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Articulo de investigación basado en un estudio etnomedicinal, de “caso cerrado”, realizado en el 2008 en el norte del Perú, de carácter descriptivo y participativo, desarrollado a través de la observación participante en 56 sesiones en la cual se atendieron 209 pacientes, para verificar las propiedades de la medicina tradicional peruana de la curación con el cactus San Pedro a través de los rituales de la Mes,a que realiza el curandero Marco Carbajal ( quien hace parte del grupo de investigación) para lo cual se hizo un seguimiento de los pacientes con consentimiento informado, de sus afecciones o enfermedades tratadas con la medicina convencional sin resultados satisfactorios. La investigación describe dos estudios de caso individuales.

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina Interna de Mexico is the property of Colegio de Medicina Interna de Mexico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Procalcitonin quantification has multiple uses, it has been used as a mortality predictor and as a guide for the use of empiric antibiotics; nevertheless, because of variations, various ranges and interindividual variability, its use as a predictor of survival and mortality based in a single procalcitonin absolute value is nowadays considered invalid. Dynamic changes in procalcitonin serum values have shown to be more predictive in severe sepsis and septic shock outcomes than a single procalcitonin value. The results in procalcitonin depuration were compared with different gravity scales such as APACHE II, SOFA and SAPS. Results showed that rapid procalcitonin depuration at 24 and 48 hours is associated with lower mortality rates. [ABSTRACT FROM AUTHOR]

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Unlabelled: The aim of this study was to investigate pain management in neonatal intensive care units (NICUs) in France and to identify factors associated with variability across units. A questionnaire sent to 143 heads of level II or III NICUs investigated the use of pain scores, pain management organization and pharmacological treatment in five clinical situations (endotracheal intubation, prolonged mechanical ventilation, acute stage of necrotizing enterocolitis, central venous catheter insertion and cephalhaematoma). The response rate was 81%. Among the 35 (30%) units that used no pain scores, 40% ascribed this to lack of knowledge. Factors associated with failure to use pain scores were level II status, no university affiliation, no surgical patients and neonatal patients only. Among the units that scored pain, 78% used valid scores for acute pain and 73% for prolonged pain. Written guidelines were available for acute pain in 65% of units and for prolonged pain in 36%. The rate of pharmacotherapy use varied widely across the five clinical situations studied (from 16 to 77%) and across units for a given clinical situation. Also extremely variable were the regimens used in each situation and the dosages of analgesics and sedatives. Only 11% of units adjusted dosages to gestational age.Conclusion: Pain assessment was performed in the most French NICUs, but a strong heterogeneity for pain treatment was observed. Reference to recently published pain management guidelines and new randomized trials could be useful to optimize pain treatment in NICUs. [ABSTRACT FROM AUTHOR]

