Natural compounds based chemotherapeutic against Chagas disease and leishmaniasis: mitochondrion as a strategic target

Over the past years, natural products have been explored in order to find biological active substances to treat various diseases. Regarding their potential action against parasites such as trypanosomatids, specially Trypanosoma cruzi and Leishmania spp., much advance has been achieved. Extracts and purified molecules of several species from genera Piper, Tanacetum, Porophyllum, and Copaifera have been widely investigated by our research group and exhibited interesting antitrypanosomal and antileishmanial activities. These natural compounds affected different structures in parasites, and we believe that the mitochondrion is a strategic target to induce parasite death. Considering that these trypanosomatids have a unique mitochondrion, this cellular target has been extensively studied aiming to find more selective drugs, since the current treatment of these neglected tropical diseases has some challenges such as high toxicity and prolonged treatment time. Here, we summarise some results obtained with natural products from our research group and we further highlighted some strategies that must be considered to finally develop an effective chemotherapeutic agent against these parasites.

Drug Repositioning for COVID-19 / Reposicionamiento de medicamentos para COVID-19

Abstract Drug repositioning is a strategy that identifies new uses of approved drugs to treat conditions different from their original purpose. With the advance of COVID-19 and the pandemic declaration; It has become the closest alternative to reduce the advance of the virus. Antimalarial, antiviral drugs, antibiotics, glucocorticoids, monoclonal antibodies, among others, are being studied; their findings, although preliminary, could establish a starting point in the search for a solution. In this review, we present a selection of drugs, of different classes and with potential activity against COVID-19, whose trials are ongoing; and as proofs of concept, double blind, add-on event-driven, would allow proposing research that generates results in less time and preserving quality criteria for drug development and approval by regulatory agencies.

Resumen El drug repositioning, es una estrategia que identifica nuevos usos de medicamentos aprobados, para tratar condiciones diferentes a las de su propósito original. Con el avance del COVID-19 y la declaración de pandemia; se ha convertido en la alternativa más cercana para frenar el avance del virus. Fármacos antimalariales, antivirales, antibióticos, glucocorticoides, anticuerpos monoclonales entre otros están siendo estudiados; sus hallazgos, aunque preliminares, podrían establecer un punto de partida en la búsqueda de la solución. En este artículo, se presenta una selección de fármacos, de distinta clase y con potencial actividad para combatir al COVID-19, cuyos ensayos se encuentran en curso; y como las prueba de concepto, double blind, add-on event-driven, permitirían proponer investigaciones que generen resultados en menor tiempo y conservando los criterios de calidad para el desarrollo de medicamentos y su aprobación por las agencias reguladoras.

Pterigión recidivante y sus alternativas terapéuticas / Recurrent pterygium and its therapeutic alternatives

RESUMEN El pterigión se trata de un crecimiento fibrovascular de morfología triangular que se extiende desde la conjuntiva hacia la córnea. Está clasificado dentro de las degeneraciones no involutivas o tumoraciones epiteliales benignas corneales y se presenta en el 10,2 por ciento de la población. El tratamiento quirúrgico es el más indicado, y tiene una tasa de recidiva independientemente de la técnica quirúrgica utilizada del 10,7 por ciento; esta tasa de recidiva se evidencia por la neovascularización y el tejido cicatrizal antes de los dos meses después de la cirugía. Lo anterior ha incentivado la investigación de nuevos tratamientos que disminuyan esta complicación, por lo que el objetivo de esta revisión bibliográfica fue la búsqueda de alternativas terapéuticas para el pterigión recidivante. Se realizó una búsqueda automatizada sobre el tema, utilizando la plataforma Infomed, cuya información fue resumida para la elaboración del informe final. Concluimos que existen diferentes tratamientos adyuvantes para disminuir la tasa de recurrencia, y es necesario realizar estudios donde se determine el tiempo y la frecuencia en la aplicación de estos para obtener resultados más efectivos en su uso(AU)

ABSTRACT Pterygium is a fibrovascular growth of triangular shape that extends from the conjunctiva to the cornea. It has been classified as a noninvolutionary degeneration or benign corneal epithelial tumor which affects 10.2 percent of the population. The treatment most commonly indicated is surgery, which has a recurrence rate of 10.7 percent, irrespective of the surgical technique used. Recurrence takes the form of neovascularization and scar tissue within two months after surgery. This has fostered research into new treatments to reduce this complication. The objective of the present bibliographic review was precisely to search for therapeutic alternatives for recurrent pterygium. An automated search was conducted about the topic on the platform Infomed. Data were summarized to write the final report. We concluded that there are several adjuvant treatments to reduce recurrence, and it is necessary to carry out studies determining the time and frequency of their application to obtain more effective results(AU)

