Spine stabilization exercises are not superior to flexion exercises for ultrasound-detected muscle thickness changes in patients with chronic low back pain and lumbar spondylolisthesis.

INTRODUCTION: exercise programs can reduce pain and improve functionality in patients with degenerative spondylolisthesis and chronic low back pain. However, there is still no consensus surrounding the superiority of any specific routine for exercise-induced trophic changes of lumbar muscles. The aim was to compare the changes in the primary lumbar stabilizing muscle thickness after spine stabilization exercises and flexion exercises in patients with spondylolisthesis and chronic low back pain. MATERIAL AND METHODS: prospective, longitudinal and comparative study was carried out. Twenty-one treatment-naive patients with a diagnosis of both chronic low back pain and degenerative spondylolisthesis over the age of 50 were included. A physical therapist taught participants either spine stabilization exercises or flexion exercises to execute daily at home. The thickness of the primary lumbar muscles was measured through ultrasound (at rest and contraction) at baseline and three months. A Mann-Whitney U test and Wilcoxon signed-rank test were performed for comparisons, and Spearman's rank correlation coefficients were calculated for associations. RESULTS: we did not find statistically between the exercise programs: all patients presented significant changes in the thickness of the multifidus muscle but in none of the other evaluated muscles. CONCLUSION: there is no difference between spine stabilization exercises and flexion exercises after three months in terms of the changes in muscle thickness evaluated by ultrasound.

INTRODUCCIÓN: el ejercicio reduce el dolor y mejora la funcionalidad en pacientes con dolor crónico lumbar y espondilolistesis degenerativa. Sin embargo, no existe a la fecha un consenso sobre la superioridad de algún programa de ejercicio para inducir cambios tróficos de los músculos estabilizadores lumbares, por lo que el objetivo fue comparar el trofismo de estos músculos mediante ultrasonido, con dos programas de ejercicio distintos: estabilización vertebral versus ejercicios flexores. MATERIAL Y MÉTODOS: estudio prospectivo, longitudinal y comparativo, en veintiún pacientes mayores de 50 años, con dolor crónico lumbar y espondilolistesis degenerativa. Se entrenó a los pacientes para la ejecución diaria de ejercicio: estabilización lumbar o ejercicios flexores, los cuales fueron asignados por aleatorización como parte de un ECA en desarrollo. El trofismo muscular fue evaluado mediante ultrasonido al inicio y a tres meses. Las pruebas de U de Mann-Whitney y prueba de Wilcoxon se usaron para comparaciones entre grupos y para correlaciones se usaron los coeficientes de correlación de Spearman. RESULTADOS: todos los pacientes presentaron ganancia en el trofismo de los músculos multífidos a tres meses, pero sin diferencias entre grupos de tratamiento. No se detectaron cambios significativos en el resto de los músculos evaluados. CONCLUSIÓN: no encontramos diferencia significativa entre los ejercicios de estabilización lumbar y los ejercicios flexores, a tres meses de seguimiento, en términos de los cambios tróficos medidos por ultrasonido de los músculos estabilizadores lumbares.

Prediction of the potential biological activity of novel spiropyrazolo[3,4-b]pyridines and spiropyrazolo[3,4-b]pyridine-5,5'-pyrimidines by a ligand-protein inverse-docking approach.

The interaction of a series of spiropyrazolo[3,4-b]pyridines and spiropyrazolo[3,4-b]pyridine-5,5'-pyrimidines with 975 molecular targets involved in different diseases and biochemical alterations in humans was assessed. In-silico and in-vivo methods were used to predict the potential biological activity of these compounds. The exposure of several individuals of C. elegans to these compounds shows that their lethality would be less than 10% and that they do not induce any alteration in their locomotion. The compounds identified as PRV-8 and 13-G were the most bioactive, and also showed other advantages such as; better structural properties, adequate pharmacokinetic and pharmacodynamic properties, and good flexibility and unsaturation, which placed them as the compounds of greatest interest to be tested in-vitro and in-vivo. The series of compounds described here exhibited significant interactions with the estrogen signaling pathway.

Tinea nigra by Hortaea werneckii, a report of 22 cases from Mexico.

