Evaluation of critical parameters in the hollow-fibre system for tuberculosis: A case study of moxifloxacin.

AIMS: The hollow­fibre system for tuberculosis (HFS­TB) is a preclinical model qualified by the European Medicines Agency to underpin the anti­TB drug development process. It can mimic in vivo pharmacokinetic (PK)­pharmacodynamic (PD) attributes of selected antimicrobials, which could feed into in silico models to inform the design of clinical trials. However, historical data and published protocols are insufficient and omit key information to allow experiments to be reproducible. Therefore, in this work, we aim to optimize and standardize various HFS­TB operational procedures. METHODS: First, we characterized bacterial growth dynamics with different types of hollow­fibre cartridges, Mycobacterium tuberculosis strains and media. Second, we mimicked a moxifloxacin PK profile within hollow­fibre cartridges, in order to check drug­fibres compatibility. Lastly, we mimicked the moxifloxacin total plasma PK profile in human after once daily oral dose of 400 mg to assess PK­PD after different sampling methods, strains, cartridge size and bacterial adaptation periods before drug infusion into the system. RESULTS: We found that final bacterial load inside the HFS­TB was contingent on the studied variables. Besides, we demonstrated that drug­fibres compatibility tests are critical preliminary HFS­TB assays, which need to be properly reported. Lastly, we uncovered that the sampling method and bacterial adaptation period before drug infusion significantly impact actual experimental conclusions. CONCLUSION: Our data contribute to the necessary standardization of HFS­TB experiments, draw attention to multiple aspects of this preclinical model that should be considered when reporting novel results and warn about critical parameters in the HFS­TB currently overlooked.

Implications in Cancer of Nuclear Micro RNAs, Long Non-Coding RNAs, and Circular RNAs Bound by PRC2 and FUS.

The eukaryotic genome is mainly transcribed into non-coding RNAs (ncRNAs), including different RNA biotypes, such as micro RNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), among others. Although miRNAs are assumed to act primarily in the cytosol, mature miRNAs have been reported and functionally characterized in the nuclei of different cells. Further, lncRNAs are important regulators of different biological processes in the cell nucleus as part of different ribonucleoprotein complexes. CircRNAs constitute a relatively less-characterized RNA biotype that has a circular structure as result of a back-splicing process. However, circRNAs have recently attracted attention in different scientific fields due to their involvement in various biological processes and pathologies. In this review, we will summarize recent studies that link to cancer miRNAs that have been functionally characterized in the cell nucleus, as well as lncRNAs and circRNAs that are bound by core components of the polycomb repressive complex 2 (PRC2) or the protein fused in sarcoma (FUS), highlighting mechanistic aspects and their diagnostic and therapeutic potential.

Exposición a ondansetrón en el primer trimestre de gestación y riesgo de malformaciones congénitas: revisión sistemática y metaanálisis / Exposure to ondansetron in the first trimester of pregnancy and risk of congenital malformations: systematic review and meta-analysis

Resumen OBJETIVO: Determinar si la exposición al ondansetrón en el primer trimestre del embarazo se asocia, en general, con mayor riesgo de malformaciones orofaciales, cardiopatías congénitas, defectos del septo interventricular, de labio o paladar hendidos. MÉTODOLOGÍA: Revisión sistemática y metanálisis de estudios aleatorizados, cohortes y casos y controles publicados en las bases de datos de PubMed, EMBASE y LILACS. RESULTADOS: Se incluyeron 15 estudios: 11 de cohorte y 4 de casos y controles, con 245,679 mujeres expuestas al ondansetrón en el primer trimestre del embarazo. No se encontró una asociación estadísticamente significativa con malformaciones congénitas en general (RM 1.1; IC95%: 0.99-1.22; I2: 72%), con cardiopatías congénitas (RM 1.05; IC95%: 0.95-1.19; I2: 78%) y con comunicación interventricular (RM 1.2; IC95%: 0.97-1.45; I2: 85%). Se encontró un pequeño aumento en el riesgo de defectos orofaciales en general (RM 1.17; IC95%: 1.04-1.32; I2:0%), no se encontró un riesgo mayor de defecto de labio (RM 1.01; IC95%: 0.84-1.21; I2%: 0%) ni de paladar hendido (RM 1.16; IC95%: 0.9-1.5; I2: 31%). CONCLUSIÓN: Los resultados muestran que el tratamiento con ondansetrón en el primer trimestre del embarazo no se asocia con un aumento de malformaciones congénitas en general, ni con un incremento de cardiopatías, labio o paladar hendido, pero sí con incremento leve del riesgo de malformaciones orofaciales.

