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Background: Obesity in children and adolescents has increased exponentially around the world. Furthermore, the COVID-19 pandemic has led to a higher pediatric obesity rate. The excess adipose tissue generates a dysregulation of adiponectin, ghrelin, and leptin, among others. Metabolic alterations can develop cardiovascular disease, dyslipidemias, arterial hypertension, type 2 diabetes mellitus, nonalcoholic fatty liver disease, sleep disorders, and higher risk of COVID-19 severity. Obesity has different therapeutic approaches such as behavioral weight loss programs, pharmacologic treatments, and surgical procedures. Therefore, timely diagnosis and treatment are important to decrease the mortality in obesity among pediatric population.

The 3a-hydroxymasticadienoic compound (3-HM) was evaluated as a corrosion inhibitor in presence of chlorides using Electrochemical Impedance Spectroscopy (EIS). The results obtained showed the best concentration is 50 ppm with an inhibition efficiency of 68.4% for sterling silver. This organic molecule exhibits anodic-like behavior as an inhibitor. 3-HM acid inhibition is maintained up to 480 hours with 88.86% efficiency. Finally, the type of adsorption is of the combined type according to the Langmuir model.

To date, there is a lack of information about the optimal conditions of the warm-up to lead to a better performance in elite tennis players. The aim of this study was to compare the effects of two different warm-up protocols (dynamic vs. self-myofascial release with foam rolling) on neuromuscular variables associated with physical determinants of tennis performance. Using a crossover randomised experimental design, eleven professional men tennis players (20.6 ± 3.5 years) performed either a dynamic warm-up (DWU) or a selfmyofascial release with foam rolling (SMFR) protocol. DWU consisted of 8 min of dynamic exercises at increasing intensity and SMFR consisted of 8 min of rolling on each lower extremity unilaterally. Just before (baseline) and after completing warm-up protocols, players performed a countermovement jump (CMJ), the 5-0-5 agility test, a 10-m sprint test and the Straight Leg Raise and Thomas tests to assess range of motion. Compared to baseline, the DWU was more effective to reduce the time in the 5-0-5 test than SMFR (-2.23 vs. 0.44%, respectively, p = 0.042, ηp2 = 0.19). However, both warm-up protocols similarly affected CMJ (2.32 vs. 0.61%, p = 0.373, ηp2 = 0.04) and 10-m sprint time changes (-1.26 vs. 1.03%, p = 0.124, ηp2 = 0.11). Changes in range of motion tests were also similar with both protocols (p = 0.448–1.000, ηp2 = 0.00–0.02). Overall, both DWU and SMFR were effective to prepare well-trained tennis players for highly demanding neuromuscular actions. However, DWU offered a better preparation for performing change of direction and sprint actions, and hence, in high-performance tennis players, the warm-up should include dynamic exercises. post-print 402 KB

INTRODUCTION: Frailty predicts functional decline and could be associated with adverse outcomes such as disability, multiple hospitalizations, falls, loss of mobility, and cardiovascular disease. In Colombia 12.5% of prevalence has been reported. In the present study, the different clinical variables associated with frailty were evaluated in a population of hospitalized patients older than 65 years in Bucaramanga, Colombia, in order to predict the behavior of these variables to generate measurement tools of greater applicability than that of currently existing tools. METHODS: An analytical observational cross-sectional study with non-probabilistic sampling was conducted from January 2016 to June 2017 in patients older than 65 years of follow-up >48 hours by the internal medicine service. Fried criteria were used to evaluate patients on their last day of hospitalization. RESULTS: A total of 155 patients were included, of whom 60.6% were frail. A combined analysis of the variables that showed association with frailty revealed that a calf circumference lower than or equal to 31 cm, a gait speed lower than or equal to 0.8 m/s, and age above 75 years were associated with frailty. It was also shown that being male and having a BMI >27 kg/m2 are protective factors for frailty. CONCLUSIONS: The prevalence of frailty in hospitalized older adults was higher than that reported in local studies for the community population. According to multivariate analysis, the variables, when analyzed together, have a predictive ability of 92% to estimate frailty in hospitalized patients.

Objectives: (1) To estimate the prevalence, geographic distribution, and demographic characteristics of patients diagnosed with mental and behavioral disorders due to the use of opioids in Colombia, between 2009 and 2018. (2) To describe the opioid sales trends in Colombia over the last few years. Methods: We conducted an observational study analyzing information from Individual National Registry of Health Services and the Colombian official database for pharmaceuticals prices and quantities sold. The included ICD-10 codes were mental and behavioral disorders due to the use of opioids (F11) codes subdivisions. Results: 12,557 cases of mental and behavioral disorders due to opioid use were reported, with a rate of 3.0 per 100,000 inhabitants for the studied period. Men represented 74.2 percent, with a male:female ratio of 2.9:1. The highest prevalence was found between 20 and 24 years, in the northwest Colombian area. A progressive increase in the total number of opioid units sold during the study period was found, and the most frequently sold opioids were tramadol (55 percent) and codeine (20 percent). Conclusions: Recognition of opioid use disorders has increased in the last 10 years; it affects more males than females, mostly young adults, and is higher in certain affluent regions of Colombia. We found a progressive annual increase in the sales of opioids in the country, which could be related to the increase in the rate of registries. Studies that have analyzed opioid abuse in Latin America are limited, and further studies are needed to evaluate this situation in middle-income countries from the region.

Brain Health is defined as the development and preservation of optimal brain integrity and neural network functioning for a given age. Recent studies have related healthy habits with better maintenance of brain health across the lifespan. As a part of the Barcelona Brain Health Initiative (BBHI), a mHealth platform has been developed with the purpose of helping people to improve and monitor their healthy habits, facilitating the delivery of health coaching strategies. A decision support system (DSS), named Intelligent Coaching Assistant (ICA), has been developed to ease the work of professional brain health coaches, helping them design and monitor adherence to multidomain interventions in a more efficient manner. Personalized recommendations are based on users’ current healthy habits, individual preferences, and motivational aspects. Taking these inputs, an initial user profile is defined, and the ICA applies an algorithm for determining the most suitable personalized intervention plan. An initial validation has been done focusing on assessing the feasibility and usability of the solution, involving 20 participants for three weeks. We conclude that this kind of technology-based intervention is feasible and implementable in real-world settings. Importantly, the personalized intervention proposal generated by the DSS is feasible and its acceptability and usability are high.

Total knee replacement is a painful surgical procedure. The inadequate control of postoperative pain is associated with adverse outcomes in the short and long term. Continuous femoral block has been shown to be effective and efficient as part of multimodal analgesia. This series of 48 patients who underwent total knee replacement, who received multimodal analgesic treatment including continuous femoral nerve block, documents the pain control profile during the first 48 hours. This is a successful experience of implementing regional techniques as part of perioperative pain relief, as documented in the literature. We emphasize that each institution must know its technical and human resource and characterize its patients, in order to implement multimodal analgesia protocols that include this regional technique. We also suggest to monitor and implement continuous improvement processes.

