Correlación entre el grado de hipertensión arterial y el índice de estrés oxidativo. Estudio de cohorte en una población de pacientes hipertensos sistémicos en República Dominicana / Correlation between the arterial hypertension degree and oxidative stress index. Cohort study in a population of systemic hypertensive patients in Dominican Republic

Introducción: la hipertensión arterial (HTA) es una de las mayores cargas de enfermedad y riesgo para infarto cardíaco, la insuficiencia cardíaca y el fallo renal. Se reconoce que el estrés oxidativo (EO) es un determinante en el desarrollo de complicaciones y el progreso de la HTA. Se determinó el índice de EO (IEO) en individuos con HTA y en un grupo sano control, para evaluar su posible correlación. Materiales y métodos: se midió IEO en una población de 112 individuos con HTA de distintos grados entre 50 y 70 años escogidos al azar y se comparó con los valores de un grupo control de voluntarios sanos, con la intención de definir el grado de correlación entre los niveles del IEO y la severidad de HTA, mediante la medición de biomarcadores para el EO en lisado de eritrocitos. Resultados: a pesar de que los beneficios de la terapia antioxidante (TAO) no han sido definitivamente probadas, en gran parte porque las enfermedades complejas no dependen de un solo componente fisiopatogénico, el EO sigue siendo una piedra angular en el desarrollo de complicaciones y el empeoramiento de los cuadros clínicos de muchos padecimientos. La demostración de biomarcardores específicos mejora la posibilidad de una TAO dirigida. El presente ensayo demostró que la edad, el género y la etnia no influyen en el IEO y que el EO fue severo en los casos de HTA iii, moderado en HTA ii y estuvo ausente en el subgrupo con HTA grado i. Conclusiones: estos resultados sugieren una relación entre los niveles de EO y severidad de HTA y sustenta evidencias para diseñar nuevos ensayos clínicos que evalúen la eficacia de una TAO adyuvante en el manejo de la HTA

Introduction: Arterial hypertension (AHT) is one of the major burdens of disease and risk for cardiac infarction, heart failure and renal failure. It is recognized that the oxidative stress (OS) is a determining factor in the development of complications and the progress of the AHT. OS Index (OSI) in individuals with AHT and a healthy control group, was determined to assess their possible correlation. Methods: OSI was measured in a population of 112 individuals with AHT of different levels between 50 and 70 years old, chosen at random and compared with the values of healthy volunteers control group with the aim of defining the degree of correlation between the levels of the OSI and the AHT severity, by measuring biomarkers for OS in a red cell lysate. Discussion: Despite the benefits of an antioxidant therapy (AOT) have not been definitely proven, largely because the complex diseases do not depend on a single pathophysiological component, OS remains as a cornerstone in the development of complications and the worsening of the clinical pictures of many ailments. The demonstration of specific biomarkers improve the possibility of an addressed AOT. This trial showed th at the age, gender and ethnicity do not influence the OSI and that OS was severe in HTA iii cases, moderate in HTA ii cases and was absent in the subgroup with HTA i. Conclusions: These results suggest a relationship between levels of EO and severity of hypertension and support evidence to design new clinical trials assessing the efficacy of an adjuvant AOT in the management of HTA

In vitro effects of plant essential oils on non-specific immune parameters of red drum, Sciaenops ocellatus L.

Phytochemicals such as plant essential oils (EOs) have been reported to favour various activities in the innate immune system of fish. Thus, the aim of this study was to verify the in vitro effect of three different plant EOs (Ocimum americanum, Cymbopogon flexuosus and Melaleuca alternifolia) on non-specific immune parameters and erythrocyte osmotic fragility of red drum, Sciaenops ocellatus. Concentrations of each plant EO evaluated in preparations of head-kidney macrophages, blood leucocytes and blood plasma were as follows: 0.0 (control), 1.0, 2.0, 4.0, 8.0, and 16.0 µg/ml. Red drum head-kidney macrophages significantly increased extracellular superoxide anion production when exposed (20 h) to O. americanum EO (1.0-8.0 µg/ml) and C. flexuosus EO (2.0 and 4.0 µg/ml). The respiratory burst of blood leucocytes (NBT test) significantly increased in all concentrations when compared to the respective control group, for all EOs. At the highest concentration (16.0 µg/ml), C. flexuosus EO significantly inhibited the haemolytic activity of complement system in red drum blood after 1 h exposure. None of the tested concentrations significantly altered plasma lysozyme activity or erythrocyte osmotic fragility after exposing (1 h) red drum whole blood to each EO. This study demonstrated that these plant EOs are capable of triggering superoxide anion production in red drum leucocytes (head-kidney macrophages and/or blood leucocytes). In vivo studies are warranted to address their potential as immunostimulants in the diet of red drum and other aquacultured species.