Abstract OBJECTIVE: To determine whether ondansetron exposure in the first trimester is associated with an increased risk of any congenital malformations. As secondary outcomes, determine if it is associated with a higher overall risk of congenital heart disease, interventricular septal defects, orofacial malformations, cleft lip defect (with or without palate) or cleft palate. METHODOLOGY: A systematic review with meta-analysis was carried out. The search was carried out in the following databases: PUBMED, EMBASE and LILACS, randomized studies, cohorts and cases and controls were chosen. RESULTS: 15 studies were included, 11 cohort studies and four case-control studies, with 245,679 women exposed to ondansetron in the first trimester. No statistically significant association was found with overall congenital malformations (OR, 1.1; 95%, CI 0.99-1.22 I2: 72%), nor with congenital heart diseases (OR, 1.05; 95%, CI 0.95-1.19 I2: 78%) not with ventricular septal defects (OR, 1.2 95% CI 0.97 - 1.45 I2: 85%). A small increased risk was found for overall orofacial defects (OR, 1.17 95% CI 1.04 - 1.32 I2:0%), no increased risk was found for lip defect (with or without palate) (OR, 1.01 CI 95% 0.84 -1.21 I2%: 0%) or cleft palate (OR, 1.16 95% CI 0.9 - 1.5 I2: 31%). CONCLUSION: The results show that the use of ondansetron in the first trimester is not associated with an increase in overall congenital malformations, nor with an increase in heart disease, cleft lip and/or palate, but there is a slight increase in the risk of orofacial malformations.

Association of the EPAS1 rs7557402 Polymorphism with Hemodynamically Significant Patent Ductus Arteriosus Closure Failure in Premature Newborns under Pharmacological Treatment with Ibuprofen.

Patent ductus arteriosus (PDA) is frequent in preterm newborns, and its incidence is inversely associated with the degree of prematurity. The first choice of pharmacological treatment is ibuprofen. Several genes, including EPAS1, have been proposed as probable markers associated with a genetic predisposition for the development of PDA in preterm infants. EPAS 1 NG_016000.1:g.84131C>G or rs7557402 has been reported to be probably benign and associated with familial erythrocytosis by the Illumina Clinical Services Laboratory. Other variants of EPAS1 have been previously reported to be benign for familial erythrocytosis because they decrease gene function and are positive for familial erythrocytosis because the overexpression of EPAS1 is a key factor in uncontrolled erythrocyte proliferation. However, this could be inconvenient for ductal closure, since for this process to occur, cell proliferation, migration, and differentiation should take place, and a decrease in EPAS1 gene activity would negatively affect these processes. Single-nucleotide polymorphisms (SNPs) in EPAS1 and TFAP2B genes were searched with high-resolution melting and Sanger sequencing in blood samples of preterm infants with hemodynamically significant PDA treated with ibuprofen at the National Institute of Perinatology. The variant rs7557402, present in the EPAS1 gene eighth intron, was associated with a decreased response to treatment (p = 0.007, OR = 3.53). The SNP rs7557402 was associated with an increased risk of pharmacological treatment failure. A probable mechanism involved could be the decreased activity of the product of the EPAS1 gene.

Non-canonical integrin signaling activates EGFR and RAS-MAPK-ERK signaling in small cell lung cancer.

