Comparison of the use of blood pressure telemonitoring versus standard medical care in the achievement of short-term therapeutic goals in blood pressure in patients with uncontrolled hypertension: An open-label clinical trial.

Background: In Mexico less than half of the treated hypertensive patients reach blood pressure (BP) targets. Most hypertensive individuals rely on the standard medical care (SMC) to achieve the BP control goals; however, the efficacy of BP telemonitoring (BPT) to achieve BP targets has been poorly studied. Aim: To compare the efficacy of BPT versus SMC to achieve BP goals in patients with uncontrolled hypertension. Methods: A two-arm, open-label clinical trial was conducted in patients ≥18 years with uncontrolled hypertension. The participants were randomized to 2 arms (BPT vs SMC) and followed for 12 weeks. For the statistical analysis, the chi-squared test and covariance were used. Results: One hundred and seventy-eight participants were included, BPT (n = 94) and SMC (n = 84), after 12 weeks of follow up, we observed a baseline-adjusted reduction in systolic BP with both BPT (-13.5 [1.3] mmHg) and the SMC (-5.9 [1.4] mmHg; p < 0.001) but a greater decrease with BPT (p < 0.001). Likewise, we found a baseline-adjusted reduction of diastolic BP with BPT (-6.9 [0.9] mmHg) and SMC (-2.7 [0.9] mmHg) (p = 0.007) with a more significant percentage change from baseline with BPT (-6.8% [1.0] vs 2.5% [1.1]; p = 0.007). In the BPT arm, a larger proportion of patients achieved the BP target versus SMC (30.5% vs 12.8%; p = 0.005). Conclusion: BPT showed a greater proportion of patients achieving office BP control goals (<140/90 mmHg), compared to standard medical care.

Primeras recomendaciones de consenso SLANH - COLABIOCLI / Primeiras Recomendações de Consenso SLANH - COLABIOCLI / (Sociedad Latinoamericana de Nefrología e Hipertensión - Confederación Latinoamericana de Bioquímica Clínica) / Informe de la tasa de filtración glomerular estimada junto a la determinación de la creatininemia en población adulta / First SLANH-COLABIOCLI Consensus Recommendations

Resumen La enfermedad renal crónica (ERC) es de alta prevalencia en América Latina y en todo el mundo. Se estima que entre 10 y 20% de la población adulta es portadora de ERC y su prevalencia va en aumento. La ERC progresa en forma silenciosa. Su diagnóstico temprano y oportuno permite iniciar un tratamiento efectivo, en la mayoría de los casos, para detener la enfermedad. Desde hace mucho tiempo, el análisis de la creatininemia es la principal prueba utilizada para valorar la función renal, pero su confiabilidad es limitada. De acuerdo con las recomendaciones de las GUIAS KDOQI del año 2002 la tasa de filtración glomerular estimada (TFGe) obtenida a través de fórmulas, se estableció como una de las herramientas principales para detectar la enfermedad renal de manera precoz, ya que alerta de forma precisa al médico y al equipo de salud sobre el nivel de función renal del paciente. La detección de una TFGe disminuida (menor de 60 mL/min/1,73 m2) es clínicamente relevante, ya que permite establecer el diagnóstico de enfermedad renal en adultos. En el año 2022, en una encuesta realizada por SLANH y COLABIOCLI dirigida a los laboratorios de análisis clínicos de América Latina (n: 237), el 49% de los mismos no informaban la TFGe rutinariamente. En base a esta realidad SLANH y COLABIOCLI elaboraron estas recomendaciones de consenso en referencia al uso de la TFGe.

Abstract Chronic kidney disease (CKD) has a high prevalence worldwide and in Latin America (10 to 20% of the adult population) and is increasing. CKD progresses silently. Opportune diagnosis and treatment are effective in most cases to improve outcomes. Serum creatinine was the main test to assess kidney function, but its reliability is limited. Through the KDOQI Guidelines 2002, the estimated glomerular filtration rate (eGFR) obtained from equations was established as one of the main tools for the early detection of kidney disease in clinical practice. The detection of a decreased eGFR (less than 60 mL/min/1.73 m2) is clinically relevant. This cut-off level establishes the diagnosis of kidney disease in adults. In 2022 SLANH and COLABIOCLI conducted a survey among the clinical laboratories from Latin America. The survey included 237 laboratories, 49% of which did not routinely report the eGFR. Based on this situation, SLANH and COLABIOCLI have elaborated the following consensus recommendations regarding the use of eGFR.

