Revista PnP n°pdf. Uploaded Download as PDF or read online from Scribd. Flag for .. PDF. Uploaded by. dilson_santos_ti · Manual Drone. Uploaded by. Um caso de Pênfigo Paraneoplástico (PNP) associado à doença de Castleman Abstract: We present a case of PNP associated with Castleman's Disease. La Revista Energética es publícada cuatrimestralmente por la. Secretaría pnp s::i1t? d!:>uµ d so1 gp. º!.m. 1uaA. U!un. 'sop npos. R8. /SOP. ilP! JO d¡so pn.
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La investigación del Comandante PNP Roger Pérez Figueroa “El Titán de Carcabón”. 6. Víctor Cuadrado de la Cruz, Revista “La Antorcha”, año 76, p. PDF | On May 15, , K. Specht and others published Specht Ersland PnP fMRI Revista v16 p the PNP switch outputs. The programmed data is stored in an EEPROM, providing security even in the event of power failure. The sensors DN GPP and DN.
Further, several studies and metaanalyses have found inverse associations between objective measures of cognitive function and plasma or serum Hcy concentrations82,, but others not95, The increased risk for cerebrovascular disease could be due to a toxic effect of Hcy on vascular tissue Regarding dementia, the interaction between B6 and Hcy is not clearly established.
A recent study98 showed a prevalence of low B6 levels in 5. Nevertheless, low vitamin B6 status has been associated with Alzheimer's disease AD and vascular dementia. Miller and others have recently reported that low PLP levels were strongly associated with AD, but not with cerebrovascular disease On the contrary, Fabbender and coworkers reported that compared with patients without cerebrovascular disease, patients with subcortical vessel encephalopathy showed significantly decreased plasma concentrations of vitamin B In both studies, there was an association between Hcy and AD and microangiopathic vascular dementia, respectively, while there was no correlation between Hcy levels and vitamin B6.
Another study found a strong relationship between periventricular and subcortical white matter lesions and low vitamin B6 levels in patients with AD Convulsive seizures Since the fifties and sixties, PN deficiency is known to cause convulsive seizures in humans and experimental animals. Hence, a number of investigators reported disorders in central nervous system CNS activity in adults and infants The neurological disorders in the infants manifested itself within 6 weeks up to 4 months by convulsive seizures, hyperirritability, and abnormal acuteness of the sense of hearing.
Two reviews from the eighties summarised research on causative factors responsible for convulsions during vitamin B6 deficiency, They propose two hypotheses explaining the onset of convulsive seizures. First, it has been shown that a particular nutritional deficiency leads to the accumulation of a potentially hazardous tryptophan metabolite, 3-HK in the CNS. Kynurenine transaminases and kynureninase catalyse are the main routes of 3-HK catabolism and require PLP. Reductions in their activities should lead to a build-up of 3-HK in the body and brain.
Experimentally produced B6 deficiency by Guilarte and Wagner caused a fold increase in brain regional 3-HK levels. This increase led the authors speculate that such levels of 3-HK could be responsible for the convulsions that typically occur in infant B6 deficiency GABA concentrations are reported to be low in the brains of vitamin B6 deficient infant animals, and such animals are often seen to convulse EEG alterations Abnormal EEG-tracing changes were reported in young adult men during experimentally induced vitamin B6 deficiency in the sixties, The type of EEG abnormalities observed in the young men generally consisted of a slowing of activity with either increased or decreased wave amplitude, and minimal to marked build-up with hyperventilation, particularly in the frontal and parietal leads Abnormal patterns could be reversed administering 0.
EEG changes are probably caused by altered neurotransmitter metabolism in the brain and are thought to occur only in cases of frank B6 deficiency.
However, before ruling out the possibility of EEG abnormalities occurring at marginal levels of vitamin B6 intake, research employing quantitative analysis of the EEG spectral data should be conducted To our knowledge such research is still lacking.