Medical and surgical treatments for tinnitus: the efficacy of combined treatment with sulodexide and melatonin.

AIM: Tinnitus is the perception of sound in the absence of an apparent acoustic stimulus. A widespread and highly debilitating disease difficult to cure. Several treatments have been advocated for tinnitus in the last years, including surgery, pharmacotherapy, counseling, cognitive behavioral therapy, sound therapy, but unfortunately without definitive conclusions. The surgery treatments could represent an important therapeutic choice on specific subgroups of tinnitus with defined causes but obviously this approach represent an invasive treatment and it should be considered with extreme caution and then, alternative pharmacological options should be investigated. METHODS: In this retrospective study 30 patients with tinnitus were treated with sulodexide (250 LSU BID, in the morning and in the evening) and melatonin (3 mg in the evening before going to sleep) for 80 days. The evaluations were performed comparing different parameters at basal (T0) and after 40 days (T1) and 80 days (T2) of treatment. RESULTS: The results of Tinnitus Handicap Inventory (THI) and acufenometry showed a significative improvement of tinnitus after treatment with sulodexide and melatonin. In particular, THI total score was reduced from 37±20 to 27±18 (P<0.001) and 21±19 (P<0.001) at T1 and T2, respectively. The percentage of patients with improved symptoms (i.e. reduced score at THI) was 76.7% at T1 and 90.0% at T2. Finally a significant improvement was also detected in the tone audiometry test. No side effects were observed during the treatment period. CONCLUSION: In conclusion, the combined use of sulodexide, a natural glycosaminoglycan with antithrombotic, profibrinolytic and vascular anti-inflammatory properties used in the treatment of many vascular diseases, included the vertigo of vascular origin and melatonin, a neurohormone produced by the pineal gland and related to multiple physiological functions, confirms to an important and promising therapeutically option in the tinnitus management.

Manifestaciones orales en pacientes VIH/SIDA asociadas a tratamiento antirretroviral y el estado inmunológico en dos fundaciones de la ciudad de Cartagena / Oral manifestations in HIV/AIDS patients associated with antiretroviral treatment and immune status in two foundations of Cartagena city

Objetivo: El objetivo de este estudio fue determinar la asociación entre las manifestaciones orales de pacientes VIH/SIDA con la terapia antirretroviral y el estado inmunológico. Metodología: Estudio de tipo transversal, en una población de 166 pacientes pertenecientes a dos fundaciones de la ciudad de Cartagena, la información se recolectó a través de un examen estomatológico intraoral teniendo en cuenta los criterios para el diagnóstico clínico de las manifestaciones orales asociadas a VIH establecidos por el Centro Colaborador de la OMS sobre las manifestaciones orales del virus de inmunodeficiencia humana, los datos como niveles de carga viral, CD4 y la terapia antirretroviral se obtuvieron de la historia clínica médica. Resultados: La prevalencia de manifestaciones orales asociadas a VIH fue del 59,5%, la candidiasis fue la manifestación oral más frecuente, con una prevalencia de 35,5%, los pacientes tratados con monoterapia presentaron menos manifestaciones orales que aquellos tratados con biterapia con valores estadísticamente significativo, OR: 0,20, IC: 0,00-0,96 (p<0,02), la candidiasis pseudomembranosa como manifestación oral asociada a VIH tiene menos probabilidades de presentarse cuando se tiene niveles de CD4 superiores a 500 cel./mm3 mostrando valores estadísticamente significativos, con un OR: 0,297, IC: 0,103-0,852 (p<0,03). Conclusión: Los pacientes tratados con monoterapia como terapéutica farmacológica antirretroviral presentaron menos manifestaciones orales que aquellos tratados con biterapia, con respecto a la candidiasis el subtipo pseudomembranosa tiene menos probabilidades de presentarse cuando se tiene niveles de CD4 superiores a 500 cel./mm3 (AU)

