Evaluating the QileX-RhE skin corrosion test for chemical subcategorization in accordance with OECD TG 431

Skin corrosion testing is integral to evaluating the potential harm posed by chemicals, impacting regulatory decisions on safety, transportation, and labeling. Traditional animal testing methods are giving way to in vitro alternatives, such as reconstructed human epidermis (RhE) models, aligning with evolving ethical standards. This study evaluates the QileX-RhE test system's performance for chemical subcategorization within the OECD TG 431 framework. Results demonstrate its ability to differentiate subcategories, accurately predicting 83% of UN GHS Category 1A and 73% of UN GHS Category 1B/1C chemicals with 100% sensitivity in corrosive prediction. Additionally, this study provides a comprehensive assessment of the test method's performance by employing nuanced parameters such as positive predictive value (PPV), negative predictive value (NPV), post-test odds and likelihood rations, offering valuable insights into the applicability and effectiveness of the QileX-RhE test method.

An effective method for culturing functional human corneal endothelial cells using a xenogeneic free culture medium

Endothelial dysfunction is a leading cause of corneal blindness in developed countries and the only available treatment is the endothelial transplantation. However, the limited availability of suitable donors remains a significant challenge, driving the exploration of alternative regenerative therapies. Advanced Therapy Medicinal Products show promise but must adhere to strict regulations that prohibit the use of animal-derived substances. This study investigates a novel culture methodology using Plasma Rich in Growth Factors (PRGF) as the only source of growth factors for primary cultures of human corneal endothelial cells (CECs). CECs were obtained from discarded corneas or endothelial rings and cultured in two different media: one supplemented with xenogeneic factors and other xenogeneic-free, using PRGF. Comprehensive characterization through immunofluorescence, morphological analyses, trans-endothelial electrical resistance measurements, RNA-seq, and qPCR was conducted on the two groups. Results demonstrate that CECs cultured in the xenogeneic-free medium exhibit comparable gene expression, morphology, and functionality to those cultured in the xenogeneic medium. Notably, PRGF-expanded CECs share 46.9% of the gene expression profile with native endothelium and express all studied endothelial markers. In conclusion, PRGF provides an effective source of xenogeneic-free growth factors for the culture of CECs from discarded corneal tissue. Further studies will be necessary to demonstrate the applicability of these cultures to cell therapies that make clinical translation possible.

Neuropsychological rehabilitation in patients with relapsing-remitting multiple sclerosis: a systematic review

Introduction: Multiple sclerosis (MS) is an autoimmune, chronic, inflammatory and demyelinating disease that affects the Central Nervous System (CNS). It is the most common disabling neurological disease in young patients not caused by traumatic shock. Depending on how symptoms appear and how often they occur, there are different subtypes of MS. One of them is the relapsing-remitting phenotype (R-R), which the symptoms appear in the form of isolated outbreaks which, little by little, are causing the increase of the disease and its sequelae. MS encompasses a wide variety of symptoms, including possible cognitive impairment. In the literature there is no clear methodology and a defined and structured consensus to carry out neuropsychological rehabilitation processes in this group.Aim: This study aims to review and synthesize the available scientific evidence about the neuropsychological intervention on cognitive impairment of people with multiple sclerosis, relapsing-remitting subtype.Methods: Keywords for database search (Pubmed and Wos) were established, as well as inclusion and exclusion criteria. Then, the articles were selected according to inclusion and exclusion criteria; methodological quality criteria were applied. Articles published in the last 10 years were included.Results: Fifteen articles that met the established criteria were selected. Most of these studies identify as effective their cognitive rehabilitation programs, some of them showed changes in neural structures after rehabilitation.Discussion: It seems that cognitive rehabilitation is effective in influencing cognitive deterioration in R-R MS. This highlights the importance of neuropsychological evaluation and intervention from the early stages of the disease.

Quality of Life of Latin-American People with Neuromuscular Disorders and Their Families During the COVID-19 Pandemic

Objectives

The COVID-19 pandemic has affected the entire population, especially the population with chronic diseases. This study aimed to describe the quality of life of children and adults with neuromuscular diseases and their caregivers during the COVID-19 pandemic.

Methods

A observational correlational study was conducted. Forty-seven participants, including adults with NMD and caregivers of children with NMD, took part in the study. The WHOQOL-BREF and PedsQL 4.0 GCS and FIM scales were used.

Results

The PedsQL indicated a mean of 55.85 (SD = 22.05) for children, and a mean of 55.76 (SD = 16.72) for caregivers. Adults reported a mean of 67 (SD = 22.5) for their general perception of quality of life, and a M = 53 (SD = 28.25) for their perception on health.

Conclusions

The results showed regular to low quality of life of all children, adults, and caregivers, mainly in the physical dimension for people with neuromuscular diseases, and in the concerns dimension for caregivers. These results warn about the physical and psychological vulnerability situation in which this population finds itself.