Neuropathies In the sixties, peripheral neuropathies have been reported in PN deficiency Demyelination of peripheral nerves has been observed, which could be caused by a disturbance of sphingomyelin synthesis owing to a lack of PLP as cofactor for serine-palmityl-transferase. Recently, peripheral neuropathy caused by vitamin B6 deficiency has been reported in patients on chronic peritoneal dialysis.
Symptoms included paresthesia, burning and painful dysthestias, and thermal sensations Interestingly, Gorson and Ropper found in diabetic patients with distal sensory polyneuropathies as most common laboratory abnormalities low levels of vitamin B6 or B1. They concluded that the frequency of low vitamin levels suggests that vitamin B1 and B6 levels should be assessed in future studies of diabetic patients with distal sensory polyneuropathies CVD and Hcy Suboptimal vitamin B6 nutriture was first associated with vascular disease following development of atherosclerosis in monkeys fed a B6 deficient diet Later, some researchers reported that estimated dietary intake of vitamin B6 and folate, and plasma concentrations of PLP and folate, were lower in patients who had myocardial infarction than in controls.
They also reported that the frequency of myocardial infarction was negatively correlated with both folate and vitamin B6 nutriture. Others confirmed the association of Hcy and vitamin B6 31, Results of epidemiologic studies suggest that moderately elevated plasma or serum Hcy levels are prevalent in the general population and are associated with increased risk for CVD, independent of classical cardiovascular risk factors94, It is still unknown if this is due to the effect of vitamin B6 on platelet function, connective tissue, blood pressure, thrombogenesis or, indirectly by causing hyperhomocysteinemia Further, low circulating vitamin B6 levels have been associated with elevation of the inflammation marker C-reactive protein independently of plasma Hcy How to handle vitamin B6 deficiency?
Although overt clinical deficiency of vitamin B6 occurs only rarely, nutrition surveys indicate that vitamin B6 intakes may be marginal or inadequate in segments of the population. Consequently, the presence of a subclinical deficiency may be fairly widespread. Especially in the elderly there is a high prevalence of deficient or borderline vitamin B6 status. A borderline deficient status, which might persist in an individual for a long time without developing clinical manifestations, could have pathological consequences.
It may contribute to the development of certain diseases, as already stated above. Treatment of B6 deficiency 1 Treatment of clinical deficiency Treatment of vitamin B6 deficiency implies mega doses of this vitamin via oral. Some drugs table III such as isoniacid, penicillamine, hydralazine, L-Dopa and cycloserine interfere with PLP reacting with the carbonyl groups, The requirements of vitamin B6 increase in eclampsia and preeclamsia, and haemodialysis.
B6-dependent syndromes, which require pharmacological doses of the vitamin, are seldom. Treatment consists of very high pharmacological doses of PN Supplementation of PN hydrochloride in various medical conditions and their doses are shown in table IV. Since a subclinical vitamin B6 deficiency has been associated to several chronic diseases especially in the elderly, a supplementation in this group seems to be indicated. Results of 11 studies that investigated the effect of vitamin B6 on fasting plasma Hcy concentrations are inconclusive.
Seven of the aforementioned studies, found no change in fasting Hcy, and one found a significant increase Some studies found a significant reduction in fasting Hcy after vitamin B6 supplementation The first of these studies, carried out in young women who had clinical and biochemical vitamin B6 deficiency, found a significant lowering of fasting Hcy of The trial, however, was not blinded or placebo-controlled and had no washout period.
McKinley et al. Since there is more than one vitamin involved in Hcy metabolism, most intervention trials use a combination supplement containing folic acid, vitamin B12, and vitamin B and therefore it is somewhat difficult to conclude the effect of a single vitamin. German data show the same pattern This indicates that the general population is not at risk for developing clinical vitamin B6 deficiency.
Further, the new DRIs set by different international organisations, are now taking into account new aspects to estimate requirements.
They do not only focus on the prevention of clinical deficiency, but try to take into account health effects that certain nutrients might have. Even though there is evidence that vitamin B6 could help to prevent CVD, certain types of cancer, and cognitive impairment, present data are insufficient to set EARs based on these new aspects. The recommended dietary allowance RDA for adults is 1. Most studies of B6 requirements have focused on adults and have been depletion-repletion studies.
