Crisis epilépticas sintomáticas agudas. Descripción clinicoelectroencefalográfica etiológica y pronóstico de una serie oncopediátrica / Acute symptomatic epileptic seizures. A clinical-electroencephalographic etiological description and prognosis of an oncopediatric series

Objetivo Determinar las características clínicas, electroencefalográficas, terapéuticas y evolutivas de una serie de pacientes oncopediátricos con convulsiones sintomáticas agudas. Pacientes y métodos Efectuamos un análisis descriptivo retrospectivo y prospectivo de registros clínicos de niños oncopediátricos evaluados por neurología en el Centro Ambulatorio Integral de Pacientes Hematooncológicos durante 2017-2021. Incluimos a niños de 1 mes a 17 años con tumores intracraneales y extracraneales que presentaron convulsiones sintomáticas agudas (CSA). Definimos convulsión sintomática aguda según la clasificación de la Liga Internacional contra la Epilepsia de 2010. Clasificamos las crisis epilépticas según la clasificación de la Liga Internacional contra la Epilepsia de 2017. Excluimos a todo paciente con diagnóstico de epilepsia previa y de episodios paroxísticos no epilépticos. Resultados Analizamos 44 casos, con una mediana de 4 años (rango: 1 mes-17 años) y una media de 5,75 meses (rango: 1 mes-11 meses) y 8,33 años (2-17 años). Registramos como principales etiologías la neurotoxicidad y el contexto posquirúrgico, con cuatro pacientes asociados a disnatremias y dos a hipertensión endocraneana. Se realizaron 41 electroencefalogramas, con resultados intercríticos con anormalidades en el ritmo de base, pero sin focos ni paroxismos. No hubo registros críticos. Las convulsiones focales fueron 25 (56,8%), y las generalizadas, 19 (43,18%). El levetiracetam fue el fármaco más utilizado para el tratamiento agudo. Conclusiones Nuestra cohorte muestra que las CSA, en esta población, no evidencian diferencias considerables entre convulsiones focales motoras y generalizadas, y ocurren mayormente en un contexto neurotóxico y posquirúrgico. También se registraron disnatremias e hipertensión endocraneana asociadas a CSA. Los electroencefalogramas poscrisis fueron sin focos o paroxismos y con evolución de las crisis. (AU)

AIM To determine clinical, electroencephalographic, therapeutic and evolutive characteristics of a series of oncopediatric patients with acute symptomatic seizures. PATIENTS AND METHODS We performed a retrospective and prospective descriptive analysis of clinical records of oncopediatric children evaluated by neurology at the comprehensive outpatient Center for Hemato-Oncological Patients during 2017-2021. We included children aged one month to 17 years with intracranial and extracranial tumors who presented with acute symptomatic seizure (ASC). We defined acute symptomatic seizure according to the 2010 International League Against Epilepsy. We classified seizures according to 2017 International League Against Epilepsy classification. We excluded any patient with a diagnosis of previous epilepsy and non-epileptic paroxysmal episodes. RESULTS We analyzed 44 cases with a median of 4 years (range: 1 month-17 years) and mean of 5.75 months (range: 1 month-11 months) and 8.33 years (2-17 years). The main etiologies were neurotoxicity and post-surgical context. Four patients presented dysnatremias and two associated with endocranial hypertension. Forty-one electroencephalograms were performed with intercritical results with abnormalities in the baseline rhythm, but without foci or paroxysms. There were no critical recordings. Focal seizures were 25 (56.8%) and generalized seizures 19 (43.18%). Levetiracetam was the most commonly used drug for acute management. CONCLUSIONS Our cohort shows that ASC, in this population, do not show considerable differences between focal motor and generalized seizures and occur mostly in neurotoxic and post-surgical contexts. Dysnatremias and endocranial hypertension associated with ASC were also recorded. Postcrisis electroencephalograms were without foci or paroxysms and good seizure evolution. (AU)

Protocol for a pilot and feasibility randomized-controlled trial of four weeks of oral γ-aminobutyric acid (GABA) intake and its effect on pain and sleep in middle-to-older aged adults.

