Development of Films, Based on Oxidized Ipomea Batatas Starch, with Protein Encapsulation / Desarrollo de Películas, Basadas en Almidón Oxidado de Ipomea Batatas, con Encapsulación de Proteínas

ABSTRACT Dialdehyde starches (DAS) have been used as biomaterials due to their biocompatibility and biodegradability; nonetheless, sweet potato (Ipomea batatas L.) starch has not been researched. Films based on sweet potato DAS, mixed with native starch (NS), poly-vinyl alcohol (PVA) and glycerin have been developed with protein encapsulation, using central composite design (CCD) and response surface methodology (RSM). Input variables were oxidation degree, NS concentration and polymeric mixture volume, while output variables were film's thickness, equilibrium swelling and BSA (Bovine serum albumin) release. DAS was obtained through hydrogen peroxide (H2O2) oxidation, and the oxidation degree is referred to as H2O2 concentration. Films presented rough surfaces, and formulations containing 10% H2O2 DAS presented micropores. Water uptake was greater with higher DAS content. Film thickness depended on the volume of the polymeric suspension and influenced swelling capacity. According to RSM, the optimal formulation was DAS with 5% H2O2 and 35% NS. These results demonstrate that oxidized sweet potato starch has potential for protein encapsulation and delivery.

RESUMEN Almidones dialdehído (DAS) se han utilizado como biomateriales por su biocompatibilidad y biodegradabilidad; sin embargo, el almidón de camote (Ipomea batatas L.) no ha sido investigado. Se han desarrollado películas de DAS de camote, con almidón nativo (NS), alcohol polivinílico (PVA) y glicerina con encapsulación de proteínas, utilizando un diseño central compuesto (CCD) y metodología de superficie de respuesta (RSM). Las variables de entrada fueron: grado de oxidación, concentración de NS y volumen de la mezcla polimérica, mientras que las variables de salida fueron: espesor de la película, hinchamiento y liberación de BSA (Albúmina de Suero Bovino) en equilibrio. DAS se obtuvo mediante oxidación con peróxido de hidrógeno (H2O2), y el grado de oxidación se define como concentración de H2O2. Las películas presentaron superficies rugosas y las formulaciones con 10% H2O2 DAS presentaron microporos. La absorción de agua fue mayor con mayor contenido de DAS. El espesor de la película dependió del volumen de la mezcla polimérica e influyó en la capacidad de hinchamiento. Según RSM, la formulación óptima fue DAS con 5% H2O2 y 35% NS. Estos resultados demuestran que el almidón de camote oxidado tiene potencial para aplicaciones en la encapsulación y liberación de proteínas.

Effects of Replacing Dry-rolled Corn with Increasing Levels of Corn Dried Distillers Grains with Solubles on Characteristics of Digestion, Microbial Protein Synthesis and Digestible Energy of Diet in Hair Lambs Fed High-concentrate Diets.

Four male lambs (Katahdin; average live weight 25.9±2.9 kg) with "T" type cannulas in the rumen and proximal duodenum were used in a 4×4 Latin square experiment to evaluate the influence of supplemental dry distillers grain with solubles (DDGS) levels (0, 10, 20 and 30%, dry matter basis) in substitution for dry-rolled (DR) corn on characteristics of digestive function and digestible energy (DE) of diet. Treatments did not influence ruminal pH. Substitution of DR corn with DDGS increased ruminal neutral detergent fiber (NDF) digestion (quadratic effect, p<0.01), but decreased ruminal organic matter (OM) digestion (linear effect, p<0.01). Replacing corn with DDGS increased (linear, p≤0.02) duodenal flow of lipids, NDF and feed N. But there were no treatment effects on flow to the small intestine of microbial nitrogen (MN) or microbial N efficiency. The estimated UIP value of DDGS was 44%. Postruminal digestion of OM, starch, lipids and nitrogen (N) were not affected by treatments. Total tract digestion of N increased (linear, p = 0.04) as the DDGS level increased, but DDGS substitution tended to decrease total tract digestion of OM (p = 0.06) and digestion of gross energy (p = 0.08). However, it did not affect the dietary digestible energy (DE, MJ/kg), reflecting the greater gross energy content of DDGS versus DR corn in the replacements. The comparative DE value of DDGS may be considered similar to the DE value of the DR corn it replaced up to 30% in the finishing diets fed to lambs.