Resumo A doença renal crônica (DRC) é altamente prevalente na América Latina e em todo o mundo. Estima-se que entre 10 e 20% da população adulta seja portadora de DRC e sua prevalência esteja aumentando. A DRC progride silenciosamente. Seu diagnóstico precoce e oportuno permite iniciar um tratamento eficaz, na maioria dos casos, para estancar a doença. Faz muito tempo, a análise da creatinina tem sido o principal teste usado para avaliar a função renal mas sua confiabilidade é limitada. De acordo com as recomendações dos GUIAS KDOQI do ano de 2002, a estimativa da taxa de filtração glomerular (eGFR), obtida por meio de fórmulas, consolidou-se como uma das principais ferramentas para a detecção precoce da doença renal, visto que alerta com precisão ao médico e ao equipe de saúde sobre o nível de função renal do paciente. A detecção de uma eGFR diminuída (inferior a 60 mL/min/1,73 m2) é clinicamente relevante, pois permite estabelecer o diagnóstico de doença renal em adultos. No ano de 2022, em pesquisa realizada pela SLANH e COLABIOCLI dirigida a laboratórios de análises clínicas da América Latina (n: 237), 49% deles não relataram rotineiramente eGFR. Com base nessa realidade, SLANH e COLABIOCLI prepararam essas recomendações de consenso sobre o uso de eGFR.

A probiotic amylase blend reduces gastrointestinal symptoms in a randomised clinical study.

A randomised, placebo-controlled, double-blind, parallel clinical study was performed to examine the effects of a probiotic- amylase (PRO) blend on gastrointestinal (GI) symptoms. Sixty men and women (44.4 ± 8.9 yr; 82.0 ± 18.4 kg; 170.3 ± 11.5 cm; 28.1 ± 4.6 kg/m2) were randomised into PRO (n = 29) or placebo (PLA: n = 31) groups. Participants exhibited mild to moderate GI symptoms and severity [via Gastrointestinal Symptom Rating Scale (GSRS)] to be eligible for participation. Participants were tested before (Baseline) and after (POST) 6 weeks of supplementation on various gastrointestinal indices, the GSRS (to assess GI symptoms, frequency, and severity), an anxiety questionnaire (GAD-7), and an overall well-being questionnaire (SF-36). Two (PRO vs PLA) × 2 (Baseline vs POST) mixed factorial ANOVAs were completed to assess group, time, and (group × time) interaction effects. Fifty-two subjects who completed the entire study were analysed (PRO: n = 25, PLA: n = 27). There were statistically significant (P≤0.05) interactions for bloating, GSRS score, and abdominal discomfort but time effects for flatulence, constipation, stool regularity, and GAD-7 total score. PRO significantly reduced GSRS score (∼60 vs 25%, d = 0.72), bloating (∼49% vs 25%, d = -0.63) and abdominal discomfort (59% vs 32%, d = -0.66) to a greater degree than PLA. PRO significantly reduced subjective feelings of irritability, pain, and overall health interference. Oral supplementation of the probiotic-amylase blend was very well tolerated. Our study showed that the probiotic-amylase blend reduced the GSRS score and other GI symptoms to a greater degree than PLA. Clinical trial registration: clinicaltrials.gov #NCT05614726.

Miositis osificante traumática en recién nacido: reporte de caso / Traumatic myositis ossificans in newborn: a case report

La miositis osificante traumática (MOT) es una enfermedad en la que ocurre osificación heterotópica en dos a cuatro semanas tras uno o múltiples traumatismos. El objetivo de este artículo es describir las características clínicas y radiológicas de un caso de MOT en un recién nacido (RN) después de la canulación intravenosa de vía periférica, poco frecuente en la práctica clínica en neonatología. Presentamos a un RN pretérmino de 33 semanas en que, a los 20 días de vida, se evidenció lesión tumoral en el tercio distal del antebrazo izquierdo de 3 cm por 2 cm, que no impresionaba dolor, ni limitación a la movilización, y en la que no había signos infecciosos. El resto del examen físico osteomuscular era normal. En la zona de lesión, tres semanas antes, se había instalado un catéter intravenoso periférico (CIVP). Una radiografía del antebrazo izquierdo demostró lesión calcificada al nivel de las partes blandas, sin disrupción de las estructuras óseas adyacentes; la ecografía del antebrazo reveló una imagen focal ovalada, de contornos parcialmente definidos, con sombra acústica posterior; el resto de los estudios de huesos largos era normal. Los niveles séricos de fosfatasa alcalina, calcio, fósforo también eran normales. En vista de la lesión tumoral al examen físico y la imagen calcificada en partes blandas a través de radiografía simple, con antecedente de microtraumas de VVP, se concluyó MOT. Se hizo seguimiento, con disminución del tamaño hasta que la lesión desapareció a los cuatro meses. No requirió control radiológico. La MOT es infrecuente en el RN, y, en general, la resolución es autolimitada y tiene buen pronóstico