Improved Tool for Predicting Skin Irritation on Reconstructed Human Epidermis Models Based on Electrochemical Impedance Spectroscopy

The rabbit skin irritation test has been the standard for evaluating the irritation potential of chemicals; however, alternative methods that do not use animal testing are actively encouraged. Reconstructed human epidermis (RhE) models mimic the biochemical and physiological properties of the human epidermis and can be used as an alternative method. On RhE methods, the metabolic activity of RhE models is used to predict skin irritation, with a reduction in metabolic activity indicating a reduced number of viable cells and linking cell death to skin irritation processes. However, new challenges have emerged as the use of RhE models increases, including the need for non-invasive and marker-free methodologies to assess cellular states. Electrochemical impedance spectroscopy (EIS) is one such methodology that can meet these requirements. In this study, our results showed that EIS can differentiate between irritant and non-irritant chemicals, with a significant increase in the capacitance values observed in the irritant samples. A ROC curve analysis showed that the prediction method based on EIS met OECD TG 439 requirements at all time points and had 95% within-laboratory reproducibility. Comparison with the MTT viability assay showed that prediction using EIS achieved higher sensitivity, specificity, and accuracy. These results suggest that EIS could potentially replace animal testing in the evaluation of irritation potential and could be a valuable addition to in vitro testing strategies.

Psychometric properties of the Spanish version of the Pediatric Quality of Life Inventory Family Impact Module (PedsQL FIM)

INTRODUCTION

This study analysed the psychometric properties of the Spanish version of the Pediatric Quality of Life Questionnaire Family Impact Module (PedsQL FIM) in the Argentinian population.

PATIENTS AND METHODS

The sample included 232 caregivers, of who 108 were parents of children with chronic diseases (mean, 9.54; standard deviation [SD], 4.43) and 124 parents of children in the general population (mean, 12.37; SD, 4.6).

RESULTS

We assessed the validity of the instrument with the known-groups method, finding significant differences between the case and control groups in the overall and subscale scores (P < .01). We also assessed test validity by means of exploratory factor analysis, which yielded an 8-factor model that explained 74.03% of the variance. We assessed reliability with the Cronbach alpha and found a high internal consistency (α=0.95).

CONCLUSION

The PedsQL module proved to be a valid and reliable tool to assess the impact of a chronic paediatric condition on caregiver quality of life and family functioning.

Nursing bedside handover in an intensive care unit with a mixed structure: Nursing professionals' perception

AIM

The main objective is to determine if the infrastructure of critical care units influences the perception of professionals using this handover method.

BACKGROUND

Nursing bedside handover is considered a safe information transfer method that can help reduce communication errors; however, it has some disadvantages expressed by health professionals and patients, related to confidentiality, stress and less rest.

METHODS

Qualitative descriptive study. The perception of nursing professionals who work in a critical care unit with a mixed structure (open and closed boxes) in a tertiary care hospital was evaluated through a semi-structured interview with a battery of common questions (prepared after literature review) and spontaneous questions according to the objectives of the study.

RESULTS

Five thematic areas related to the study objectives were observed: patient safety, message content, confidentiality/privacy, intimacy/rest/noise, and patient participation.

CONCLUSIONS

Nursing bedside handover improves safe communication between professionals, because it avoids errors or distractions by double or triple checking (if we include the patient) as well as empowering the patient and including him in his recovery. Carrying it out in closed boxes increases confidentiality and improves intimacy as there are no other patients or relatives nearby who can hear the message. However, the place or shift where the handover is performed does not interfere with the effectiveness of the communication of the message. The morning shift is the busiest, which could affect the patient's rest, a fact that could be solved if it is carried out in a closed box.

IMPLICATIONS FOR NURSING MANAGEMENT

Carrying out the handover in individual boxes in intensive care units would provide greater privacy to the patient and reduce the perception of external noise, contributing to the reduction of interruptions and the increase of the patient's rest. It is also a key element in patient safety through verification by double or triple check-up, the structuring of the message and the visualization of devices presented by the patient. In addition, it will allow the professional to start a process of early humanization and participation of the patient in the health process.

In-house performance assessment of 3D QobuR-Reconstructed Human Cornea-Like Epithelium (RhCE) for the evaluation of eye hazard

To replace the Draize eye irritation test (OECD Test Guideline 404), several test methods based on reconstructed cornea-like epithelium (RhCE) have been developed and adopted in the OECD TG 492. The objective of this study was to stablish the experimental procedures and evaluate the performance assessment of QobuR-RhCE, an in-house RhCE model to be used for the evaluation of eye hazard. We define the essential structural, functional and procedural elements of the test method components to help assuring that the proposed test method is based on the same concepts as the validated reference methods. Performance assessment was evaluated in accordance with the revised performance standards for the assessment of proposed similar or modified in vitro reconstructed human cornea-like epithelium and the minimum list of reference chemicals was evaluated. As result, the proposed method scored 93.3% sensibility, 60% specificity, 76.7% accuracy and 96.7% within-laboratory reproducibility (WLR), providing a similar performance in comparison to the validated reference methods. Additionally, we describe a secondary endpoint based on Transepithelial Electrical Resistance (TEER) that could be of use to better discriminate between irritants and non-irritants. Taken together the results indicate that the QobuR-RhCE test method is an accurate screening tool that can be used as a standalone alternative to evaluate ocular irritation.

Impedance-based non-invasive assay for ocular damage prediction on in vitro 3D reconstructed human corneal epithelium

Reconstructed human cornea-like epithelium (RhCE) holds unprecedented promise for toxicological analyses and the replacement of animal use. However, current standards to evaluate potential ocular irritancy present a major downfall, the need to invasively alter tissue samples to evaluate cell viability. In this study, the applicability of impedance analysis was validated by monitoring the change in cell capacitance during tissue maturation and before and after chemical application using coupled electrodes. Our results indicate that cell maturation on RhCE models can be evaluated during model production using capacitance sensing offering a faster and simpler quality control criteria for RhCE model usability. Additionally, cell capacitance resulted to be more sensitive in detecting slight cell damages than methods based on cell metabolism, and when integrated into OECD-approved testing strategies, capacitance sensing performed as good as currently accepted methodologies displaying 66% sensitivity, 100% specificity and 83% accuracy when evaluated at 300 Hz. In summary, a quantitative analysis to predict in vivo ocular irritation based on changes in RhCE capacitance by impedance spectroscopy is suggested. This methodology represents a non-invasive and non-destructive alternative that would enable the monitoring of reversible effects or repeated dose toxicity.