Tinea nigra is a superficial mycosis caused by Hortaea werneckii. It is an infrequent asymptomatic infection that affects human palms and soles, and is mostly observed in tropical countries. We evaluate retrospectively twenty-two confirmed cases of tinea nigra from a total of eleven yr (1997-2007) and discuss the epidemiology, clinical features and treatment of this disease. In twelve cases, adults were involved, in 10, children. In nineteen cases the disorder was located on palms of hands and in three on soles of feet. In all cases, the obtained isolates were morphologically identified as Hortaea werneckii and the identification of ten isolates was retrospectively confirmed with the help of sequences of the internal transcribed spacer regions of the ribosomal DNA. The patients received topical treatment with Whitfield ointment, ketoconazole, bifonazole, or terbinafine. Treatment with keratolytic agents and topical antifungals was effective.

Salted meat consumption as a risk factor for cancer of the oral cavity and pharynx: a case-control study from Uruguay.

A hospital-based, case-control study of oropharyngeal cancer was conducted in the Oncology Institute, Montevideo, Uruguay, during 1988-1992, in which 246 new cases and 253 controls were interviewed. The study was restricted to males. As in most previous studies, tobacco smoking and alcohol drinking were the major risk factors. Past and current salted meat consumption was associated with increased risks of oropharyngeal cancer after controlling for the effects of tobacco and alcohol; current consumption was associated with a significant increase in risk (odds ratio, 2.3; 95% confidence interval, 1.1-5.2). Current heavy consumption of salted meat was associated with a significant 4.7% increased risk of oropharyngeal cancer after adjusting for tobacco smoking and alcohol drinking. These findings suggest that current consumption of salted meat is more relevant to the etiology of this set of neoplasms than past consumption. Furthermore, the joint effect of pack-years of cigarette smoking, alcohol drinking, and ever consumption of salted meat was associated with a high risk of oral and pharyngeal cancer (odds ratio, 10.0; 95% confidence interval, 4.7-21.3) using the referent category of moderate smokers, moderate drinkers, and never users of salted meat.

The effect of alcohol on the risk of lung cancer in Uruguay.

A hospital-based case-control study of the association between alcohol drinking and lung cancer was carried out in Uruguay between January 1988 and December 1990. The sample included 327 men with lung cancer and 350 male controls. Personal interviews were conducted in the Institute of Oncology by trained personnel using a structured questionnaire. The results showed a significant positive association between beer intake and the risk of lung cancer. The odds ratio for beer drinkers in the highest quartile was 3.4 (95% confidence limits, 1.3-6.6) after adjustment for tobacco. The association between beer and lung cancer was consistent for all the cell types, analyzed separately. A moderate effect for total alcohol consumption was also observed, with a relative risk of 2.2 for those subjects in the highest quartile.

Mate drinking and risk of lung cancer in males: a case-control study from Uruguay.

During the period from January 1988 to December 1994, a case-control study that included 497 cases of lung cancer and 497 controls was carried out at the Instituto de Oncologia, Montevideo, Uruguay, to evaluate the relationship between the drinking of mate (a local tea prepared with infusions of the herb Ilex paraguariensis) and the risk of lung cancer in men. Mate drinking has been associated with risk of most upper-aerodigestive tract cancers. After adjusting for major covariates, including pack-years of cigarette smoking, the amount of mate was associated with a 1.6-fold increase in risk for heavy drinkers, compared with light drinkers, with a significant dose-response pattern. When the analysis was performed by cell type, small cell lung cancer showed a significant increase in relative risk for mate amount (odds ratio, 2.9; 95% confidence interval, 1.3-6.2) and mate duration (odds ratio, 3.6; 95% confidence interval, 1.3-9.9). On the other hand, pulmonary adenocarcinoma was not associated with mate drinking. Possible reasons for these results are discussed, and areas for future research are suggested.

Black (air-cured) and blond (flue-cured) tobacco and cancer risk. III: Oesophageal cancer.

Relative risks of oesophageal cancer for smoking were higher in communities smoking mainly black tobacco, when compared with results from populations comprising mainly users of blond tobacco. Also, hand-rolled cigarette smoking, which could be considered as a proxy indicator of black tobacco smoking, was also associated with higher risk of oesophageal cancer, in comparison with the use of commercial (manufactured) cigarettes. Finally, the use of pipes and cigars showed odds ratios of higher magnitude than those associated with cigarettes. This indirect evidence of a higher risk of oesophageal cancer due to the use of black products was confirmed in three recent hospital-based case-control studies. These investigations were able to compare the effect of both types of tobacco; relative risks for black tobacco were two to three times higher than risks associated with blond tobacco smoking, after controlling for major potential confounders. Laboratory evidence suggests that swallowing tobacco condensates could be a major risk factor for oesophageal cancer. Also, the higher content of tobacco-specific N-nitroso compounds in black tobacco, including organospecific substances, could explain its higher carcinogenic effect on the oesophageal mucosa.