Approximately 1.71 billion people globally live with musculoskeletal pain conditions, including low back pain, knee pain, and neck pain Cieza et al. (2020). In the US, an estimated 20.4% of U.S. adult had chronic pain and 8.0% of U.S. adults had high-impact chronic pain, with higher prevalence associated with advancing age Dahlhamer et al. (2018). On the other hand, between 50 and 70 million US adults have a sleep disorder (American Sleep Association). Although the link between sleep and pain is widely established, the neurobiological mechanisms underlying this relationship have yet to be fully elucidated, specifically within an aged population. As currently available sleep and chronic pain therapies are only partially effective, novel treatment approaches are urgently needed. Given the potential mechanistic role of γ-aminobutyric acid (GABA) in both conditions, and the availability of GABA supplements over the counter, the present proposal will determine the feasibility and acceptability of oral GABA administration in middle-to-older aged adults with chronic pain and sleep disorders as well as characterize the potential neurobiological mechanisms involved in both conditions. Results from the present investigation using a parallel, double-blinded, placebo-controlled study will provide novel preliminary information needed for future translational pain and sleep research.

Teores de polifenóis totais e de umidade em amostras de rizomas de Limonium brasiliense / Total polyphenols and moisture contents in samples of Limonium brasiliense rhizomes / Polifenoles totales y contenido de humedad en muestras de rizomas de Limonium brasiliense

O Limonium brasiliense (Boiss.) Kuntze (Plumbaginaceae), chamado popularmente de baicuru ou guaicuru é uma erva perene presente em todo litoral sul do Brasil, sendo indicada tradicionalmente para síndrome pré-menstrual e distúrbios menstruais. Essas atividades são atribuídas à presença dos polifenóis concentrados em seus rizomas, que também apresentam atividades bacteriostáticas, antioxidantes, antivirais e anti-inflamatórias. No desenvolvimento de formulações feitas a partir da droga vegetal são necessários testes de controle de qualidade durante todo o processo a fim de garantir a segurança, eficácia e qualidade da matéria-prima até sua formulação final. As metodologias utilizadas no desenvolvimento deste trabalho foram de análises físico-químicas para o controle de qualidade, análises quantitativas para determinação do teor de polifenóis totais e, por fim, uma análise comparativa entre os resultados obtidos no ano da coleta do material vegetal (2010) e das mesmas características após 13 anos da coleta, utilizando amostras do L. brasiliense com a presença de fungos ou sem nos rizomas. Sendo assim, este trabalho teve como objetivo realizar o controle de qualidade comparativo dos rizomas de Limonium brasiliense coletados em 2010 em relação ao teor de polifenóis totais e de umidade em 2023. Os resultados obtidos evidenciaram a produção de polifenóis pelos fungos na amostra contaminada, além de mostrarem a qualidade de armazenagem da droga vegetal. Com isso, foi possível concluir que o teor de polifenóis totais da amostra com fungo aumentou após 13 anos da coleta, e que neste interim não houve mudanças no teor de umidade da amostra sem fungo, garantindo sua qualidade no desenvolvimento de formulações ou pesquisas futuras.

Limonium brasiliense (Boiss.) Kuntze (Plumbaginaceae), popularly called baicuru or guaicuru, is a perennial herb present throughout the southern coast of Brazil, traditionally indicated for premenstrual syndrome and menstrual disorders. These activities are attributed to the presence of polyphenols concentrated in its rhizomes, which also have bacteriostatic, antioxidant, antiviral and anti-inflammatory activities. When developing formulations made from plant-based drugs, quality control tests are necessary throughout the process to ensure the safety, efficacy and quality of the raw material until its final formulation. The methodologies used in the development of this work were physical-chemical analyzes for quality control, quantitative analyzes to determine the total polyphenol content and, finally, a comparative analysis between the results obtained in the year the plant material was collected (2010) and the same characteristics after 13 years of collection, using samples of L. brasiliense with or without the presence of fungi in the rhizomes. Therefore, this work aimed to carry out comparative quality control of Limonium brasiliense rhizomes collected in 2010 in relation to the content of total polyphenols and moisture in 2023. The results obtained showed the production of polyphenols by fungi in the contaminated sample, in addition to show the storage quality of the plant drug. With this, it was possible to conclude that the total polyphenol content of the sample with fungus increased after 13 years of collection, and that in the meantime there were no changes in the moisture content of the sample without fungus, guaranteeing its quality in the development of formulations or future research.