Traumatic myositis ossificans (TMO) is a disorder in which heterotopic ossification occurs two to four weeks after one or multiple traumas. The goal of the present article is to describe the clinical and radiological characteristics of a case of TMO in a newborn (NB) after a peripheral intravenous cannulation, a rare procedure in the clinical practice of neonatology. The patient is a premature 33-week-old NB who, 20 days after birth, presented with a 3 cm x 2 cm lump in the distal third of the left forearm that did not seem to cause pain or to limit movements, and with no evidence of infection. The rest of the physical exam was within normal limits. Three weeks before the lesion, a peripheral intravenous catheter (PIVC) was placed in that area. A radiograph of the left forearm showed soft-tissue calcification without disruption of adjacent bone structures. Ultrasound revealed a focal, oval soft tissue lesion with partially-defined borders and posterior acoustic shadow; the rest of study showed normal long bones. The serum levels of alkaline phosphatase, calcium, and phosphorus were all normal. In view of the tumor lesion on the physical examination and the calcified image in softtissue on plain X-ray and a recent history of PIVC microtrauma, we reached to the diagnoses of TMO. During the follow-up, the lesion decreased in size until it completely disappeared four months after the diagnosis. No radiological control was needed. Uncommon in NBs, TMO is generally self-limited and with a good prognosis

[Application of the « Junior Doctor ¼ status in Radiation Oncology]. / Guide du Docteur Junior en oncologie-radiothérapie.

Introduced in 2017, the reform of the 3rd cycle has modified the organization of the residency in all specialties, and in particular radiation oncology. The residency was thus divided into 3 phases with increasing knowledge and responsibilities. The latter, carried out under the status of "junior doctor", created and defined by decree n°2018-571 of July 3, 2018 and the decree of January 16, 2020, is a phase of supervised autonomy of the resident. Radiotherapy is a singular specialty, with multiple and complex activities, and requires multiple skills. A guide defining the status of the "Junior Doctor" in radiation oncology therefore appears necessary, defining each resident's role and obligations. This guide is of an advisory nature and must be adapted to the particularities of each department. This guide aims to help the implementation of the reform of the 3rd cycle in radiation oncology and especially the final year called the consolidation phase. It is destined to evolve, expanded by individual and collective feedback and the constant renewal of our speciality.

Psicoestimulantes menores consumidos por estudiantes de la Universidad San Francisco Xavier de Chuquisaca, 2019 / Minor psychostimulants consumed by students of San Francisco Xavier de Chuquisaca University, 2019

El objetivo del estudio fue determinar el consumo de psicoestimulantes en estudiante de la Universidad San Francisco Xavier de Chuquisaca. Se recolectaron los datos mediante encuestas aplicadas a 331 estudiantes. El estudio reveló el psicoestimulante de mayor consumo con 31,88% el café y la coca cola con 26,65%, en su mayoría fueron consumidos con fines académicos. En los efectos secundarios, la sed se estableció como el más frecuente en estudiantes con 30,74%, seguido por cefalea con 27,56% y el cansancio en 14,84%. Se concluye que el café se determina como psicoestimulante menor más consumido en épocas de actividad académica y la sed como el efecto secundario más frecuente.

The objective of the study was to determine the consumption of psychostimulants in a student at the San Francisco Xavier de Chuquisaca University. The data were collected through surveys applied to 331 students. The study revealed the psychostimulant with the highest consumption with 31.88%, coffee and coca cola with 26.65%, most of which were consumed for academic purposes. Regarding side effects, thirst was established as the most frequent in students with 30.74%, followed by headache with 27.56% and fatigue in 14.84%. It is concluded that coffee is determined as the minor psychostimulant most consumed in times of academic activity and thirst as the most frequent side effect.

Mechanisms of NRF2 activation to mediate fetal hemoglobin induction and protection against oxidative stress in sickle cell disease.

IMPACT STATEMENT: Sickle cell disease (SCD) is a group of inherited blood disorders caused by mutations in the human ß-globin gene, leading to the synthesis of abnormal hemoglobin S, chronic hemolysis, and oxidative stress. Inhibition of hemoglobin S polymerization by fetal hemoglobin holds the greatest promise for treating SCD. The transcription factor NRF2, is the master regulator of the cellular oxidative stress response and activator of fetal hemoglobin expression. In animal models, various small chemical molecules activate NRF2 and ameliorate the pathophysiology of SCD. This review discusses the mechanisms of NRF2 regulation and therapeutic strategies of NRF2 activation to design the treatment options for individuals with SCD.

Label-free in-flow detection of receptor recognition motifs on the biomolecular corona of nanoparticles.

