum toxin type A and another group of 42 patients underwent lateral internal sphincterotomy. The results were statistically compared with a confidence interval of 95 percent and error of 0.05. Results: Sphincterotomy and botulinum toxin were effective in terms of healing in 85.4 percent and 77.5 percent of cases, respectively. Recurrences occurred in 4.8 percent and 12.5 percent of cases, respectively. Incontinence occurred in 9.5 percent and 2.5 percent of cases, respectively. Postoperative pain was present in 14.8 percent and 5.0 percent of cases, respectively. Conclusions: Sphincterotomy was better in terms of healing and recurrence, while botulinum toxin application showed better results regarding fecal incontinence and postoperative pain(AU)

Correlación cito-histológica en tumores de glándula parótida / Cyto-histological correlation in tumors of the parotid gland / Correlação cito-histológica em tumores da glândula parótida

Introducción y Objetivo: La utilidad de la citología por punción aspiración con aguja fina en la valoración de tumores parotídeos es controvertida, ya que existe gran variabilidad en cuanto a la sensibilidad y especificidad en las distintas series publicadas. Nuestro objetivo es evaluar la utilidad de la punción aspiración con aguja fina (PAAF) de los tumores de glándula parótida en nuestro medio. Métodos: Se realizó un estudio retrospectivo y observacional con una muestra de 77 pacientes con tumores de glándula parótida, en el periodo 2000-2017 en dos centros hospitalarios de Montevideo, Uruguay, que fueron sometidos a punción aspiración con aguja fina preoperatoria y que posteriormente se correlacionó con el estudio anatomopatológico definitivo. Resultados: La edad media fue de 54 años con un rango comprendido entre los 14 y 87 años. El 56,8% eran mujeres y el 44,2% hombres. La sensibilidad de la punción aspiración con aguja fina para el diagnóstico de malignidad fue del 30% y la especificidad fue del 98,46%, con un valor predictivo positivo del 75% y un valor predictivo negativo del 90,14%. Conclusiones: La punción aspiración con aguja fina es un método diagnóstico muy útil a la hora de estudiar un tumor de glándula parótida, sobre todo por su valor predictivo negativo, lo que permite afirmar con alta probabilidad la benignidad del proceso.

Introduction and objectives: the usage of fine needle aspiration cytology in the evaluation of parotid gland tumors is controversial, since there is great variability in terms of sensitivity and specificity in different series published. Our objective is to evaluate the usage of fine needle aspiration cytology in the study of parotid gland tumors in our population. Methods: A retrospective study was conducted using a sample of 77 patients with parotid gland tumors between 2000-2017 in two hospital centers in Montevideo, Uruguay, who underwent preoperative diagnostic fine needle aspiration cytology and subsequently were treated with surgery and anatomopathological study. Results: The mean age was 54 years old, with interval between 14-87 years of age. 56.8% were female. The sensitivity of the fine needle aspiration cytology for the diagnosis of malignancy was 30%, and the specificity was 98.46% with a positive predictive value of 75% and a negative predictive value of 90.14% Conclusions: fine needle aspiration cytology is a very useful diagnostic method in the evaluation of parotid gland tumors, mainly due to its high negative predictive value.

Introdução e objetivo: a utilidade da citologia por punção com aspiração com agulha fina na avaliação de tumores parotídeos é controversa, ja que existe uma grande variabilidade em termos de sensibilidade e especificidade nas diferentes séries publicadas. Nosso objetivo é avaliar a utilidade da punção de aspiração de agulha fina de tumores da glândula parótida em nosso meio. Métodos: realizou-se estudo retrospectivo e observacional com uma amostra de 77 pacientes com tumores da glândula parótida, no período 2000-2017 em dois hospitais em Montevidéu, Uruguai, que foram sobmetidos a punção de aspiração com agulha fina pré-operatória e posteriormente correlacionou-se com o estudo anatomopatológico definitivo. Resultados: A idade média foi de 54 anos, numa faixa entre 14 e 87 anos. 56,8% eram mulheres e 44,2% eram homens. A sensibilidade da punção de aspiração com agulha fina para o diagnóstico de malignidade foi de 30% ea especificidade foi de 98,46%, com um valor preditivo positivo de 75% e um valor preditivo negativo de 90,14%. Conclusões: A punção de aspiração com agulha fina é um método de diagnóstico muito útil na hora de estudar um tumor da glândula parótida, principalmente seu valor preditivo negativo, o que permite afirmar a benignidade do processo com alta probabilidade.

