Bezlotoxumab en la profilaxis de la infección recurrente por Clostridium difficile. Resultados en una serie de 4 casos / Bezlotoxumab in the prophylaxis of recurrent Clostridium difficile infection. Results in a series of 4 patients

Bezlotoxumab es un fármaco usado en la prevención de recurrencias de infección por Clostridium difficile, actuando mediante su unión a la toxina B de la bacteria, produciendo su inactivación. Este tipo de infección es muy frecuente en pacientes inmunodeprimidos, los cuales suelen presentar varias recurrencias que, junto con su enfermedad de base, pueden poner en compromiso la salud e incluso la vida del paciente. El objetivo de este trabajo es evaluar la efectividad de bezlotoxumab en la prevención de recaídas de infección por Clostridium difficile en una serie de cuatro pacientes. Para ello, se recopiló la información clínica necesaria y se anonimizó la base de datos antes de su análisis. Tras el análisis de nuestra serie de datos, obtuvimos resultados positivos ya que tres de los cuatro pacientes no sufrieron episodios de recurrencias en los cuatro meses posteriores a la administración de bezlotoxumab y ninguno presentó efectos adversos o intolerancias. Un paciente falleció un mes después de la administración de bezlotoxumab debido a la situación de inmunosupresión causada por su enfermedad de base y la infección no curada de Clostridium difficile. (AU)

Bezlotoxumab is a drug used in the treatment of recurrences of Clostridium difficile infection, acting by binding to the toxin B of the bacterium, producing its inactivation. This type of infection is very common in immunocompromised patients, who usually present several recurrences that, together with their underlying disease, can compromise the health and even the patient’s life. The aim of this study is to evaluate the effectiveness of bezlotoxumab in the prevention of four patients admitted for relapses of Clostridium difficile infection after the previous therapeutic failure of other drugs such as vancomycin, metronidazole or fidaxomycin. To do this, the necessary clinical information was collected and the database was anonymized before analysis. After analyzing our data series, we obtained positive results as three of the four patients did not suffer relapse episodes in the four months after bezlotoxumab administration and none had adverse effects or intolerances. One patient died one month after administration of bezlotozumab due to immunosuppression caused by his underlying disease and uncured Clostridium difficile infection. (AU)

Barotrauma pulmonar en joven buceador / Pulmonary barotrauma in young diver

La mayoría de las lesiones en buceo están relacionadas con el comportamiento de gases y presiones durante el descenso y ascenso. Las cuatro principales patologías en Medicina de buceo incluyen: barotrauma (sinusal, ótico y pulmonar); enfermedad por descompresión; edema pulmonar y efectos tóxicos y farmacológicos de presiones parciales de gases aumentadas. Las manifestaciones clínicas de una lesión de buceo pueden aparecer durante una zambullida y hasta 24 horas después de ella. Los médicos que viven lejos de zonas donde se bucea no están excluidos de la posibilidad de encontrarse pacientes con lesiones de buceo y por lo tanto deben estar al tanto de estas lesiones. Describimos un caso clínico de un joven buceador que sufrió un barotrauma pulmonar después de una secuencia de inmersiones libres a 5 metros y sugerimos un posible mecanismo (AU)

Most diving injuries are related to the behaviour of the gases and pressure changes during descent and ascent. The four main pathologies in diving medicine include: barotrauma (sinus, otic, and pulmonary); decompression illness; pulmonary edema and pharmacological and toxic effects of increased partial pressures of gases. The clinical manifestations of a diving injury may be seen during a dive or up to 24 h after it. Physicians living far away from diving places are not excluded from the possibility of encountering diver-injured patients and therefore need to be aware of these injuries. We report a case of a young diver who suffered an episode of pulmonary barotrauma after a sequence of free divers to five metres, and suggest a possible mechanism (AU)

Autoantibodies against oxidized LDL and serum total antioxidant status in active cyclists and ex-cyclists.

There is an apparent paradox between the benefits of aerobic exercise and the potentially deleterious effects of increased free radicals and decreased circulating antioxidants generated during exercise. To assess the oxidative/antioxidative status in competitive cyclists and ex-cyclists, we measured two markers not well studied in these situations, serum total antioxidant status (TAS) and antibodies against oxidized LDL (AuAb-ox-LDL) in 18 competitive male cyclists, 10 ex-competitive cyclists and 14 healthy males. AuAb-ox-LDL was evaluated by enzyme immunoassay, and serum TAS concentration was analyzed by spectrophotometry. Ex-cyclists had serum TAS levels statistically higher than the control group and cyclists group (p = 0.001 and p < 0.001, respectively). Active sportsmen showed significantly less AuAb-ox-LDL than healthy sedentary males, while there was a non-significant trend in the ex-cyclists to have lower AuAb-ox-LDL than the corresponding control group. AuAb-ox-LDL levels were not statistically different between the groups of active and previously active sporting men. There was a positive correlation between TAS and LDL-cholesterol in active cyclists under heavy training. In the ex-cyclist group, there was a negative correlation between serum TAS and the time elapsed since they had ended the competition. Competitive cycling decreases AuAb-ox-LDL levels, suggesting that it may decrease ox-LDL levels. After ending physical training, antioxidative status remains increased for at least one year, but the effect on AuAb-ox-LDL levels is lost.

Postnatal development of argyrophilic nucleolar organizer regions in the mammillary body of undernourished rats.

The effects of undernutrition during pregnancy and/or lactation periods on cortical structures have already been reported. However, its effect on non-cortical areas like the hypothalamic, that participates in the regulation of the autonomic nervous system or food intake, has not been extensively investigated. We studied the postnatal development of the medial mammillary nucleus (hypothalamus) in the rat offspring that had a dietary restriction in utero and during lactation. The argyrophilic nucleolar regions (Ag-NORs), that represent the transcriptional activity of the cell, were quantified in their neurons. No statistically significant differences were found in the results between the control and undernourished groups in the ages studied (7, 14, 21 and 30 days). However, a delay in the neuronal activity of the latter group was observed. A critical period in the development of this nucleus, at about 21 days of age, was also seen in both groups. After this age, the activity levels remained steady.