Nanomedicine, nanotargeting and nanotherapeutics have in the last few years faced several difficulties in translating the promising results obtained in vitro to an in vivo scenario. The origin of this discrepancy might be found in the lack of a detailed and realistic characterization of the biological surface of nanoparticles. Despite the capability to engineer nanomaterials with a great variety and a precise control of the surface functionalization, the targeting capability is lost when the nanoparticles are embedded in complex biological media, due to the formation of a biological layer (biomolecular corona). This biological layer represents the ultimate nanoparticle surface, likely to interact with the cell machinery. Therefore, in addition to traditional nanoparticle characterization techniques, a more insightful investigation of the biomolecular corona is needed, including the capability to assess the orientation and functionality of specific key molecular features. Here we present a method for the rapid screening of exposed protein recognition motifs on the surface of nanoparticles exploiting quartz crystal microbalance (QCM). We quantify accessible functional epitopes of transferrin-coated nanoparticles and correlate them to differences in nanoparticle size and functionalization. The target recognition occurs label free in flow, thereby pushing our investigation into a more in vivo-like scenario. Our method is applicable to a wide array of nanoparticles and therefore holds the potential to become an advanced technique for the classification of all kinds of nanobioconstructs based on their biological external functionality.

Post-keratoplasty Endophthalmitis by Multidrug-resistant Pseudomonas Aeruginosa With Positive Culture of the Contralateral Donor Cornea: A Case Report.

PURPOSE: The aim of this paper is to present the case report of a patient developing endophthalmitis after penetrating keratoplasty caused by a multidrug-resistant Pseudomonas aeruginosa, detected only in the contralateral donor tissue. CASE REPORT: A 77-year-old man underwent an uneventful penetrating keratoplasty with a preoperative culture-negative donor cornea; however, the fellow cornea grew multidrug-resistant Pseudomonas aeruginosa. The patient developed and was treated for endophthalmitis after penetrating keratoplasty, and aqueous and vitreous taps grew P. aeruginosa with antibiotic resistance identical to the isolate from the mate cornea. Sequence analysis of the 16S ribosomal gene from the two isolates and confirmation analyzing the sequence of P. aeruginosa heat shock protein gene (groES) were performed showing the same strain for both organisms. CONCLUSION: This case report documents the presence of the same multidrug-resistant P. aeruginosa causing endophthalmitis after penetrating keratoplasty and in the contralateral donor tissue, suggesting that we must be cautious in deciding to transplant tissues with positive culture in the contralateral donor cornea.

The Value of Pre-Screening in the Alzheimer's Prevention Initiative (API) Autosomal Dominant Alzheimer's Disease Trial.

The Alzheimer's Prevention Initiative (API) Autosomal Dominant Alzheimer's Disease (ADAD) trial evaluates the anti-amyloid-ß antibody crenezumab in cognitively unimpaired persons who, based on genetic background and age, are at high imminent risk of clinical progression, and provides a powerful test of the amyloid hypothesis. The Neurosciences Group of Antioquia implemented a pre-screening process with the goals of decreasing screen failures and identifying participants most likely to adhere to trial requirements of the API ADAD trial in cognitively unimpaired members of Presenilin1 E280A mutation kindreds. The pre-screening failure rate was 48.2%: the primary reason was expected inability to comply with the protocol, chiefly due to work requirements. More carriers compared to non-carriers, and more males compared to females, failed pre-screening. Carriers with illiteracy or learning/comprehension difficulties failed pre-screening more than non-carriers. With the Colombian API Registry and our prescreening efforts, we randomized 169 30-60 year-old cognitively unimpaired carriers and 83 non-carriers who agreed to participate in the trial for at least 60 months. Our findings suggest multiple benefits of implementing a pre-screening process for enrolling prevention trials in ADAD.

Effects of dietary supplementation with a standardized aqueous extract of Terminalia chebula fruit (AyuFlex®) on joint mobility, comfort, and functional capacity in healthy overweight subjects: a randomized placebo-controlled clinical trial.