Leukemoid reaction is defined by a leukocyte level above 50 x 103/µL with a predominance of mature neutrophils and the presence of immature granulocytic forms in the peripheral blood (left shift). We report a case of a 36-year-old woman with severe coronavirus disease 2019 (COVID-19) infection admitted to the ICU with a leukocytosis of 70.9 x 103/µL white blood cells (WBC) throughout her hospitalization. A left shift with bandemia along with toxic granulations was also noticed and further investigation excluded more commonly known causes. A presumptive diagnosis of leukemoid reaction was made secondary to COVID-19 infection; however, it could not be confirmed since workup for lymphoproliferative disorders could not be performed as the patient passed away. The leukemoid reaction could be associated with severe COVID-19 infection; however, more data are needed to evaluate this association.

Posterior reversible encephalopathy syndrome (PRES) is a neurological syndrome characterized by acute encephalopathy due to different medical conditions. This syndrome may present with a wide spectrum of neurological symptoms including headache, disorders of consciousness, visual changes, seizures, and focal neurological deficits, in addition to nonspecific symptoms such as nausea and vomiting. Neuroimaging findings of bilateral cortical and subcortical brain edema involving the parieto-occipital regions are a hallmark of the disease. We present a case report of an eight-year-old boy who complained of headache and vomiting for 20 days until the discovery of severely high blood pressure (BP). He developed altered mental status, hemiplegia, loss of visual field, and seizure, requiring transfer to the intensive care unit. Magnetic resonance imaging of the brain showed hyperintense signals in the bilateral cortical and subcortical parieto-occipital areas. The BP measure of the extremities recognized a hypertensive upper extremity and normotensive lower extremity, and an MRI angiography was consistent with coarctation of the aorta (CoA). The fundoscopic exam showed no abnormalities. The diagnosis was kept as PRES secondary to a hypertensive emergency. Later, stenting of the aorta was performed, improving overall symptoms leaving a sequel loss of peripheral vision.

Serrated polyposis syndrome (SPS) implies a slightly elevated risk of colorectal cancer (CRC) during endoscopic follow-up, but its natural course is still not well known. The main objective of this study was to describe the long-term risk of developing advanced neoplasia (AN) in these patients. Until October 2020, individuals who fulfilled 2010 WHO criteria I and/or III for SPS were retrospectively recruited. We selected those under endoscopic surveillance after resection of all lesions &gt, 3 mm in a high-quality colonoscopy. We excluded patients with total colectomy at diagnosis and those with any interval between colonoscopies &gt, 3.5 years. We defined AN as advanced serrated polyp (≥10 mm and/or with dysplasia), advanced adenoma, or CRC. In 109 patients, 342 colonoscopies were performed (median = 3, median interval = 1.8 years) during a median follow-up after colonic clearance of 5.0 years. Five-year cumulative incidences of AN were 21.6% globally, and 5.6%, 10.8%, and 50.8% in patients who fulfilled criterion I, III, and both, respectively (p &lt, 0.001). No CRC was diagnosed and only 1 (0.9%) patient underwent surgery. In conclusion, cumulative incidences of AN could be lower than previously described, at least in patients who fulfil the 2010 WHO criterion III alone. Therefore, low-risk individuals might benefit from less stringent surveillance.

Hiccups are involuntary, spasmodic contractions of the diaphragm and intercostal muscles and can be classified as acute (< 48 h), persistent (48 h to a month) or intractable (> 1 month). A previously healthy 29-year-old man sought the Emergency Department with flu-like symptoms and a two-day history of persistent hiccups. His physical examination was otherwise unremarkable and vital signs were within normal limits. An unenhanced computed tomography scan of the chest showed small focal ground-glass opacities scattered throughout 25% of the lungs. A COVID-19 test was positive. Chlorpromazine was prescribed for the hiccups with improvement over 10 h. The patient was discharged home on the same day without hiccups and no other complications.

Post-exercise microcurrent based treatments have shown to optimise exercise-induced adaptations in athletes. We compared the effects of endurance training in combination with either, a microcurrent or a sham treatment, on endurance performance. Additionally, changes in body composition, post-exercise lactate kinetics and perceived delayed onset of muscle soreness (DOMS) were determined. Eighteen males (32.8 ± 6.3 years) completed an 8-week endurance training programme involving 5 to 6 workouts per week wearing a microcurrent (MIC, n=9) or a sham (SH, n=9) device for 3-h post-workout or in the morning during non-training days. Measurements were conducted at pre- and post-intervention. Compared to baseline, both groups increased (P

Background There is an increasing interest in the use of eccentric muscle exercise to improve physical condition, especially with regards to its health-related benefits. However, it is known that unaccustomed eccentric exercise causes muscle damage and delayed pain, commonly defined as “delayed onset muscle soreness” (DOMS). The efficacy of herbal preparations in subjects suffering from DOMS has been reported in a few previous studies with small or moderate outcome measures related to muscle recovery. The present study aimed to evaluate the effects of a polyherbal mixture containing whole Zingiber officinale Roscoe and Bixa orellana L., powders called ReWin(d), in young male athletes suffering from DOMS induced by a 1 h session of plyometric exercises. Methods Thirty-three young male athletes participated in this randomized, Triple-blind, placebo-controlled trial: 17 of them assigned to the ReWin(d) group and 16 of them to the placebo group. Creatine kinase (CK) was measured as a muscle damage marker, pain was assessed using the Visual Analog Scale (VAS), muscle performance was measured through half-squat exercise (HS) monitored with an accelerometer (Encoder), and heart rate variability (HRV) was monitored for 5 min with the subjects in the supine position. All determinations were performed before and after the eccentric session and 24, 48, and 72 h after the session. Results The eccentric exercise session caused an increase in CK at 24 and 48 h after exercise intervention in both groups (p < 0.001). There was no interaction between groups regarding muscle damage. The pain increased after the training session in both groups (p < 0.001), and a significant interaction was observed between groups at 48 h after exercise (p = 0.004). Lower limb muscular power showed a significant interaction between groups 24 h after exercise (p = 0.049); the placebo group showed a reduction in muscle power compared to the ReWin(d) group. The LF/HF ratio decreased significantly at 72 h after exercise in the herbal group but not in the placebo group. Conclusion The herbal supplement maintained the maximum power of the lower limbs and attenuated muscle pain. Natural Origins PO_8_7_2019 4.566 JCR (2020) Q1, 14/81 Physiology 1.320 SJR (2020) Q2, 45/178 Physiology No data IDR 2019 UEM

