Mechanical properties, in vitro degradation and cytocompatibility of woven textiles manufactured from PLA/PCL commingled yarns.

The mechanical, thermal, and biological performance of fabrics manufactured with hybrid PLA/PCL commingled yarns were studied. Commingled hybrid yarns take advantage of the higher elastic modulus of PLA and the higher ductility and toughness of PCL to produce yarns and fabrics with high strength and ductility that is transferred to the woven textiles. Furthermore, PLA and PCL exhibit different degradation rates and also allow to tailor this property. Degradation of the textiles was carried out in phosphate-buffered saline solution for up to 160 days at 37 °C and 50 °C (accelerated degradation). Neither the thermal nor the mechanical properties were altered by immersion at 37 °C during 80 days and a slight degradation was observed as a result of chain scission of the PLA fibres after 160 days. However, immersion at 50 °C led to a rapid reduction in strength after 40 days due to the hydrolysis of PLA, and the fabric was highly degraded after 160 days as a result of chain scission in PCL. Finally, while indirect tests did not predict optimal biocompatibility, the direct tests provided a different perspective of the cell interaction between the textile and pre-osteoblasts regarding cell attachment and cell morphology. These results show the potential of hybrid commingled yarns to manufacture textile scaffolds of biodegradable polymers with tailored mechanical properties and good ductility for connective tissue engineering (ligaments and tendons).

Changing rate of serious infections in biologic-exposed rheumatoid arthritis patients. Data from South American registries BIOBADABRASIL and BIOBADASAR.

OBJECTIVE: Most reports on serious infections (SI) in rheumatoid arthritis (RA) patients treated with biological disease-modifying antirheumatic drugs (bDMARDs) are from the USA and Western Europe. Data from other regions are largely missing. We report data from South American countries with different backgrounds and health-care systems but similar registries. METHODS: We merged 2010-2016 data from two registries, BIOBADABRASIL (Brazil) and BIOBADASAR (Argentina), which share the same protocol, online platform and data monitoring process. Patients with active RA were included when they began the first bDMARD or a conventional synthetic DMARD (csDMARD, control group). The SI incidence rate (IR) per 1000 patient/years and adjusted IR ratio (aIRR) were estimated for bDMARDs and csDMARDs. RESULTS: Data were analysed for 3717 RA patients with an exposure of 13,380 patient/years. The 2591 patients treated with bDMARDs (64% tumour necrosis factor-α inhibitors (TNFi)) had a follow-up of 9300 years, and the 1126 treated with csDMARDs had an exposure of 4081 patient/years. The SI IR was 30.54 (CI 27.18-34.30) for all bDMARDs and 5.15 (CI 3.36-7.89) for csDMARDs. The aIRR between the two groups was 2.03 ([1.05, 3.9] p = 0.034) for the first 6 months of treatment but subsequently increased to 8.26 ([4.32, 15.76] p < 0.001). The SI IR for bDMARDs decreased over time in both registries, dropping from 36.59 (28.41-47.12) in 2012 to 7.27 (4.79-11.05) in 2016. CONCLUSION: While SI remains a major concern in South American patients with RA treated with bDMARDs, a favourable trend toward a reduction was observed in the last years.Key Points• New comprehensive data on biologic drugs safety from international collaboration in South America.• First proposal for national registries data merging in South America.• Serious infections remain a major concern in RA patients treated with biologics.• A significant reduction of serious infections in RA patients exposed to biologics was observed over a 7 years period.