BACKGROUND: Joint and connective tissue integrity, comfort and function are paramount to optimal performance in exercise, recreational and occupational activities. The fruit of Terminalia chebula has been used extensively in various traditional health systems for different ailments, with additional preclinical and clinical data demonstrating antioxidant and anti-inflammatory potential. The aim of this study was to evaluate the effects of a standardized aqueous extract of Terminalia chebula fruit (AyuFlex®) dietary supplementation on joint mobility, comfort, and functional capacity in healthy overweight subjects. METHODS: One-hundred and five (105) overweight, apparently healthy male and female subjects (35-70 years of age) were pre-screened and randomized to one of three groups for 84 days: placebo, AyuFlex1 (250 mg twice daily) or AyuFlex2 (500 mg twice daily) in a randomized, double-blind, placebo-controlled design. A two-week placebo lead-in period was used to improve data quality/validity. All subjects had no knee joint discomfort at rest, but experienced knee joint discomfort only with activity/exercise of at least 30 on 100 mm Visual Analog Scale (VAS). Primary outcome measures included symptoms of joint health and function as measured by modified-Knee Injury & Osteoarthritis Outcomes Score (mKOOS) global & modified-Western Ontario and McMaster Universities Arthritis Index (mWOMAC) subscales (discomfort, stiffness and function). Secondary outcomes included VAS questionnaires on overall/whole-body joint health, low back health, knee mobility, willingness and ability to exercise, 6-min walk test for distance and range of motion (ROM) of pain-free knee flexion/extension. Tertiary outcome measures included inflammatory (high sensitivity C-reactive protein (hsCRP), tumor necrosis factor (TNF)-α) and extracellular matrix (ECM)/Connective Tissue (COMP) biomarkers, and safety (vital signs and blood markers) & tolerability (Adverse Event (AE)/ side effect profiles). RESULTS: Compared to placebo, at day 84 AyuFlex® treatment significantly: 1) improved mKOOS global scores in AyuFlex1 + AyuFlex2 (P = 0.023), and improved total and physical function subscale of mWOMAC relative to baseline, 2) improved VAS scores for Knee Discomfort with activity/exercise in AyuFlex1 + AyuFlex2 (P = 0.001) relative to baseline, 3) improved VAS scores for whole-body joint function in AyuFlex1 + AyuFlex2 (P < 0.029) relative to baseline, 4) improved VAS score for decreased knee joint soreness following leg extension challenge for AyuFlex1 (P = 0.022) and AyuFlex2 (P = 0.043) relative to baseline, 5) improved 6-min walk performance distance covered (P = 0.047) and VAS discomfort (P = 0.026) post-6 min walk in AyuFlex1 + AyuFlex2 relative to baseline, 6) and tended to decrease COMP levels in AyuFlex1 + AyuFLex2 (P = 0.104) relative to baseline. All biomarkers of safety remained within normative limits during the study. Low back health tended to improve in the AyuFlex1 and AyuFlex2 group, but failed to reach significance relative to placebo group. CONCLUSIONS: AyuFlex® improved mKOOS global scores, knee joint discomfort with activity/exercise, 6-min walk test distance covered and discomfort post-6 min walk test, overall whole-body joint function, knee soreness following leg extension resistance exercise in a healthy, overweight population, without AE. Differences between 250 mg/BID and 500 mg/BID were non-significant for most of the outcome measures, validating the efficacy of the lower dose. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT02589249 ; October 26, 2015.

[Adult experience with the tibialis posterior transposition to the center of the foot in neuromuscular disease]. / Transposición tendinosa del tibial posterior al centro del pie en lesiones neuromusculares. Experiencia en pacientes adultos.

The transfer of the posterior tibial tendon to the center of the dorsum of the foot is a method used to achieve dorsiflexion in flaccid paralysis of the anterolateral leg muscles or muscular imbalance of clubfoot. OBJECTIVE: To describe functional results back to the surgical procedure for transposition of posterior tibial the center of the foot. MATERIAL AND METHODS: The study design was observational, descriptive, transversal, ambispective with a description of the world of work patients with impaired dorsiflexora foot muscles and impaired gait in the period January 2008 to December 2014. RESULTS: A total of 18 patients who were candidates for what this type of treatment was obtained. DISCUSSION: We believe that this study can be estimated as generating hypotheses about whether it is a superior alternative to arthrodesis. For this plan to continue studies in this field, with an increased number of assessments both before and after surgery to have more objective results and a greater number of individuals.

La transferencia del tibial posterior al centro del dorso del pie es un método que se utiliza para lograr la dorsiflexión en parálisis flácida de la musculatura anteroexterna de la pierna o para contrarrestar el desequilibrio muscular del pie equino varo. Objetivo: Describir los resultados funcionales después del procedimiento quirúrgico de transposición del tibial posterior al centro del pie. Material y métodos: Estudio observacional, descriptivo, transversal y ambispectivo con una descripción del universo de trabajo en pacientes con deficiencia de la musculatura dorsiflexora del pie y afectación de la marcha en el período de Enero de 2008 a Diciembre de 2014. Resultados: Se obtuvo un total de 18 pacientes. Discusión: Creemos que este estudio podría considerarse como generador de hipótesis sobre si representa una alternativa superior a la artrodesis. Para ello proponemos continuar estudios en esta rama con mayor cantidad de evaluaciones en el preoperatorio y postoperatorio para obtener resultados más objetivos y con un grupo más amplio de individuos.