El cacao rico en flavonoides tiene efectos positivos en el metabolismo de lípidos y podría mejorar el rendimiento en atletas a través de la mejora de su composición corporal. Se llevó a cabo un estudio de intervención controlado por placebo en atletas de resistencia que recibieron 5 g de cacao al día (425 mg de flavanoles) durante 10 semanas. Se midió ingesta dietética, composición corporal, rendimiento deportivo y niveles plasmáticos de follistatina, miostatina y leptina. La ingesta de cacao redujo significativamente el porcentaje de grasa corporal (p = 0,020), específicamente en el tronco (p = 0,022), área visceral (p = 0,034) y miembros inferiores (p = 0.004). La reducción de la masa grasa corporal fue acompañada por un aumento de follistatina plasmática y una disminución de leptina, mientras que los niveles de miostatina se mantuvieron sin cambios. La ingesta de cacao redujo el porcentaje de grasa corporal de los atletas, sin ningún impacto en el rendimiento de los atletas. Flavanols-rich cocoa has positive effects on lipid metabolism and might enhance the performance of athletes through an improvement in their body composition. To test this hypothesis a placebo-controlled intervention study in training endurance athletes who received 5 g of cocoa daily (425 mg of flavanols) for 10 weeks was performed. Dietary intake, body composition, exercise performance, and plasma levels of follistatin, myostatin, and leptin were measured. Cocoa intake significantly reduced body fat percentage (p = 0.020), specifically in the trunk (p = 0.022), visceral area (p = 0.034) and lower limbs (p = 0.004). The reduction in body fat mass was accompanied by an increase in plasma follistatin and a decrease in leptin, while myostatin levels remained unchanged. The intake of cocoa reduced the percentage of body fat of athletes, without any impact on athletes' performance. The change in fat body composition did not improve athletes' performance. Ministerio de Economía y Competitividad (Proyecto AGL2016-77288-R) Programa de Becas Ramón y Cajal (2012_11910) Ministerio de Educación, Cultura y Deporte (Beca FPU 2016/01110) 5.396 JCR (2020) Q1, 22/144 Food science & Technology 1.145 SJR (2020) Q1, 38/332 Food Science No data IDR 2019 UEM

The aim of this study was to evaluate changes in electromyographic activity with the use of gradual compression stockings (GCSs) on middle-distance endurance athletes&rsquo, performance, based on surface electromyography measurement techniques. Sixteen well-trained athletes were recruited (mean &plusmn, SD: age 33.4 &plusmn, 6.3 years, VO2max 63.7 &plusmn, 6.3 mL&middot, kg&minus, 1&middot, min&minus, 1, maximal aerobic speed 19.7 &plusmn, 1.5 km&middot, h). The athletes were divided into two groups and were assigned in a randomized order to their respective groups according to their experience with the use of GCSs. Initially, a maximum oxygen consumption (VO2max) test was performed to standardize the athletes&rsquo, running speeds for subsequent tests. Afterward, electromyographic activity, metabolic, and performance variables for each group were measured with surface electromyography. In addition, blood lactate concentration was measured, both with and without GCSs, during 10 min at 3% above VT2 (second ventilatory threshold), all of which were performed on the track. Next, surface electromyography activity was measured during a 1 km run at maximum speed. No significant changes were found in electromyography activity, metabolic and performance variables with GCSs use (p &gt, 0.164) in any of the variables measured. Overall, there were no performance benefits when using compression garments against a control condition.

Beetroot juice (BJ) contains high levels of inorganic nitrate (NO3&minus, ) and its intake has good evidence in increasing blood nitrate/nitrite concentrations. The ingestion of BJ has been associated with improvements in physical performance of endurance sports, however the literature in intermittent sports is scarce. The aim of this study was to investigate whether BJ could improve physical performance in tennis players. Thirteen well-trained tennis players (25.4 &plusmn, 5.1 years) participated in the study during their preparatory period for the tennis season. Subjects were randomly divided into two groups and performed a neuromuscular test battery after either BJ or placebo (PLA) consumption. Both trials were executed on two separate days, in randomized order, with one week of wash out period. The test battery consisted of serve velocity test (SVT), countermovement jump (CMJ), isometric handgrip strength (IHS), 5-0-5 agility test (5-0-5), and 10 m sprint (10-m). No significant differences were found in SVT (1.19%, p = 0.536), CMJ (0.96%, p = 0.327), IHS (4.06%, p = 0.069), 5-0-5 dominant and nondominant side (1.11&ndash, 2.02%, p = 0.071&ndash, 0.191) and 10-m (1.05%, p = 0.277) when comparing BJ and PLA ingestion. Thus, our data suggest that low doses of BJ (70 mL) consumption do not enhance tennis physical performance.

OBJECTIVE: To evaluate the profile of antibiotic consumption and its impact on bacterial resistance in a university hospital in Para State, Northern Brazil, from 2012 to 2016. MATERIALS AND METHODS: A total of 279 blood cultures from adult patients, both sexes, admitted to wards and Intensive Care Unit (ICU), were selected for further analysis of clinical specimen culture results. RESULTS: Primary bloodstream infections accounted for 60.2% of the total. Gram-negative bacilli (GNB) were the most frequent microorganisms (51.3%), of which the fermenters were resistant to ceftazidime (83.0%) and cefepime (76.1%). Staphylococcus aureus resistance to clindamycin and oxacillin reached 57.4% and 48.9%, respectively. There was a statistically significant reduction in overall consumption of piperacillin + tazobactam and vancomycin. In ICU, there was reduction in ceftriaxone, oxacillin, piperacillin + tazobactam and vancomycin consumption and increase in amikacin and meropenem consumption (all statistically significant). Fermentative GNB and S. aureus showed a positive and nonlinear correlation between the increase of resistance rates and cefepime and oxacillin consumption, respectively. CONCLUSION: Antimicrobial consumption and its impact on bacterial resistance varied over the study period, highlighting the positive and nonlinear correlation between increased cefepime and oxacillin consumption and the recrudescence of fermenting BGN strains and resistant S. aureus strains, respectively.