Fibrin-Plasma Rich in Growth Factors Membrane for the Treatment of a Rabbit Alkali-Burn Lesion

The purpose of this work is to describe the use of Fibrin-Plasma Rich in Growth Factors (PRGF) membranes for the treatment of a rabbit alkali-burn lesion. For this purpose, an alkali-burn lesion was induced in 15 rabbits. A week later, clinical events were evaluated and rabbits were divided into five treatment groups: rabbits treated with medical treatment, with a fibrin-PRGF membrane cultured with autologous or heterologous rabbit Limbal Epithelial Progenitor Cells (LEPCs), with a fibrin-PRGF membrane in a Simple Limbal Epithelial Transplantation and with a fibrin-PRGF membrane without cultured LEPCs. After 40 days of follow-up, corneas were subjected to histochemical examination and immunostaining against corneal or conjunctival markers. Seven days after alkali-burn lesion, it was observed that rabbits showed opaque cornea, new blood vessels across the limbus penetrating the cornea and epithelial defects. At the end of the follow-up period, an improvement of the clinical parameters analyzed was observed in transplanted rabbits. However, only rabbits transplanted with cultured LEPCs were positive for corneal markers. Otherwise, rabbits in the other three groups showed positive staining against conjunctival markers. In conclusion, fibrin-PRGF membrane improved the chemically induced lesions. Nonetheless, only fibrin-PRGF membranes cultured with rabbit LEPCs were able to restore the corneal surface.

Diseases and parasites of wild and cultivated mussels along the Patagonian coast of Argentina, southwest Atlantic Ocean

A histological survey of the commercially edible mussels Mytilus platensis and M. chilensis from wild and cultivated populations along the coast of Patagonia, Argentina (42°00' to 54°47'S), was carried out to determine their health status. Diagnostic results included 3 types of inflammatory responses (infiltrative, nodular, and encapsulation), disseminated neoplasia disease, 2 abnormal reproductive conditions (gonadal atresia and intersex), prokaryotic inclusions, protozoans, and metazoans. Pathogen prevalence and infection intensity among mussels of different sampling sites and between those of wild and cultivated populations were compared. Inflammatory responses were recorded in all mussels from all sites, while disseminated neoplasia only occurred in the most southern cultivated M. chilensis. Intracellular prokaryotic inclusions were broadly distributed in the mussels from both northern and southern Patagonian coasts. Ciliates showed the highest prevalence among wild mussels from the colder waters of Bahía Brown. Turbellaria were recorded at higher prevalence in cultured mussels (41.7%), and trematode metacercariae occurred exclusively in intertidal wild mussels. None of the parasites found appears to be a problem to the fishery or farming, although disseminated neoplasia should be monitored. In addition, we found that mytilid species coexisting with M. platensis (Aulacomya atra and Perumytilus purpuratus) at one location shared the same pathological conditions and parasites, which differed from those of M. platensis at a distant locality. These results suggest that pathological conditions and parasites were influenced more by ecological habitat factors than by the species of mussels present, based on similar parasite assemblages found among closely related mytilid hosts in the same geographical area.

Reduced graphene oxide membranes in ocular regenerative medicine

Biological membranes are currently used in Ophthalmology in order to treat different ocular disorders. These membranes have different properties such as cellular biocompatibility and promoting wound healing. Moreover, intrinsic antimicrobial properties could also be desirable because it would allow their use reducing the risk of infections. Graphene and its derivatives are promising biomaterials that already proved their bactericidal effect. However, their clinical use is limited due to the controversial results regarding their toxicity. In this work, we have developed and characterized a reduced graphene oxide membrane (rGOM) for its use in ocular Regenerative Medicine, and studied its in vitro and in vivo biocompatibility and genotoxicity with different types of human ocular cells. We proved that rGOM allowed the growth of different ocular cells without inducing in vitro or in vivo cytotoxicity or genotoxicity in the short-term. These results indicate that rGOM may be a promising candidate in Regenerative Medicine for the treatment of different ocular pathologies.

Morphology and molecular systematic of marine gregarines (Apicomplexa) from Southwestern Atlantic spionid polychaetes

Gregarines are a common group of parasites that infect the intestines of marine invertebrates, and particularly polychaetes. Here, we describe for the first time four gregarine species that inhabit the intestines of three spionid species: Dipolydora cf. flava, Spio quadrisetosa and Boccardia proboscidea from the Patagonian coast, Argentina, using light and scanning electron microscopy and molecular phylogenetic analyses of small subunit (SSU) rDNA sequences. Even though the spionid species thrive in the same environments, our results showed a high host specificity of the gregarine species. Selenidium cf. axiferens and Polyrhabdina aff. polydorae were both identified from the intestine of D. cf. flava. The new species, Polyrhabdina madrynense sp. n. and Selenidium patagonica sp. n., were described from the intestines of S. quadrisetosa and the invasive species B. proboscidea, respectively. All specimens of D. cf. flava and S. quadrisetosa were infected by gregarines (P = 100%), recording the highest mean intensity values of infection (MI = 80; 60 respectively), in contrast to B. proboscidea (P = 60%; MI = 38). We associated this finding with the recent invasion of this host. It is expected that in the future, an increase of its population density might favour a rising intensity of this gregarine infection.