Background: Small cell lung cancer (SCLC) is an extremely aggressive cancer type with a patient median survival of 6-12 months. Epidermal growth factor (EGF) signaling plays an important role in triggering SCLC. In addition, growth factor-dependent signals and alpha-, beta-integrin (ITGA, ITGB) heterodimer receptors functionally cooperate and integrate their signaling pathways. However, the precise role of integrins in EGF receptor (EGFR) activation in SCLC remains elusive. Methods: We analyzed human precision-cut lung slices (hPCLS), retrospectively collected human lung tissue samples and cell lines by classical methods of molecular biology and biochemistry. In addition, we performed RNA-sequencing-based transcriptomic analysis in human lung cancer cells and human lung tissue samples, as well as high-resolution mass spectrometric analysis of the protein cargo from extracellular vesicles (EVs) that were isolated from human lung cancer cells. Results: Our results demonstrate that non-canonical ITGB2 signaling activates EGFR and RAS/MAPK/ERK signaling in SCLC. Further, we identified a novel SCLC gene expression signature consisting of 93 transcripts that were induced by ITGB2, which may be used for stratification of SCLC patients and prognosis prediction of LC patients. We also found a cell-cell communication mechanism based on EVs containing ITGB2, which were secreted by SCLC cells and induced in control human lung tissue RAS/MAPK/ERK signaling and SCLC markers. Conclusions: We uncovered a mechanism of ITGB2-mediated EGFR activation in SCLC that explains EGFR-inhibitor resistance independently of EGFR mutations, suggesting the development of therapies targeting ITGB2 for patients with this extremely aggressive lung cancer type.

Implementing best practices on data generation and reporting of Mycobacterium tuberculosis in vitro assays within the ERA4TB consortium.

Tuberculosis (TB) is the historical leading cause of death by a single infectious agent. The European Regimen Accelerator for Tuberculosis (ERA4TB) is a public-private partnership of 30+ institutions with the objective to progress new anti-TB regimens into the clinic. Thus, robust and replicable results across independent laboratories are essential for reliable interpretation of treatment efficacy. A standardization workgroup unified in vitro protocols and data reporting templates. Time-kill assays provide essential input data for pharmacometric model-informed translation of single agents and regimens activity from in vitro to in vivo and the clinic. Five conditions were assessed by time-kill assays in six independent laboratories using four bacterial plating methods. Baseline bacterial burden varied between laboratories but variability was limited in net drug effect, confirming 2.5 µL equally robust as 100 µL plating. This exercise establishes the foundations of collaborative data generation, reporting, and integration within the overarching Antimicrobial Resistance Accelerator program.

Nutriepigenomics in Environmental-Associated Oxidative Stress.

Complex molecular mechanisms define our responses to environmental stimuli. Beyond the DNA sequence itself, epigenetic machinery orchestrates changes in gene expression induced by diet, physical activity, stress and pollution, among others. Importantly, nutrition has a strong impact on epigenetic players and, consequently, sustains a promising role in the regulation of cellular responses such as oxidative stress. As oxidative stress is a natural physiological process where the presence of reactive oxygen-derived species and nitrogen-derived species overcomes the uptake strategy of antioxidant defenses, it plays an essential role in epigenetic changes induced by environmental pollutants and culminates in signaling the disruption of redox control. In this review, we present an update on epigenetic mechanisms induced by environmental factors that lead to oxidative stress and potentially to pathogenesis and disease progression in humans. In addition, we introduce the microenvironment factors (physical contacts, nutrients, extracellular vesicle-mediated communication) that influence the epigenetic regulation of cellular responses. Understanding the mechanisms by which nutrients influence the epigenome, and thus global transcription, is crucial for future early diagnostic and therapeutic efforts in the field of environmental medicine.

Identification and characterization of the causative agents of Focal Ulcerative Dermatitis in commercial laying hens.