The aim of this work was to study effects of ketotifen fumarate (KF) on prevention of tissue damage in testes of rats with experimental autoimmune orchitis (EAO) and on the contralateral testis in a model of prolonged testicular cord torsion (TCT). Rats with EAO or TCT were injected intraperitoneally once daily with KF or saline solution (vehicle group). Incidence and severity of testicular damage were evaluated by histopathology using an EAO score or a Johnsen score. Mast cells (MC) were identified by histochemistry and quantified. In EAO model, KF significantly reduced severity of histopathological testicular damage compared to rats in the vehicle group. KF also reduced the number of testicular MC compared to vehicle group. Similarly, in TCT model, multifocal damage of the contralateral testis was observed 30 days after testicular torsion characterized by sloughing of the germinal epithelium, seminiferous tubule atrophy, and interstitial edema. Focal signs of inflammation and fibrosis of seminiferous tubular walls were also observed. In contrast, sections of contralateral testis of rats injected with KF and killed 30 days after surgery showed normal histological features. A significant decrease in the number of MC was observed in rats treated with KF compared to untreated animals. In conclusion, we demonstrated that treatment with KF reduced testicular inflammatory process and MC infiltrates in both EAO and TCT models. The results suggest a promising treatment for infertile male patients with testicular pathologies associated with inflammation and germ cell loss. Fil: Moreno, Diego Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas; Argentina Fil: Sobarzo, Cristian Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas; Argentina Fil: Lustig, Livia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas; Argentina Fil: Rodriguez Peña, Marcelo Javier. Ministerio de Defensa. Ejercito Argentino. Hospital Militar Campo de Mayo Cirujano Primero Doctor Juan Madera; Argentina Fil: Guazzone, Vanesa Anabella. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas; Argentina

To determine the effect of circadian rhythm on neuromuscular responses and kinematics related to physical tennis performance, after a standardised warm-up, 13 highly competitive male tennis players were tested twice for serve velocity/accuracy (SVA), countermovement vertical jump (CMJ), isometric handgrip strength (IS), agility T-test (AGIL) and a 10-m sprint (10-m RUN). In a randomised, counter-balance order, tennis players underwent the test battery twice, either in the morning (i.e., AM; 9:00 h) and in the afternoon (i.e., PM; 16:30 h). Paired t-tests were used to analyse differences due to time-of-day in performance variables. Comparison of morning versus afternoon testing revealed that SVA (168.5 ± 6.5 vs. 175.2 ± 6.1 km · h−1; P = 0.003; effect size [ES] = 1.07), CMJ (32.2 ± 0.9 vs. 33.7 ± 1.1 cm; P = 0.018; ES = 1.46), AGIL (10.14 ± 0.1 vs. 9.91 ± 0.2 s; P = 0.007; ES = 1.23) and 10-m RUN time (1.74 ± 0.1 vs. 1.69 ± 0.1 s; P = 0.021; ES = 0.67) were significantly blunted during the morning testing. However, IS was not affected by time-of-day (P = 0.891). Thus, tennis performance may be reduced when competing in the morning in comparison to early evening. Therefore, coaches and tennis players should focus on schedule the SVA, power, speed and agility training sessions in the afternoon. Sin financiación 2.733 JCR (2017) Q1, 19/81 Sport Sciences 1.127 SJR (2017) Q1, 43/285 Orthopedics and Sports Medicine, 23/201 Physical Therapy, Sports Therapy and Rehabilitation; Q2, 33/127 Sports Science No data IDR 2017 UEM

International audience; The objectives of this study were to determine (i) whether Chlamydia (C) abortus would adhere to the intact zona pellucida (ZP-intact) of early in vitro produced bovine embryos; (ii) whether the bacteria would adhere to the embryos (ZP-free) after in vitro infection; and (iii) the efficacy of the International Embryo Transfer Society (LETS) washing protocol.The experimentation was made twice. For each replicate 100 (8-16-cell) bovine embryos produced in vitro were randomly divided into 10 batches. Height batches (4 ZP-intact and 4 ZP-free) of 10 embryos were incubated in a medium containing 4 x 10(7) Chlamydia/ml of AB7 strain. After incubation for 18 h at 37 degrees C in an atmosphere of 5% CO2, the embryos were washed in accordance with the LETS guidelines. In parallel, two batches (1 ZP-intact and 1 ZP-free) of 10 embryos were subjected to similar procedures but without exposure to C abortus as a control group. The 10 washing fluids from each batch were collected and centrifuged for 1 h at 13,000 xg. Each batch of washed embryos and each wash pellets were tested using PCR.C abortus DNA was found in all ZP-intact and ZP-free batches of 10 embryos after 10 successive washes. For ZP-intact infected embryos, Chlamydia-DNA was also detected in all 10 wash baths for two batches (2/8) of embryos, whereas for ZP-free infected embryos, Chlamydia-DNA was detected in all 10 wash baths for 6/8 batches of embryos. In contrast, none of the embryos or their washing fluids in the control batches was DNA positive. The bacterial load for batches of 10 embryos after the 10 wash baths was significantly higher for batches of ZP-free embryos (20.7 +/- 9 x 10(3) bacteria/mL) than for batches of ZP-intact embryos (0.47 +/- 0.19 x 10(3) bacteria/mL).These results demonstrate that C. abortus adheres to the ZP as well as the early embryonic cells of in vitro produced bovine embryos after in vitro infection, and that the standard washing protocol recommended by the LETS fails to remove it.

Internal training load refers to the degree of disturbance in psychophysiological homeostasis provoked by a training session and has been traditionally measured through session-RPE, which is the product of the session Rate of Perceived Exertion (RPE) and the duration. External training load refers to the actual physical work completed, and depends on session volume, intensity, frequency and density. Drafting, which is achieved by running closely behind another runner has been demonstrated to reduce the energy cost of running at a fixed speed and to improve performance. Therefore, it is hypothesised that psychophysiological responses might reflect different levels of internal load if training is performed individually or collectively. 16 elite middle-distance runners performed two high-intensity training sessions consisting of 4 repetitions of 500 m separated by 3 min of passive recovery. Sessions were performed individually and collectively. Times for each repetition, RPE, core affect (valence and felt arousal) and blood lactate concentrations [BLa] were measured after each repetition. Main time effect was significant and increased across repetitions for [BLa] and RPE (p

Despite a wide number of toxicological studies that describe benzo[a]pyrene (BaP) effects, the metabolic mechanisms that underlie these effects in fish are largely unknown. Of great concern is the presence of BaP in aquatic systems, especially those in close proximity to human activity leading to consumption of potentially contaminated foods. BaP is a known carcinogen and it has been reported to have adverse effects on the survival, development and reproduction of fish. The purpose of this study was to investigate if a low dose of BaP can alter genes and key metabolic pathways in the liver and testis in male adult tilapia, and whether these could be associated with biological endpoints disruption. We used both high-throughput RNA-Sequencing to assess whole genome gene expression following repeated intraperitoneal injections of 3 mg/kg of BaP (every 6 days for 26 days) and morphometric endpoints as indicators of general health. Condition factor (K) along with hepatosomatic and gonadosomatic indices (morphometric parameters) were significantly lower in BaP-treated fish than in controls. BaP exposure induced important changes in the gene expression pattern in liver and testis as revealed by both Pathway and Gene Ontology (GO) analyses. Alterations that were shared by both tissues included arachidonic acid metabolism, androgen receptor to prostate-specific antigen signaling, and insulin-associated effects on lipogenesis. The most salient liver-specific effects included: biological processes involved in detoxification, IL6-associated insulin resistance, mTOR hyperactivation, mitotic cytokinesis, spindle pole and microtubule binding. BaP effects that were confined to the testis included: immune system functions, inflammatory response, estrogen and androgen metabolic pathways. Taken together, gene expression and morphometric end point data indicate that the reproductive success of adult male tilapia could be compromised as a result of BaP exposure. These results constitute new insights on the mechanism of action of low dose BaP in a non-model organism (tilapia).