Removal of retained Foley catheter in bladder with novel use of ureteral catheter: lasso technique.

Numerous and varied foreign bodies have been described in the lower urinary tract. Techniques previously used to remove these objects have included open and endoscopic removal. We present a novel endoscopic technique using a ureteral catheter as a lasso to remove a retained foreign body, in this case a retained Foley catheter.

Treatment of neurocysticercosis: current status and future research needs.

Here we put forward a roadmap that summarizes important questions that need to be answered to determine more effective and safer treatments. A key concept in management of neurocysticercosis is the understanding that infection and disease due to neurocysticercosis are variable and thus different clinical approaches and treatments are required. Despite recent advances, treatments remain either suboptimal or based on poorly controlled or anecdotal experience. A better understanding of basic pathophysiologic mechanisms including parasite survival and evolution, nature of the inflammatory response, and the genesis of seizures, epilepsy, and mechanisms of anthelmintic action should lead to improved therapies.

[Anatomical landmarks and surgical limits in the suboccipital transmeatal approach to the acoustic neuroma]. / Referencias anatómicas y límites quirúrgicos en el abordaje suboccipital transmeatal del neurinoma acústico.

INTRODUCTION: To completely remove the intracanalicular portion of the acoustic neuroma through the retrosigmoid approach, we must open the posterior wall of the internal auditory canal (IAC). Therefore, drilling the IAC is one of the key steps we need to take in the transmeatal surgical approach. Nevertheless, there are no clear anatomical landmarks to identify structures such as the semicircular canals, the jugular bulb or air cells. The individual anatomical variations and those caused by the tumour itself make preoperative evaluation essential if we wish to avoid complications such as deafness, cerebrospinal fluid leakage, bleeding and air embolism. OBJECTIVE: We describe here the personal experience of the senior author (EU) in drilling the posterior wall of the IAC, with special reference to the anatomical landmarks and surgical limits in the suboccipital approach to the intracanalicular portion of the acoustic neuromas. MATERIAL AND METHODS: This work is based on anatomical data obtained from drilling human temporal bones obtained from cadavers, along with our experience with 20 patients who were operated on for acoustic neuroma using Samii's technique. RESULTS: We did not operate on any purely intracanalicular neurinomas using this approach. Two tumors were grade II (up to 20mm in diameter), 12 were grade III and 6 were grade IV. We did not drill far enough in any of these cases to be able to see the fundus of the IAC, which was confirmed by postoperative CT. Despite this, the tumor was considered to be completely removed in 17 cases. There was no mortality and we has no major complications as a result of drilling the IAC such as cerebrospinal fluid leakage or air embolism. we cannot guarantee that hearing loss of postoperative deafness, which were the norm except in one case of grade II, were caused by nervous, ischemic or labyrinthine lesions. CONCLUSION: In our material it was not possible to completely expose the IAC fundus using a retrosigmoid approach without injury to labyrinth. The areas in which the risk of secondary complications is greatest when drilling are the inferior wall and the IAC fundus. The medial extension of the suboccipital craniotomy makes drilling the intrameatal tumor exposure easier. There are no intraoperative landmarks to locate the petrous structures while drilling the IAC except for those provided by the surgeon's own experience.