Odontodisplasia regional: a propósito de un caso / Regional odontodysplasia: a case report

La odontodisplasia regional (OR) es una anomalía del desarrollo poco frecuente, que involucra componentes del ectodermo y el mesodermo, esta alteración afecta tanto den- tición temporal como permanente, siendo el maxilar frecuentemente más afectado que la mandíbula. Acude paciente masculino de 13 años por presentar retraso en la erupción de órganos dentarios 21 al 24. A la exploración intraoral los tejidos blandos contaban con características normales, se apreciaba una formación incompleta de los órganos den- tarios sin lograr apreciar una distinción en la opacidad entre el esmalte y la dentina, con cámaras pulpares amplias. Se procedió a la extracción quirúrgica de los dientes 21 al 24, un mes posterior a esto se realizó la rehabilitación protésica temporal. La OR es una alte- ración poco descrita por lo que aún falta esclarecer la etiología y evolución a largo plazo del padecimiento, el dar a conocer los nuevos casos permite ampliar el conocimiento en cuanto a su frecuencia, además de concientizar al profesional de la salud acerca de la presencia y tratamiento de la misma.

The regional odontodysplasia (RO) is a rare development anomaly that involves com- ponents of the ectoderm and mesoderm, this alteration affects both temporary and per- manent dentition, being the maxilla more frequently affected than the mandible. A 13-year-old male patient presented delayed eruption of dental organs 21 to 24. Intrao- ral examination of the soft tissues had normal characteristics, an incomplete formation of the dental organs was distinguished without achieving a distinction in the opacity between enamel and dentin, with wide pulp chambers. We proceeded to the surgical extraction of teeth 21 to 24, a month after this, temporary prosthetic rehabilitation was performed. The RO is a little described alteration so it is still necessary to clarify the etiology and long-term evolution of the condition, the disclosure of new cases will allow to expand the knowledge regarding its frequency, as well as to raise awareness among the health professional about the presence and treatment of it

Reproductive characteristics of pike-characids Boulengerella cuvieri (Ctenoluciidae) in the middle Xingu River, Eastern Amazon.

This study evaluated the reproductive characteristics of pike-characids, Boulengerella cuvieri, during the hydrological cycle in the Xingu River, eastern Amazon. The sex ratio was 1:1 and the gonado-somatic index and relative frequency of maturation stages indicate a short breeding season of single phase spawning that coincides with a filling and flood period. Mean standard length at first sexual maturity for female B. cuvieri was estimated to be 22·9 cm.

Impact of regulatory measures on antipsychotics drug consumption in Castilla y León, Spain.

OBJECTIVES: Antipsychotics are currently used to treat different diseases; even some off-labelled conditions are treated with this medication. Consumption and cost of antipsychotic drugs sharply increased in Spain after second-generation drugs were marketed; several regulatory measures were adopted to curb this trend. The aim of this study was to examine the impact of these measures upon the use and cost of antipsychotics. STUDY DESIGN: Study of drug use (SDU) from 1995 to 2012. Consumption and cost data were obtained from the CONCYLIA database; this database contains the retail community pharmacies sales of medicinal products reimbursed by the National Health System in Castilla y León (Spain). METHODS: Data are presented as defined daily doses per 1000 inhabitants per day (DID) and day treatment cost (DTC). RESULTS: First-generation antipsychotics prescriptions gradually decreased from 3.0 to 1.8 DID; meanwhile, prescriptions for second-generation antipsychotics considerably increased from 0.3 to 9.9 DID. The use of risperidone dropped after the marketing of its structural derivative paliperidone with a similar efficacy but with a substantially higher cost per day. In 2011 and thereafter, patients in Spain began to pay a part of the medications cost, but this did not decrease antipsychotics consumption. Global cost of antipsychotics only began to fall after measures were adopted to lower the price of medicines because of the economic collapse in Spain after May 2010. CONCLUSION: Several health policy measures have tried to reduce antipsychotics consumption in Spain, special ways of dispensing, marketing of generic drugs and special economic measures for patients. These measures eventually failed to avoid the increase in antipsychotics use. The cost only dropped when lowering prescription drug prices took place.

Interacción entre dronedarona y simvastatina identificada durante el seguimiento farmacoterapéutico en una farmacia comunitaria / Dronedarone interaction with simvastatin identified during a pharmacotherapeutic follow-up of patients in a community pharmacy

No disponible

HBV/HDV co-infection in the Western Brazilian Amazonia: an intriguing mutation among HDV genotype 3 carriers.