Nutritional supplements are popular among athletes to improve performance and physical recovery. Protein supplements fulfill this function by improving performance and increasing muscle mass; however, their effect on other organs or systems is less well known. Diet alterations can induce gut microbiota imbalance, with beneficial or deleterious consequences for the host. To test this, we performed a randomized pilot study in cross-country runners whose diets were complemented with a protein supplement (whey isolate and beef hydrolysate) (n = 12) or maltodextrin (control) (n = 12) for 10 weeks. Microbiota, water content, pH, ammonia, and short-chain fatty acids (SCFAs) were analyzed in fecal samples, whereas malondialdehyde levels (oxidative stress marker) were determined in plasma and urine. Fecal pH, water content, ammonia, and SCFA concentrations did not change, indicating that protein supplementation did not increase the presence of these fermentation-derived metabolites. Similarly, it had no impact on plasma or urine malondialdehyde levels; however, it increased the abundance of the Bacteroidetes phylum and decreased the presence of health-related taxa including Roseburia, Blautia, and Bifidobacterium longum. Thus, long-term protein supplementation may have a negative impact on gut microbiota. Further research is needed to establish the impact of protein supplements on gut microbiota. Cátedra Real Madrid-UEM project 2016/RM05 Ramón y Cajal grant 2012_11919 4.171 JCR (2018) Q1, 16/87 Nutrition & Dietetics 1.493 SJR (2018) Q1, 16/327 Food Science, 16/128 Nutrition and Dietetics No data IDR 2018 UEM

Purpose: To compare the absolute and relative training load of the Marathon (42k) and the Ironman (IM) training in recreational trained athletes. Methods: Fifteen Marathoners and Fifteen Triathletes participated in the study. Their performance level was the same relative to the sex's absolute winner at the race. No differences were presented neither in age, nor in body weight, height, BMI, running VO2max max, or endurance training experience (p > 0.05). They all trained systematically for their respective event (IM or 42k). Daily training load was recorded in a training log, and the last 16 weeks were compared. Before this, gas exchange and lactate metabolic tests were conducted in order to set individual training zones. The Objective Load Scale (ECOs) training load quantification method was applied. Differences between IM and 42k athletes' outcomes were assessed using Student's test and significance level was set at p < 0.05. Results: As expected, Competition Time was significantly different (IM 11 h 45 min ± 1 h 54 min vs. 42k 3 h 6 min ± 28 min, p < 0.001). Similarly, Training Weekly Avg Time (IM 12.9 h ± 2.6 vs. 42k 5.2 ± 0.9), and Average Weekly ECOs (IM 834 ± 171 vs. 42k 526 ± 118) were significantly higher in IM (p < 0.001). However, the Ratio between Training Load and Training Time was superior for 42k runners when comparing ECOs (IM 65.8 ± 11.8 vs. 42k 99.3 ± 6.8) (p < 0.001). Finally, all ratios between training time or load vs. Competition Time were superior for 42k (p < 0.001) (Training Time/Race Time: IM 1.1 ± 0.3 vs. 42k 1.7 ± 0.5), (ECOs Training Load/Race Time: IM 1.2 ± 0.3 vs. 42k 2.9 ± 1.0). Conclusions: In spite of IM athletes' superior training time and total or weekly training load, when comparing the ratios between training load and training time, and training time or training load vs. competition time, the preparation of a 42k showed to be harder. Sin financiación 3.394 JCR (2017) Q1, 20/83 Physiology 1.590 SJR (2017) Q1, 41/191 Physiology, 23/107 Physiology (medical) No data IDR 2017 UEM

Parasitic diseases are a public health problem affecting millions of people worldwide. One of the scaffolds used in several drugs for the treatment of parasitic diseases is the benzimidazole moiety, a heterocyclic aromatic compound. This compound is a crucial pharmacophore group and is considered a privileged structure in medicinal chemistry. In this study, the benzimidazole core served as a model for the synthesis of a series of 2-(2-amino-5(6)-nitro-1H-benzimidazol-1-yl)-N-arylacetamides 1–8 as benznidazole analogues. The in silico pharmacological results calculated with PASS platform exhibited chemical structures highly similar to known antiprotozoal drugs. Compounds 1–8 when evaluated in silico for acute toxicity by oral dosing, were less toxic than benznidazole. The synthesis of compounds 1–8 were carried out through reaction of 5(6)-nitro-1H-benzimidazol-2-amine (12) with 2-chlroactemides 10a–h, in the presence of K2CO3 and acetonitrile as solvent, showing an inseparable mixture of two regioisomers with the -NO2 group in position 5 or 6 with chemical yields of 60 to 94%. The prediction of the NMR spectra of molecule 1 coincided with the experimental chemical displacements of the regioisomers. Comparisons between the NMR prediction and the experimental data revealed that the regioisomer endo-1,6-NO2 predominated in the reaction. The in vitro antiparasitic activity of these compounds on intestinal unicellular parasites (Giardia intestinalis and Entamoeba histolytica) and a urogenital tract parasite (Trichomonas vaginalis) were tested. Compound 7 showed an IC50 of 3.95 μM and was 7 time more active against G. intestinalis than benznidazole. Compounds 7 and 8 showed 4 times more activity against T. vaginalis compared with benznidazole.