Silk Fibroin Films for Corneal Endothelial Regeneration: Transplant in a Rabbit Descemet Membrane Endothelial Keratoplasty

Purpose

Develop a silk fibroin (SF)-based artificial endothelial graft for its use in a rabbit Descemet membrane endothelial keratoplasty (DMEK).

Methods

Human and rabbit artificial corneal endothelial grafts were developed through the culture of human and rabbit corneal endothelial cells (CECs) on SF films. Rabbit artificial SF endothelial grafts were transplanted in a DMEK surgery into a rabbit in vivo model.

Results

SF artificial endothelial grafts showed the characteristic endothelial markers: zonula occludens (ZO-1) and Na+/K+ ATPase. In a rabbit model of DMEK surgery, SF artificial endothelial graft restored the corneal transparency and thickness at 6 week of follow-up. Anterior segment optical coherence tomography revealed the SF graft as a fully integrated component in the corneal tissue, displaying a similar corneal thickness and endothelial cell count when compared with its healthy contralateral cornea. Histologic analysis showed that the SF artificial endothelial graft was attached and integrated on the surface of the corneal stroma without a significant inflammatory reaction, and rabbit CECs consisted in a monolayer that showed their characteristic markers ZO-1 and Na+/K+ ATPase, suggesting proper intercellular junctions and cellular pump function.

Conclusions

We have developed SF films with biological properties that supported the growth of rabbit and human CECs, which showed normal morphology and characteristic markers; and with mechanical properties that allowed its use in a DMEK surgery, proving its in vivo functionality in a rabbit model of endothelial dysfunction.

Estandarización del Child Behavior Checklist para preescolares de población urbana de Argentina

<p>puede afectar sus posibilidades de desarrollar al máximo sus recursos emocionales y cognitivos. El diagnóstico precoz de estos problemas resulta una medida preventiva por excelencia, por ello es necesario contar con instrumentos<br />validados. Se propuso estandarizar el Child Behavior Checklist (CBCL 1½-5) en su versión en español para padres. Se realizó un estudio instrumental, sobre una<br />muestra de 541 niños en edad preescolar pertenecientes a la población urbana de Argentina, n = 369 pertenecientes a la población general, y n = 172 de un grupo clínico de salud mental. Se demostró que el CBCL 1½-5 permite evaluar grados de problemas comportamentales y emocionales en edades tempranas. Las escalas generales (puntaje total, problemas externalizantes y problemas internalizantes) discriminaron adecuadamente entre el grupo clínico y el grupo de población general. Se corroboró la confiabilidad del instrumento a partir del alto grado de acuerdo entre informantes (madre y padre), los valores adecuados de consistencia interna y los altos valores de correlación pasados 7 días (test-retest) y pasados 6 meses (estabilidad). La estandarización del CBCL 1½-5 permite contar con un instrumento de detección temprana de problemas comportamentales y emocionales, fortaleciendo la capacidad diagnóstica de problemas en la salud mental infantil.</p>

Human Bone Derived Collagen for the Development of an Artificial Corneal Endothelial Graft. In Vivo Results in a Rabbit Model

Corneal keratoplasty (penetrating or lamellar) using cadaveric human tissue, is nowadays the main treatment for corneal endotelial dysfunctions. However, there is a worldwide shortage of donor corneas available for transplantation and about 53% of the world's population have no access to corneal transplantation. Generating a complete cornea by tissue engineering is still a tough goal, but an endothelial lamellar graft might be an easier task. In this study, we developed a tissue engineered corneal endothelium by culturing human corneal endothelial cells on a human purified type I collagen membrane. Human corneal endothelial cells were cultured from corneal rims after corneal penetrating keratoplasty and type I collagen was isolated from remnant cancellous bone chips. Isolated type I collagen was analyzed by western blot, liquid chromatography -mass spectrometry and quantified using the exponentially modified protein abundance index. Later on, collagen solution was casted at room temperature obtaining an optically transparent and mechanically manageable membrane that supports the growth of human and rabbit corneal endothelial cells which expressed characteristic markers of corneal endothelium: zonula ocluddens-1 and Na+/K+ ATPase. To evaluate the therapeutic efficiency of our artificial endothelial grafts, human purified type I collagen membranes cultured with rabbit corneal endothelial cells were transplanted in New Zealand white rabbits that were kept under a minimal immunosuppression regimen. Transplanted corneas maintained transparency for as long as 6 weeks without obvious edema or immune rejection and maintaining the same endothelial markers that in a healthy cornea. In conclusion, it is possible to develop an artificial human corneal endothelial graft using remnant tissues that are not employed in transplant procedures. This artificial endothelial graft can restore the integrality of corneal endothelium in an experimental model of endothelial dysfunction. This strategy could supply extra endothelial tissue and compensate the deficit of cadaveric grafts for corneal endothelial transplantation.

Keratin-chitosan membranes as scaffold for tissue engineering of human cornea

PURPOSE

To study the attachment and growth of human corneal cells on keratin-chitosan membranes. The end goal is to develop a bioengineered cornea based on this material.