Pharmacologic interventions to treat renal colic pain in acute stone episodes: Systematic review and meta-analysis.

OBJECTIVE: To assess effectiveness of pharmacologic interventions to relieve pain in patients suffering an acute stone episode. METHODS: Relevant trials that included patients with acute renal colic and radiological findings of urinary stones were identified in four databases. The main outcome was pain relief evaluated by Visual Analogue Scale score (VAS). RESULTS: In overall, diclofenac was superior to other NSAIDs for pain relief (MD of -12.57 [95% CI: -19.26, -5.88]). Paracetamol was superior to morphine for pain reduction at 30minutes (MD of -3.92 [95% CI: -6.41, -1.43]) and also to placebo at 15minutes (MD of -24.77 [95% CI: -33.19, -16.35]) and at 30minutes (MD of -16 [95% CI:-29, -2.96]) after drug administration. Finally, diclofenac was superior to paracetamol for pain reduction at 60 (MD of 6.60 [95% CI: 4.37, 8.83]) and 90minutes (MD of 3.4 [95% CI: 2.01, 4.79]). CONCLUSIONS: Diclofenac was superior to other NSAIDs and paracetamol for diminishing pain in patients suffering an acute stone episode. Paracetamol was superior to morphine and placebo for short pain relief. Future trials should address the role of paracetamol in the management of pain in patients suffering an acute stone episode.

Transposición tendinosa del tibial posterior al centro del pie en lesiones neuromusculares. Experiencia en pacientes adultos / Adult experience with the tibialis posterior transposition to the center of the foot in neuromuscular disease

Resumen: La transferencia del tibial posterior al centro del dorso del pie es un método que se utiliza para lograr la dorsiflexión en parálisis flácida de la musculatura anteroexterna de la pierna o para contrarrestar el desequilibrio muscular del pie equino varo. Objetivo: Describir los resultados funcionales después del procedimiento quirúrgico de transposición del tibial posterior al centro del pie. Material y métodos: Estudio observacional, descriptivo, transversal y ambispectivo con una descripción del universo de trabajo en pacientes con deficiencia de la musculatura dorsiflexora del pie y afectación de la marcha en el período de Enero de 2008 a Diciembre de 2014. Resultados: Se obtuvo un total de 18 pacientes. Discusión: Creemos que este estudio podría considerarse como generador de hipótesis sobre si representa una alternativa superior a la artrodesis. Para ello proponemos continuar estudios en esta rama con mayor cantidad de evaluaciones en el preoperatorio y postoperatorio para obtener resultados más objetivos y con un grupo más amplio de individuos.

Abstract: The transfer of the posterior tibial tendon to the center of the dorsum of the foot is a method used to achieve dorsiflexion in flaccid paralysis of the anterolateral leg muscles or muscular imbalance of clubfoot. Objective: To describe functional results back to the surgical procedure for transposition of posterior tibial the center of the foot. Material and methods: The study design was observational, descriptive, transversal, ambispective with a description of the world of work patients with impaired dorsiflexora foot muscles and impaired gait in the period January 2008 to December 2014. Results: A total of 18 patients who were candidates for what this type of treatment was obtained. Discussion: We believe that this study can be estimated as generating hypotheses about whether it is a superior alternative to arthrodesis. For this plan to continue studies in this field, with an increased number of assessments both before and after surgery to have more objective results and a greater number of individuals.

Effects of an amylopectin and chromium complex on the anabolic response to a suboptimal dose of whey protein.

BACKGROUND: Previous research has demonstrated the permissive effect of insulin on muscle protein kinetics, and the enhanced insulin sensitizing effect of chromium. In the presence of adequate whole protein and/or essential amino acids (EAA), insulin has a stimulatory effect on muscle protein synthesis, whereas in conditions of lower blood EAA concentrations, insulin has an inhibitory effect on protein breakdown. In this study, we determined the effect of an amylopectin/chromium (ACr) complex on changes in plasma concentrations of EAA, insulin, glucose, and the fractional rate of muscle protein synthesis (FSR). METHODS: Using a double-blind, cross-over design, ten subjects (six men, four women) consumed 6 g whey protein + 2 g of the amylopectin-chromium complex (WPACr) or 6 g whey protein (WP) after an overnight fast. FSR was measured using a primed, continuous infusion of ring-d5-phenylalanine with serial muscle biopsies performed at 2, 4, and 8 h. Plasma EAA and insulin were assayed by ion-exchange chromatography and ELISA, respectively. After the biopsy at 4 h, subjects ingested their respective supplement, completed eight sets of bilateral isotonic leg extensions at 80% of their estimated 1-RM, and a final biopsy was obtained 4 h later. RESULTS: Both trials increased EAA similarly, with peak levels noted 30 min after ingestion. Insulin tended (p = 0.09) to be higher in the WPACr trial. Paired samples t-tests using baseline and 4-h post-ingestion FSR data separately for each group revealed significant increases in the WPACr group (+0.0197%/h, p = 0.0004) and no difference in the WP group (+0.01215%/hr, p = 0.23). Independent t-tests confirmed significant (p = 0.045) differences in post-treatment FSR between trials. CONCLUSIONS: These data indicate that the addition of ACr to a 6 g dose of whey protein (WPACr) increases the FSR response beyond what is seen with a suboptimal dose of whey protein alone.