Focal Ulcerative Dermatitis (FUDS) is an emerging dermatological disease that affects cage-free laying flocks, it is characterized by the development of a lesion on the dorsum of the birds; FUDS is sporadic in nature and can result in a drop in egg production and up to 50% of cumulative mortality. A total of two cage-free flocks (flock 1: no history of FUDS; flock 2: birds affected with FUDS) from a commercial laying hen operation in the mid-west U.S. were sampled in this study. The microbial composition of skin, cloacal, cecal, and ileal samples from each bird was characterized through next generation sequencing (NGS). Results identified Staphylococcus aureus and Staphylococcus agnetis as the potential causative agents of FUDS, being the most predominant in FUDS positive birds. These results were confirmed by plating, with both staphylococci as the only pathogens isolated from lesions of FUDS positive birds. A total of 68 confirmed Staphylococcus isolates from skin and environmental samples were further analyzed by whole genome sequencing (WGS) for the presence of antimicrobial resistance (AMR) genes and virulence factors that could have contributed to the development of FUDS. Forty-four-point one-two percent of the isolates had between one and four acquired AMR genes encoding for macrolides, lincosamides, spectrogramines, and beta-lactams resistance. Six classes of virulence factors associated with adherence, enzyme, immune evasion, secretion system, toxin, and iron uptake were identified. The antimicrobial effect of 4 proprietary Bacillus Direct Fed Microbial (DFM) combinations was evaluated against the Staphylococcus aureus and Staphylococcus agnetis isolates, by agar well-diffusion (AWD) assay and competitive exclusion (CE) on broth culture. Through this antimicrobial screening, a particular two-strain combination of Bacillus pumilus was identified as the most effective inhibitor of both staphylococci. A customized Bacillus pumilus product is being used at different farms with history of FUDS resulting in the successful inhibition of both Staphylococcus aureus and Staphylococcus agnetis, decreasing FUDS mortalities, and improving harvestable eggs.

Prevalence, clinical features, and outcomes of SARS-CoV-2 infection in pregnant women with or without mild/moderate symptoms: Results from universal screening in a tertiary care center in Mexico City, Mexico.

The perinatal consequences of SARS-CoV-2 infection are still largely unknown. This study aimed to describe the features and outcomes of pregnant women with or without SARS-CoV-2 infection after the universal screening was established in a large tertiary care center admitting only obstetric related conditions without severe COVID-19 in Mexico City. This retrospective case-control study integrates data between April 22 and May 25, 2020, during active community transmission in Mexico, with one of the highest COVID-19 test positivity percentages worldwide. Only pregnant women and neonates with a SARS-CoV-2 result by quantitative RT-PCR were included in this study. Among 240 pregnant women, the prevalence of COVID-19 was 29% (95% CI, 24% to 35%); 86% of the patients were asymptomatic (95% CI, 76%-92%), nine women presented mild symptoms, and one patient moderate disease. No pregnancy baseline features or risk factors associated with severity of infection, including maternal age > 35 years, Body Mass Index >30 kg/m2, and pre-existing diseases, differed between positive and negative women. The median gestational age at admission for both groups was 38 weeks. All women were discharged at home without complications, and no maternal death was reported. The proportion of preeclampsia was higher in positive women than negative women (18%, 95% CI, 10%-29% vs. 9%, 95% CI, 5%-14%, P<0.05). No differences were found for other perinatal outcomes. SARS-CoV-2 test result was positive for nine infants of positive mothers detected within 24h of birth. An increased number of infected neonates were admitted to the NICU, compared to negative neonates (44% vs. 22%, P<0.05) and had a longer length of hospitalization (2 [2-18] days vs. 2 [2-3] days, P<0.001); these are potential proxies for illness severity. This report highlights the importance of COVID-19 detection at delivery in pregnant women living in high transmission areas.

Cardiovascular disease risk stratification by the Framigham score is markedly improved by ambulatory compared with office blood pressure.

INTRODUCTION AND OBJECTIVES: Ambulatory blood pressure (BP) better predicts cardiovascular disease (CVD) outcomes than office BP measurements (OBPM). Nonetheless, current CVD risk stratification models continue to rely on exclusively daytime OBPM along with traditional factors, eg, age, sex, smoking, dyslipidemia, and/or diabetes. METHODS: Data from 19 949 participants of the primary care-based Hygia Project assessed by 48-hour ambulatory BP monitoring (ABPM) and without prior CVD events were used to compare the diagnostic accuracy, discrimination, and performance of the original Framingham risk score (RSOFG) and its adjusted version to the Hygia Project study population (RSAFG) with that of a novel CVD risk stratification model constructed by replacing OBPM with ABPM-derived prognostic parameters (RSABPM). RESULTS: During the follow-up, lasting up to 12.7 years, 1854 participants experienced a primary CVD outcome of CVD death, myocardial infarction, coronary revascularization, heart failure, stroke, transient ischemic attack, angina pectoris, or peripheral artery disease. Asleep systolic BP (SBP) mean and sleep-time relative SBP decline were the only joint significant ABPM-derived predictive factors of CVD risk and were therefore used to substitute for in-clinic SBP in the RSABPM model. The RSABPM model, in comparison with the RSOFG and RSAFG models, showed significantly improved calibration, diagnostic accuracy, discrimination, and performance (always P<.001). The RSAFG-derived event-probabilities of 57.3% of the participants were outside the 95% confidence limits of the event probability determined by the RSABPM model. CONCLUSIONS: These collective findings reveal important limitations of CVD risk stratification when based upon OBPM, as in the Framingham score, and corroborate the clinical value of around-the-clock ABPM to properly diagnose true hypertension and reliably stratify CVD vulnerability.