Caracterización de los episodios de agitación durante la emergencia de la anestesia general en pediatría / Characterization of agitation episodes during the emergence from general anesthesia in Pediatrics

RESUMEN Introducción: la agitación durante la emergencia de la anestesia general es una complicación frecuente en pediatría que puede causar daños físicos, retrasar el alta y aumentar los costos. Objetivo: caracterizar los episodios anestesia general en el paciente pediátrico. Materiales y métodos: se realizó un estudio descriptivo, prospectivo, longitudinal de 246 pacientes que presentaron anestesia general en el Hospital "Eliseo Noel Caamaño" entre septiembre de 2015 y diciembre de 2018. Se estudiaron las variables: edad, género, ASA, tiempo quirúrgico y tiempo anestésico, tipo de cirugía, método de anestesia, agentes usados para la inducción y el mantenimiento, severidad de los episodios y necesidad de tratamiento. Resultados: la mayoría de los pacientes que presentaron anestesia general tenían entre 2 y 6 años (63,4%), eran masculinos (67,9%), ASA I (78,1%) y fueron operados de excéresis de lesiones de partes blandas (27,6%). El tiempo quirúrgico fue de 31,2 ± 10,4 minutos y el anestésico 43,5±8,8 minutos. El método anestésico más indicado fue la anestesia balanceada (84,2%), como inductor el propofol (86,2%) y para el mantenimiento isoflurano (34,1%) y sevoflurano (26,4%). Predominaron los episodios severos (51,2%) y el 56,9% necesitó intervención farmacológica. Conclusiones: esta anestesia fue más frecuente en los menores de seis años, masculinos, sanos, a los cuales se les realizaron procederes cortos, con anestesia balanceada, se usó propofol para la inducción e isoflurano y sevoflurano para el mantenimiento de la anestesia. Prevalecieron los episodios severos y la mayoría requirió tratamiento farmacológico (AU).

ABSTRACT Introduction: agitation during the emergence from general anesthesia is a frequent complication in Pediatrics that can cause physical damages, delay discharge and increase costs. Objective: to characterize the episodes of general anesthesia in the pediatric patient. Materials and methods: a descriptive, prospective, longitudinal study was carried out with 246 patients who presented general anesthesia in the Hospital "Eliseo Noel Caamaño" from September 2015 to December 2018. The studied variables were age, gender, ASA, surgical time, anesthetic time, kind of surgery, anesthetic method, agents used for the induction and maintenance, episodes severity and treatment necessity. Results: most of patients treated with general anesthesia were aged 2-6 years (63.4 %), male (67.9 %), ASA I (78.1 %), and underwent the removal of soft parts lesions (27.6 %). The average surgical time was 31,2 ± 10,4 minutes and the anesthetics one was 43,5±8,8 minutes. The most used anesthetics method was balanced anesthesia (84.2 %), the most used inductor was propofol (86.2 %) and for the maintenance isoflurane (34,1%) and sevoflurane (26,4%). Severe episodes (51,2%) predominated, and 56.9 % needed pharmacologic intervention. Conclusions: this kind of anesthesia is more frequently used in children aged less than 6 years, male, healthy, who underwent short procedures with balanced anesthesia and the use of propofol for the induction and isoflurane and sevoflurane for maintaining it. Severe episodes predominated, and most of them required pharmacologic treatment (AU).

Caracterización de los episodios de agitación durante la emergencia de la anestesia general en pediatría / Characterization of agitation episodes during the emergence from general anesthesia in Pediatrics