Therapeutic alternatives for the prevention of intra peritoneal adhesions

Intestinal adhesions are bands of fibrous tissue created by the intimate contact of two injured surface tissues; these appear in 93% of the patient undergoing intra-abdominal or gastrointestinal surgery. The comorbidities associated with the formation of adhesions have an impact on quality care offered to patients, leading to an increase in healthcare. Goals of this study was to perform a review that includes different therapeutic alternatives in basic and clinical research to prevent the formation of postoperative abdominal peritoneal adhesions. A bibliographic search was conducted in different databases including Pub med, Medline, Cochrane, science direct, from the years 2000 to 2018 using the keywords: gastrointestinal adhesions, small bowel obstruction, prophylaxis, treatment. Only experimental and clinical articles were selected. The development of peritoneal adhesions in most of the experimental studies occurred with cecal abrasion, studying the effect of biodegradable materials, drugs and gels such as mXG Hydrogel. Nanofiber membranes, agents created with recombinant technology such as periostin antisense oligonucleotide and aerosol applications such as polysaccharide 4DryField PH, are positioned to replace in the future the actual limited mechanical barriers application commonly used in abdominal surgery such as seprafilm and interceed. There are several anti-adhesion agents in experimental phase with different mechanism of action that could be used in the short term to prevent the formation of post-surgical intestinal adhesions. The inclusion of gastrointestinal surgeons in basic research is increasing and necessary with multidisciplinary collaboration. It is expected in short term the study and development of a greater number of materials to minimize tissue trauma and decrease the formation of post-surgical adhesions.

¿Cuánto sabemos los médicos sobre transfusión de sangre y hemocomponentes? / How much do doctors know about blood transfusion and blood components?

Analizamos los conocimientos de médicos generales y especialistas de la Caja Nacional de Salud, sobre indicaciones, beneficios y riesgos de las transfusiones sanguíneas y de hemocomponentes antes de la implementación del nuevo formulario de solicitud de transfusión de sangre y/o hemocomponentes del Programa Nacional de Sangre y de la Caja Nacional de Salud. Distribuimos 207 encuestas autoaplicadas a médicos generales y especialistas de diferentes hospitales y centros médicos de la Caja Nacional de Salud regional La Paz; las encuestas contenían 8 preguntas extraídas del último acápite del nuevo formulario de solicitud de transfusión sanguínea. Se incluyeron según criterios 141 encuestas. El 90.8% de los profesionales esperaron encontrar mejoría clínica con la transfusión, el 99.3% conocen los riesgos de transmisión de infecciones a través de estas, el 92.9% evalúan los beneficios y riesgos antes de indicarla y el 66.6% de profesionales registran en la historia clínica las razones de su indicación; sin embargo, existe poco conocimiento sobre alternativas terapéuticas antes de transfundir y las indicaciones de transfusión sanguínea no son uniformes. La estrategia de ahorro de transfusión tiene que partir de la capacitación del personal médico relacionado con su indicación, de la elaboración de un manual del uso adecuado de hemocomponentes y de protocolos de utilización de estimulantes hematínicos y folatos en casos de rescate preoperatorio, anemias ferropénicas y megaloblásticas y de la conformación de comités de hemovigilancia de acuerdo a las políticas del Programa Nacional de Sangre.

We analyzed the knowledge of general and specialists doctors from the Caja Nacional de Salud, about indications, benefits and risks of blood transfusions and blood derivatives before the implementation of the new blood transfusion application form or blood derivatives of the National Blood Program and the Caja Nacional de Salud. We distributed 207 self applied enquiries to general and specialist medics from different hospitals and medical centers from the Caja Nacional de Salud, the enquiries included 8 questions extracted from the last paragraph of the new blood transfusion application form; 141 enquires were included by criteriain the study; 90.8% of professionals expected to find clinical improvement with transfusion, 99.3% know the transmission of infection risks through these, 92.9% evaluated benefits and risks before commanding the blood transfusion, 66.6% of register in the clinical history the reasons for the indication, however, there is a few knowledge about the therapeutic alternatives before transfuse and the blood transfusion indications are not uniform. The transfusion-saving strategy has to begin with the training of medical personnel related to indications, the development of a adequate user manual of blood derivatives and stimulants haematinics and folates use protocols in preoperative rescue cases, ferropenic, megaloblastic anemias and the creation hemosurveillance committee in accordance with the policies of the National Blood Program.