Dramatic pain relief and resolution of bone inflammation following pamidronate in 9 pediatric patients with persistent chronic recurrent multifocal osteomyelitis (CRMO)

<p>Abstract</p> <p>Background</p> <p>Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory, non-infectious osteopathy that affects predominantly patients ≤ 18 years of age. There is no uniformly effective treatment. Our objective is to describe clinical, magnetic resonance imaging (MRI), and bone resorption response to intravenous pamidronate in pediatric CRMO.</p> <p>Methods</p> <p>We report our prospectively documented experience with all CRMO patients treated with pamidronate between 2003 and 2008 at a tertiary pediatric centre. Pamidronate was administered as intravenous cycles. The dose of pamidronate varied among subjects but was given as monthly to every 3 monthly cycles depending on the distance the patient lived from the infusion center. Maximum cumulative dose was ≤ 11.5 mg/kg/year. Pamidronate treatment was continued until resolution of MRI documented bone inflammation. Visual analog scale for pain (VAS) and bone resorption marker urine N-telopeptide/urine creatinine (uNTX/uCr) were measured at baseline, preceding each subsequent pamidronate treatment, at final follow-up, and/or at time of MRI confirmed CRMO flare. MRI of the affected site(s) was obtained at baseline, preceding every 2^ndtreatment, and with suspected CRMO recurrence.</p> <p>Results</p> <p>Nine patients (5 F: 4 M) were treated, with a median (range) age at treatment of 12.9 (4.5–16.3) years, and median (range) duration of symptoms of 18 (6–36) months. VAS decreased from 10/10 to 0–3/10 by the end of first 3–day treatment for all patients. The mean (range) time to complete MRI resolution of bone inflammation was 6.0 (2–12) months. The mean (confidence interval (CI)) baseline uNTX/uCr was 738.83 (CI 464.25, 1013.42)nmol/mmol/creatinine and the mean (CI) decrease from baseline to pamidronate discontinuation was 522.17 (CI 299.77, 744.56)nmol/mmol/creatinine. Median (range) of follow-up was 31.4 (24–54) months. Four patients had MRI confirmed CRMO recurrence, which responded to one pamidronate re-treatment. The mean (range) uNTX/uCr change as a monthly rate from the time of pamidronate discontinuation to flare was 9.41 (1.38–19.85)nmol/mmol/creatinine compared to -29.88 (-96.83–2.01)nmol/mmol/creatinine for patients who did not flare by the time of final follow-up.</p> <p>Conclusion</p> <p>Pamidronate resulted in resolution of pain and MRI documented inflammation in all patients. No patient flared while his/her uNTX/uCr remained suppressed. We propose that pamidronate is an effective second-line therapy in persistent CRMO.</p

La imagen latente : Walter Benjamin y la historia del arte

Doctorado en filosofía, mención en estética y teoría del arteLa presente tesis se propone analizar las diversas modulaciones que alcanza en la obra de Walter Benjamin el concepto de «aura», cuyos efectos han sido en general calibrados a partir de las formulaciones expresadas en su famoso ensayo «La obra de arte en la época de su reproductibilidad técnica», y que en esta ocasión son contrastados con un conjunto de textos que, en mayor o menos medida, complejizan esas afirmaciones. En este sentido, se intenta demostrar que el concepto de aura no es un concepto caduco, vinculado a ciertas formas artísticas arcaicas, sino que posee plena actualidad para pensar en general los problemas atingentes a la visualidad moderna y contemporánea, y en particular algunas cuestiones referentes a la historia del arte. A partir de lo anterior, esta tesis establece una serie de cruces entre las nociones de aura, experiencia, imagen e historia, anudándolos en el concepto de «imagen latente», que viene a designar el modo en que lo que Benjamin llama la «historicidad específica» de una obra de arte, adviene a sus condiciones propicias de legibilidad en una época determinadaMarzo 201