Limonium brasiliense (Boiss.) Kuntze (Plumbaginaceae), popularmente llamada baicuru o guaicuru, es una hierba perenne presente en toda la costa sur de Brasil, tradicionalmente indicada para el síndrome premenstrual y trastornos menstruales. Estas actividades se atribuyen a la presencia de polifenoles concentrados en sus rizomas, que también tienen actividades bacteriostáticas, antioxidantes, antivirales y antiinflamatorias. Cuando se desarrollan formulaciones elaboradas a partir de medicamentos de origen vegetal, son necesarios ensayos de control de calidad durante todo el proceso para garantizar la seguridad, eficacia y calidad de la materia prima hasta su formulación final. Las metodologías utilizadas en el desarrollo de este trabajo fueron análisis físico- químicos para control de calidad, análisis cuantitativos para determinar el contenido de polifenoles totales y, finalmente, un análisis comparativo entre los resultados obtenidos en el año de recolección del material vegetal (2010) y el mismas características después de 13 años de colecta, utilizando muestras de L. brasiliense con o sin presencia de hongos en los rizomas. Por lo tanto, este trabajo tuvo como objetivo realizar un control de calidad comparativo de los rizomas de Limonium brasiliense recolectados en 2010 en relación al contenido de polifenoles totales y humedad en 2023. Los resultados obtenidos mostraron la producción de polifenoles por hongos en la muestra contaminada, además de mostrar la calidad de almacenamiento de la droga vegetal. Con esto se pudo concluir que el contenido total de polifenoles de la muestra con hongos aumentó después de 13 años de colecta, y que mientras tanto no hubo cambios en el contenido de humedad de la muestra sin hongos, garantizando su calidad en el desarrollo. de formulaciones o investigaciones futuras.

Detecting underreport in real-world assessment contexts: The utility of multiple-scale indicators / Detectar la minimización de síntomas en contextos de evaluación reales. La utilidad de indicadores de escalas múltiples

Underreport of symptoms and personality characteristics is a relevant problem for psychological assessment. Nevertheless, most of the studies in this field use simulation designs. This study aims at comparing underreport prevalence in real world samples of different contexts, using single-scale and multiple scale underreport indicators from the Minnesota Multiphasic Personality Inventory–2 (MMPI-2) to identify the best one and assess its implications on the clinical scales scores. Using a Differential Prevalence Group design, 1438 participants were assessed with the MMPI-2, grouped in three samples from two non-clinical contexts (community and organizational) and one clinical context. The organizational sample had the highest prevalence of underreporting. Overall, multiple scale indicator LKS ≥ T65 performed better at distinguishing these samples. Analysis of variance revealed that LKS ≥ T65 was also the only indicator in which participants doing underreport consistently varied from honest re-sponders in the clinical scales scores, while also having lower probability of producing both type I and II errors. The existence of underreport has clear implication on the clinical scales results. The multiple scale indicator is the most robust and should be used in the detection of underreporting. This is a relevant implication for psychological assessment in different contexts, mainly in the organizational context.(AU)

La minimización de síntomas es un problema relevante para la evaluación psicológica. La mayoría de los estudios utilizan diseños de simulación. Este estudio tiene como objetivo comparar la prevalencia de la minimización de síntomas y sus implicaciones, utilizando indicadores de escala única y de escala múltiple del Inventario Multifásico de Personalidad de Minnesota-2 (MMPI-2) en muestras reales. Utilizando un diseño de Grupo de Prevalencia Diferencial se evaluaron 1438 participantes, agrupados en tres muestras: dos no clínicas (comunitario y organizacional) y una muestra clínica. La muestra organizacional tuvo la mayor prevalencia de minimización de síntomas. En general, el indicador de escala múltiple LKS ≥ T65 proporcionó los mejores resultados. El análisis de la varianza reveló que el LKS ≥ T65 era también el único indicador de diferenciación, en las escalas clínicas, de los participantes que realizaban o no la minimización de síntomas, a la vez que tenía una menor probabilidad de producir errores tipo I y II. La presencia de minimización tiene una clara implicación en las puntuaciones clínicas. El indicador de escalas múltiples es el más robusto en la detección de la minimización de síntomas y es relevante para la evaluación en diferentes contextos, principalmente en lo organizacional.(AU)

The naturally-derived alkaloids as a potential treatment for COVID-19: A scoping review.