Anthropogenic drivers and global warming are altering the occurrence of infectious marine diseases, some of which produce mass mortalities with considerable ecosystemic and economic costs. The Mediterranean Sea is considered a laboratory to examine global processes, and the fan mussel Pinna nobilis a sentinel species within it. Since September 2016, fan mussels suffer a die-off, very likely provoked by the protozoan Haplosporidium pinnae. Population dynamic surveys, rescue programmes, larvae collector installation and protection of infected adults from predators, have increased knowledge about the factors conditioning the spread of the die-off; previous model simulations indicate that water temperature and salinity seem to be related to the manifestation of the disease, which at the end are strongly influenced by climate change and anthropogenic actions. The absence of natural recruitment implies that fan mussel populations are not recovering, but the survival of populations living in paralic environments provides an opportunity to study the disease and its conditioning factors. The fan mussel disease outbreak provides a case example for how climate change may mediate host-protozoan dynamics and poses several questions: are we witnessing the potential extinction of a sentinel species? Can we avoid it by applying active measures? If so, which measures will be more effective? How many other more overlooked species might experience a massive and unnoticed die-off before it is too late to implement any preservation action? This is especially relevant because the loss of keystone species can drive to community effects that influence marine ecosystem processes., This research was partially funded by the Spanish Ministry for the Ecological Transition, project 28-5310 “Rescate de 215 ejemplares de nacra (Pinna nobilis) y su mantenimiento en 5 centros especializados en el marco del Proyecto UFE IP-PAF INTEMARES (LIFE15 IPE ES 012)”, “Gestión integrada, innovadora y participativa de la Red Natura 2000 en el medio marino español” as well as those agreements and contracts with the participating entities (IFAPA, IRTA, IEO) derived from this project, and by the Prince Albert II of Monaco Foundation to project BF/HEM 15-1662, “The study, protection and possible breeding of pen shell (Pinna nobilis) in the Boka Kotorska Bay”. Maite Vázquez-Luis was supported by the postdoctoral contract, Juan de la Cierva-Incorporación (IJCI-2016-29329) of Ministerio de Ciencia, Innovación y Universidades. G. Catanese was supported by a research contract from the INIA-CCAA (DOC INIA 8/2013) MINECO programme. The M. López-Sanmartín contract is co-financed by the State Plan for Scientific and Technical Research and Innovation 2013–2016, MINECO, ref. PTA215-11709-I.

Lymphogranuloma venereum (LGV) is a sexually transmitted infectious disease caused by serovars L1, L2 and L3 of Chlamydia trachomatis. The initial presentation is usually a painless ulcerated papule on the genitalia or distal proctitis. The progression of the infection can lead to major complications: rectal strictures, intestinal obstruction or perforation. We present five cases of LGV proctitis as the initial presentation of the disease. All patients were male, mean age 44.6 years, with positive serology to human immunodeficiency virus (HIV) and promiscuous men who have sex with men (MSM). The initial diagnosis was made by rectosigmoidoscopy indicated for pain and anal discharge. All cases were confirmed by polymerase chain reaction technique in rectal tissue. Endoscopic images obtained showed a great variety of rectal lesions, from mild erythema of the mucosa and ulcers to deep ulcers with elevated borders and purulent exudate. All cases were resolved after treatment with doxycycline for 3 weeks. It emphasizes the importance of suspecting this re-emerging disease in patients with risk factors (HIV and MSM), with the aim of early treatment and to avoid major complications.

ResumenIntroducciónLa efectividad del haloperidol en la profilaxis para náuseas y vómito postoperatorios (NVPO) ha sido demostrada en estudios previos resumidos en 2004 por Buttner. Desde entonces ha surgido nueva evidencia, por lo cual nuestro objetivo es actualizar el estado presente del conocimiento en este tema. Se realizó una revisión sistemática y metaanálisis con el fin de aproximarnos a la efectividad y a la seguridad del uso de haloperidol en la profilaxis de NVPO.MetodologíaLa búsqueda sistemática, la selección de artículos relevantes, la extracción de datos, el análisis crítico de los estudios primarios, las comparaciones y los análisis se realizaron con base en las recomendaciones de Cochrane Collaboration y a través del software RevMan5.ResultadosDiez experimentos clínicos controlados, publicados entre 1962 y 2010, que incluyen 2.711 pacientes, cumplen los criterios de selección. Comparado con el droperidol (RR: 0,97; IC95%: 0,52-1,79) y con el ondansetrón (RR: 1,24; IC95%: 0,66-2,35), no se encontraron diferencias en la efectividad a las 24h. Se evidencia un efecto protector contra NVPO asociado al uso de haloperidol en diferentes dosis, vías de administración y momentos de administración al comparar frente a placebo. No hay reporte de aumento de efectos adversos de forma significativa.DiscusiónLa efectividad de haloperidol como profilaxis de NVPO queda sustentada por esta revisión sistemática sin que se logren identificar diferencias estadísticamente significativas cuando se compara con el ondansetrón o el droperidol.ConclusionesEl haloperidol es un medicamento efectivo y seguro para la profilaxis de NVPO.AbstractIntroductionThe effectiveness of haloperidol for the prophylaxis of postoperative nausea and vomiting (PONV) has been proven in prior trials summarized by Buttner in 2004. New evidence has surfaced since then. Our objective is thus to update the current knowledge on the topic. A systematic review and a meta-analysis were performed, in order to determine the effectiveness and safety of the use of haloperidol as prophylaxis for PONV.MethodologyThe systematic search, the selection of relevant articles, the extraction of data, the critical analysis of the primary studies, the comparisons and analyses were all based on the recommendations of the Cochrane Collaboration and using RevMan5 software.ResultsTen controlled clinical trials published between 1962 and 2010, that included 2,711 patients, met the selection criteria. As compared against droperidol (RR: 0.97; 95%CI: 0.52-1.79) and against ondansetron (RR: 1.24; 95%CI: 0.66-2.35), no differences were found in terms of effectiveness after 24hours. A protective effect against PONV associated with the use of haloperidol at varying doses, routes of administration and timing of administration was observed as compared with placebo. No significant increases in adverse events have been reported.DiscussionThis systematic review supports the effectiveness of haloperidol as prophylactic treatment of PONV. No statistically significant differences were found as compared against ondansetron or droperidol.ConclusionsHaloperidol is an effective prophylactic drug for PONV.

The need for an effective and safe medical treatment of nonalcoholic fatty liver disease is urgent due to its high prevalence and progressive character. At the moment, therapeutic strategies are largely empirical and based on the control of associated clinical conditions (especially obesity, type 2 diabetes mellitus, and hypertriglyceridemia) and the use of some specific drugs (insulin sensitizing agents, cytoprotectives, antioxidants, and anticytokines) as an attempt to counteract known elements of the pathogenesis. None of these specifics measures have been found to display enough evidence to recommend their clinical use. It is indispensable to join efforts in coordinated networks to define, as soon as possible, the best treatment and the best time to start it.

The challenges of growing prevalence and evident trend to progressive damage of primary nonalcoholic fatty liver disease confront a poorly understood pathogenesis. It appears to develop in two steps. First, a high adipocyte protein production in the context of a silent inflammatory background causes insulin resistance in adipose tissue. It leads both to lipolysis, with increase of the circulating and hepatic uptake of free fatty acids, and hyperinsulinemia. Within hepatocytes, the subsequent lipogenesis, together with a decreased secretion of lipoproteins, induces an accumulation of excessive hepatic triglycerides (steatosis), impliying some oxidative damage, but it remain balanced by uncoupling protein upregulation and antioxidant systems activation. Second, a more forceful fat catabolism by beta and omega oxidation results in respiratory chain hyperactivity with overproduction of free radicals and reactive oxygen species that exceed the antioxidant capacity. These agents lead to hepatocellular injury and necrosis, inflammatory infiltration and fibrosis (steatohepatitis) through induction of Fas ligand and cytokines (tumor necrosis factor alpha, transforming growth factor beta, interleukin-8), and lipid peroxidation and by-products (malondialdehyde and 4-hydroxynonenal). Other mechanisms (hepatic iron, Kupffer cells dysfunction or endotoxemia) play uncertain roles.

