Tiotidine,a new H2-receptor antagonist,is a potent inhibitor of nocturnal acid secretion in duodenal ulcer patients

The efficacy of tiotidine, a new H₂-receptor antagonist, in reducing nocturnal acid secretion of duodenal ulcer patients (N=12, ages 21–60 years) was investigated. Different doses of tiotidine, 25, 50, 100, and 150 mg or placebo, were given as a single oral dose and acid secretion collected overnight. Tiotidine produced a significant, prolonged, and dose-related reduction of the nocturnal acid secretion without important side effects. The inhibition of cumulative H⁺ secretion after 25, 50, 100, and 150 mg tiotidine was 80, 89, 96, and 98% of that observed after placebo, while 300 mg of cimetidine caused an 87% inhibition. Compared to cimetidine, tiotidine appears to be approximately eight times more potent on a molar basis than cimetidine as an inhibitor of acid secretion, and the tiotidine effect is more prolonged. This strong and safe H₂-receptor antagonist may be an important addition to the treatment of acid hypersecretory states.     

Natural bioburden levels detected on rigid lumened medical devices before and after cleaning

Controversy exists concerning the degree of microbial contamination associated with the us of rigid lumened medical devices, the efficacy of standard cleaning techniques used to remove pathogenic microorganisms from lumen channels, and whether patients are placed at risk of cross infection because of microbial contamination. In this study the level and types of microorganisms found on rigid lumened medical devices before and after cleaning in a hospital environment were investigated. The bioburden level after clinical use was found to be relatively low, ranging from 10¹ to 10⁴ colony forming units (CFU) per device. After the instruments were cleaned, none of the devices studied contained bioburden levels greater than 10⁴ CFU and 83% had bioburden levels less than or equal to 10² CFU. The bioburden present before cleaning was comprised of organisms derived from the handling of the device, from the hospital environment, and from the patient. The bioburden present after cleaning was comprised of organisms typically derived from the handling of the device and from the hospital environment. The level of bioburden per device was also related to the anatomic site where the device was used, with lower numbers of organisms found on devices exposed to sterile body sites and the respiratory tract.     

A narrative review of imaging in calcinosis associated with systemic sclerosis

Clinical Rheumatology - Calcinosis is dystrophic calcification of the soft tissue which can lead to painful and debilitating disease. It is commonly seen in patients with systemic sclerosis (SSc)....     

Effect of Two Types of Active Recovery on Fatigue and Climbing Performance

Performing intra-session recovery is important in rock climbing due to the multiple efforts that climbers are required to make in competitions, as well as repeated climbing trials that they carry out during training sessions. Active recovery has been shown to be a better option than passive recovery. However, the type of active recovery that should be done and the influence of the type and quantity of muscle mass activated are not clear. The aim of this study was to compare the effects of recovering with easy climbing (CR) or walking (WR) on markers of fatigue and climbing performance. For this purpose, 14 subjects participated in this randomly assigned crossover protocol completing three two-minute climbing trials separated by two minutes of active recovery with the assigned method. Seven days later participants carried out the same protocol with the other recovery method. Blood lactate (La^-), rating of perceived exertion (RPE), and heart rate (HR) were analyzed as markers of fatigue and recovery, while meters climbed (MC) and handgrip force (HF) were analyzed for performance. La- values before the last climbing trial (p < 0.05; d = 0.69) and Peak La- values (p < 0.05; d = 0.77) were lower for CR than for WR. Climbers were able to ascend more meters in the set time when following the CR protocol (p < 0.01; d = 0.6), which shows the important role of the active recovery method carried out on climbing performance. There were no differences in HR, HF or RPE between protocols. A more sport-specific recovery protocol, in addition to moving great muscle mass (e.g. lower limbs), seems to enhance recovery and to facilitate lactate removal. For this reason, CR appears to be a more effective active recovery method than WR in sport rock climbing.

Key points

• Climbing recovery improved lactate removal in comparison with walking recovery.
• Subjects were able to climb more meters in a determined time when easy climbing instead of walking during recoveries.
• Activating both great muscle mass like that of the lower limbs as well as the main fatigue producing muscles (forearms in climbing) seems more effective for recovering than activating just great muscle mass.

Key words: Blood lactate, rock climbing, handgrip force, active recovery, fatigue, performance     

An insight into the sialotranscriptome of Triatoma matogrossensis, a kissing bug associated with fogo selvagem in South America

Triatoma matogrossensis is a Hemiptera that belongs to the oliveirai complex, a vector of Chagas' disease that feeds on vertebrate blood in all life stages. Hematophagous insects' salivary glands (SGs) produce potent pharmacologic compounds that counteract host hemostasis, including anticlotting, antiplatelet, and vasodilatory molecules. Exposure to T. matogrossensis was also found to be a risk factor associated with the endemic form of the autoimmune skin disease pemphigus foliaceus, which is described in the same regions where Chagas' disease is observed in Brazil. To obtain a further insight into the salivary biochemical and pharmacologic diversity of this kissing bug and to identify possible allergens that might be associated with this autoimmune disease, a cDNA library from its SGs was randomly sequenced. We present the analysis of a set of 2,230 (SG) cDNA sequences, 1,182 of which coded for proteins of a putative secretory nature.     

Exploiting PI3K/mTOR signaling to accelerate epithelial wound healing

The molecular circuitries controlling the process of skin wound healing have gained new significant insights in recent years. This knowledge is built on landmark studies on skin embryogenesis, maturation, and differentiation. Furthermore, the identification, characterization, and elucidation of the biological roles of adult skin epithelial stem cells and their influence in tissue homeostasis have provided the foundation for the overall understanding of the process of skin wound healing and tissue repair. Among numerous signaling pathways associated with epithelial functions, the PI3K/Akt/mTOR signaling route has gained substantial attention with the generation of animal models capable of dissecting individual components of the pathway, thereby providing a novel insight into the molecular framework underlying skin homeostasis and tissue regeneration. In this review, we focus on recent findings regarding the mechanisms involved in wound healing associated with the upregulation of the activity of the PI3K/Akt/mTOR circuitry. This review highlights critical findings on the molecular mechanisms controlling the activation of mTOR, a downstream component of the PI3K–PTEN pathway, which is directly involved in epithelial migration and proliferation. We discuss how this emerging information can be exploited for the development of novel pharmacological intervention strategies to accelerate the healing of critical size wounds.     

Tratamiento quirúrgico de la mediastinitis necrosante descendente

Introduction

Descending necrotizing mediastinitis (DNM) is a serious infection which occurs as a complication of oropharyngeal infection. Its surgical management and the routine transthoracic approach remain controversial. In this article we report our experience in the management of this disease, and review the different surgical approaches that have been reported in the medical literature.

Material and methods

A retrospective review was made of the clinical records of 29 patients treated between 1988 and 2009. Several demographic variables were analyzed, origin of the initial infection, stage of the disease according to Endo's classification, surgical technique and outcome.

Results

Surgical treatment consisted of both cervical and mediastinal drainage and radical debridement. The mediastinal drainage was made through a transcervical approach in 10 cases and transthoracic in 19, depending on the extent of the mediastinitis. The outcome was satisfactory in 24 patients and 5 died (mortality 17.2%).

Conclusions

According to our results and the conclusions of the main authors, we recommend a prompt and aggressive surgery with a transthoracic approach in cases of widespread DNM.