Tobacco, alcohol, diet and risk of non-Hodgkin's lymphoma: a case-control study in Uruguay.

To test whether high meat intake is associated with the development of non-Hodgkin lymphoma (NHL) in the Uruguayan population, a case-control study was performed at the Instituto Nacional de Oncologia, Montevideo, Uruguay. After controlling for age, sex, residence, education, urban/rural status and the habit of drinking the beverage 'mate', red meat intake was associated with an increased risk of NHL of 2.5. This finding was similar in both sexes separately. Odds ratios (OR) for the highest tertile of barbecued meat was 1.7 among men, whereas salted meat was associated with an increased risk of NHL (OR 4.9, 95% CI 1.4-17.7). The effect of processed and salted meat among women was of much less magnitude and the OR's were non-significant. Also, cumulative exposure to 'mate' drinking displayed an OR of 2.4 (95% CI 1.0-5.6). Smokers of black tobacco and hand-rolled cigarettes were associated with an increased risk of 3.5 (95% 1.1-10.9), whereas beer drinkers showed an increased OR of 5.5 (95% 1.1-26.7) in men. It could be concluded that red or salted meat intake, smoking of black tobacco, and beer and 'mate' drinking are risk factors for NHL in the Uruguayan population.

Smoking of hand-rolled cigarettes as a risk factor for small cell lung cancer in men: a case-control study from Uruguay.

During the time period January 1989-December 1992, a case-control study involving 476 cases of lung cancer and 561 controls was carried out at the Instituto Nacional de Oncología, Montevideo, Uruguay, in order to analyze the patterns of risk of the different cell types of lung cancer, associated with smoking manufactured and hand-rolled cigarettes. Lifelong smokers of hand-rolled cigarettes displayed a non-significant 30% increased risk, compared with smokers of commercial cigarettes, for all types of lung cancer combined. The analysis for cell-type disclosed a fourfold increase in the risk of small cell lung carcinoma associated with lifelong smoking of hand-rolled products. The possibilities of a chance finding and of misclassification of the disease appears to be an unlikely explanation of this strong and rather specific association.

Hard liquor drinking is associated with higher risk of cancer of the oral cavity and pharynx than wine drinking. A case-control study in Uruguay.

In order to examine the relationship between pure drinkers of alcoholic beverages and cancer of the oral cavity and pharynx, a case-control study was conducted in Uruguay between 1992 and 1996. 471 cases and 471 controls, admitted for diagnosis or treatment in the four major hospitals in Montevideo, were considered eligible for the study. Pure hard liquor drinking was associated with an increased risk of 3.6 (95% confidence limit (CL) 2.1-6.2), whereas pure wine drinking showed an odds ratio (OR) of 2.1 (95% CL 1.3-3.3). When pure hard liquor drinkers were compared with pure wine drinkers, the OR for pure liquor drinkers was 1.7 (95% CL 1.1-2.7). Furthermore, the risk associated with pure hard liquor drinking was analysed by subsite, and the highest odds ratios were observed for oral cavity cancer. Further studies should be carried out in order to replicate these findings in other populations.

Oral tolerance impairment in mice with staphylococci-induced wasting syndrome.

The effects of staphylococci-induced experimental wasting disease on the immune response of 1 month old CD1 mice were investigated. Animals were separated into different subgroups in order to study their cellular immune competence. Malnutrition of wasted mice was associated with anorexia, diarrhea and weakness. Footpad-injected splenic cells produced normal graft vs. host (GvH) reactions in the popliteal lymph nodes of F1 hybrids. In other experiments, the SRBC intragastric feeding of wasted mice did not cause a tolerant anti-erythrocyte humoral immune response. Three weeks after the staphylococci injections, convalescent erythrocyte-fed wasted mice exhibited an anti-SRBC PFC production similar to that observed in non-tolerant immunized control healthy mice. In return, healthy SRBC-fed control mice showed the specific attenuation of antibody response characteristics of oral tolerance. Differences were found between the immune competence of the undernourished staphylococci-treated wasted mice and those shown by other authors in protein-depleted mice.