La enfermedad por reflujo gastroesofagico (ERGE) se define como el paso espontaneo de contenido gastrico al esofago, sin acompanarse de nauseas, vomito o eructo, que entrana un riesgo de complicaciones fisicas o produce un deterioro en la calidad de vida del paciente 1

Introducción:La efectividad del haloperidol en la profilaxis para náuseas y vómito postoperatorios (NVPO) ha sido demostrada en estudios previos resumidos en 2004 por Buttner. Desde entonces ha surgido nueva evidencia, por lo cual nuestro objetivo es actualizar el estado presente del conocimiento en este tema. Se realizó una revisión sistemática y metaanálisis con el fin de aproximarnos a la efectividad y a la seguridad del uso de haloperidol en la profilaxis de NVPO. Metodología:La búsqueda sistemática, la selección de artículos relevantes, la extracción de datos, el análisis crítico de los estudios primarios, las comparaciones y los análisis se realizaron con base en las recomendaciones de Cochrane Collaboration y a través del software RevMan5. Resultados:Diez experimentos clínicos controlados, publicados entre 1962 y 2010, que incluyen 2.711 pacientes, cumplen los criterios de selección. Comparado con el droperidol (RR: 0,97; IC95%: 0,52-1,79) y con el ondansetrón (RR: 1,24; IC95%: 0,66-2,35), no se encontraron diferencias en la efectividad a las 24h. Se evidencia un efecto protector contra NVPO asociado al uso de haloperidol en diferentes dosis, vías de administración y momentos de administración al comparar frente a placebo. No hay reporte de aumento de efectos adversos de forma significativa. Discusión:La efectividad de haloperidol como profilaxis de NVPO queda sustentada por esta revisión sistemática sin que se logren identificar diferencias estadísticamente significativas cuando se compara con el ondansetrón o el droperidol. Conclusiones: El haloperidol es un medicamento efectivo y seguro para la profilaxis de NVPO. Introduction: The effectiveness of haloperidol for the prophylaxis of postoperative nausea and vomiting (PONV) has been proven in prior trials summarized by Buttner in 2004. New evidence has surfaced since then. Our objective is thus to update the current knowledge on the topic. A systematic review and a meta-analysis were performed, in order to determine the effectiveness and safety of the use of haloperidol as prophylaxis for PONV. Methodology: The systematic search, the selection of relevant articles, the extraction of data, the critical analysis of the primary studies, the comparisons and analyses were all based on the recommendations of the Cochrane Collaboration and using RevMan5 software. Results: Ten controlled clinical trials published between 1962 and 2010, that included 2,711 patients, met the selection criteria. As compared against droperidol (RR: 0.97; 95% CI: 0.52-1.79) and against ondansetron (RR: 1.24; 95% CI: 0.66-2.35), no differences were found in terms of effectiveness after 24 hours. A protective effect against PONV associated with the use of haloperidol at varying doses, routes of administration and timing of administration was observed as compared with placebo. No significant increases in adverse events have been reported. Discussion: This systematic review supports the effectiveness of haloperidol as prophylactic treatment of PONV. No statistically significant differences were found as compared against ondansetron or droperidol. Conclusions: Haloperidol is an effective prophylactic drug for PONV.

Pollen-stratigraphic data and radiocarbon dates are presented for a full Holocene series of sediment cores obtained from a high-level site in the Appennino Parmense, northern Italy. Three 'marker' horizons are identified on the basis of sediment changes and pollen stratigraphy, and the extent to which they indicate episodes of significant human interference in the local vegetation is discussed. The earliest (M1) is dated to around 6300 BP. From the pollen evidence, some form of human impact on the regional vegetation at this time is suspected, but there is no convincing archaeological evidence to support this. The pollen evidence from the second (M2: 5000-4000 BP) and third (M3: ca. 1400 BP) marker horizons is consistent with archaeological information in suggesting that the high parts of the Apennines, close to the tree-line, were subject to intense summer grazing during the late Neolithic through to the Copper Age, and the immediate post-Roman period. A review of archaeological and documentary evidence from the region is presented to demonstrate how an integration of these lines of research on the one hand, with pollen-stratigraphic studies on the other, may provide a better understanding of the pattern and intensity of land-use changes during the mid- to late-Holocene.