Referencias anatómicas y límites quirúrgicos en el abordaje suboccipital transmeatal del neurinoma acústico / Anatomical landmarks and surgical limits in the suboccipital transmeatal approach to the acoustic neuroma

Introducción. En la extirpación completa del neurinoma acústico por vía suboccipital retrosigmoidea, es obligada la apertura de la pared posterior del conducto auditivo interno (CAI). Por lo tanto, uno de los pasos clave en el abordaje quirúrgico transmeatal es el fresado del CAL Sin embargo, no existen claras referencias anatómicas intraoperatorias para la identificación de estructuras tales como los canales semicirculares, el golfo de la vena yugular o las celdas aéreas. Las variaciones anatómicas individuales y las producidas por el propio tumor, obligan en cada caso a una correcta planificación preoperatoria, si queremos evitar complicaciones secundarias a su lesión yatrógena (cofosis, licuorrea, hemorragia y embolismo aéreo).Objetivo: Se expone la experiencia del primer autor firmante (EU) en el fresado del CAI con especial referencia a la topografía anatómica y límites quirúrgicos en el abordaje suboccipital retrosigmoideo a la porción intracanalicular del neurinoma acústico. Material y métodos. Este trabajo está basado en datos anatómicos obtenidos del fresado de huesos temporales normales extraídos de material autópsico junto a nuestra experiencia sobre 20 pacientes intervenidos de neurinoma acústico siguiendo la técnica y protocolo de Samii. Resultados. No hemos intervenido por esta vía ningún tumor puramente intracanalicular. 2 casos han sido de grado II (hasta 20mm de diámetro), 12 de grado III y 6 casos de grado IV En ningún caso se ha llegado a fresar tanto como para visualizar el fondo del CAI, lo que se confirmó con el TAC postoperatorio; a pesar de ello en 17 casos se ha considerado la extirpación como completa. No ha existido mortalidad y no hemos tenido complicaciones mayores atribuidas al fresado del CAI, como licuorrea o embolismo aéreo. No podemos asegurar que la hipoacusia o la cofosis postoperatoria, que han sido la regla excepto en un caso de grado II, haya sido causada por lesión nerviosa, laberíntica o isquémica. Conclusiones. En nuestro material no ha sido posible la exposición completa del fondo del CAI por vía retrosigmoidea sin lesionar alguna estructura laberíntica. Las zonas de mayor riesgo de complicaciones secundarias al fresado son la pared inferior y el fondo del CAL La extensión medial de la craniectomía suboccipital facilita al fresado y a la exposición tumoral intrameatal. No existen referencias intraoperatorias para localizar las estructuras petrosas durante el fresado del CAI excepto la propia experiencia del cirujano (AU)

Human T and B cell epitope mapping of Taenia solium paramyosin.

Taenia solium paramyosin is an immunodominant antigen in human and porcine cysticercosis that has shown promise as a vaccine candidate against schistosomiasis and some filariasis. There are few studies to identify the immunologically relevant regions of paramyosin. In this work, we characterize the humoral and cellular response of neurocysticercotic patients against T. solium paramyosin. Western blots using different recombinant fragments of T. solium paramyosin, showed that the sera from neurocysticercotic patients were strongly reactive against the carboxyl end region, with poor recognition of the central and amino regions. In contrast, the cellular immune response of patients did not show preferential recognition of any region of paramyosin.

Medical treatment for neurocysticercosis characterized by giant subarachnoid cysts.

BACKGROUND: Infection with the larval form of the pork tapeworm, Taenia solium, can lead to the development of cysts in the brain. Surgical removal of cysts has been the accepted treatment for neurocysticercosis characterized by giant cysts when there is associated intracranial hypertension. METHODS: We describe 33 patients whom we treated medically for malignant forms of neurocysticercosis. All patients had evidence of intracranial hypertension and subarachnoid cysts at least 50 mm in diameter. All patients received 15 mg of albendazole per kilogram of body weight per day for four weeks. Ten patients were also treated with 100 mg of praziquantel per kilogram per day for four weeks. Seventeen patients received a second course of albendazole, three received a third course, and one received a fourth course. During the first cycle of treatment, all patients also received dexamethasone. Five patients had previously undergone neurosurgery for giant cysts. RESULTS: After a median of 59 months of follow-up (range, 7 to 102), the condition of all 33 patients had improved, and the cysts had disappeared or become calcified. Of the 22 patients with a history of seizures, only 11 continued to receive antiseizure medications. The median quality-of-life score on the Karnofsky scale improved from 40 to 100. Fifteen patients received a ventriculoperitoneal shunt because of hydrocephalus. Four patients had persistent sequelae (bilateral partial optic atrophy, stroke, or diplopia) of the cysts. CONCLUSIONS: Intensive medical treatment can be effective in patients with neurocysticercosis characterized by giant cysts. Neurosurgery may be required only when there is an imminent risk of death.