TEM evidence of ultrastructural alteration on Pseudomonas aeruginosa by photocatalytic TiO2 thin films.

The antibacterial efficiency of longwave UV-irradiated TiO(2) thin films as well as the ultrastructural damage on bacterial cells was evaluated using Pseudomonas aeruginosa as a model. The quantitative antibacterial efficiency assays showed a bacterial inhibition in the range of 32-72% at different times of irradiation. Transmission electron microscopy (TEM) was used to detect the effect of irradiation of TiO(2) thin films on the ultrastructure of the bacterial cell in order to reveal possible cellular damage. After 40 min irradiation, an abnormal cellular division was observed: instead of a normal septum, an 'elongated bridge' was formed. At a longer irradiation time, wavy structures all around the outer cell membrane were observed, and also some bubble-like protuberances, which expelled inner material. The mechanism of irreversible bacterial cell damage caused by the photocatalytic effect of TiO(2) could be related to abnormal cell division, aside from the reported physicochemical alteration of the cell membrane.

Safety of fosphenytoin sodium.

Fosphenytoin sodium is reviewed, and its safety is compared with that of phenytoin. After i.v. or i.m. injection, fosphenytoin, a phenytoin prodrug, is rapidly hydrolyzed to phenytoin. Free-phenytoin concentrations equivalent to those obtained with i.v. phenytoin can be achieved with fosphenytoin given at equimolar loading doses by selecting the appropriate rate of fosphenytoin administration. Fosphenytoin can be expected to interact with the same drugs that interact with phenytoin. The dosage is expressed as phenytoin sodium equivalents (PE). The standard loading dose for adults with status epilepticus is 15-20 mg PE/kg i.v. infused at 100-150 mg/min; i.m. administration is not recommended for this condition. For nonemergency situations, a 10- to 20-mg PE/kg loading dose can be given i.v. or i.m. Fosphenytoin has advantages over phenytoin injection that are related to its greater aqueous solubility, which obviates the extreme alkalinity, propylene glycol, and ethanol needed in the injectable phenytoin formulation. Intravenous fosphenytoin has been associated with less soft-tissue injury and fewer adverse effects in general than phenytoin. Fosphenytoin, when administered i.m., is completely absorbed, is relatively well tolerated, and provides more predictable serum drug concentrations than i.m. phenytoin. Fosphenytoin offers practical and clinical advantages over i.v. phenytoin.

Tobacco, alcohol, diet and risk of prostate cancer.

A hospital-based case-control study of the association between tobacco smoking, alcohol drinking and several relevant dietary items and prostate cancer was carried out in the National Cancer Institute of Uruguay between January 1988 and December 1994. The sample included 156 patients with histologically proven prostatic cancer and 302 controls with a variety of neoplastic and non-neoplastic diseases. The results showed increased risks of prostate cancer associated with beer drinking, meat, milk and fruit consumption, after adjusting for major confounders. The possible role of N-nitroso compounds from beer in prostatic carcinogenesis is discussed.

Alcohol drinking and tobacco smoking in gastric cancer. A case-control study.

This study compares 210 cases of cancer of the stomach (138 males and 72 females) with 630 controls (414 males and 216 females) afflicted with a wide variety of diseases. All patients (cases and controls) were admitted for treatment at the University Hospital of Montevideo, Uruguay in the time period July 1985-December 1988. They were submitted to the same detailed questionnaire by 3 social workers unaware of the objectives of the study. The analysis was performed at the Louisiana State University of New Orleans, using multiple logistic regression. The variables analyzed were cigarette smoking, alcohol ingestion, salted meat intake, total vegetable consumption, total fruit consumption and "mate" ingestion. Strong positive associations were found in both sexes for low fruit and vegetable consumption, high intake of salted meat and "mate" ingestion. Only males showed significantly elevated OR's for tobacco smoking and alcohol drinking. Of the main tobacco variables, time-dependent one's (age at start, duration) displayed significant gradients of increasing risks. Thus, a prolonged exposure seems more important than the amount smoked per day for the risk of developing gastric carcinoma. Both wine and hard liquor carried increased OR's, but heavy drinkers of wine displayed a six-fold increase in risk, replicating previous reports from France.

