Periodontitis periapical sintomática y agranulocitosis por analgésicos

Se presentó un caso de agranulocitosis en una paciente de 62 años, atribuible a ingesta continuada de analgésicos sin prescripción, para tratar el dolor debido a periodontitis periapical sintomática. Se realizó tratamiento de conductos radiculares. Dada la escasa incidencia de agranulocitosis por analgésicos a pesar de la frecuente utilización de los mismos, hemos creído de interés su publicación ya que este efecto indeseable puede ser grave o incluso mortal en algún caso. A pesar de conocerse los efectos indeseables de los analgésicos, la automedicación en los pacientes sigue siendo frecuente. Debido al diagnóstico y al tratamiento precoces de la enfermedad, este caso evolucionó favorablemente hasta la total recuperación de la paciente

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Ecological niche and phylogeography elucidate complex biogeographic patterns in Loxosceles rufescens (Araneae, Sicariidae) in the Mediterranean Basin

Background: Understanding the evolutionary history of morphologically cryptic species complexes is difficult, and made even more challenging when geographic distributions have been modified by human-mediated dispersal. This situation is common in the Mediterranean Basin where, aside from the environmental heterogeneity of the region, protracted human presence has obscured the biogeographic processes that shaped current diversity. Loxosceles rufescens (Araneae, Sicariidae) is an ideal example: native to the Mediterranean, the species has dispersed worldwide via cohabitation with humans. A previous study revealed considerable molecular diversity, suggesting cryptic species, but relationships among lineages did not correspond to geographic location. Results: Delimitation analyses on cytochrome c oxidase subunit I identified 11 different evolutionary lineages, presenting two contrasting phylogeographic patterns: (1) lineages with well-structured populations in Morocco and Iberia, and (2) lineages lacking geographic structure across the Mediterranean Basin. Dating analyses placed main diversification events in the Pleistocene, and multiple Pleistocene refugia, identified using ecological niche modeling (ENM), are compatible with allopatric differentiation of lineages. Human-mediated transportation appears to have complicated the current biogeography of this medically important and synanthropic spider. Conclusions: We integrated ecological niche models with phylogeographic analyses to elucidate the evolutionary history of L. rufescens in the Mediterranean Basin, with emphasis on the origins of mtDNA diversity. We found support for the hypothesis that northern Africa was the center of origin for L. rufescens, and that current genetic diversity originated in allopatry, likely promoted by successive glaciations during the Pleistocene. We corroborated the scenario of multiple refugia within the Mediterranean, principally in northern Africa, combining results from eight atmosphereocean general circulation models (AOGCMs) with two different refugium-delimitation methodologies. ENM results were useful for providing general views of putative refugia, with fine-scale details depending on the level of stringency applied for agreement among models

Iatrogènies medicamentoses

Els processos patològics apareguts com a conseqüència d'un acte mèdic s'agrupen sota el terme 'iatrogènia'. En el cas que siguin deguts a l'acció d'un fàrmac, s'anomenen 'iatrogénies medicamentoses', efectes indesitjables o tam- bé reaccions adverses. ..

Nonholonomic Hamilton-Jacobi Theory via Chaplygin Hamiltonization

We develop Hamilton-Jacobi theory for Chaplygin systems, a certain class of nonholonomic mechanical systems with symmetries, using a technique called Hamiltonization, which transforms nonholonomic systems into Hamiltonian systems. We give a geometric account of the Hamiltonization, identify necessary and sufficient conditions for Hamiltonization, and apply the conventional Hamilton-Jacobi theory to the Hamiltonized systems. We show, under a certain sufficient condition for Hamiltonization, that the solutions to the Hamilton-Jacobi equation associated with the Hamiltonized system also solve the nonholonomic Hamilton-Jacobi equation associated with the original Chaplygin system. The results are illustrated through several examples.Comment: Accepted for publication in Journal of Geometry and Physic

Liberación de noradrenalina por reserpina II. Interacción con bretilio en conducto deferente de rata

Desde hace ya algunos años estudiamos en nuestro Departamento la interacción de la reserpina con distintas sustancias que actúan en la presinapsis adrenérgica (simpaticomiméticos indirectos, inhibidores de la MAO, etc.). El bretilio es un bloqueante de la conducción del impulso nervioso que actúa también a nivel presináptico. ..

Liberación de noradrenalina por reserpina I. Interacción con anfetamina y con bretilio en bazo de gato

Continuando con experiencias anteriores ya presentadas en esta Asociación (PLANAS y cols., 1977) sobre la interacción de la reserpina con distintos fármacos, hemos estudiado en esta ocasión las posibles modificaciones del efecto de la reserpina cuando previamente se perfunde el bazo de gato in situ con anfetamina o bretilio. ..