HDV infection still remains a serious public health problem in Amazonia. There are few data regarding the biomolecular aspects of HBV/HDV co-infection in this region. We studied 92 patients HBsAg(+) /anti-HDV IgG(+) followed at the Hepatitis Referral Centers of Porto Velho (RO), Rio Branco and Cruzeiro do Sul (AC), Brazil, from March 2006 to March 2007 for whom the HDV and/or the HBV genotype could be determined. The HDV genotype could be determined in 90 patients, while the HBV genotypes could be positively determined in 74. HBV subgenotype F2 is the most prevalent (40.2%), followed by the subgenotypes A1 (15.2%) and D3 (8.7%), while 16.4% were other subgenotypes or genotypes, 4.3% were discordant and 15.2% were unamplifiable. Surprisingly, HDV genotype 3 (HDV-3) was found in all of the HBV/HDV-infected patients that could be genotyped for HDV, confirming that HDV-3 can associate with non-F HBV genotypes. However, a HDV-3 mutant was found in 29.3% of patients and was more frequently associated with non-F HBV genotypes (P < 0.001) than were nonmutant strains, suggesting that the mutation may facilitate association of HDV-3 with non-F HBV genotypes.

Nonalcoholic Fatty liver disease in chronic hepatitis B and C patients from Western Amazon.

Nonalcoholic fatty liver disease (NAFLD) includes a wide spectrum of histological conditions, extending from simple steatosis to end-stage liver failure. The aim of this study was to examine the prevalence of NAFLD and its associations in chronic hepatitis B and C patients. Methods. We included all patients diagnosed with chronic hepatitis B and C who underwent a liver biopsy between January 2010 and October 2011 (n = 104). Parameters studied included hepatitis type, anthropometric data, histologic, hepatic, metabolic and lipid assessments, presence of hypertension and viral load. Results. Hepatitis B was presented in 28.8% (n = 30) of patients, while hepatitis C was presented in 71.2% (n = 74). In addition, hepatic steatosis was present in 25% (n = 26) of the patients. Steatosis was frequently found in hepatitis C patients (31.1%; 25% n = 23), but infrequently in hepatitis B patients (10%; n = 3) (P = 0.024). It was also found that steatosis was frequently present in hepatitis C patients with intense fibrosis (52.94%) (P = 0.025). Discussion. Our results suggest that steatosis is a common feature in patients with viral chronic hepatitis, and that it plays a different role in each type of hepatitis.

Efecto del clorhidrato de mianserina sobre preparaciones de órgano aislado de cobaya y de rata "in vitro" / Effects of mianserin hydrochloride on isolated organ preparations of guinea-pig and rat "in vitro"

OBJETIVO. Estudiar las modificaciones inducidas por Mianserina en las respuestas del ileon aislado de cobaya a acetilcolina e histamina, conducto deferente de rata a noradrenalina y útero aislado de rata a histamina. MATERIAL Y MÉTODOS. Se utilizó ileon aislado de cobaya incubado en solución de Tyrode, conducto deferente de rata incubado en solución de Krebs- Henseleit y útero aislado de rata incubado en solución de Jalón. Se realizaron curvas dosis-efecto a acetilcolina, histamina y noradrenalina en ausencia y en presencia de mianserina y se calculó el pA2. RESULTADOS. La mianserina se comporta como antagonista de los neurotransmisores estudiados. Conclusión: La mianserina se comporta como fármaco escasamente estabilizador inespecífico de membrana (AU)

OBJETIVE. Study the modifications produced by mianserin in the responses of isolated guinea-pig to acetylcholine and histamine, rat vas deferens to noradrenalinee and rat uterus to histamine. MATERIAL AND METHODS. Guinea-Pig ileum incubated in Tyrode solution were used. Dose-effect curves to acetylcholine and histamine were made in absence and in the presence of mianserin. Rat vas deferens incubated in Krebs-Henseleit solution were used. Dose-effect curves to noradrenaline were made in absence and in the presence of mianserin. Uterus of rat incubated in Jalon solution were used. Dose-effect curves to histamine were made in absence and in the presence of mianserin, pA2 was calculated. RESULTS. Mianserin behave as antagonist of acethylcholine, histamine and noradrenaline. Conclusions: Mianserin acts as few unspecific membrane stabilizer (AU)

Patterns of Guillain-Barre syndrome in children: results from a Mexican population.