High endogenous calcium buffering in Purkinje cells from rat cerebellar slices.

1. The ability of Purkinje cells to rapidly buffer depolarization-evoked intracellular calcium changes (delta [Ca2+]i) was estimated by titrating the endogenous buffer against incremental concentrations of the Ca(2+)-sensitive dye fura-2. 2. In cells from 15-day-old rats, pulse-evoked delta [Ca2+]i were stable during the loading with 0.5 mM fura-2 through the patch pipette. In cells from 6-day-old rats, delta [Ca2+]i decreased by approximately 50% during equivalent experiments. This decrease was not related to changes in Ca2+ influx, since the integral of the Ca2+ currents remained constant throughout the recording. 3. Experiments with high fura-2 concentrations (1.75-3.5 mM) were performed in order to obtain for each cell the curve relating delta [Ca2+]i to fura-2 concentration. From this relationship, values for the Ca2+ binding ratio (the ratio of buffer-bound Ca2+ changes over free Ca2+ changes) were calculated. 4. In Purkinje cells from 15-day-old rats, the Ca2+ binding ratio was approximately 2000, an order of magnitude larger than that of other neurones and neuroendocrine cells studied to date. This Ca2+ binding ratio was significantly smaller (approximately 900) in Purkinje cells from 6-day-old rats. 5. We propose that the large Ca2+ binding ratio of Purkinje cells is related to the presence of large concentrations of Ca2+ binding proteins and that these cells regulate their ability to handle Ca2+ loads during development through changes in the concentration of Ca2+ binding proteins.

Jugular venous pulsations as the sole landmark for percutaneous internal jugular cannulation.

Successful internal jugular venous cannulations were obtained in 210 of 212 consecutive patients using the venous pulsations as the sole landmark with which to locate the vein. Jugular venous blood was aspirated on the initial insertion of a 23-gauge seeker needle in 87.7% of the patients and successful passage of either a 14- or 8-French cannula occurred on the first attempt in 82.5% of patients. The ease, success and relative safety of this technique compare favourably with other techniques. The carotid artery was punctured in three patients (1.5%).

Intracellular calcium clearance in Purkinje cell somata from rat cerebellar slices.

1. The mechanisms governing the return of intracellular calcium (Cai2+) to baseline levels following depolarization-evoked [Ca2+]i rises were investigated in Purkinje cell somata using tight-seal whole-cell recordings and fura-2 microfluorometry, for peak [Ca2+]i ranging from 50 nm to 2 microM. 2. Cai2+ decay was well fitted by a double exponential with time constants of O.6 and 3 s. Both time constants were independent of peak [Ca2+]i but the contribution of the faster component increased with [Ca2+]i. 3. Thapsigargin (10 microM) and cyclopiazonic acid (50 microM) prolonged Cai2+ decay indicating that sarco-endoplasmic reticulum Ca2+ (SERCA) pumps contribute to Purkinje cell Cai2+ clearance. 4. A modest participation in clearance was found for the plasma membrane Ca2+ (PMCA) pumps using 5,6-succinimidyl carboxyeosin (40 microM). 5. The Na(+)-Ca2+ exchanger also contributed to the clearance process, since replacement of extracellular Na+ by Li+ slowed Cai2+ decay. 6. Carbonyl cyanide m-chlorophenylhydrazone (CCCP, 2 microM) and rotenone (10 microM) increased [Ca2+]i and elicited large inward currents at -60 mV. Both effects were also obtained with CCCP in the absence of external Ca2+, suggesting that mitochondrial Ca2+ uptake uncouplers release Ca2+ from intracellular stores and may alter the membrane permeability to Ca2+. These effects were irreversible and impeded tests on the role of mitochondria in Cai2+ clearance. 7. The relative contribution of the clearance systems characterized in this study varied as a function of [Ca2+]i. At 0.5 microM Cai2+, SERCA pumps and the Na(+)-Ca2+ exchanger contribute equally to removal and account for 78% of the process. Only 45% of the removal at 2 microM Cai2+ can be explained by these systems. In this high [Ca2+]i range the major contribution is that of SERCA pumps (21%) and of the Na(+)-Ca2+ exchanger (18%), whereas the contribution of PMCA pumps is only 6%.