Introduction Boldo is an extract of a Chilean tree leave ( Peumus boldus mol ) that have been traditionally employed in folk medicine. We have presented a case of subtherapeutic tacrolimus levels in a renal transplant patient while taking boldo. In the literature search, no interaction has been reported between boldo and tacrolimus. Case Report A 78-year-old Hispanic man with history of diabetes mellitus, hypertension, and deceased donor renal transplant in 2005 presented to the renal clinic for regular follow-up on September 1, 2010. No complaints were reported and physical examination was unremarkable. Laboratory tests taken on July 26, 2010, were significant for tacrolimus level of <3 ng/mL (measured by liquid chromatography/tandem mass spectrometry) and serum creatinine of 1.2 mg/dL (106 μmol/L). Medications included tacrolimus 2 mg bid and mycophenolate 500 mg bid. On further inquiry, the patient admitted taking herbal medication, boldo 300 mg bid, for the last few weeks. There was no change in his regular medications. He was adherent to his medication. He had been taking tacrolimus from the same company and pharmacy since August 2009. The last dose of boldo was on September 1, 2010. One week after he stopped taking boldo, tacrolimus level was 6.1 ng/mL (9/8/2010) on the same tacrolimus dose of 2 mg bid. Tacrolimus dose was increased to 3 mg bid (9/9/2010), awaiting tacrolimus levels. Subsequent levels (ng/mL) were 8.6 and 9.5, which made us resume the prior tacrolimus dose (2 mg bid). Conclusions We have reported a case of an allograft renal transplant recipient who presented to the clinic with subtherapeutic levels of tacrolimus while taking the herbal remedy boldo. Tacrolimus levels rose to the intended target after discontinuation of boldo. Although it is a single case report, our observation suggests a possible herb–drug interaction. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Obesity is a chronic and recurrent inflammatory disease, associated with high risk to health. It is a world public health problem that affects children and adolescents. It is present in rich and poor countries. Type 2 diabetes, systemic arterial hypertension, blood lipid disorders, and cardiovascular disease together compose the metabolic syndrome (BMI > 95th percentile, weight circumference ≥ 85th percentile, serum glucose ≥ 100 mg/dL, high-density lipoprotein cholesterol ≤ 40 mg/dL, serum triglycerides ≥ 110 mg/dL); orthopedic lesions and psychosocial problems (marginalization and depression) are present early in life in obese individuals. OBJECTIVE: The objective of this study was to describe the frequency of comorbidity in a cohort of 185 obese Mexican children and adolescents. METHODS: A total of 185 obese Mexican children and adolescents were included in the study. The following parameters were measured: BMI, serum lipid profile, serum glucose, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and serum uric acid. Complete physical examinations were performed, including blood pressure measurements. RESULTS: BMI was at the 95th percentile in 97% of cases; 75% had ≥1 clinical indicator of comorbidity associated with obesity. Skin lesions (nigricans acanthosis; folliculitis; and grooves in hip, abdomen, and upper and lower extremities), serum lipid disorders (high level of serum triglycerides, low level of high-density lipoprotein cholesterol), systemic arterial hypertension, and others (eg, hypertransaminemia, hyperuricemia, orthopedic lesions) were the most common. CONCLUSIONS: Obesity in children and adolescents is a severe world public health problem. Obese children and adolescents frequently had associated comorbidity. It is necessary to improve health, juridical, and educational world policies that prevent and support the treatment of obesity in early life. [ABSTRACT FROM AUTHOR]

Objectif Epidémiologie comparative des gestes douloureux entre 2005 et 2011 chez le nouveau-né en réanimation. Matériel et méthodes Recueil prospectif pendant 14 jours des gestes stressants et douloureux pratiqués chez 589 nouveau-nés dans les 16 unités de réanimation néonatale d’Ile de France. Résultats La moyenne (DS) d’âge gestationnel et de durée de participation à l’étude étaient respectivement de 33,3 (4,5) semaines d’aménorrhée et de 7,4 (4,5) jours. Les nouveau-nés ont subi 103239 gestes dont 40927 (39,6%) douloureux et 62312 (60,4%) stressants. La médiane (extrêmes) du nombre total des gestes par enfant a été de 125 (3-699) pendant l’étude et de 21 (2–50) par jour d’hospitalisation. Quant aux gestes douloureux, la médiane (extrêmes) a été de 44 (0–353) pendant l’étude et de 8 (0–27) par jour d’hospitalisation. Sur les 40927 gestes douloureux, 38,8% ont été réalisés avec une analgésie spécifique au geste et 61,8% avec une analgésie spécifique et/ou une analgésie par perfusion continue de fond. Ces chiffes étaient supérieurs à ceux retrouvés lors de l’étude Epippain1 en 2005 qui étaient de 34,2% et 50,9%, p< 0,001 respectivement. Conclusion Le nombre de gestes douloureux et stressants demeure important. L’utilisation des moyens analgésiques a augmenté entre 2005 et 2011. [ABSTRACT FROM AUTHOR]