Coronavirus disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which has a high mortality rate and transmissibility. In this context, medicinal plants have attracted attention due to the wide availability and variety of therapeutic compounds, such as alkaloids, a vast class with several proven pharmacological effects, like the antiviral and anti-inflammatory activities. Therefore, this scoping review aimed to summarize the current knowledge of the potential applicability of alkaloids for treating COVID-19. A systematic search was performed on PubMed and Scopus, from database inception to August 2021. Among the 63 eligible studies, 65.07% were in silico model, 20.63% in vitro and 14.28% clinical trials and observational studies. According to the in silico assessments, the alkaloids 10-hydroxyusambarensine, cryptospirolepine, crambescidin 826, deoxynortryptoquivaline, ergotamine, michellamine B, nigellidine, norboldine and quinadoline B showed higher binding energy with more than two target proteins. The remaining studies showed potential use of berberine, cephaeline, emetine, homoharringtonine, lycorine, narciclasine, quinine, papaverine and colchicine. The possible ability of alkaloids to inhibit protein targets and to reduce inflammatory markers show the potential for development of new treatment strategies against COVID-19. However, more high quality analyses/reviews in this field are necessary to firmly establish the effectiveness/safety of the alkaloids here described.

Non-contrast transoesophageal echo-guided transapical transcatheter aortic valve replacement: 10-year experience of a renoprotective strategy.

OBJECTIVES: This study aims to evaluate the efficacy, safety and long-term outcomes of a renoprotective non-contrast, transoesophageal echocardiography-guided transapical (TA) transcatheter aortic valve replacement (TAVR) strategy with a balloon-expandable prosthesis, as well as to determine its impact on renal function. METHODS: Between 2009 and 2019, 200 consecutive patients underwent a non-contrast, transoesophageal echocardiography-guided TA TAVR with a balloon-expandable prosthesis. RESULTS: The device success rate was 95.5%. Transoesophageal echocardiography-guided deployment demonstrated a low rate of procedure-related complications: 9.5% of acute kidney injury, 8% postoperative bleeding, 6% low-cardiac output, 4.5% postprocedural aortic regurgitation ≥+2, 4% implantation of permanent pacemaker and 2% stroke. There were no significant differences between preoperative and on discharge estimated glomerular filtration rate (53.9 ± 22.2 vs 54.3 ± 22.9 ml/min/1.73 m2, P = 0.60). Logistic regression analysis confirmed postoperative bleeding as an independent predictor for acute kidney injury (odds ratio (OR) 11.148, 95% confidence interval 3.537-35.140, P < 0.001). In-hospital mortality was 7.5%. The mean follow-up was 48.5 ± 39.9 months. Renal function and patient's chronic kidney disease stage did not significantly vary during follow-up. Long-term cumulative survival at 1, 5 and 10 years was 84.2 ± 0.027%, 42.9 ± 0.038% and 32.5 ± 0.044%, respectively. Renal function affected on neither in-hospital mortality nor long-term survival. CONCLUSIONS: Non-contrast, transoesophageal echocardiography-guided TA TAVR is a safe and reproducible technique with a low incidence of periprocedural complications that avoids the use of contrast and mitigates the incidence of acute kidney injury.

Academic achievement and gender among adult critical care program directors.

PURPOSE: Accreditation Council for Graduate Medical Education (ACGME) program director (PD) qualifications includes scholarly activity with demonstrated academic productivity and dissemination. Our hypothesis: academic productivity among adult critical care medicine (CCM) fellowship PDs is affected by gender with women having lower productivity. MATERIALS AND METHODS: PDs in 39 institutions with CCM fellowships in anesthesiology, surgery, and pulmonary medicine were analyzed using data from ACGME website, PubMed, and NIH Research Portfolio Online Reporting Tools. Primary outcomes were total publications and h-index. Secondary outcomes included NIH funding and past five year publications. Independent variables and covariates included gender, academic rank, year appointed as program director, years certified in CCM, and specialty. RESULTS: PDs who were women had fewer total publications (median: 13 vs: 20, p = 0.030), past 5 years publications (median: 6 vs median: 9; p = 0.025), and less NIH funding (12% vs 32%; p = 0.046) compared to men. In exploratory analyses stratified by rank, assistant professor ranked women had fewer total (p = 0.027) and recent publications (p = 0.031) compared to men. CONCLUSIONS: Women who were PDs had fewer publications and less NIH funding compared to men with differences in publications more prominent in early career faculty.