METHODS

Keratin-chitosan membranes were prepared as previously described by Tanabe et al., 2002. Briefly, 7.15 mg/cm2 of keratin dialysate was mixed with 10 wt% chitosan solution and 20 wt% glycerol. The solution was cast into a silicone mold and dried at 50ºC for 36 hours. Eyes were attained from a local eye bank after penetrant-keratoplastic surgery. Human epithelial, stromal and endothelial cells were obtained of the limbal, stromal and endothelial regions. Cells were cultured on keratin-chitosan membranes, as well as on plastic dishes as controls. When cultured cells reached confluence, they were fixed, incubated with primary antibodies (E-cadherin, cytokeratin high molecular weight (CK), vimentin and Na+/K+ ATPase) and visualized by indirect immunocytochemistry.

RESULTS

Epithelial, stromal and endothelial cells were able to attach and grow on keratin-chitosan membranes. All the cells maintained their morphology and cellular markers, both in the membrane and on the culture plate. Epithelial cells stained positively for CK and E-cadherin. A positive vimentin stain was observed in all stromal cells, while endothelial cells were positive for vimentin and Na+/K+ ATPase, but negative for E-cadherin.

CONCLUSIONS

Keratin-chitosan membranes have been shown to be a good scaffold for culturing epithelial, stromal and endothelial corneal cells; therefore, future applications of keratin-chitosan membranes may be developed for reconstruction of the cornea.

Syndromes of collateral-reported psychopathology for ages 18-59 in 18 Societies

The purpose was to advance research and clinical methodology for assessing psychopathology by testing the international generalizability of an 8-syndrome model derived from collateral ratings of adult behavioral, emotional, social, and thought problems. Collateral informants rated 8,582 18-59-year-old residents of 18 societies on the Adult Behavior Checklist (ABCL). Confirmatory factor analyses tested the fit of the 8-syndrome model to ratings from each society. The primary model fit index (Root Mean Square Error of Approximation) showed good model fit for all societies, while secondary indices (Tucker Lewis Index, Comparative Fit Index) showed acceptable to good fit for 17 societies. Factor loadings were robust across societies and items. Of the 5,007 estimated parameters, 4 (0.08%) were outside the admissible parameter space, but 95% confidence intervals included the admissible space, indicating that the 4 deviant parameters could be due to sampling fluctuations. The findings are consistent with previous evidence for the generalizability of the 8-syndrome model in self-ratings from 29 societies, and support the 8-syndrome model for operationalizing phenotypes of adult psychopathology from multi-informant ratings in diverse societies.

Seasonal variations of gonadotropins and prolactin in the laboratory rat. Role of maternal pineal gland

The laboratory rat, a non-photoperiodic rodent, exhibits seasonal fluctuations of melatonin. Melatonin has been found to be readily transferred from the maternal to the fetal circulation. No data exist on the possible influence of maternal pineal gland upon seasonal variations of the offspring. The aim of the present study was to asses the influence of the maternal melatonin rhythm on the offspring postnatal development of the reproductive hormones LH, FSH and prolactin. Male offspring from control, pinealectomized (PIN-X) and PIN-X + melatonin (PIN-X+MEL) mother Wistar rats were studied at 21, 31, and 60 days of age. Seasonal age-dependent variations were found for all hormones studied in control offspring but PIN-X offspring showed a tendency to have reduced duration or altered seasonal variations. Maternal melatonin treatment to PIN-X mothers partially restored the effect of pinealectomy. The chronological study of LH, FSH, and prolactin in PIN-X offspring also showed an altered pattern as compared to control-offspring. Melatonin treatment to the mothers partially restored the developmental pattern of reproductive hormones. Results of this study indicate that maternal pineal gland of the laboratory rat is involved in the seasonal postnatal development variations of reproductive hormones of the offspring.

[Genetic variability of hepatitis C virus in the health area of Elche (Spain). Correlation between core antigen and viral load]

We investigated the prevalence of the various genotypes of hepatitis C virus (HCV) in 281 patients evaluated between March, 2000 and March, 2002 in the health area of Elche. Of these patients, 55 were coinfected with human immunodeficiency virus (HIV). The genotype was related to viral load and the co-existence of HIV infection. Likewise, the relationship between these parameters and the presence of the HCV core antigen was established. The results indicate that genotype 1b was the most prevalent (38.4%) followed by genotype 3a (23.1%). Patients coinfected with HIV presented fewer infections due to group 1 genotypes (p < 0.05).Patients with HIV presented a greater viral load in all the genotypes, with genotype 3 presenting a high viral load. Detection of the HCV core antigen showed a close correlation with viral load determinations. Although not yet sufficiently assessed, determination of the HCV core antigen constitutes a simple technique that could eventually contribute to improving the management of patients with chronic HCV hepatitis.

In-use evaluation of Perasafe compared with Cidex in fibreoptic bronchoscope disinfection

The mycobactericidal activity of Perasafe (0.26% peracetic acid) was compared with that of Cidex (2% alkaline glutaraldehyde) by an in-use test. Fibreoptic bronchoscopes were artificially contaminated with Mycobacterium tuberculosis or Mycobacterium avium-intracellulare in sputum and, after manual pre-cleaning with a neutral soap, 10 and 20 min disinfection periods were tested. Perasafe was as effective as Cidex, thus requiring a 10 min disinfection period against M. tuberculosis and 20 min against M. avium-intracellulare. The results demonstrate that Perasafe is an effective disinfectant for use in reprocessing fibreoptic bronchoscopes.