Objective: The aim of this study was to determine the association between oral manifestations of AIDS patients with antiretroviral therapy and their immune status. Methodology: a cross-sectional study was done in a population of 166 patients from two Cartagena's city foundations, the information was collected through an intraoral stomatological examination considering the standard for the clinical diagnosis of oral manifestations associated with AIDS established by the Collaborating Centre WHO about oral manifestations of human immunodeficiency virus, information such as viral load, CD4 and antiretroviral therapy were obtained from the medical history. Results: The prevalence of oral manifestations associated with AIDS was 59.5%, candidiasis was the most common oral manifestation with a prevalence of 35.5%, the patients treated with oral monotherapy had fewer events than those treated with combination therapy with statistically significant values, OR: 0.20, CI 0.00-0.96 (p<0.02), pseudomembranous candidiasis as oral manifestations associated with AIDS has less probabilities to occur when patients have CD4 levels above 500 cel./mm3 showing values statistically significant with a OR: 0.297, CI: 0103-0852 (p<0.03). Conclusions: Patients treated with monotherapy as antiretroviral drug therapy presented less oral manifestations than patients treated with dual therapy, about candidiasis, the subtype pseudomembranous candidiasis has less probabilities to occur when you have CD4 levels above 500 cel./mm3 (AU)

Spectroscopic alterations on enamel and dentin after nanosecond Nd:YAG laser irradiation.

Laser irradiation on hard tissue has produced a resistant surface that is likely to prevent caries. In this study, human enamel and dentine were exposed to nanosecond pulsed Nd:YAG laser with energy densities of 20-40 J/cm(2) and pulse width of 6 ns inducing chemical changes in these tissues. Infrared analysis of human dental enamel and dentine was performed using the KBr method (2mg sample/300 mg KBr). A correlation between non-lased and lased spectra was performed that gives an indication of the changes in organic and inorganic compounds after laser-tissue interaction. Spectra of teeth simultaneously show the inorganic and organic parts of the tissue. The principal bands: amide bands A, I, II, and III from the collagen-matrix, phosphate from the mineral content, and carbonate bands were identified. The normalized area of peak versus peak position was determined. Changes of the bands attributed to the collagen matrix were verified after Nd:YAG irradiation. The present results suggest a chemical modification of organic and mineral compounds by laser. The spectral results indicated an alteration in the absorption bands relative to, essentially, organic compounds.

New and interesting Laboulbeniales parasitic on Brazilian Diptera.

Three new Laboulbeniales occurring on Brazilian Diptera are described. These are Stigmatomyces cearensis, parasitic on Guttipsilopa (Nesopsilopa) stonei (Mathis & Wirth) (Ephydridae); Stigmatmyces gratiellae, parasitic on Cressonomyia meridionalis (Cresson) (Ephydridae); and Stigmatomyces litoralis, parasitic on Glenanthe caribea Mathis and Paraglenanthe bahamensis Wirth (both Ephydridae). Fifteen other dipterophilous Laboulbeniales are reported for the first time from Brazil. The synonomy between Stigmatomyces notiphilae Thaxt. and S. leucophengae Thaxt. also is proposed.

Combined effect of holmium laser and fluoride in prevention of dental caries in vitro

Investigates the possibility of using a holmium laser for preventions of dental caries. Changes in physical properties of dental enamel were observed by measuring microhardness, analyzing the relative concentration of calcium andphosphorous atoms after acid demineralization of enamel.

Cancer and comorbidity in older patients: a descriptive profile.

In 1992, the National Institute on Aging (NIA) and the National Cancer Institute (NCI) initiated a study to assess the prevalence of comorbid conditions in elderly patients with cancer. Seven cancer sites were selected for the study: breast, cervix, ovary, prostate, colon, stomach, and urinary bladder. This report on approximately 7600 patients in the study sample describes the NIA/NCI approach to developing information on comorbidity in elderly patients and addresses the chronic disease burden (i.e., comorbidity) and severity for six particular conditions: arthritis, chronic obstructive pulmonary disease (COPD), diabetes, gastrointestinal problems, heart-related conditions, and hypertension. Data on comorbidity were collected by abstracting information from hospital medical records. Patients were registered in six geographic areas of the NCI Surveillance, Epidemiology, and End Results (SEER) Program. A stratified random sample of patients aged 55 to 64, 65 to 74, and 75 years or older-with the index cancers were selected. Comorbidity data were matched with data from the conventional SEER monitoring system. Analyses showed that hypertension is the most prevalent condition and is also much more common as a current management problem rather than as history for the NIA/NCI SEER Study patients. Heart conditions varied slightly in the percentage of severity reported, but percentages for all tumors remained within a range of 13 to 26% for current and past categories. A similar range was observed for arthritis, with the higher percentage seen in the current problem category. For episodic complaints (e.g., gastrointestinal problems), a medical history was more common, except for cancers that involve complaints associated with the malignancy (e.g., colon and stomach cancers and, to a lesser extent, ovarian cancer). COPD and diabetes were less prevalent. Analyses currently under way will determine the impact of a patient's comorbidity burden on the cancer care continuum of diagnosis, treatment, and survival. The broad and independent effects of chronic conditions, singly and in combination, are being examined.