Cellular immune response and Th1/Th2 cytokines in human neurocysticercosis: lack of immune suppression.

Some reports have suggested that human neurocysticercosis (NCC) induces immunosuppression. To test this hypothesis, we performed a study on active cases of NCC who had not received cestocidal or immunosuppressive treatments. We examined blood counts and specific T cell markers (CD3, CD4, and CD8) by flow cytometry and found no differences between patients with NCC and healthy individuals. Both groups responded to concanavalin A (Con A), and patients with NCC responded more to a parasite crude antigen than uninfected individuals. Peripheral blood mononuclear cells were examined for interleukin (IL)-2, interferon-gamma, IL-10, and IL-4 mRNA. Regardless of infection status, more than 60% of individuals synthesized IL-2 mRNA and, less frequently, the other cytokines. These data suggest that immunosuppression does not occur in NCC patients.

An outbreak of plague including cases with probable pneumonic infection, Ecuador, 1998.

During February and March of 1998, 12 sudden deaths were reported among residents of a high-Andean community in Ecuador. All 12 fatalities were members of the same extended family and some had apparent exposure to sick guinea-pigs. Following an initial investigation by public health officials, an additional death was reported in a nearby community in April, also associated with exposure to sick guinea-pigs. Blood samples from humans, dogs, and a rodent were tested for antibody to the F1 antigen of Yersinia pestis by passive haemagglutination assay. Tissue from rodents was subjected to direct fluorescent antibody staining using fluorescein-labelled monoclonal antibody to Y. pestis F1 antigen. Formalin-fixed specimens from the 2 autopsies were evaluated using a 2-step alkaline phosphatase immunoassay with a monoclonal antibody to Y. pestis F1 antigen, and tissues that had not been embedded in paraffin were tested for the presence of DNA encoding the F1 structural antigen by polymerase chain reaction. Serological evaluation of close contacts of the fatalities revealed positive titres to F1 antigen of Y. pestis, the aetiological agent of plague, in 3 contacts from the first community and 1 from the second. Immunohistochemical staining of tissues collected from 2 of the fatalities provided evidence that both had pneumonic plague. Five of 14 dogs found in the communities were seropositive for plague antibody, providing evidence of a recent epizootic plague in the area.

Malignant fibrous histiocytoma of the scalp. Multidisciplinary treatment.

BACKGROUND: Malignant fibrous histiocytomas (MFH) are uncommon in the skin, and even less frequent on the scalp. On the scalp they are often very difficult to excise and it is even more difficult to close the resulting wound. OBJECTIVE: To review all malignant fibrous histiocytomas diagnosed and treated in our Department during the past 6 years, and to describe the multidisciplinary procedure employed to treat one special case of aggressive malignant fibrous histiocytoma on the scalp that recurred twice. RESULT: Malignant fibrous histiocytomas represent 0.01% of malignant cutaneous tumors in our area. The immediate results after a multidisciplinary treatment performed on a recurrent malignant fibrous histiocytoma located on the scalp were excellent, but recurrence was observed 6 months later. Two years later we have also treated another case of MFH on the scalp. The same surgical technique was performed, but the patient received high-dose-methotrexate-based neoadjuvant chemotherapy (HD-MTX). One year later, this patient is still alive and no signs of recurrence have been detected. CONCLUSION: When malignant fibrous histiocytoma occurs on the scalp it must be treated immediately by means of an excision with a large peripheral edge of 2 cm from the visual or CAT limits of the lesion, since the first treatment must be definitive.

Albendazole and praziquantel treatment in neurocysticercosis of the fourth ventricle.