Influence of fasting on the effects of ischemic preconditioning in the ischemic-reperfused rat heart

The effects of fasting and ischemic preconditioning (IP) on heart function of Langendorff-perfused rat hearts exposed to 25 min global ischemia plus 30 min reperfusion (RP), were correlated with lactate release and tissue-levels of long-chain acyl carnitine (LCCa) and CoA (LCCoA). IP was achieved by a 3 min ischemia plus a 5 min reperfusion cycle. Creatine kinase leakage was measured to assess the extent of cardiac injury. Fasting reduced the ischemic-induced contracture, improved RP recovery of mechanical function, reduced lactate release and increased the end-ischemia LCCoA and LCCa levels. Both in the fed and the fasted rat hearts IP delayed the pacemaker depression, reduced the amplitude of ischemic contracture and improved the RP recovery of contraction. However, IP reduced creatine kinase and lactate release only in the fed rat hearts. IP had no effects on tissue LCCa and LCCoA in both groups. These data suggest that: 1) beneficial effects of fasting may be ascribed, at least in part, to a reduced lactate production which may attenuate ischemic myocyte acidification and to the accumulation of fatty acyl esters which would favour citric acid cycle replenishment during RP. 2) beneficial effects of IP could be in part explained by the reduction of lactate production in the fed group although data obtained with the fasted rat heart indicate that another mechanisms must also be involved in the effects of IP. 3) accumulation of LCCoA and LCCa is not involved in the noxious effects of ischemia as well as in the protection effected by IP.

Functional and molecular characterization of the K-Cl cotransporter of Xenopus laevis oocytes

The K-Cl cotransporters (KCCs) have a broad range of physiological roles, in a number of cells and species. We report here that Xenopus laevis oocytes express a K-Cl cotransporter with significant functional and molecular similarity to mammalian KCCs. Under isotonic conditions, defolliculated oocytes exhibit a Cl(-)-dependent (86)Rb(+) uptake mechanism after activation by the cysteine-reactive compounds N-ethylmaleimide (NEM) and mercuric chloride (HgCl(2)). The activation of this K-Cl cotransporter by cell swelling is prevented by inhibition of protein phosphatase-1 with calyculin A; NEM activation of the transporter was not blocked by phosphatase inhibition. Kinetic characterization reveals apparent values for the Michaelis-Menten constant of 27.7 +/- 3.0 and 15.4 +/- 4.7 mM for Rb(+) and Cl(-), respectively, with an anion selectivity for K(+) transport of Cl(-) = PO(4)(3-) = Br(-) > I(-) > SCN(-) > gluconate. The oocyte K-Cl cotransporter was sensitive to several inhibitors, including loop diuretics, with apparent half-maximal inhibition values of 200 and 500 microM for furosemide and bumetanide, respectively. A partial cDNA encoding the Xenopus K-Cl cotransporter was cloned from oocyte RNA; the corresponding transcript is widely expressed in Xenopus tissues. The predicted COOH-terminal protein fragment exhibited particular homology to the KCC1/KCC3 subgroup of the mammalian KCCs, and the functional characteristics are the most similar to those of KCC1 (Mercado A, Song L, Vazquez N, Mount DB, and Gamba G. J Biol Chem 275: 30326--30334, 2000).

Alternatively spliced isoform of apical Na(+)-K(+)-Cl(-) cotransporter gene encodes a furosemide-sensitive Na(+)-Cl(-)cotransporter

In the absence of vasopressin, medullary thick ascending limb cells express a K(+)-independent, furosemide-sensitive Na(+)-Cl(-) cotransporter that is inhibited by hypertonicity. The murine renal specific Na(+)-K(+)-2 Cl(-) cotransporter gene (SLC12A1) gives rise to six alternatively spliced isoforms. Three feature a long COOH-terminal domain that encodes the butmetanide-sensitive Na(+)-K(+)-2 Cl(-) cotransporter (BSC1-9/NKCC2), and three with a short COOH-terminal domain, known as mBSC1-A4, B4, or F4 (19). Here we have determined the functional characteristics of mBSC1-A4, as expressed in Xenopus laevis oocytes. When incubated at normal oocyte osmolarity (approximately 200 mosmol/kgH(2)O), mBSC1-4-injected oocytes do not express significant Na(+) uptake over H(2)O-injected controls, and immunohistochemical analysis shows that the majority of mBSC1-4 protein is in the oocyte cytoplasm and not at the plasma membrane. In contrast, when mBSC1-4 oocytes are exposed to hypotonicity (approximately 100 mosmol/kgH(2)O), a significant increase in Na(+) uptake but not in (86)Rb(+) uptake is observed. The increased Na(+) uptake is Cl(-) dependent, furosemide sensitive, and cAMP sensitive but K(+) independent. Sodium uptake increases with decreasing osmolarity between 120 and 70 mosmol/kgH(2)O (r = 0.95, P < 0.01). Immunohistochemical analysis shows that in hypotonic conditions mBSC1-A4 protein is expressed in the plasma membrane. These studies indicate that the mBSC1-A4 isoform of the SLC12A1 gene encodes a hypotonically activated, cAMP- and furosemide-sensitive Na(+)-Cl(-) cotransporter. Thus it is possible that alternative splicing of the BSC1 gene could provide the molecular mechanism enabling the Na(+)-Cl(-)-to-Na(+)-K(+)-2Cl(-) switching in thick ascending limb cells.