BACKGROUND: Guillain-Barré syndrome (GBS) is an acute, immune-mediated flaccid paralysis frequently associated with Campylobacter infection. Of two predominant GBS subtypes, a demyelinating subtype (acute inflammatory demyelinative polyneuropathy [AIDP]) predominates in the United States and Europe, and axonal subtype (acute motor axonal neuropathy [AMAN]) is the predominant form in China. Previous clinical studies suggested that AMAN also occurs in Mexican children. The purpose of this study was to describe the subtypes of GBS in children from Mexico City. METHODS: We prospectively studied 121 children admitted to two pediatric hospitals in Mexico City from 1996 to 2002. Clinical histories were obtained, electrophysiologic studies were performed to determine GBS subtype, and microbiologic studies were performed. RESULTS: Of the 121 children, 46 had AMAN and 32 had AIDP. The male to female ratio was 1.3 for AMAN cases (mean age = 6.3) and 3.0 for AIDP cases (mean age = 7.0). There was a strong seasonal distribution of AMAN cases in July to September. Children with AMAN, but not AIDP, had worsening of illness during hospitalization as judged by peak severity scores. Vomiting was more likely in AIDP (28.1%) vs AMAN (6.5%) (p = 0.012) and diarrhea was more common in AMAN (32.6%) than AIDP (12.5%) (p = 0.06). IgG anti-GM1 antibody titers were higher in patients with AMAN vs AIDP (p = 0.067). Anti-GD1a antibodies were equally present in both groups. Anti GQ1b titers were higher in AMAN vs AIDP (p = 0.009). Campylobacter antibody responses were positive in 44.1% of patients with AMAN and 37.0% of patients with AIDP. Twenty patients (14 = AMAN, 6 = AIDP) had positive stool cultures for C jejuni. Two serotypes, HS:19 and HS:41, accounted for 6 of 10 Campylobacter isolates available for serotyping from these cases. CONCLUSIONS: This study confirms that acute motor axonal neuropathy is an important Guillain-Barré syndrome subtype in Mexican children, is associated with diarrhea, and occurs seasonally.

Acute necrotizing esophagitis: a large retrospective case series.

BACKGROUND AND STUDY AIMS: Acute necrotizing esophagitis is a rarely described entity. Its incidence has not yet been established, and its multifactorial etiology remains unknown. The aim of the present study was to establish the incidence, clinical presentation, endoscopic course, accompanying factors, and pathogenesis of the condition. PATIENTS AND METHODS: A retrospective analysis of clinical, laboratory, endoscopic and histological data and the clinical course in 29 patients with acute necrotizing esophagitis was carried out over a 5-year period. RESULTS: Acute necrotizing esophagitis was observed in 29 of 10 295 upper gastrointestinal endoscopies (0.28 %) carried out during the 5-year period. The average age of the patients was 75.24 years (range 40 - 91), and they were predominantly male. Eighty-three percent of the patients had comorbid conditions. In all cases, acute necrotizing esophagitis became evident with upper gastrointestinal bleeding, without hemodynamic stabilization in the majority of cases (75.9 %). The lesions predominantly affected the lower two-thirds of the esophagus (59 %), and there were coexisting abnormal endoscopic findings in 83 % of cases. Empirical supportive therapy, including oral nutritional rest, omeprazole, sucralfate (15 cases) and broad-spectrum antibiotics (7 cases) was provided. The condition resolved in all patients. Ten patients in the group died of other causes (coexisting illnesses). CONCLUSIONS: Acute necrotizing esophagitis was more commonly recognized than has previously been reported. It is a serious clinical entity that should be considered in the differential diagnosis of upper gastrointestinal bleeding, particularly in elderly patients. The prognosis depends more on the patient's advanced age and on comorbid illnesses than on the course of the esophageal lesions, which resolved in all patients in this series.