Clinical symptoms of vitamin B6 deficiency have only been observed during depletion with very low levels of B6 and have never been seen at intakes of 0. Ribaya-Mercado and coworkers employed a vitamin B6 depletion-repletion protocol in healthy elderly and showed that higher than RDA men: 2. In a related series of experiments, the amount of vitamin B6 essential to restore several immunologic indices lymphocyte number and percentages, mitogenic responses, and IL-2 production to baseline values was also greater than the current DRI Higher levels of fasting insulin and plasma glucose were also observed during the periods of low vitamin B6 status Despite evidence that the requirement for vitamin B6 may be slightly higher in older adults, several surveys have found that over half of individuals over age 60 consume less than the current DRI 1.
Several studies have found elderly populations to have plasma PLP concentrations below the cut-off threshold for deficiency Food fortification The possibility to enrich food with vitamins allows it to increase the health status of the population.
The United States and Canada started with the first official guidelines concerning the fortification of food with folic acid. Further, Hungary and Chile followed the guidelines and voluntary fortification is present in Switzerland, Australia and Great Britain.
Due to the interrelationship of the vitamins that participate in the Hcy cycle, it has been debated if vitamin B6 and vitamin B12 should be added to folate-enriched foods. Toxicity Values of maximum tolerable intakes are summarised in table VI.
As a water-soluble vitamin which is rapidly metabolised and excreted, B6 might be expected to have low toxicity. In fact, no adverse effects have been associated with high intake of vitamin B6 from food sources. Some patients developed abnormally low plasma concentrations of PLP after high doses of vitamin B6. This rebound avitaminosis presumably reflects induction of pyridoxal oxidase, and hence increased catabolism of the vitamin.
Within 4 months, plasma concentrations of the vitamin return to normal without supplementation References 1. Food and Nutriton Board.
Dietary reference intakes for thiamine, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. National Academy Press. Washington DC, The binding of pyridoxal to haemoglobin. J Biol Chem ; Relationship between body store of vitamin B6 and plasma pyridoxal-P clearance: metabolic balance studies in humans. J Lab Clin Med ; Gregory JF, 3rd: Bioavailability of vitamin B6. Eur J Clin Nutr ; 51 Supl. Snell EE. Shane B, Contractor SF.
In Human vitamin B6 requirements. The metabolism of small doses of vitamin B6 in men. J Nutr ; Jansonius JN. Structure, evolution and action of vitamin B6-dependent enzymes. Curr Opin Struct Biol ; Kleijnen J. Knipschild P. Niacin and vitamin B6 in mental functioning: a review of controlled trials in humans.
Biol Psychiatry ; B vitamins, homocysteine, and neurocognitive function in the elderly. Mudd SH et al. The natural history of homocystinuria due to cystathionine beta-synthase deficiency. Am J Hum Genet ; Selhub J, Miller JW. The pathogenesis of homocysteinemia: interruption of the coordinate regulation by S-adenosylmethionine of the remethylation and transsulfuration of homocysteine.
Am J Clin Nutr ; Leklem JE. Modern Nutrition in Health and Disease. Lea and Febiger. Lumeng L, Li TK. Vitamin B6 metabolism in chronic alcohol abuse. Pyridoxal phosphate levels in plasma and the effects of acetaldehyde on pyridoxal phosphate synthesis and degradation in human erythrocytes. J Clin Invest ; Validation of the diagnostic value of vitamin B6 supplementation during pregnancy: a prospective study.
Vitamin B6. A status report. J Nutr ; Supl. Bitsch R. Int J Vitam Nutr Res ; Changes in vitamin B6 status indicators of women fed a constant protein diet with varying levels of vitamin B6. Biochemical assessment of vitamin B6 status in man. Urinary- 4-pyridoxic acid, plasma pyridoxal phosphate and erythrocyte aminotransferase levels in oral contraceptive users receiving controlled intakes of vitamin B6. Bender DA. Vitamin B6 requirements and recommendations.