Introduccion : a pesar que la infeccion por VIH/SIDA es uno de los principales problemas de salud en Colombia, son escasos los estudios clinicos y epidemiologicos que evaluen el tratamiento de estos pacientes. La ciudad de Cartagena de Indias, posee condiciones propicias para la infeccion por VIH como su condicion de distrito turistico, epicentro de cambios demograficos y sociales que estan vinculados con un alto riesgo de infeccion por VIH (4), no posee estudios que evaluen la efectividad de los tratamientos antirretrovirales. Objetivo : estimar la efectividad a seis meses, de la terapia TARGA en pacientes VIH positivo ingresados a un programa de tratamiento de una IPS de la ciudad. Metodologia: estudio descriptivo retrospectivo en el que se analizaron todos los pacientes adscritos al programa de VIH/SIDA en la IPS “Atencion integral” entre enero de 2007 a Julio de 2010. Se estudiaron variables demograficas como sexo edad, peso, indice de masa corporal, los diferentes esquemas antirretrovirales, conteo de linfocitos CD4, carga viral. Resultados: se encontraron 167 pacientes adscritos al programa, de estos se excluyeron 9 casos por no haber realizado la TARGA y 96 por no presentar el reporte de la carga viral antes o despues del tratamiento; en total se analizaron 62 casos. El 59,7% era de sexo masculino, el promedio de edad fue de 35 anos con desviacion estandar (DE) de 9,4 anos. El 49,5% de los casos tenia 30 anos o menos; la edad minima fue de 20 y la maxima de 58 anos en promedio el 44,4% de las historias clinicas no tenia reportes de alguno de los paraclinicos de ingreso. El 16,1% de los pacientes tenia anemia, el 19,4% hipertrigliridemia, 17,7% hipercolesterolemia y 21,0% niveles bajos de colesterol HDL. Los cinco esquemas de TARGA mas frecuentemente utilizados fueron: Lamivudina Estavudina Nevirapina con 29,0% de los casos, Lamivudina Zidovudina Efavirenz 19,4%, Lamivudina Estavudina Kaletra 11,3% y Lamivudina Abacavir Kaletra 8,1%. La efectividad de la TARGA teniendo en cuenta los parametros anteriores muestra que existe una disminucion estadisticamente significativa de la carga viral. La proporcion de efectividad general de la TARGA fue de 9,9% para disminucion del recuento de linfocitos T CD4 (+) y del 58,9% para disminucion de la carga viral Conclusion : la evaluacion de la terapia antirretroviral en el paciente con VIH/SIDA es un punto neuralgico de la atencion de estos pacientes y al mismo tiempo el menos estudiado. Nuestra investigacion pretende resaltar este tema e invitar a los interesados a realizar estudios prospectivos al respecto, los cuales incidiran positivamente en la salud de los pacientes, asignacion de recursos gubernamentales, iniciativas encaminadas a la vigilancia y control de estos programas y reestructuraciones de los mismos. Rev.cienc.biomed. 2011; 2 (1): 44-53 PALABRAS CLAVE Sindrome de inmunodeficiencia adquirida. Terapia antirretroviral altamente activa. Carga viral. Linfocitos T CD4-positivos. Guias de practica clinica. SUMMARY Background: Although HIV infection / AIDS are one of the major health problems in Colombia, there are few clinical and epidemiological studies assessing the treatment of these patients. The city of Cartagena de Indias, has favorable conditions for infection with HIV because of their status as tourist district and for being an epicenter of social and demographic changes that are associated with an increased risk of HIV infection (4), however no studies have evaluated the effectiveness of antiretroviral treatment. Aim: To estimate effectiveness of six months of HAART therapy in HIV patients admitted to a treatment program in a health center of the city. Methods: Retrospective descriptive study that examined all patients assigned to the program for HIV / AIDS in the health center “Atencion integral” from January 2007 to July 2010. We studied demographic variables as sex, age, weight, body mass index, different antiretroviral schemes, CD4 count and viral load. Results: There were 167 patients assigned to the program. Nine cases were excluded for failing to adherence HAART and 96 for not having the report of viral load before or after treatment. A total of 62 cases were analyzed. 59.7% were male, average age was 35 years with standard deviation (SD) of 9.4 years. 49.5% of patients were 30 years or less, the minimum age was 20 and maximum of 58 years. An average of 44.4% of medical charts had no reports of any of the initial labs.16.1% of patients had anemia, 19.4% hipertrigliridemia 17.7% hypercholesterolemia and 21.0% low HDL cholesterol levels. The five schemes more frequently used of HAART were Lamivudine Stavudine Nevirapine with 29.0% of cases, 19.4% Lamivudine Zidovudine Efavirenz, 11.3% Kaletra® Stavudine Lamivudine and 8.1% Lamivudine Abacavir Kaletra®. The effectiveness of HAART, taking into account the above parameters, shows that there is a statistically significant decrease in viral load. The proportion of overall effectiveness of HAART was 9.9% for decrease in CD4 T lymphocyte count (+) and 58.9% for viral load decrease. Conclusion: The evaluation of antiretroviral therapy in patients with HIV/AIDS is a hub for the care of these patients and at the same time the least studied. Our research aims to highlight this issue and invite interested parties to carry out studies in this regard, which positively affect the health of patients, allocation of government resources, initiatives aimed at monitoring and monitoring of these programs and restructuring of the same. Rev.cienc.biomed. 2011; 2 (1): 44-53 KEYWORD Acquired Immunodeficiency Syndrome. Highly Active Antiretroviral Therapy. Viral load. CD4-positive T-lymphocytes. Practice guidelines

We report a patient with common variable hypogammaglobulinemia and diffuse nodular lymphoid hyperplasia of the small intestine complicated by a jejunal malignant lymphoma. Immunopathological and histological studies showed a polymorphous centroblastic lymphoma with intracytoplasmatic IgM immunoglobulin and lambda light chains. Some mucosal nodules separate from the tumor mass showed atypical lymphoid cell populations similar to lymphoma cells, suggesting a transition between hyperplastic nodules and lymphoma nodules. Four similar cases, and six other patients with malignant lymphoma of the small intestine, associated with diffuse nodular lymphoid hyperplasia, but without immunodeficiency, have already been described. All these cases suggest that nodular lymphoid hyperplasia increases the risk of small intestine lymphoma.

Nodular regenerative hyperplasia (NRH) is a condition characterized by hepatocytic nodules distributed throughout the liver without perinodular fibrosis. The etiology is unknown, but it has been reported in patients with a variety of diseases, including autoimmune diseases and primary biliary cirrhosis (PBC). In this study, the liver biopsies of 64 patients with PBC were reviewed. Thirty-five biopsies in histological stages I or II belonging to 30 patients were suitable for study. NRH was found in 43% of biopsies (47% of patients). In 80% of these biopsies, nodular transformation was focal, while it was diffuse in the remaining 20%. Splenomegaly was more common in patients with NRH. Laparoscopy displayed evidence of portal hypertension in two of these patients and endoscopy showed esophageal varices in one patient. Serum levels of gamma-glutamyl transpeptidase were also higher in these patients. Lesions in small intrahepatic vessels, florid bile duct lesions, and portal granulomas were found more frequently in biopsies with NRH. We conclude that nodular hyperplastic changes are very common in early histological stages of PBC, and consequently, this disease should be considered in the etiology of NRH. These changes may contribute to early development of portal hypertension in these patients.

Abdominal distention during pneumoperitoneum results in a marked increase in plasma arginine vasopressin levels, which has been ascribed to an increase in intrathoracic pressure. Because of this relationship, tense ascites could contribute to nonosmotic release of antidiuretic hormone, to the development of hyponatremia, and eventually to further ascites formation. The effect of pneumoperitoneum, thoracocentesis, and paracentesis on plasma arginine vasopressin levels was studied in three groups of patients, and the mechanism by which these maneuvers may induce these changes was investigated. Patients with pleural effusion, pneumothorax, or ascites showed a significant increase in plasma arginine vasopressin levels, and thoracocentesis or paracentesis resulted in a decrease in these levels. Plasma vasopressin levels increased significantly during pneumoperitoneum, as did intrathoracic and atrial pressures; the atrial transmural pressure gradient declined. However, no changes in plasma levels of norepinephrine, aldosterone, and renin activity were observed during pneumoperitoneum. Changes in plasma arginine vasopressin levels correlated with the changes in intrathoracic and atrial pressures and transmural pressure gradient. The authors conclude that increased intrathoracic pressure is associated with an increase in plasma arginine vasopressin levels and propose that ascites could be a factor promoting vasopressin release by acting on intrathoracic volume receptors in decompensated cirrhotics.