[Ogilvie's syndrome. Therapeutic efficacy of cecostomy]. / Síndrome de Ogilvie. Eficácia terapêutica de cecostomia.

Ogilvie's syndrome is an uncommon clinical situation, which was first described in 1948. It is characterized by an acute colonic massive dilatation without evidence of organic obstruction. Association with extracolonic disease is a nearly constant feature. Clinically, the syndrome manifests itself as an acute abdominal distention the cecum being the site of greatest dilatation. This situation is rapidly progressive and, if untreated, may cause cecal necrosis and perforation. Treatment should be instituted early, beginning with medical measures, followed by surgery if no improvement is seen. We report a case of Ogilvie's syndrome, and discuss the treatment procedures.

Synthesis of alkyl chain-modified ether lipids and evaluation of their in vitro cytotoxicity.

A series of alkyl lysophospholipid (ALP) analogs of ET-18-OCH3 (1-O-octadecyl-2-O-methyl-rac-glycero-3-phosphocholine) containing modifications in the long C-1 chain has been synthesized and evaluated in human tumor cell line cytotoxicity assays. The compounds have also been evaluated in platelet activating factor (PAF) receptor agonism and hemolysis tests. Two modifications have been studied, introduction of a carbonyl group at different positions of the C-1 chain and branching of this chain, in some compounds with incorporation of a phenyl group. Several compounds showed a cytotoxic potency comparable to that of the reference compound ET-18-OCH3, associated with reduced proaggregating and hemolytic effects. The two enantiomers of 1-O-(7-oxooctadecyl)-2-O-methyl-rac-glycero-3-phosphocholine (2) showed the same level of cytotoxicity or antiproliferative activity, with the PAF-agonistic effect confined to R-2. The very low stereoselectivity found in the in vitro cytotoxicity confirms earlier results and indicates a lack of stereospecific interactions with a macromolecular target.

Macrophage responses and myelin clearance during Wallerian degeneration: relevance to immune-mediated demyelination.

Macrophages are important effector cells in immune-mediated demyelination. Current concepts regarding their entry and activation focus on the effects of T-cell-derived cytokines. This presentation describes the responses of macrophages and microglia to a non-inflammatory, non-immune injury, Wallerian degeneration. During Wallerian degeneration in the peripheral nervous system (PNS), macrophages are promptly and abundantly recruited from the circulation, and myelin clearance is prompt. In the central nervous system (CNS), the appearance of macrophages is markedly slower, and entry from the circulation is modest or absent. Myelin clearance is similarly delayed. The nature of the factors promoting macrophage entry and activation in Wallerian degeneration, and the bases for the differences between PNS and CNS, are relevant to current issues in immune-mediated demyelination.

Matched pair of siblings concordant for 46,XY hermaphroditism with female sex assignment, and discordant for erotosexual outcome.

The two siblings in this comparison constitute a matched pair on the basis of concordance not only for prenatal history and diagnosis but also for assigned sex as girls, and for spontaneous hormonal puberty that was not feminizing, but masculinizing. They were further concordant in being surgically and hormonally feminized, with their own informed consent, early in adolescence. Subsequently, they became discordant, for the younger one has lived continuously as a woman, with a feminine gender-identity/role (G-I/R) socially and erotosexually, whereas the older one became self-reassigned to live as a man with a masculine G-I/R socially and erotosexually, hormonally supported on testosterone replacement therapy. Flattening of the chest was readily accomplished by plastic surgery, but phalloplasty was not attempted, primarily because of the technical obstacles and, to a lesser extent, the cost.