The purpose of this study was to determine the therapeutic efficacy of albendazole and praziquantel administration in the treatment of neurocysticercosis of the fourth ventricle. The authors report the results obtained in 10 patients with cystic neurocysticercosis of the fourth ventricle who were treated with albendazole at a dosage of 15 mg/kg/day for 2 weeks. Because of the failure of albendazole treatment, two of the patients received an additional course of praziquantel at a dosage of 100 mg/kg/day for 2 weeks. A total of 16 courses of albendazole and two courses of praziquantel were administered to the 10 patients. In eight patients (80%), there was complete disappearance of the cyst, in one other (10%) there was an important decrease in the size of the cyst, and in one (10%), no change was seen. None of the patients had complications during the follow-up period of between 6 and 26 months (average 15.7 months). The authors postulate that a regimen of albendazole is the treatment of choice for this type of neurocysticercosis, although praziquantel may also be useful.

[Treatment of amyotrophic lateral sclerosis with daily intrathecal TRH. A year's experience. Pilot study II]. / Tratamiento de la esclerosis lateral amiotrófica con TRH intratecal diario. Experiencia de un año. Estudio piloto II.

This study presents the experience of one year of treatment in patients with amyotrophic lateral sclerosis, with intrathecal TRH administered daily by a subcutaneous reservoir connected to the intrathecal lumbar space by a double catheter system as to provide continuous circulation of CSF and to avoid sac formation since this would be a source of infection. Clinical evaluation was carried out with a scale developed by the authors with the main aim of evaluating the loss of vital motor abilities and not as a localized evaluation. Secondary effects due to the implantation of the reservoir in addition to its use are presented although data were not important. Intrathecal administration of TRH was carried out similarly (600 micrograms/day) with secondary effects being the same as those by other routes of administration although of a lesser intensity. The results of the clinical evaluation at the beginning and end of the treatment as well as after patient follow up demonstrated that beneficial effects do not occur equally in all patients but rather are transitory and do not improve the natural evolution of the disease. The authors conclude that, methodologically, this series study does not enter within the frame of an advisable statistical study since the aim is to provide data for a future controlled study.

The effect of antimalarial chloroquine therapy and prophylaxis on concurrent infection with Onchocerca volvulus in Ecuador.

The effect of chloroquine phosphate on Onchocerca volvulus in vivo was studied in Ecuadorians undergoing treatment for malaria. All persons with a diagnosis of acute malaria and treated with 2500 mg of chloroquine over 3 d showed a 100% reduction of dermal O. volvulus microfilariae 7 d after treatment. However, 28 d after treatment the microfilarial densities returned to their pre-treatment levels and at 35 d they had increased to 121.6% of their pre-treatment values. Treatment did not appear to have any effect on the adult O. volvulus examined histologically in extirpated nodules. Patients treated for acute malaria and subsequently kept on a prophylactic regimen of 500 mg chloroquine weekly showed a reduction of 56.7% from pre-treatment microfilarial density after 27 weeks. Patients who underwent nodulectomy as well as treatment for acute malaria and were given 500 mg of chloroquine prophylactically for 27 weeks showed a reduction in dermal microfilarial density of 93.6%. Symptoms of onchocerciasis were reduced in the latter group of patients, with the elimination of all acute dermatological changes within 6 weeks. Ocular examination of these surgically and chemotherapeutically treated individuals revealed reductions of 94.9% of microfilariae in the anterior chamber, 95.9% of live microfilariae in the cornea, and 95.1% of dead microfilariae in the cornea. There was a reduction of 69.8% in corneal fluffy opacities. No alteration in the visual acuity or in visible lesions in the posterior segment was recorded. The results suggest that a complex interaction between chloroquine and O. volvulus takes place in vivo, which can be beneficial to the patient over a long period.(ABSTRACT TRUNCATED AT 250 WORDS)

Estudios operativos sobre el control de la teniasis/cisticercosis por taenia solium en el Ecuador / Operational studies on the control of taenia solium taeniasis/cysticercosis in Ecuador

Operational studies on the control of taenia solium taeniasis/cysticercosis in Ecuador

Estudios operativos sobre el control de la teniasis/cisticercosis por taenia solium en el Ecuador / Operational studies on the control of taenia solium taeniasis/cysticercosis in Ecuador

Operational studies on the control of taenia solium taeniasis/cysticercosis in Ecuador

Se pública en inglés en el Bull. WHO 67((4), 1989

Onchocerciasis in Ecuador, 1980-1986: epidemiological evaluation of the disease in the Esmeraldas province.

