Medicina
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The aim of the present work was to describe the distribution of lymphocyte P-glycoprotein activity on a population of healthy individuals, taking also into account sex and age. P-glycoprotein activity in lymphocytes was measured by the Rhodamine 123 efflux assay using flow cytometry, in the presence and absence of verapamil, a P-glycoprotein inhibitor. We obtained a range of P-glycoprotein activity from 1.04 to 3.79. ⋯ When healthy volunteers were separated according to sex, similar distributions were observed, although for men an increase in proportion of higher P-glycoprotein function group was observed. The variability observed in the population studied was important, with some volunteers with very scarce activity and some with a fourfold higher activity. Characterization of P-glycoprotein functionality in the population represents a useful contribution to the beginning of pharmacological treatments that consider its effect on pharmacokinetics and pharmacodynamics of individualized patients.
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Pulmonary disease due to nontuberculous myco bacteria is a well known clinical entity, being Mycobacterium avium complex the pathogen most frequently involved. The Lady Windermere syndrome is a variation of this disease, as interesting as it is little known.
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Letter Biography Historical Article
[Should Wegener's disease retain its name?].
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A 29 year old woman suffered massive brain injury after a cerebellum hemorrhage at 17 weeks' gestation. Several hours later, and after brainstem test, she was declared brain dead. ⋯ After a cardiac arrest, on week 25, a 450 g infant was delivered through a cesarean section. The somatic support of mother and fetus according to the expected physiologic changes after brain death and its ethical implications are discussed.
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Informed consent should be the expression of active participation of patients in the decision-making process. It is an application of the ethical principle of respect for patient autonomy. However, there are some concerns about the direct extrapolation of the Anglo-saxon concept of autonomy into other societies which could impose an unwanted level of patient participation. ⋯ These results suggest that in the current medical environment, one previously dominated in Argentina by a tendency towards beneficient paternalism on the part of physicians and surgeons, patients want to be extensively informed about risks, benefits, and procedural alternatives before electing to undergo a surgical procedure. Patient preferences regarding how family members should be involved in the decision-making should be elicited. Careful consideration is warranted, however, in the way health care providers might address risks of procedure-related death so that subjects who do not want to know about this risk can be identified.