Adaptation of Coccomyxa sp. to Extremely Low Light Conditions Causes Deep Chlorophyll and Oxygen Maxima in Acidic Pit Lakes.

Deep chlorophyll maxima (DCM) and metalimnetic oxygen maxima (MOM) are outstanding biogeochemical features of acidic pit lakes (APL). However, knowledge of the eukaryotic phototrophs responsible for their formation is limited. We aimed at linking the dynamics of phototrophic communities inhabiting meromictic APL in Spain with the formation of these characteristic layers. Firstly, the dynamics of DCM and MOM and their relation to physico-chemical parameters (photosynthetically active radiation (PAR), pH, dissolved ferric iron concentration, temperature), pigments and nutrient distribution is described; secondly, the phototrophic community composition is studied through a combination of microscopy, biomolecular and "omics" tools. Phototrophic communities of the studied APL show a low diversity dominated by green microalgae, specifically Coccomyxa sp., which have been successfully adapted to the chemically harsh conditions. DCM and MOM are usually non-coincident. DCM correspond to layers where phototrophs have higher chlorophyll content per cell to cope with extremely low PAR (<1 µmol m-2 s-1), but where photosynthetic oxygen production is limited. MOM correspond to shallower waters with more light, higher phytoplankton biomass and intense photosynthetic activity, which affects both oxygen concentration and water temperature. The main drivers of DCM formation in these APL are likely the need for nutrient uptake and photo-acclimation.

Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial.

AIMS: The Hygia Chronotherapy Trial, conducted within the clinical primary care setting, was designed to test whether bedtime in comparison to usual upon awakening hypertension therapy exerts better cardiovascular disease (CVD) risk reduction. METHODS AND RESULTS: In this multicentre, controlled, prospective endpoint trial, 19 084 hypertensive patients (10 614 men/8470 women, 60.5 ± 13.7 years of age) were assigned (1:1) to ingest the entire daily dose of ≥1 hypertension medications at bedtime (n = 9552) or all of them upon awakening (n = 9532). At inclusion and at every scheduled clinic visit (at least annually) throughout follow-up, ambulatory blood pressure (ABP) monitoring was performed for 48 h. During the 6.3-year median patient follow-up, 1752 participants experienced the primary CVD outcome (CVD death, myocardial infarction, coronary revascularization, heart failure, or stroke). Patients of the bedtime, compared with the upon-waking, treatment-time regimen showed significantly lower hazard ratio-adjusted for significant influential characteristics of age, sex, type 2 diabetes, chronic kidney disease, smoking, HDL cholesterol, asleep systolic blood pressure (BP) mean, sleep-time relative systolic BP decline, and previous CVD event-of the primary CVD outcome [0.55 (95% CI 0.50-0.61), P < 0.001] and each of its single components (P < 0.001 in all cases), i.e. CVD death [0.44 (0.34-0.56)], myocardial infarction [0.66 (0.52-0.84)], coronary revascularization [0.60 (0.47-0.75)], heart failure [0.58 (0.49-0.70)], and stroke [0.51 (0.41-0.63)]. CONCLUSION: Routine ingestion by hypertensive patients of ≥1 prescribed BP-lowering medications at bedtime, as opposed to upon waking, results in improved ABP control (significantly enhanced decrease in asleep BP and increased sleep-time relative BP decline, i.e. BP dipping) and, most importantly, markedly diminished occurrence of major CVD events. TRIAL REGISTRATION: ClinicalTrials.gov, number NCT00741585.