Eur J Clin Nutr ; Proceedings of a Workshop. Effect of oral contraceptives and vitamin B6 deficiency on carbohydrate metabolism. Vitamin B6 requirement of young adult women. Metabolism of methionine in oral contraceptive users and control women receiving controlled intakes of vitamin B6. Park YK, Linkswiler H. Effect of vitamin B6 depletion in adult man on the excretion of cystathionine and other methionine metabolites. Tryptophan and methionine metabolism of adult females as affected by vitamin B6 deficiency.
Linkswiler HM. Methods in vitamin B6 nutrition, analysis and status assessment. Plenum Press. New York. Sturman JA. Graham IM et al.
Plasma homocysteine as a risk factor for vascular disease. The European Concerted Action Project.
JAMA ; Nutritional factors in physical and cognitive functions of elderly people. Bottomley SS. Wintrobes clinical haematology. Linkswiler H.
Revista PnP n°11.pdf
Biochemical and physiological changes in vitamin B6 deficiency. Vitamin B6 deficiency anemia. Schweiz Med Wochenschr ; The role of vitamins in the prevention and control of anaemia. Public Health Nutr ; Stoerk HC. Effects of calcium deficiency and pyridoxine deficiency on thumic atropy accidental involution.
Proc Soc Exp Biol Med ; Suppression of circulating antibodies by pyridoxine deficiency. Grimble RF. Modification of inflammatory aspects of immune function by nutrients.
Nutr Res ; Meydani SN et al. Vitamin B6 deficiency impairs interleukin 2 production and lymphocyte proliferation in elderly adults. Pyridoxine supplementation: effect on lymphocyte responses in elderly persons. Kannan K, Jain SK. Effect of vitamin B6 on oxygen radicals, mitochondrial membrane potential, and lipid peroxidation in H2O2-treated U monocytes. Free Radic Biol Med ; Pyridoxine supplementation corrects vitamin B6 deficiency but does not improve inflammation in patients with rheumatoid arthritis.
Arthritis Res Ther ; 7:RR Chiang EP et al. Inflammation causes tissue-specific depletion of vitamin B6. Elevations of serum cystathionine and total homocysteine in pyridoxine-, folate-,and cobalamin-deficient rats. J Nutr Biochem ; Blount BC et al. Folate deficiency causes uracil misincorporation into human DNA and chromosome breakage: implications for cancer and neuronal damage.
Folate depletion impairs DNA excision repair in the colon of the rat. Gut ; Vitamin B6 requirement and status assessment of young women fed a high-protein diet with various levels of vitamin B6.
DNA methylation, molecular genetic, and linkage studies in prostate cancer. Prostate Supl. The role of DNA methylation in cancer. Adv Cancer Res ; Eto I, Krumdieck CL. Essential nutrients in carcinogenesis.
Guilarte TR. Vitamin B6 and cognitive development: recent research findings from human and animal studies. Nutr Rev ; Current topics in Nutrition and Disease: clinical applications for Vitamin B6.
Liss Inc. Pyridoxal supplementation reduces cell proliferation and DNA synthesis in estrogen-dependent and -independent mammary carcinoma cell lines. Nutr Cancer ; Komatsu SI et al. Vitamin B6-supplemented diets compared with a low vitamin B6 diet suppress azoxymethane-induced colon tumorigenesis in mice by reducing cell proliferation.
Dietary vitamin B6 suppresses colon tumorigenesis, 8-hydroxyguanosine, 4-hydroxynonenal, and inducible nitric oxide synthase protein in azoxymethane-treated mice. J Nutr Sci Vitaminol Tokyo ; Wei EK et al.
Plasma vitamin B6 and the risk of colorectal cancer and adenoma in women. J Natl Cancer Inst ; Vitamin B6 may help prevent colorectal cancer in women.
A dietary component is poised to join a list of strategies that help lower our risk for this largely preventable cancer. As such their task was to oversee public morals and social progress in general.
A secret police force, known as the Civil Brigade Brigada Civil , also came into being at that time. Its mission was to identify those conspiring against Independence, whose agents were infiltrating into the administrative structures of the new government, and even into the army.