Experimental studies of the applications of the holmium laser in dentistry.

The purpose of this study is to evaluate the possibility of using a pulsed Ho:YLF laser for endodontic surgery access, preparation of cavities, etching of dental enamel, and treatment of dental caries. Specimens were irradiated with a prototype of pulsed Ho:YLF laser (2,065 microns). Laser energies in the range of 120-750 mJ per pulse were used. The study of morphological changes on enamel and dentine was conducted on light and scanning electron microscopes. Perforation of approximately 4 mm depth with homogeneous and smooth aspect of its wall surfaces was obtained. There was no carbonization. Irradiation with low energy results in melted and recrystalized surface with small and shallow pits. In accordance with our results the Ho:YLF laser produces surfaces that are white in appearance in contrast to the Nd:YAG modified enamel and dentine surfaces, that were darkened. These are indications that the holmium laser may be useful for dentistry in the future.

Chevron osteotomy for hallux valgus.

A retrospective study of the Chevron osteotomy procedure for hallux valgus was carried out on 112 patients (168 feet) with an average age of 39.7 years (range 19 to 61 years). The average follow-up was 4.4 years (range 13 months to 7.5 years). The preoperative diagnosis was symptomatic hallux valgus. The average preoperative intermetatarsal 1-2 angle was 15.5 degrees (range 11 degrees to 18 degrees) and the hallux valgus angle was 28.1 degrees (range 21 degrees to 42 degrees). The operation was effective in improving symptoms, cosmesis, and function and in decreasing the deformity.

[Abdominal visceral lesions in patients with multiple trauma]. / Le lesioni viscerali addominali nel politraumatizzato.

The paper describes a series of 385 cases of multiple injuries which were treated between 1987 and 1991 at the Emergency Unit of the Fatebenefratelli Hospital in Milan. Special attention was paid to abdominal trauma and visceral injuries in terms of both diagnosis and treatment.

Mode-locking operation of a pulsed Nd:YAG laser with F(2) BF:LiF color-center crystal in a dual configuration.

Passive stable mode locking of a pulsed Nd:YAG laser was achieved with a long-decay-time saturable absorber in a coupled-cavity longitudinal scheme. In this configuration the saturable absorber (LiF:F(2) ) also behaves as an active medium in intracavity pumping and is the load for the Nd laser. This arrangement provides proper lasing conditions for the F(2) color centers so that the cavity photon lifetime of the color centers is much shorter than the cavity round-trip time of the Nd laser. In this way the Nd pulses are simultaneously Q switched and mode locked. The pulses show a stable temporal profile, with an envelope of 160 ns and a train of mode-locked pulses of less than 200-ps duration.

Studies on citrate metabolism in normal subjects and kidney stone patients.

The study was carried out in order to investigate citrate metabolism (i.e. serum levels, filtered load, tubular reabsorption, total and fasting urinary excretion) in a large group of normal subjects (n = 39) and kidney stone patients (n = 45). We found that mean serum citrate levels and filtered loads were similar in the two groups studied. On the other hand, both the 24-hour urinary citrate and the fasting citrate/creatinine ratio were significantly reduced, whereas the mean tubular reabsorption of citrate appeared to be significantly increased in kidney stone patients in respect to control subjects. A good correlation was found between the fasting and the 24-hour citrate/creatinine ratio in both normal subjects (r = 0.84, p less than 0.001) and kidney stone patients (r = 0.89, p less than 0.001). Our data indicate that the kidney appears to be involved in the pathogenesis of hypocitraturia in kidney stone patients and that a substantial proportion of these patients show a reduced urinary excretion of citrate. Finally, the evaluation of the fasting citrate/creatinine ratio may replace the measurement of the substance on the basis of a 24-hour urine collection.

Biochemical picture accompanying sclerotic bone metastases of prostatic origin.

This study was carried out to evaluate the metabolic consequences of osteosclerotic skeletal metastases of prostatic origin in a homogeneous group of patients. We found significantly increased mean values of serum alkaline phosphatase activity and significantly reduced mean values of serum phosphate, 24-h urinary calcium, fasting calcium excretion and TmP/GFR in cancer patients with respect to age-matched controls. Mean serum immunoreactive parathyroid hormone (iPTH) levels were raised, with two patients showing increased values of the hormone above our normal limits. Our findings indicate that mild secondary hyperparathyroidism is a feature of these patients. However, it cannot be excluded that both the reduced serum phosphate and TmP/GFR values may be related, at least in some cases, to the effects of the tumour itself on tubular reabsorption of phosphate.