Personality and psychopathology heterogeneity in MMPI-2 and health-related features in fibromyalgia patients.

Personality and psychopathology features may play an important role as predisposing factors for fibromyalgia (FM). However, psychological heterogeneity of FM patients has been suggested. Based on two personality psychopathology clusters, we intend to explore psychological heterogeneity in FM patients, specifically, to identify if personality features had other psychological and psychopathological correlates. Secondarily, we also want to identify if personality features have association with health-related correlates. The participants were female FM patients (n = 56) between 30 and 60 years old. The instruments were: Minnesota Multiphasic Personality Inventory (MMPI-2) content and supplementary scales, Fibromyalgia Impact Questionnaire (FIQ), and Numerical Rating Scale (NRS-11). Multivariate analyses of variance (MANOVAs) identified that Cluster 2 (n = 24), characterized by a combination of negative affectivity and social inhibition, presented a more disturbed profile, with several features of symptomatic behavior, general maladjustment, and important clinical problem areas. The associations of personality variables with FM impact and self-reported pain are null, with the exception of Disconstraint scale. In conclusion, FM patients may be very different at the psychological level, concerning personality and psychopathological features that may compromise their treatment. Personality and health-related dimensions do not seem to be associated.

Envejecimiento y caídas. Su impacto social / Ageing and falls. Its social impact

RESUMEN El creciente envejecimiento demográfico observado en los diferentes países constituye un fenómeno complejo de relevancia mundial, que repercute en los diversos sectores de la sociedad, entre ellos, el de la salud. Entre los grandes problemas geriátricos que afectan la calidad de vida de los ancianos y constituyen un marcador de fragilidad se encuentran las caídas; las mismas constituyen un evento frecuente entre los adultos mayores de 60 años. Aproximadamente 1 de cada 3 adultos que viven en la comunidad tiene riesgo de presentar una caída en un año. Ese riesgo aumenta con la edad, la presencia de comorbilidades, el antecedente de caídas previas y los trastornos en la marcha, entre otros. Sus consecuencias son graves y pueden llevar a la institucionalización e incluso a la muerte. Tienen implicaciones sociales y de salud pública; por este motivo se considera de fundamental relevancia que el personal de salud y la sociedad en general puedan adquirir conocimientos básicos acerca de las caídas en los adultos mayores, para detectarlas e intervenir de manera adecuada, lo que garantiza el logro de una longevidad con bienestar (AU).

ABSTRACT The growing demographic ageing observed in different countries constitutes a complex phenomenon of global relevance, which has an impact on the various sectors of society, public health among them. Falls are found among the great geriatric problems affecting elder people´s life quality, constituting a fragility marker and a frequent event in people aged 60 years and more. Almost one of each three adults living in the community have the risk of falling once a year. The risk increases with age, the presence of co morbidities, antecedents of previous falls and gait disorders, among others. Its consequences are serious and could lead to the admittance in institutions and even death. They have social and public health implications; for that reason it is considered very relevant that health care staff and the society in general could acquire basic knowledge on falls in elder people, to detect them and properly intervene; it warranties the achievement of longevity with wellbeing (AU).

Soledad social en ancianos hospitalizados en el servicio de Geriatría. Hospital "Comandante Faustino Pérez" / Social loneliness in elder people hospitalized in the Geriatrics service. Clinical Surgical Hospital "Comandante Faustino Pérez"

RESUMEN Introducción: la soledad social se define como la experiencia subjetiva de insatisfacción frente a la sociedad en la que se vive; en términos de estilos de vida, de valores y de uso de nuevas tecnologías, entre otros aspectos. Objetivo: caracterizar la soledad social en los adultos mayores hospitalizados. Materiales y método: se realizó un estudio observacional, descriptivo, transversal en pacientes que ingresaron en el servicio de Geriatría del Hospital Clínico Quirúrgico "Comandante Faustino Pérez", provincia Matanzas, desde octubre 2015 - 2016. El universo estuvo constituido por 212 pacientes que vivían en compañía y no padecían de demencia, confusión mental ni enfermedades graves. Para la recogida de la información se aplicó al universo de estudio la Escala ESTE II de soledad social, validada a nivel nacional e internacional para identificar el nivel de soledad social. Se utilizaron métodos de estadística descriptiva. Los resultados se presentaron en tablas. Resultados: alto nivel de soledad social en los ancianos estudiados, en el grupo atareo de 60-70 años, sin pareja, de bajo nivel de escolaridad y con enfermedades crónicas. Insuficiente percepción de apoyo y participación social, así como un limitado uso de las nuevas tecnologías. Conclusiones: predominó alto nivel de sentimiento de soledad en los ancianos, asociado a insuficiente percepción de apoyo y participación social, más un bajo acceso a las nuevas tecnologías (AU).