RESUMEN Introducción: la agitación durante la emergencia de la anestesia general es una complicación frecuente en pediatría que puede causar daños físicos, retrasar el alta y aumentar los costos. Objetivo: caracterizar los episodios anestesia general en el paciente pediátrico. Materiales y métodos: se realizó un estudio descriptivo, prospectivo, longitudinal de 246 pacientes que presentaron anestesia general en el Hospital "Eliseo Noel Caamaño" entre septiembre de 2015 y diciembre de 2018. Se estudiaron las variables: edad, género, ASA, tiempo quirúrgico y tiempo anestésico, tipo de cirugía, método de anestesia, agentes usados para la inducción y el mantenimiento, severidad de los episodios y necesidad de tratamiento. Resultados: la mayoría de los pacientes que presentaron anestesia general tenían entre 2 y 6 años (63,4%), eran masculinos (67,9%), ASA I (78,1%) y fueron operados de excéresis de lesiones de partes blandas (27,6%). El tiempo quirúrgico fue de 31,2 ± 10,4 minutos y el anestésico 43,5±8,8 minutos. El método anestésico más indicado fue la anestesia balanceada (84,2%), como inductor el propofol (86,2%) y para el mantenimiento isoflurano (34,1%) y sevoflurano (26,4%). Predominaron los episodios severos (51,2%) y el 56,9% necesitó intervención farmacológica. Conclusiones: esta anestesia fue más frecuente en los menores de seis años, masculinos, sanos, a los cuales se les realizaron procederes cortos, con anestesia balanceada, se usó propofol para la inducción e isoflurano y sevoflurano para el mantenimiento de la anestesia. Prevalecieron los episodios severos y la mayoría requirió tratamiento farmacológico.

ABSTRACT Introduction: agitation during the emergence from general anesthesia is a frequent complication in Pediatrics that can cause physical damages, delay discharge and increase costs. Objective: to characterize the episodes of general anesthesia in the pediatric patient. Materials and methods: a descriptive, prospective, longitudinal study was carried out with 246 patients who presented general anesthesia in the Hospital "Eliseo Noel Caamaño" from September 2015 to December 2018. The studied variables were age, gender, ASA, surgical time, anesthetic time, kind of surgery, anesthetic method, agents used for the induction and maintenance, episodes severity and treatment necessity. Results: most of patients treated with general anesthesia were aged 2-6 years (63.4 %), male (67.9 %), ASA I (78.1 %), and underwent the removal of soft parts lesions (27.6 %). The average surgical time was 31,2 ± 10,4 minutes and the anesthetics one was 43,5±8,8 minutes. The most used anesthetics method was balanced anesthesia (84.2 %), the most used inductor was propofol (86.2 %) and for the maintenance isoflurane (34,1%) and sevoflurane (26,4%). Severe episodes (51,2%) predominated, and 56.9 % needed pharmacologic intervention. Conclusions: this kind of anesthesia is more frequently used in children aged less than 6 years, male, healthy, who underwent short procedures with balanced anesthesia and the use of propofol for the induction and isoflurane and sevoflurane for maintaining it. Severe episodes predominated, and most of them required pharmacologic treatment.

Embarazo ectópico sobre cicatriz de cesárea / Ectopic pregnancy on caesarean section scar

El embarazo ectópico en topografía ístmico-cervical y cicatriz de cesárea anterior es muy poco frecuente, por lo que no existe un tratamiento protocolizado estándar. Se presenta un caso clínico de una paciente con una gestación ectópica ístmico-cervical sobre la cicatriz de dos cesáreas previas. Se ingresa en el servicio de ginecología por el riesgo de ruptura uterina. La evolución se caracterizó por invasión trofoblástica de la histerorrafia y acretismo placentario, y culminó con la interrupción de la gestación. Sin complicaciones maternas. El tratamiento consistió en embrioscopia intervencionista uterina con extracción del disco embrionario e interrupción de la circulación placento-embrionaria, con resultado materno satisfactorio

Pregnancy ectopic ístmico-cervical topography and previus c-section scar is very rare so it not existe standard protocololized treatment. It presents a clinical case of a patient witch an ectopic gestation istmico-cervical on two previous caesarean section scar. She was admited in the gynaecology service because of the risk of uterine rupture, the evolution is characterized by invasion. Trophoblastic of the histerorrafia and acretismo placental culmininating with interruption of gestation. Without maternal complications. The treatment consisted of uterine interventional embrioscopia witch extraction of the embryonic disc and interruption of the placenta-embryonic circulation, witch satisfactory maternal outcome

Tratamiento integral del paciente gran quemado / Comprehensive treatment of severe burnt patient