Evidencias farmacológicas de la participación del sistema opioide endógeno en la respuesta inflamatoria local de la pata de la rata

Hemos investigado el papel del sistema opioide endógeno (SOE) en la respuesta inflamatoria inducida por la inyección subplantar (SP) de salino (SS) y carragenina (CA) en la pata trasera de la rata. Se usó naloxona intraperitoneal (IP) para desenmascarar los efectos de los opiáceos endógenos liberados durante la inflamación periférica. Tres grupos de ratas recibieron uno de los siguientes tratamientos SP: SS, CA o ninguna inyección (NI). En condiciones basales y 3 horas después del tratamiento fueron evaluados el umbral del dolor por presión (PPT), el volúmen de la pata (edema) y la temperatura local. En cada grupo fueron también investigados los efectos del vehículo IP, naloxona y (+)-naloxona (0,1 mg/kg). Los grupos SS y CA indujeron una significativa respuesta inflamatoria con hiperalgesia, edema e hiperemia local. La administración IP de naloxona pero no de (+)-naloxona, 15 minutos antes de la prueba, incrementó significativamente el edema en todos los grupos de tratamiento (p< 0,05) sin alterar el PPT o la temperatura local. El ANOVA de dos vías, reveló que el tratamiento y los fármacos, así como sus interacciones tenían un impacto significativo en el edema el cual estaba relacionado con los efectos de la CA y la naloxona. Nuestros hallazgos ilustran la implicación del sistema opioide endógeno a la respuesta fisiológica a la lesión local, regulando la fuga microvascular en los tejidos inflamados

Cost-effectiveness of exercise referral schemes enhanced by self-management strategies to battle sedentary behaviour in older adults: Protocol for an economic evaluation alongside the SITLESS three-armed pragmatic randomised controlled trial

Introduction: Promoting physical activity (PA) and reducing sedentary behaviour (SB) may exert beneficial effects on the older adult population, improving behavioural, functional, health and psychosocial outcomes in addition to reducing health, social care and personal costs. This paper describes the planned economic evaluation of SITLESS, a multicountry three-armed pragmatic randomised controlled trial (RCT) which aims to assess the short-term and long-term effectiveness and cost-effectiveness of a complex intervention on SB and PA in community-dwelling older adults, based on exercise referral schemes enhanced by a group intervention providing self-management strategies to encourage lifestyle change. Methods and analysis: A within-trial economic evaluation and long-term model from both a National Health Service/personal social services perspective and a broader societal perspective will be undertaken alongside the SITLESS multinational RCT. Healthcare costs (hospitalisations, accident and emergency visits, appointment with health professionals) and social care costs (eg, community care) will be included in the economic evaluation. For the cost-utility analysis, quality-adjusted life-years will be measured using the EQ-5D-5L and capability well-being measured using the ICEpop CAPability measure for Older people (ICECAP-O) questionnaire. Other effectiveness outcomes (health related, behavioural, functional) will be incorporated into a cost-effectiveness analysis and cost-consequence analysis. The multinational nature of this RCT implies a hierarchical structure of the data and unobserved heterogeneity between clusters that needs to be adequately modelled with appropriate statistical and econometric techniques. In addition, a long-term population health economic model will be developed and will synthesise and extrapolate within-trial data with additional data extracted from the literature linking PA and SB outcomes with longer term health states. Methods guidance for population health economic evaluation will be adopted including the use of a long-time horizon, 1.5% discount rate for costs and benefits, cost consequence analysis framework and a multisector perspective. Ethics and dissemination: The study design was approved by the ethics and research committee of each intervention site: the Ethics and Research Committee of Ramon Llull University (reference number: 1314001P) (Fundació Blanquerna, Spain), the Regional Committees on Health Research Ethics for Southern Denmark (reference number: S-20150186) (University of Southern Denmark, Denmark), Office for Research Ethics Committees in Northern Ireland (ORECNI reference number: 16/NI/0185) (Queen’s University of Belfast) and the Ethical Review Board of Ulm University (reference number: 354/15) (Ulm, Germany). Participation is voluntary and all participants will be asked to sign informed consent before the start of the study. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement number 634 270. This article reflects only the authors' view and the Commission is not responsible for any use that may be made of the information it contains. The findings of the study will be disseminated to different target groups (academia, policymakers, end users) through different means following the national ethical guidelines and the dissemination regulation of the Horizon 2020 funding agency. Use of the EuroQol was registered with the EuroQol Group in 2016. Use of the ICECAP-O was registered with the University of Birmingham in March 2017. Trial registration number: NCT02629666; Pre-results