Diferencias en las concentraciones de ácido úrico en pacientes hipertensos, normotensos y prehipertensos / Differences in levels of uric acid in hypertensive, normotensive and prehypertensive patients

Resumen ANTECEDENTES: la prehipertensión es una condición que aumenta el riesgo de padecer hipertensión arterial. Las concentraciones séricas elevadas de ácido úrico se asocian con hipertensión arterial y dificultan su control. OBJETIVO: evaluar las concentraciones circulantes de ácido úrico en pacientes prehipertensos en comparación con las de sujetos normotensos e hipertensos. MATERIAL Y MÉTODO: estudio clínico transversal en el que de enero a junio de 2016 las concentraciones séricas de ácido úrico se determinaron por método enzimático en pacientes con prehipertensión (de acuerdo con los criterios del JNC VII), así como en sujetos normotensos y sujetos hipertensos. Los métodos estadísticos usados fueron ANOVA y prueba exacta de Fisher. RESULTADOS: se incluyeron 90 pacientes con prehipertensión, 90 sujetos normotensos y 90 sujetos hipertensos. Encontramos que el grupo de prehipertensos tuvo valores significativamente mayores de ácido úrico que los normotensos (6.24±1.5 mg/dL vs 5.4±1.2 mg/dL, p=0.000206), mientras que aunque los valores en hipertensos fueron superiores (6.7±2 mg/dL), no alcanzaron significación estadística con los prehipertensos (p=0.99). Encontramos asociación significativa entre hiperuricemia con prehipertensión (p=0.015 IC 95%; 1.18-3.99). CONCLUSIONES: los pacientes prehipertensos mostraron concentraciones de ácido úrico superiores a las de los normotensos y aunque los valores mencionados fueron menores que en los hipertensos, esto no fue significativo. La hiperuricemia puede contribuir, al menos en parte, a mayor progresión hacia hipertensión arterial observada en los prehipertensos.

Abstract BACKGROUND: Prehypertension increases the risk of hypertension, serum uric acid levels are also associated with increased risk of hypertension. Increased levels of resistin and/or decreased levels of adiponectin are associated with cardiovascular mortality and the development of hypertension. OBJECTIVE: To evaluate uric acid serum levels in normotensive, prehypertensive and hypertensive patients. MATERIAL AND METHOD: A clinical, cross-sectional study was made from January to June 2016 in which circulating levels of uric acid were measured (enzymatic method) in normotensive, prehypertensive and hypertensive patients. Statistical analysis was performed with ANOVA and Fisher test. RESULTS: Ninety normotensive, 90 prehypertensive and 90 hypertensive patients were included. Prehypertensive patients have significantly greater levels of uric acid than normotensive subjects (6.24±1.5 mg/dL vs 5.4±1.2 mg/dL, p=0.000206). We also observed that hypertensive patients had increased, although non-significantly, values of uric acid than prehypertensive subjects (6.7±2 mg/dL, p=0.99). We also found a significantly association between hyperuricemia and prehypertension (p=0.015 IC 95%; 1.18-3.99). CONCLUSIONS: Prehypertensive patients had greater levels of uric acid when compared with normotensive subjects, this may explain why prehypertensive patients shown increased risk for hypertension than normotensive patients.

[Fluoroquinolones: Non-antibacterial properties]. / Fluoroquinolonas: perspectivas no antibacterianas.

Fluoroquinolones are a class of well-established chemotherapeutic agents with a potent biological activity being the structure of 4-quinolone-3-carboxilic acids privileged because it contains different sites for functionalization allowing expand its use in clinical practice for their antifungal, antiviral and anticancer activities. Quinolones structural changes have resulted in a first, second, third and fourth generation of drugs so it is advisable to continue modifying existing structures in new ways to generate compounds with desirable biological and pharmacological properties.

Survival of acral lentiginous melanoma in the National Cancer Institute of Colombia.