Paciente masculino de 47 años de edad, con antecedentes de hipertensión arterial. En mayo de 2009 sufrió un accidente en su hogar con gasolina inflamada, lo que le produjo lesiones en cara, cuello anterior, tronco y extremidades. Estas alcanzaron el 67,7 % de la superficie corporal total, de ellas el 51,3 % fueron quemaduras hipodérmicas y el 16,4 % dérmicas AB, para un índice de gravedad de 59,5 y pronóstico de vida de crítico extremo. Se decide ingreso en régimen de terapia intensiva del Servicio de Caumatología del Hospital Militar Central “Dr. Luis Díaz Soto”, donde se le realizaron varios tratamientos quirúrgicos. Tuvo una estadía hospitalaria de 98 días. Al alta quedaron como secuelas posquemaduras, múltiples cicatrices hipertróficas y queloideas en todo su cuerpo, sindactilia en mano izquierda y microstoma. Regresó a nuestro servicio a los 2 años y 6 meses para tratamiento reconstructivo de cicatriz queloidea que interesaba mentón y labio superior, así como del microstoma. Se realizó la reconstrucción de la zona afectada mediante la combinación de plastias locales y a distancia. Se obtuvo satisfactorios resultados estéticos y funcionales, lo que demuestra que el tratamiento integral del paciente quemado garantiza la sobrevida, el control de la sepsis, la mejoría estética, funcional y de la esfera psíquica.

A 47 year-old male patient with a history of hypertension suffered an inflamed gasoline accident at home in May 2009. This accident produced lesions on his face, anterior neck, trunk and limps. These burns reached 67.7 % of the total body surface area, out of which 51.3 % were hypodermic burns, and 16.4 % dermal AB, for a 59.5 severity index and prognosis of extremely critical. His admission is decided in intensive care regimen of the Burn Therapy Service at the Central Military Hospital where various surgical treatments were performed. He had a hospital stay of 98 days. At discharge sequelae were left as post burns, multiple keloids and hypertrophic scars all over his body, syndactyly microstoma in his left hand. The patient returned to our service at 2 years and 6 months for reconstructive treatment of keloid scar affecting his chin and upper lip, and the microstoma. Reconstruction of the affected area was performed by combining local and distance plasty. Satisfactory aesthetic and functional results were obtained, demonstrating that comprehensive treatment of burn patients guarantees survival, sepsis control, aesthetic, functional and psychic sphere improvement.

Tratamiento integral del paciente gran quemado / Comprehensive treatment of severe burnt patient

Paciente masculino de 47 años de edad, con antecedentes de hipertensión arterial. En mayo de 2009 sufrió un accidente en su hogar con gasolina inflamada, lo que le produjo lesiones en cara, cuello anterior, tronco y extremidades. Estas alcanzaron el 67,7 por ciento de la superficie corporal total, de ellas el 51,3 por ciento fueron quemaduras hipodérmicas y el 16,4 por ciento dérmicas AB, para un índice de gravedad de 59,5 y pronóstico de vida de crítico extremo. Se decide ingreso en régimen de terapia intensiva del Servicio de Caumatología del Hospital Militar Central Dr Luis Díaz Soto, donde se le realizaron varios tratamientos quirúrgicos. Tuvo una estadía hospitalaria de 98 días. Al alta quedaron como secuelas posquemaduras, múltiples cicatrices hipertróficas y queloideas en todo su cuerpo, sindactilia en mano izquierda y microstoma. Regresó a nuestro servicio a los 2 años y 6 meses para tratamiento reconstructivo de cicatriz queloidea que interesaba mentón y labio superior, así como del microstoma. Se realizó la reconstrucción de la zona afectada mediante la combinación de plastias locales y a distancia. Se obtuvo satisfactorios resultados estéticos y funcionales, lo que demuestra que el tratamiento integral del paciente quemado garantiza la sobrevida, el control de la sepsis, la mejoría estética, funcional y de la esfera psíquica(AU)

A 47 year-old male patient with a history of hypertension suffered an inflamed gasoline accident at home in May 2009. This accident produced lesions on his face, anterior neck, trunk and limps. These burns reached 67.7 percent of the total body surface area, out of which 51.3 percent were hypodermic burns, and 16.4 percent dermal AB, for a 59.5 severity index and prognosis of extremely critical. His admission is decided in intensive care regimen of the Burn Therapy Service at the Central Military Hospital where various surgical treatments were performed. He had a hospital stay of 98 days. At discharge sequelae were left as post burns, multiple keloids and hypertrophic scars all over his body, syndactyly microstoma in his left hand. The patient returned to our service at 2 years and 6 months for reconstructive treatment of keloid scar affecting his chin and upper lip, and the microstoma. Reconstruction of the affected area was performed by combining local and distance plasty. Satisfactory aesthetic and functional results were obtained, demonstrating that comprehensive treatment of burn patients guarantees survival, sepsis control, aesthetic, functional and psychic sphere improvement(AU)

Quality of fresh-cut baby spinach grown under a floating trays system as affected by nitrogen fertilisation and innovative packaging treatments.