ABSTRACT Introduction: social loneliness is defined as the subjective experience of dissatisfaction toward society in which one lives, in terms of lifestyles, values ​​and use of new technologies among others. Objective: to characterize social loneliness in hospitalized elder adults. Material and Method: a cross-sectional, observational, descriptive, study was conducted in patients admitted to the Geriatrics Service of the Clinical Surgical Hospital "Comandante Faustino Pérez", province of Matanzas, in the period October 2015 - 2016. The universe was formed by 212 patients who lived accompanied and did not suffer from dementia, mental confusion nor serious illnesses. For collecting the information of the studied universe, the authors used the ESTE II Scale of social loneliness validated at national and international level to identify the level of social loneliness. Descriptive statistical methods were used and the results were shown in tables. Results: high level of social loneliness in studied elder people of the 60-70 years-old group, without a partner, with a low level of scholarship and with chronic diseases. They had an insufficient perception of support and social participation, as well as made a limited use of the new technologies. Conclusions: a high level of the loneliness feeling predominated in elder people, associated to an insufficient perception of support and social participation, plus a low access to the new technologies (AU).

Fibromyalgia: heterogeneity in personality and psychopathology and its implications.

The fibromyalgia syndrome (FM) is a chronic widespread pain condition whose etiology remains unknown and no treatment has satisfactory levels of success. A meta-analysis has identified a distinct Minnesota Multiphasic Personality Inventory-2 (MMPI-2) clinical profile between FM female patients and healthy controls, and differences between FM and other chronic pain condition with clear etiology have also been found. However, heterogeneity in this population has been suggested in several studies. We aim to assess clinical aspects in FM patients, based on personality psychopathology characteristics, in order to explore heterogeneity and the existence of core common aspects. In this cross-sectional study, a relatively homogeneous sample of 56 female FM patients (Mage = 45.95, SDage = 9.39) was assessed through MMPI-2. A K-Means cluster analysis identified two clusters, one (n = 24) with clinically significant levels in Negative Emotionality and Introversion scales. Subsequent MANOVAs identified important features of this cluster on several MMPI-2 dimensions. Moreover, several dimensions are clinically elevated in both clusters. In conclusion, the combination of psychopathological negative emotionality, interpersonal isolation, and low hedonic capacity, in a group of patients, has implications for the daily living and treatment of FM patients, and several core aspects of FM need to be addressed.

Espondilodiscitis por fiebre Q. Descripción de 2 casos / Q fever spondylitis: 2 cases report

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Cardiac performance after an endurance open water swimming race.

PURPOSE: Endurance exercise competitions have shown a transient negative effect on global right ventricular (RV) performance. Most published studies are based on terrestrial sports. The aim of our study was to evaluate the cardiac effects after an open water swimming race. METHODS: We evaluated 33 healthy swimmers (mean age 40.9 ± 7.2) participating in a 9.5 km open water swimming race. All subjects underwent a standard transthoracic echocardiography including an evaluation of dimensions and myocardial ventricular deformation. Echocardiography was performed 24 h before and within the first hour of arrival at the finish line. Cardiac troponin I (cTn I), NT-ProBNP and leukocytes were also evaluated. RESULTS: No changes in left ventricle (LV) ejection fraction or LV global longitudinal strain were observed. A significant increase in RV end-diastolic area (RVEDA) was noted after the race (RVEDA at baseline 15.12 ± 1.86; RVEDA after race 16.06 ± 2.27, p < 0.05), but no changes were seen in RV fractional area change or RV global longitudinal strain. Cardiac biomarkers and leukocytes significantly increased. No association was detected between the increase in cTn I or NT-proBNP and the RV acute dilatation or LV performance. A significant association was observed between cTn I and leukocytes (r = 0.375, p < 0.05). CONCLUSIONS: An acute RV dilatation but without an impairment in RV deformation was observed after participating in an endurance swimming race. The correlation between the increase in cTn I and leukocytes, but not with ventricular performance, may support the hypothesis of an exercise-induced increase in myocardial sarcolemmal permeability due to an inflammatory response rather than myocardial injury.