An increase in both the prevalence (68.3%) and intensity of infection (106.2%) occurred in the Ecuadorian onchocercal focus during the 6 year period, 1980 to 1986. In 1986, a higher prevalence of infection was noted in males (53.6%) than females (33.1%), but a greater rate of increase of infection over the 6 years was seen in females than males (75.7% vs 61.9% respectively). In all endemic areas, the Chachi race had a higher prevalence of infection as well as higher increase rate of infection than the Black. In the hyperendemic and hypoendemic areas the highest increase of infection was seen in the Chachi female and Chachi male respectively. The prevalence of infection in 1986 was greater than that in 1980 for all ages, with the greatest increase of infection in the 1-4 year age groups. There was an average increase of 106.2% in the microfilarial skin density with an increase seen in all age groups. A higher microfilariae density increase was seen in the hypoendemic (100.0%) than the hyperendemic (66.5%) areas. The Blacks showed a greater microfilarial density increase than the Chachi (155.1% vs 70.7% respectively) with the Black female showing the highest increase (117.6%) in the hyperendemic area and the Black male showing the highest (155.6%) in the hypoendemic area. Along the Rio Cayapas, high microfilarial densities were found in 3 major areas on the river, a reflection of man-vector exposure.

Onchodermatitis--correlation between skin disease and parasitic load in an endemic focus in Ecuador.

Onchocerciasis is a chronic parasitic infection in which infiltration of the skin by microfilariae has been associated with a number of different pathological changes. This survey compared the prevalence of different forms of skin disease in two villages, one of which was located within the endemic zone for onchocerciasis (Zapallo Grande), in a lowland rain forest area of western Ecuador. The commonest skin diseases in both villages were scabies, pyoderma and pityriasis versicolor. In addition changes closely correlated with the presence of microfilariae in skin snips were found in Zapallo Grande--such as atrophic gluteal changes, and acute and chronic papular dermatitis. The only other skin disease associated with onchocerciasis was widespread tinea corporis due to T. rubrum. The Amerindians in the endemic onchocerciasis area were more likely than Negroes to have generalized atrophic changes of the skin, whereas in the latter group significant numbers of individuals had no obvious skin lesions but large numbers of microfilariae were detected in skin snips. Acute papular dermatitis was common in both groups and in biopsied lesions microfilariae could usually be identified within the epidermis or close to the dermo-epidermal junction. One patient had developed severe reactive onchodermatitis (Sowda). Swabs taken from onchocercal skin lesions showed no evidence of skin surface carriage of Staphylococcus aureus. Changes classically associated with onchocerciasis such as pretibial hypopigmentation (leopard skin) and hanging groin were notably absent in this population.

Operational studies on the control of Taenia solium taeniasis/cysticercosis in Ecuador.

A large-scale study in Loja and El Oro Provinces, Ecuador, demonstrated that population-based treatment of human taeniasis with a low dose of praziquantel is feasible and effective for the short-term control of transmission of Taenia solium in hyperendemic areas. Chemotherapeutic intervention also effectively promoted local preventive measures and contributed greatly to the elaboration of a long-term control programme.

Operational studies on the control of Taenia solium taeniasis/cysticercosis in Ecuador

A large-scale study in Loja and El Oro Provinces, Ecuador, demonstrated that population-based treatment of human taeniasis with a low dose of praziquantel is feasible and effective for the short-term control of transmission of Taenia solium in hyperendemic areas. Chemotherapeutic intervention also effectively promoted local preventive measures and contributed greatly to the elaboration of a long-term control programme (Au)