Mutational analysis of patients with p47-phox-deficient chronic granulomatous disease: The significance of recombination events between the p47-phox gene (NCF1) and its highly homologous pseudogenes

OBJECTIVE

The aim of this study was to determine the molecular basis of p47-phox-deficient chronic granulomatous disease (CGD), the most common autosomal recessive form of the disease. CGD is an inherited condition characterized by defective oxygen radical production due to defects in the phagocyte nicotinamide adenine dinucleotide phosphate (NADPH) oxidase. Mutational analysis of p47-phox-deficient CGD patients previously demonstrated that the majority of patients have a GT dinucleotide (Delta GT) deletion at the start of exon 2, a signature sequence also observed in the highly homologous pseudogenes of NCF1.

MATERIALS AND METHODS

We performed genetic analysis of NCF1 and its pseudogenes using genomic DNA in 29 p47-phox-deficient CGD patients from 22 separate families. First-strand cDNA analysis was performed in 17 of the 29 patients.

RESULTS

We confirmed the significance of the Delta GT mutation; in 27 of 29 patients, only the Delta GT sequence was detectable. All but one of the 27 had at least one additional signature sequence, specific to the pseudogene, in either intron 1 and/or intron 2. We extended our analysis to look at signature sequence differences in exons 6 and 9 and detected both the wild-type and pseudogene sequences in all patients tested.

CONCLUSIONS

Although detection of only Delta GT sequence accounts for over 85% of affected patients, the molecular basis is most likely due to partial cross-over events between the wild-type and pseudogene(s) of p47-phox at different recombination sites. Our results suggest that complete gene conversion or deletion of the p47-phox gene (NCF1) occurs rarely, if it all.

[Wiktor coronary stent for elective placement with an antiaggregation regimen. WINE study. WINE Group Study]

INTRODUCTION AND OBJECTIVES

The main problems associated with coronary stent implantation are subacute thrombosis and vascular and hemorrhagic complications due to the intensive anticoagulant regime. We studied the complications and the six-month restenosis rate after the elective implantation of a Wiktor stent in patients treated only with antiplatelet drugs.

PATIENTS AND METHODS

The WINE study is an open, observational, multicenter study that included 368 patients (380 lesions) from 11 Spanish hospitals. All patients were treated with aspirin (125-325 mg/day) and ticlopidine (250 mg/12 h for 4 weeks). After hospitalization, a clinical control and clinical and angiographic controls were performed at one and six months respectively.

RESULTS

27 patients were excluded after the procedure because of failed delivery of the stent (5 cases), suboptimal angiographic result (15 cases) or lack of adherence to the antithrombotic regime (7 cases). Among the 341 patients with an adequate result most lesions (76.2%) were type B, including 39.1% type B2 and 8.5% type C. Subacute stent occlusion occurred in two patients (0.6%). Seven patients (2.1%) had vascular complications related to the arterial puncture. No major hemorrhagic complications needing transfusion were found. At six months 64 patients (19.8%) showed angiographic restenosis.

CONCLUSIONS

When the angiographic result after Wiktor stent placement is adequate, the therapy with aspirin and ticlopidine is associated with a very low stent thrombosis rate as well as with a low rate of vascular complications and 6 month angiographic restenosis.

[The value of exercise echocardiography in the diagnosis of coronary disease in patients with left heart branch block in the bundle of His]

OBJECTIVE

To assess the diagnostic value of exercise echocardiography in patients with complete left bundle branch block and clinical suspicion of coronary artery disease.

MATERIAL AND METHODS

Among 1,176 exercise echocardiograms performed from May of 1994 to November of 1996, 92 showed complete left bundle branch block in the resting electrocardiogram. We retrospectively analyzed data of 23 patients who had coronary angiography performed within 6 weeks of the exercise echo (19 males and 4 females, age 62 +/- 8, resting ejection fraction 52 +/- 10%). Previous acute myocardial infarction was demonstrated in 8 of them. The development of new or worsening regional dysfunction was considered an ischaemic response on exercise echo; whereas we assumed that there was significant coronary artery disease on the coronariography whether there was > or = 1 vessel disease in patients without previous myocardial infarction or > or = 2 vessel disease in patients with previous infarction.

RESULTS

Ten patients showed multivessel disease (> or = 2 vessels, 6 with previous infarction); 5 one-vessel disease; and 8 non significant coronary artery disease. Exercise echocardiography sensitivity for ischaemia detection in the entire group was 86% (95% confidence interval 67-100%); the specificity was 67% (36-98%), predictive value of a positive test was 80% and predictive value of a negative test was 75%. Sensitivity for the detection of > 50% stenosis in the left anterior descending coronary territory was 92% (76%-100%) and specificity 64% (35%-92%); for right coronary artery sensitivity was 80% (55%-100%) and specificity 77% (54%-100%); and for left circumflex artery sensitivity was 70% (42%-98%) and specificity 69% (44%-94%).

CONCLUSIONS

Exercise echocardiography may be useful in the evaluation of patients with left bundle branch block and clinical suspicion of coronary artery disease; with good sensitivity and low specificity.