A propósito de un caso, linfoma cerebral primario diagnosticado durante estudio de demencias en una paciente inmunocompetente / Presentation of a case of primary cerebral lymphoma diagnosed in an immunocompetent patient during a dementia study

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Behavioral effects of the combined use of alcohol and energy drinks on alcohol hangover in an experimental mice model.

In last few years it has been a significant increase in the consumption of alcohol combined with energy drink. The aim of this work was to study the effect of this mixture in motor and affective behaviors during an alcohol hangover episode. Male Swiss mice received one of the following treatments: saline + sucrose; saline + energy drink; ethanol + sucrose; ethanol + energy drink. Ethanol dose was 3.8 g/kg BW (i.p.) and energy drink dose was 18 ml/kg BW (gavage) at ZT1 (8 am) (ZT: Zeitgeber time; ZT0: 7 am; lights on). The behavioral tests used were tight rope test to determine motor coordination; hanging wire test to study muscular strength; elevated plus maze and open field tests to evaluate anxiety like-behavior and locomotor activity. Tests were carried out at basal point that matched with lights onset and every 6 h up to 18 h after treatments. Hangover onset was established at ZT7 when blood alcohol concentration (BAC) was almost zero. Our results showed that the mixture of alcohol and energy drink altered significantly motor skills. Specifically, a significant decrease was observed in the performance of the animals in the tightrope and hanging wire tests in groups treated with the mixture of alcohol and energy drink. A significant impairment in the anxiety-like behavior was observed mainly at the beginning of alcohol hangover. These findings suggest that energy drink added to alcohol extends motor disabilities observed during an alcohol hangover episode in comparison with animals that received alcohol alone.

Especialización médica en Chile: tipos, mecanismos y requisitos de postulación: una actualización de los procesos para los médicos generales / Medical specialization in Chile: a centralized vision

Medical graduates face different postgraduate training options, but their priority is to obtain a primary medical specialty, defined as a specialty that does not derive from other. There are different specialty training programs in Chile, which can be dependent or independent of the Ministry of Health. The information about these programs is available in different Internet sites. However a centralized information service that groups and synthetize these programs is lacking, hampering graduate choice decisions. This article aims to review all specialization program modalities, providing a general vision of the institutional structure and implications that govern the specialization process in Chile.

Safety of a proteoliposome from Neisseria meningitides as adjuvant for a house dust mite allergy vaccine.

The proteoliposome (PL) of Neisseria meningitidis serogroup B has been reported as a safe and potent vaccine adjuvant, inducing a TH1-skewed response. The present study describes a pre-clinical safety evaluation of an allergy therapeutic vaccine candidate based on purified allergens from Dermatophagoides siboney house dust mite and PL as adjuvant, both components adsorbed onto aluminum hydroxide gel. Two separate studies of acute toxicity evaluation were performed in mice and rabbits, and two repeat-dose studies were conducted in non-sensitized and allergen-sensitized Balb/c mice, respectively. The study in sensitized mice intends to model a therapeutic setting. Aerosolized allergen challenge was used in both settings to model natural respiratory exposure. In the therapeutic setting, mice were administered with three doses containing 2 µg allergen at weekly intervals [subcutaneous route] and subsequently challenged with aerosolized allergen for 6 consecutive days. Parameters of general toxicity effects were assessed via measures of behavior, body weight, food and water consumption, and macroscopic evaluation of organs. Histological examination of organs and the injection site was performed. Potential immunotoxicity effects at the systemic level were assessed by blood eosinophil counting and serum allergen specific IgE by ELISA The vaccine did not produce general or functional toxic effects of significance, at a dose up to 100 µg allergen per kg body weight. An expected local reaction at the injection site was observed, which could be attributed mostly to the immunological effect of aluminum hydroxide. The models implemented here suggest an acceptable safety profile of this vaccine for testing in clinical trials of allergy immunotherapy.