OBJECTIVE: To determine survival of a cohort of patients with acral lentiginous melanoma (ALM), treated at the National Cancer Institute of Colombia, the largest referral hospital of the country. METHODS: All patients diagnosed with an invasive ALM between 2003 and 2009 at the Colombian National Cancer Institute were included for analyses and followed for vital status and date of death. Using Kaplan-Meier methods, overall survival at 1, 3 and 5 years post diagnosis was determined, and Cox proportional hazards models were constructed for the variables showing a significant effect on survival in univariate analyses. RESULTS: Overall survival of this cohort of 90 patients was 77% at 1 year, 59% at 3 years and 54% at 5 years after diagnosis. Females had a better prognosis in univariate analyses but this advantage disappeared in multivariate models. Clinical stage was a strong predictor of survival, in univariate and multivariate models, particularly among elderly patients. CONCLUSIONS: Prognosis of ALM in Colombia is relatively poor, particularly for patients with higher clinical stage. The large proportions of ALM diagnosed in stage III and IV explain the relatively poor survival, and illustrate the importance of improving prognosis by lowering stage at diagnosis through better education and early detection programmes.

Feeding value of supplemental curcas crude oil in finishing diets for feedlot lambs.

The objective of this experiment was to determine the feeding value of a mechanically extracted nontoxic variety of oil (JCO) as source of energy for feedlot lambs. Twenty Pelibuey × Katahdin lambs were individually fed a dry-rolled-corn-based finishing diet supplemented with 0%, 2%, 4%, or 6% JCO (diet dry matter basis). Supplemental JCO replaced dry rolled corn in the basal diet. Fatty acid composition of JCO was C16:0, 14.0%; C18:0, 8.2%; C18:1, 26.0%; C18:2, 50.3%, and C18:3, 0.4%. Daily intakes of JCO averaged 24.7, 51.1, and 77.3 g/day or 0.57, 1.08, and 1.62 g/kg LW for the 2%, 4%, and 6% levels of supplementation, respectively. Supplemental JCO did not affect ( = 0.33) dry matter intake (DMI), but tended to increase (linear effect, = 0.06) average daily gain, efficiency of gain (linear effect, < 0.01), and dietary net energy (linear effect, < 0.01) and decreased (linear effect, < 0.01) the ratio of observed/expected DMI. At low levels (20 g/kg diet dry matter) of supplementation, the net energy (NE) value of JCO corresponds closely (0.99) to the NE value assigned by current standards (), and this NE value decreased linearly as the inclusion level of JCO increased. There were not treatment effects on plasma metabolites. Across treatments, the concentrations of hemoglobin (11.64 ± 1.08 g/dL), hematocrit (39.15 ± 3.67%), glucose (85.2 ± 17.64 mg/dL), creatinine (1.43 ± 0.28 mg/dL), and urea (20.70 ± 4.35 mg/dL) were within normal (9-15 g/dL, 27%-40%, 50-90 mg/dL, 1.0-1.8 mg/dL, and 15-50 mg/dL, for hemoglobin, hematocrit, glucose, creatinine, and urea, respectively) ranges for healthy lambs. Based on DMI, performance and plasma metabolites observed in this study, nontoxic JCO is a suitable source of energy in finishing diets for lambs.

Association between disease occurrence and fertility of dairy cows in three geographic regions of Chile.

The objective was to analyze the association between disease occurrence during early lactation and reproductive performance and survival of dairy cows in high-producing herds, under different management practices in three geographic regions of Chile. Data included 30,757 lactation records of cows calving from January 2013 to June 2014 in three different locations: Central (C) area (n = 6198 cows in eight herds), Central-South (CS) area(n = 17,234 cows in 12 herds), and South (S) area (n = 7325 cows in six herds). Data were analyzed using logistic regression and ANOVA, considering cow as the experimental unit. Covariables offered to the models included parity number, season of calving, cow and herd relative milk yield, geographic location, and management system. Average milk yield (305 ME) per cow were 12,091, 11,783, and 6852 kg for C, CS, and S regions, respectively. Time from calving to first service and time to conception were consistently greater for cows with at least one disease event within 50 days in milk (DIM), for cows that were reported lame, or for cows that had mastitis or metritis. The odds (95% confidence interval) of pregnancy at 150 DIM (P150) and the odds of survival until 150 DIM (S150) for cows that had at least one disease event within 50 DIM were 0.84 (0.79-0.91) times the odds of pregnancy and 0.25 (0.22-0.28) times the odds of survival for healthy cows. The odds of P150 for cows located in the C and CS areas were 1.56 (1.36-1.80) and 1.16 (1.04-1.30) times the odds of P150 for cows in the S area. The odds of S150 for cows located in the C and CS areas were 0.48 (0.37-0.62) and 0.54 (0.42-0.67) times the odds of S150 for cows in the S area. These data suggested that cow health status and geographic location are significantly associated with reproductive performance and survival in this population of Chilean dairy cows.