Interleukin-15 augments superoxide production and microbicidal activity of human monocytes against Candida albicans

Interleukin-15 (IL-15) is a newly described cytokine that shares biological activities with IL-2. We report here results demonstrating the ability of IL-15 to enhance superoxide production and antifungal activity of human monocytes. After 18 and 48 h of treatment with IL-15, human elutriated monocytes manifested enhanced superoxide production in response to either phorbol myristate acetate or opsonized Candida albicans blastoconidia. Similar results were obtained when monocytes were treated with IL-2, but to a lesser extent. Combination studies with IL-15 and IL-2 showed no additive or synergistic effects. Following incubation of monocytes with IL-15 for 18 h, there was no significant increase in mRNA transcripts for components of the NADPH oxidase complex, p40-phox, p47-phox, and gp91-phox, suggesting a posttranscriptional modulation of enhanced superoxide production. Antibodies against the gamma chain of the IL-2 receptor and, to a lesser extent, against the beta chain partially abrogated the IL-15-mediated enhanced superoxide production. Additionally, human monocytes showed enhanced killing activity against C. albicans after 18 h of incubation with IL-15 or IL-2, but this treatment did not enhance the ability of these cells to phagocytose the organism. In addition, the enhanced fungicidal activity seen after 18 h of treatment was no longer detectable after 48 h of cytokine treatment. Culture supernatants from the IL-15-treated monocytes were assayed for the presence of other proinflammatory cytokines. IL-15 treatment did not induce the release of detectable levels of tumor necrosis factor alpha, IL-1beta, or IL-12. Our results indicate that IL-15 upregulates the microbicidal activity of human monocytes against C. albicans.

[A paradoxical intraventricular gradient in a patient with atypical hypertrophic myocardiopathy]

A paradoxic diastolic intraventricular flow (directed from apex to base), caused by a pressure gradient between a small apical aneurysm and the main left ventricular cavity, connected by a narrow muscular tunnel, was detected by Doppler echocardiography in a 69 year old male with apical hypertrophic cardiomyopathy and effort angina. Coronary arteriography was normal and the clinical, electrocardiographic, echocardiographic and angiocardiographic features of the patient were otherwise typical of apical hypertrophic cardiomyopathy. Paradoxic diastolic gradients have been occasionally described in patients with hypertrophic cardiomyopathy, and indicate the existence of a sequestered apical cavity, which is frequently not detected by echocardiography. Identification of these gradients may have important clinical implications, since they have been related with a higher incidence of embolic events, severe ventricular arrhythmias and myocardial ischaemia and necrosis.

[Fiberoptic bronchoscope disinfection with glutaraldehyde phenolate in 1:8 solution]

We evaluated the efficacy of phenolated glutaraldehyde in a 1:8 solution for the disinfection of bronchofibroscopes that were highly contaminated with Serratia marcescens and Pseudomonas aeruginosa. An Olympus BF-P10 bronchofibroscope was contaminated with artificial samples containing one of the aforementioned microorganisms in concentrations nearing 10(8) colony forming units per milliliter (cfu/ml). The instruments were then washed with soap and water and submerged in a 1:8 solution of phenolated glutaraldehyde. Samples were taken for culturing after contamination, after washing, and after 10, 15 and 30 min in the disinfectant solution. The level of cfu/ml in the cultures was measured and the definition of failure-to-disinfect was a finding of > or = 1 cfu/ml after each experimental procedure. Twenty procedures, 10 for each microorganism, were carried out. Washing of the bronchofibroscope afforded significant elimination of microorganisms and no colony growth was observed in cultures after 10 min submersion in phenolated glutaraldehyde. We conclude that immersion in a 1:8 solution of phenolated glutaraldehyde after careful washing is a valid way to disinfect bronchofibroscopes that are highly contaminated with S. marcescens and P. aeruginosa.

Multicenter double-blind trial of gabexate mesylate (FOY) in unselected patients with acute pancreatitis

A multicenter, randomized, double-blind trial was carried out to evaluate the efficacy of gabexate mesylate (FOY) in acute pancreatitis. One hundred unselected patients were randomly allocated into two groups: 51 were assigned to receive FOY (12 mg/kg/day as continuous intravenous infusion for a minimum of 4 days and a maximum of 12 days), and 49 were allocated to placebo. The groups were comparable in demographic, clinical and biochemical parameters, etiology of pancreatitis, and disease severity, which was generally mild. Gallstones were the main etiological factor. All patients received fluid and electrolyte replacement, analgesia and nasogastric suction for at least 48 h after admission. Experimental therapy was initiated no later than 12 h after the beginning of symptoms. The results showed no statistically significant differences between the two groups with respect to the evolution of clinical and biochemical parameters, analgesic requirements, development of complications, hospitalization time or mortality at completion of the trial. In conclusion, early treatment with FOY does not appear to have any demonstrable beneficial effects in acute pancreatitis.

[Comparative study of sucralfate and ranitidine in the treatment of bleeding duodenal ulcer]

Sixty patients with bleeding duodenal ulcers were randomized to treatment with sucralfate or ranitidine. Endoscopy was performed in all patients within 24 hours from admission. Acute phase outcome was similar in both groups. Four patients in the sucralfate group and 1 patient in the ranitidine group rebled and required surgical treatment (NS). Healing rate at 6 weeks was 88% with sucralfate and 96.6% with ranitidine. Relapsing rate without maintenance therapy at 6 and 12 months was 21.1% and 42.1% for sucralfate-treated patients and 33.3% and 56.5% for ranitidine-treated patients (NS). Sucralfate-treated patients had a significantly lesser relapsing rate at 12 months compared to ranitidine treated patients, in the smokers group.