BACKGROUND: Alternative techniques for cultivation of leafy vegetables such as a floating tray system and unconventional gas mixtures for post-harvest active modified atmosphere packaging (MAP) could be of interest in the minimally processed vegetable industry. RESULTS: The combined effect of three pre-harvest fertilisation doses (8, 12 or 16 mmol N L(-1)) and three post-harvest MAP conditions (passive, super-atmospheric or N2O-enriched) on the main quality attributes of fresh-cut baby spinach leaves throughout 10 days at 5 degrees C was studied. After 8 days of shelf life, spinach leaves fertilised with 8 and 16 mmol N L(-1) and stored under N2O-enriched MAP showed the lowest microbial growth, with good sensory quality. Such combined treatments also preserved the total antioxidant capacity sampled at harvest (8 g ascorbic acid equivalent antioxidant capacity kg(-1) f.w.). A decrease of 10-20% in total vitamin C content regardless of N fertilisation and packaging treatment was found during shelf life. Total phenolics content at harvest was 2 g gallic acid equivalents kg(-1) f.w., which was slightly decreased or preserved during shelf life while total chlorophylls were preserved for all treatments assayed around 550 mg kg(-1) f.w. CONCLUSION: No clear effect of fertilisation doses was observed during post-harvest storage on overall quality of fresh-cut baby spinach leaves, while N2O-enriched atmospheres seems to be a promising alternative to passive MAP for extending shelf life.

Novel alpha-KTx peptides from the venom of the scorpion Centruroides elegans selectively blockade Kv1.3 over IKCa1 K+ channels of T cells.

From the venom of the Mexican scorpion Centruroides elegans Thorell five peptides were isolated to homogeneity by chromatographic procedures and their full amino acid sequence was determined by automatic Edman degradation. They all belong to the Noxiustoxin subfamily of scorpion toxins and were given the systematic names alpha-KTx 2.8 to 2.12, with trivial names Ce1 to Ce5, respectively. They have 39 amino acid residues, except for Ce3 which has only 38, but all of them have three disulfide bridges, and have molecular weights of 4255, 4267, 4249, 4295 and 4255 atomic mass units, respectively for Ce1 to Ce5. The C-terminal residues of Ce2, Ce4 and Ce5 were found to be amidated. The electrophysiological assay (whole-cell patch-clamp) showed that out of the five peptides, Ce1 (alpha-KTx 2.8), Ce2 (alpha-KTX2.9) and Ce4 (alpha-KTx 2.11) were effective blockers of Kv1.3 channels of human T lymphocytes, whereas these peptides did not inhibit the Ca2+-activated K+ channels (IKCa1) of the same cells. The equilibrium dissociation constants of these peptides for Kv1.3 were 0.70, 0.25 and 0.98nM for Ce1, Ce2 and Ce4, respectively. Furthermore, toxins Ce1, Ce2 and Ce4 practically did not inhibit the related voltage gated Shaker K+ channels, and rKv2.1 channels of the Shab family. The high affinity blockage of Kv1.3 channels by these peptides and their selectivity for Kv1.3 over IKCa1 may have significance in the development of novel tools for suppressing the function of those T cell subsets whose proliferation critically depends on the activity of Kv1.3 channels.

[The hospital faced with a prolonged Legionella outbreak]. / El hospital ante un brote prolongado de legionelosis.

OBJECTIVE: To describe the health resources used in patients hospitalized with Legionella pneumonia during an outbreak of Legionnaire's disease in Alcoy (Spain), and to compare them with those used in other forms of pneumonia. METHODS AND RESULTS: Using a clinical protocol, 177 Legionella pneumonia patients were compared with 180 patients hospitalized for other types of pneumonia. Data on therapy and the resources used were collected. The most common antibiotic treatment in both groups was clarithromycin, but intensive care and mechanical ventilation requirements were greater in Legionella pneumonia. Home-based hospital care was successfully used in 15.6% of patients with Legionella pneumonia and in 11.3% of those with other types of pneumonia. Home oxygen therapy after discharge was less frequent in the Legionella pneumonia group (7.8%) than in the group with non-Legionella pneumonia (16.7%). CONCLUSIONS: Notable results were the greater requirement for mechanical ventilation in Legionella pneumonia and the good results obtained by home-based hospital care within current health care management.