Plasmapheresis vs. immunoglobulin in autoimmune neurologic diseases: a meta-analysis

Objectives: to evaluate the efficacy and safety of human immunoglobulin versus plasmapheresis in the management of autoimmune neurologic diseases. Likewise, length of hospital stay and duration of ventilator support were compared. Methods: Randomized controlled trials and analytical observational studies of more than 10 cases, were reviewed. Cochrane Neuromuscular Disease Group trials, MEDLINE, EMBASE, HINARI Ovid, the Database of abstracts of reviews of effectiveness and the Economic evaluation Database were searched as data source. Reference lists were examined for further relevant articles. A random-effect model was used to derive a pooled risk ratio. Results: 725 articles were found and 27 met the criteria for a population studied of 4717 cases: 14 articles were about Guillain Barré syndrome, 10 of Myasthenia Gravis, one of Sydenham Chorea, one of Chronic inflammatory demyelinating polyneuropathy, and one of PANDAS. No evidence was found in favor of any of the two treatments as regards effectiveness (OR 0.94, IC 0.63 – 1.41, p= 0.77) or ventilator support time; IGIV had a significant better safety profile than plasmapheresis (OR 0.70, IC 0.51 – 0.96, p= 0.03) and patients needed less time of hospital stay (p=0.03). Conclusions: There is no evidence for superiority in the effectiveness of immunoglobulin or plasmapheresis in the management of autoimmune neurologic diseases. Nevertheless, patients treated with immunoglobulin have statistically significant less adverse effects, a shorter hospital stay and a tendency of less ventilator support time. These premises could lead to fewer costs for health services but an economic study should be done.

Two isomeric reaction products: hydrogen-bonded sheets in methyl 4-(5-amino-3-phenyl-1H-pyrazol-1-yl)-3-nitrobenzoate and hydrogen-bonded chains of edge-fused rings in methyl 3-nitro-4-[(5-phenyl-1H-pyrazol-3-yl)amino] benzoate

In methyl 4-(5-amino-3-phenyl-1H-pyrazol-1-yl)-3-nitrobenzoate, C17H14N4O4, the molecules are linked into complex sheets by a combination of N-H center dot center dot center dot N, N-H center dot center dot center dot O and C - H center dot center dot center dot O hydrogen bonds. In the isomeric methyl 3-nitro-4-[(5-phenyl- 1H-pyrazol-3-yl)amino] benzoate, molecules exhibit a polarized molecular-electronic structure and are linked into chains of edge-fused rings by a combination of N-H center dot center dot center dot O and C - H center dot center dot center dot O hydrogen bonds.

“Superficial Water Concessions In Light Of The General Theory of the Administrative Act” The Incidence of the Public Law’s Dogmatic Tradition of Public Law Within Environmental Law

This paper seeks the determine the ways in which anomalous decisions derived from the particularization and constitutionalization of environmental law can arise given the general theory of administrative action. This is seen through the lens of a study and characterization of administrative decisions issued by the Regional Autonomous Corporation of Cundinamarca –CAR- within the superficial water concessions procedure. It also discusses the conceptual contents of these licenses.

Las TIC en la administración de la cadena de suministro y su incidencia en el desempeño operacional

Las tecnologías de la información han empezado a ser un factor importante a tener en cuenta en cada uno de los procesos que se llevan a cabo en la cadena de suministro. Su implementación y correcto uso otorgan a las empresas ventajas que favorecen el desempeño operacional a lo largo de la cadena. El desarrollo y aplicación de software han contribuido a la integración de los diferentes miembros de la cadena, de tal forma que desde los proveedores hasta el cliente final, perciben beneficios en las variables de desempeño operacional y nivel de satisfacción respectivamente. Por otra parte es importante considerar que su implementación no siempre presenta resultados positivos, por el contrario dicho proceso de implementación puede verse afectado seriamente por barreras que impiden maximizar los beneficios que otorgan las TIC.