Un nuevo anestésico intravenoso: propofol : evaluación clínica y experimental en el perro

El propofol es un anestésico intravenoso no relacionado químicamente con ningún otro anestésico conocido. La inducción anestésica con propofol es rápida y el mantenimiento puede realizarse, bien mediante infusión continua, bien con dosis de mantenimiento en «bolus», y no presenta efecto acumulativo como ocurre con el tiopental sódico, anestésico muy similar en cuanto a acción anestésica y que sirve de referencia. Puede complementarse con analgésicos opiáceos u óxido nitroso para proporcionar analgesia. Al ser la recuperación anestésica más rápida en comparación con otros agentes anestésicos intravenosos o intramusculares, se reduce la aparición de complicaciones.Propofol is a new intravenous anaesthetic agent chemically unrelated to any other anaesthetic. When propofol is used, anaesthetic induction is fast and maintenance can be achieved by continuous infusion or by incremental doses in «bolus», without the cumulative effect seen with thiopentone, a well known barbiturate with similar anaesthetic activity and used as a reference drug. Complementation with opioids or nitrous oxide can provide adequate analgesia. Compared to other intravenous or intramuscular anaesthetic agents, anaesthetic recovery is fast, reducing the complications associated with more prolonged recoveries

Network-Targeted Approach and Postoperative Resting-State Functional Magnetic Resonance Imaging Are Associated with Seizure Outcome

Objective Postoperative resting‐state functional magnetic resonance imaging (MRI) in children with intractable epilepsy has not been quantified in relation to seizure outcome. Therefore, its value as a biomarker for epileptogenic pathology is not well understood. Methods In a sample of children with intractable epilepsy who underwent prospective resting‐state seizure onset zone (SOZ)‐targeted epilepsy surgery, postoperative resting‐state functional MRI (rs‐fMRI) was performed 6 to 12 months later. Graded normalization of the postoperative resting‐state SOZ was compared to seizure outcomes, patient, surgery, and anatomical MRI characteristics. Results A total of 64 cases were evaluated. Network‐targeted surgery, followed by postoperative rs‐fMRI normalization was significantly (p < 0.001) correlated with seizure reduction, with a Spearman rank correlation coefficient of 0.83. Of 39 cases with postoperative rs‐fMRI SOZ normalization, 38 (97%) became completely seizure free. In contrast, of the 25 cases without complete rs‐fMRI SOZ normalization, only 3 (5%) became seizure free. The accuracy of rs‐fMRI as a biomarker predicting seizure freedom is 94%, with 96% sensitivity and 93% specificity. Interpretation Among seizure localization techniques in pediatric epilepsy, network‐targeted surgery, followed by postoperative rs‐fMRI normalization, has high correlation with seizure freedom. This study shows that rs‐fMRI SOZ can be used as a biomarker of the epileptogenic zone, and postoperative rs‐fMRI normalization is a biomarker for SOZ quiescence

Adressing Chronic Diseases and Healthy Ageing across the Life Cycle (JA-CHRODIS)

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Neprilysin inhibition, endorphin dynamics, and early symptomatic improvement in heart failure : a pilot study

Altres ajuts: This work was supported in part by Fundació La Marató de TV3 (201516-10, 201502-30), Societat Catalana de Cardiologia, "la Caixa" Banking Foundation.Sacubitril/valsartan is a first-in-class angiotensin receptor-neprilysin inhibitor developed for the treatment of heart failure with reduced ejection fraction. Its benefits are achieved through the inhibition of neprilysin (NEP) and the specific blockade of the angiotensin receptor AT1. The many peptides metabolized by NEP suggest multifaceted potential consequences of its inhibition. We sought to evaluate the short-term changes in serum endorphin (EP) values and their relation with patients' physical functioning after initiation of sacubitril/valsartan treatment. A total of 105 patients with heart failure with reduced ejection fraction, who were candidates for sacubitril/valsartan treatment, were included in this prospective, observational, multicentre, and international study. In a first visit, and in agreement with current guidelines, treatment with angiotensin-converting enzyme inhibitors or angiotensin receptor blocker was replaced by sacubitril/valsartan because of clinical indication by the responsible physician. By protocol, patients were reevaluated at 30 days after the start of sacubitril/valsartan. Serum levels of α- (α-EP), γ-Endorphin (γ-EP), and soluble NEP (sNEP) were measured using enzyme-linked immunoassays. New York Heart Association (NYHA) functional class was used as an indicator of patient's functional status. Baseline median levels of circulating α-EP, γ-EP, and sNEP were 582 (160-772), 101 (37-287), and 222 pg/mL (124-820), respectively. There was not a significant increase in α-EP nor γ-EP serum values after sacubitril/valsartan treatment (P value = 0.194 and 0.102, respectively). There were no significant differences in sNEP values between 30 days and baseline (P value = 0.103). Medians (IQR) of Δα-EP, Δγ-EP, and ΔsNEP between 30 days and baseline were 9.3 (−34 − 44), −3.0 (−46.0 − 18.9), and 0 units (−16.4 − 157.0), respectively. In a pre-post sacubitril/valsartan treatment comparison, there was a significant improvement in NYHA class, with 36 (34.3%) patients experiencing improvement by at least one NYHA class category. Δα-EP and ΔsNEP showed to be significantly associated with NYHA class after 30 days of treatment (P = 0.014 and P < 0.001, respectively). Δα-EP was linear and significantly associated with NYHA class improvement after 30 days of sacubitril/valsartan treatment. These preliminary data suggest that beyond the haemodynamic benefits achieved with sacubitril/valsartan, the altered cleavage of endorphin peptides by NEP inhibition may participate in patients' symptoms improvement

Comunicaciones científicas breves y notas geocientíficas

COMUNICACIONES CIENTÍFICAS BREVES: RESÚMENES DEL COLOQUIO SOBRE EL TRIÁSICO-JURÁSICO&nbsp;EN COLOMBIA. LA TECTÓNICA DEL TRIÁSICO - JURÁSICO EN SUDAMÉRICA.&nbsp;Mojica J. PLUTONISMO TRIÁSICO – JURÁSICO&nbsp;EN LA CORDILLERA CENTRAL DE COLOMBIA. González, H.; Núñez, A. TECTÓNICA EXTENSIVA JURÁSICA AL MARGEN CONTINENTAL NORANDINO Y EL ORIGEN DE LA FALLA DE BUCARAMANGA.&nbsp;Kammer, A. EDADES POR TRAZAS DE FISIÓN DE CIRCONES PROVENIENTES DE LA&nbsp;FORMACIÓN SALDAÑA, VALLE SUPERIOR DEL MAGDALENA. Schwabe, E; Toro, G; Kairuz, Ch; Ferreira, P EL GRUPO GIRÓN UNA MOLASA (?) MESOZOICA (?) DE LA CORDILLERA&nbsp;ORIENTAL (?) DE COLOMBIA (?).&nbsp;Cediel, F. ESTRATIGRAFÍA Y GÉNESIS DE LA FORMACIÓN NOREAN:&nbsp;EVIDENCIA DE VOLCANISMO JURÁSICO EN EL VALLE MEDIO&nbsp;DEL RÍO MAGDALENA.&nbsp;Clavijo Torres, J. NOTAS GEOCIENTÍFICAS: SINOPSIS DE LAS ACTIVIDADES DE LA COMISIÓN COLOMBIANA&nbsp;DE ESTRATIGRAFÍA: PERSPECTIVAS PARA SU DESARROLLO.&nbsp;Clavijo Torres, J. &nbsp; &nbsp; &nbsp