Influencia de las enfermedades respiratorias crónicas en el crecimiento y desarrollo

Sin resume

Proyecto de purificacion del agua por medio de filtros lentos de arena para uso domestico

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Efficacy of pamidronate therapy in children with chronic non-bacterial osteitis: disease activity assessment by whole body magnetic resonance imaging

OBJECTIVE: The aim of this study was to describe the efficacy of pamidronate therapy on disease activity in children with chronic non-bacterial osteitis (CNO) using whole body MRI (WB-MRI).METHODS: Clinical assessment and WB-MRI were obtained in 11 children before and after 1 year of pamidronate therapy using a 1.5 T MRI scanner and short tau inversion recovery sequences. The images were reported by a paediatric radiologist.RESULTS: WB-MRI identified 75 lesions in 11 patients; 16 of these lesions had not been detected by clinical examination. Follow-up MRI after 1 year of pamidronate showed complete resolution of inflammation in 45 lesions, moderate improvement in 10 lesions and no change in 20 lesions. Two new lesions developed while on treatment.CONCLUSION: WB-MRI allows a more accurate assessment of the disease extent in CNO than clinical examination alone and is useful in the objective measurement of treatment efficacy. Pamidronate appears to be an effective treatment in children with CNO unresponsive to NSAIDs.</p

Cyclic AMP-dependent protein kinase and mechanical heart function in ventricular hypertrophy induced by pressure overload or secondary to myocardial infarction

The role of cyclic AMP-dependent protein kinase (PKA) and systolic function during the development of left ventricular hypertrophy (LVH) still remain uncertain. The aim of this work is to study PKA activity and mechanical heart function in two experimental heart hypertrophy models: specifically, one induced by pressure overload (Goldblatt model: two kidneys, one clamped, Gb); and another secondary to myocardial infarction (MI) generated by ligation of the left coronary artery. Hypertension in the Gb group becomes evident by the third and fourth week after surgery without any significant change in the corresponding sham group. The myocardial infarction group did not show any change in systolic pressure. Different degrees of LVH for the two experimental models were observed. Relative cardiac mass (RCM) and relative ventricular mass (RVM) increased 23 and 16%, respectively, above the sham-operated rats in MI group (P&lt;0.05). For the pressure overload model, the increase values were 42 an

Actividad plasmática de la enzima convertidora de angiotensina I en población chilena normal y relación con el genotipo inserción/delección (I/D) de la enzima convertidora de angiotensina

El objetivo del estudio fue estimar la prevalencia de los distintos alelos del polimorfismo del gen de la enzima convertidora de angiotensina (ECA), inserción/deserción (I/D) y simultáneamente la actividad de ECA plasmática (pl) asociada en población sana chilena normotensa. 117 sujetos sanos normotensos (entre 45 y 60 años, de nivel socioeconómico medio, no obesos ni diabéticos) fueron seleccionados de un estudio poblacional sobre prevalencia de factores de riesgo de enfermedades crónicas. Las frecuencias de los alelos I y D fueron 0,57 y 0,43 respectivamente. La actividad de ECApl fue en promedio 15,3±3,9 U/mL. Comparado con sujetos con genotipo II, la actividad de ECApl fue significativamente mayor en sujetos con genotipo ID y DD sin diferencias entre ellos. No se observó correlación entre actividad de ECApl y masa VI en ningún sexo ni en los distintos genotipos. El análisis de regresión lineal multivariado (que usó masa VI e índice de masa VI como variables dependientes mostró efectos independientes (p<0,05) del sexo (mayor masa VI en varones) y de la presión diastólica, pero no del genotipo DD. En conclusión, en esta población la presencia del alelo del alelo D del gen de la ECA determina mayor actividad de ECA circulante, lo cual podría estar asociado a mayor morbilidad cardiovascular. En esta población sana normotensa, el sexo masculino y la presión diastólica, pero no la presencia del alelo D, están asociados a mayor masa VI