Three new ministries were created: Government and Foreign Relations which took responsibility for policing , War and the Navy, and Finance. The Guardia Nacional was staffed by soldiers released from the army and was organised on military lines; it remained part of the armed forces and constituted the army reserve.
In the serenos town watchmen of the viceroyal period were re-constituted, now properly armed and in uniform. This time the new Guard was created as a national security organization distributed in all departments, and the decree that created it issued new rules and regulations to define the functions, political authorities and the General Inspectorate of the service. The same year of its creation, , 8 Companies of Infantry Gendarmes formed into 2 Battalions and a Regiment of Cavalry Gendarmes composed of 4 Squadrons became operational.
The first Gendarmerie provisions were enacted in and However the Head of Government for Lima Dr. Juan del Mar raised a man company of Guardsmen for the duties of public security in the Peruvian capital city, independent from the Gendarmerie proper, due to its pressing needs for security.
On August 7 of , the old organization of the Gendarmerie was disbanded. Replacing it, the infantry component of the Gendarmerie were, by now, the 1st and 2nd Gendarme Infantry Battalions, and the Gendarme Cavalry Squadron.
The Police Reform and the War of the Pacific [ edit ] Don Manuel Pardo Lavalle 's presidential term commenced on August 2, , and one of his first actions was to reorganize the national police force. By Supreme Decree signed on December 31 of , with legislative approval effective April 3 of , President Manuel Pardo formally reorganized the police in the following manner: "Neighborhood Organization", composed by the neighborhood residents against criminals, by the Mayors of the respective municipalities.
Don Manuel Pardo Lavalle formally confirmed the paramilitary organization of both forces but to fulfill duties of maintaining order and security nationwide. The National Congress later on that year informed him of the readiness of the Civil Guard nationwide to fuifill the functions stated in the decree, and the fact that the Civil Guard had reached its initial operational capability.
The new "Civil Guard" would work to provide security and safety to citizens, while the Gendarmerie would maintain the safety and security of public buildings, prisons and buildings of government as well as of the civil workforce.
To help the Civil Guards in its mission, on Nov. Its formal mission is the training of all service personnel of the service.
The 2010 Emergency and Party Politics in Kingston, Jamaica
Even his enemies congratulated him due to this action and he later was promoted to the next higher grade of Guards Inspector, Peruvian Civil Guard. The Gendarmerie also became involved in the war as the 8th Lima Infantry Battalion under the command of Lt. Both services fought in all the battles of the war as the wartime reinforcement of the Peruvian Armed Forces under the Ministry of War.
Among other things, it provided for the establishment of "a school for aspiring police officers and individuals in the institution. This study was approved by the President himself, who considered the plan proposed in the 14 projects mentioned, the only reasons for the reorganization, for his excellent ways of adapting the state economy and despite the improvement of all services involved would transform the police into a modern institution.
The First Mission of the Civil Guard of Spain which helped reorganize Peru's police force in The new Civil Guard that came out of this reorganization would bear the image not just of its Spanish counterparts but also of its past: The new Civil Guard Charter in its first article stated that Honor is the principal emblem of the Civil Guard, a distinction that must never be hurt, for when it is done it will never be repaired and in other articles stated the peacetime and wartime organization of the service plus many other features.
As a result of work carried out by the Spanish Mission, the government issued July 3 of a Supreme Decree stipulating in its operative part the creation of the "School of the Civil Guard and Police of the Republic. Most of all the decree formally made the long overdue wish of the police forces to have its own officers academy.
Formerly these officer cadets of the Civil Guard, the Security Corps, and the soon to be created Investigation and Surveillance Brigade shared the same academy as the officer cadets of the Peruvian Army : the Chorrillos Military School , and shared the same reporting ministry in the War Ministry, not in the Government and Police Ministry, as well as the military tradition and rank system as part of the Peruvian Armed Forces, while the CGIC was only limited to other ranks as well as being the post graduate specialty school for the officers.
A plaque was unveiled by the presiding officers to commemorate the occasion. The academy began operations on November 4 of , had its first exams in March , and graduated on September 3, the first batch of Civil Guards officers totaling up to , 59 graduating classes all in all.
The strength of the first class of graduates from the Police Academy, addressed to the Commissioners for Lima, constituted the both State Security Corps and the reorganized Civil Guard. The brand new uniforms of the Civil Guard and the Security Corps reflected the effects of that mission: While the new Civil Guard kept the kepis with their dress beige uniforms Security Corps personnel wore peaked caps with their dress and duty blue uniforms.
Civil Guards were also distinguished by the very same items Peruvian Army cavalry officers used then in their uniforms while the Security Corps uniforms were modeled on those worn by European police services of the period. This mission also provided for the establishment of the state investigations service, in it would bear fruit with the raising of the Investigations and Surveillance Brigade of the Civil Guard, then a brigade-sized formation, and at the same time, the 1st "Republican Guard" Gendarme Battalion became a full regiment.
The combined forces, reporting to the Ministry of Government and Police from now on, were led by an Inspector General. Police organization in the rural and urban areas then were different from each other. Rural organization of the Civil Guard was on posts, lines, sectors, commands and regions while Security Corps' urban organization mirrored military organization save that, instead of companies, commissaries were the basic unit.
The cavalry was formed under the name of the Cavalry Squadron of Provincial Security, which was organized on the basis of the Cavalry Gendarme Squadron "Lima Guard" at the "Quinta de Presa", one of the new mounted police units to be raised as part of the Civil Guard. Two more were later raised, but all were disbanded in and converted to instruction squadrons in the Police Academy. On February 22, , President Augusto B. Police officer in The baptism of fire for the new Security Corps came with the death of two personnel from the service on May 26, , while on a routine mission in Villa de Olaya.
The August 18, decree established the 1st Joint Command of the Civil Guard, with an Infantry Battalion, composed of two companies, and a Cavalry Squadron formed on the basis of the former mounted police. The 1st Command would move to new quarters on 28 July Avenue on January 16, Its baptism of fire came in while fighting the forces of local rebel Eleodoro Benel Zuloeta in Cutervo Province and later while fighting warlords in Cajamarca. Due to this and other actions the Civil Guard size was increased and 3 independent companies had to be raised as a result.
A presidential decree of March 28, established August 30 every year as Police Day. Its first observance was marked by a grand parade in Lima's outskirts by all the participating units. Law No. The service was started in November of that year. The Health Services of the Police was renamed in another Supreme Decree on August 12 the same year as the Government and Police Health Services, and on the 26th of the same month the Investigation and Surveillance Brigade was elevated to a full Corps. Subsequently, the First Security Infantry Regiment, consisting of battalions, was raised, which in turn merged with the Commissioners for Lima.Not only it was the presidential guard regiment until it was also, by virtue of the provisions of the law, mandated as the following: State prisons and border guard service Maintainer of order in worse situations when required Intervening force for national security and defense During wartime, part of the Armed Forces under the War Ministry and assigned directly to the Army as a full regiment of infantry That very same year the Investigation and Surveillance Corps, through Law no.
Nonetheless, their own experience and exposure to political risk in changing the communities they represent gives them real credibility, should they seek to undertake reforms that can move Jamaica further in the direction of a more open and less violent democracy.
This gradient is maintained thanks to the immediate rephosphorylation occurring inside the cells. Hypochromic, microcytic, iron-refractory anemia B6-deficiency anemia is one form of sideroblastic anemia, characterised by ineffective erythropoiesis with hypochromic, microcytic anemia, splenomegaly, elevated tissue and serum iron, and large numbers of ringed sideroblasts in the bone marrow The younger Coke did not contest his extradition and, in August , pled guilty to charges in the Federal Court for the Southern District of New York.
In vitamin B6 deficiency, a test dose of methionine 3 g in an adult results in abnormal accumulation and excretion of Hcy and the mixed disulphide of Hcy and cysteine, as well as cystathionine and cysteine sulphinic acid, and reduced excretion of taurine