Remediation experiment of Ecuadorian acid mine drainage: geochemical models of dissolved species and secondary minerals saturation.

Acid mine drainage is one of the main environmental hazards to ecosystems worldwide and it is directly related to mining activities. In Ecuador, such acidic-metallic waters are drained to rivers without treatment. In this research, we tested a laboratory combined (Ca-Mg) Dispersed Alkaline Substrate (DAS) system as an alternative to remediate acid drainage from the Zaruma-Portovelo gold mining site, at El Oro, Ecuador. The system worked at low and high flow hydraulic rates during a period of 8 months, without signs of saturation.. Analysis of physico-chemical parameters and water composition (ICP-OES, ICP-MS) demonstrated that treatment effectively increased water pH and promoted the retention of about 80% of Fe, Al, Mn and Cu. Under acid conditions As, Cr and Pb concentrations decreased with Fe and possible precipitation of jarosite and schwertmannite. However, the homogeneous depletion of Cr at pH above 6 could be related to ferrihydrite or directly with Cr (OH)3 precipitation. After DAS-Ca, sulphate, phosphate and rare earth elements (REE) concentrations decreased to 1912, 0.85 and 0.07 mg/L respectively, while DAS-Mg contributed to form a complex model of minor carbonate and phosphate phases as main sink of REE. DAS-Mg also promoted the retention of most divalent metals at pH values over seven. Thus, this low cost treatment could avoid environmental pollution and international conflicts. Anyway, further investigations are needed to obtain higher Zn retention values. Graphical abstract.

Diagnosis and management of hypertension: around-the-clock ambulatory blood pressure monitoring is substantially more effective and less costly than daytime office blood pressure measurements.

The cost-effectiveness of ambulatory blood pressure (BP) monitoring (ABPM) versus traditional office BP measurement (OBPM) for the diagnosis and management of hypertension has been evaluated only by few studies and based solely on the reduction of medical care expenses through avoiding treatment of isolated-office hypertension. Data from the 21963 participants in the Hygia Project, a multicenter outcomes study that incorporates into routine primary care periodic, at least yearly, 48 h ABPM evaluation, were utilized to assess the cost-effectiveness - relative to vascular pathology expenditures countrywide in Spain - of ABPM versus OBPM. The actual reported Spanish healthcare expenditure for vascular pathology in 2015 - aggregate costs of medical examinations, outpatient and inpatient care, therapeutic interventions, plus non-healthcare services (productivity losses due to morbidity/mortality and informal family/friends-provided care) - was used to compare yearly costs when diagnostic and treatment decisions for hypertension are based on the OBPM versus the ABPM-model. Our economic analysis is based on the more realistic and feasible approach of restricting ABPM solely to high-risk individuals of age ≥60 years and/or with diabetes, chronic kidney disease, and/or previous cardiovascular event, who in the Hygia Project accounted for >90% of all documented events. The projected net benefit countrywide in favor of the proposed ABPM-model is ~5294M€/year, i.e., 360.33€/year (95%CI [347.52-374.85]) per ABPM-evaluated person. This highly conservative economic analysis indicates ABPM is a much more cost-effective strategy than repeated OBPM not only for accurate diagnosis and management of true hypertension but marked reduction of expenditures on elevated BP-associated vascular pathology.

A Systematic Approach to Identify and Characterize the Effectiveness and Safety of Novel Probiotic Strains to Control Foodborne Pathogens.

A total of 44 lactic acid bacteria (LAB) strains originally isolated from cattle feces and different food sources were screened for their potential probiotic features. The antimicrobial activity of all isolates was tested by well-diffusion assay and competitive exclusion on broth against Salmonella Montevideo, Escherichia coli O157:H7 and Listeria monocytogenes strain N1-002. Thirty-eight LAB strains showed antagonistic effect against at least one of the pathogens tested in this study. Improved inhibitory effect was observed against L. monocytogenes with zones of inhibition up to 24 mm when LAB overnight cultures were used, and up to 21 mm when cell-free filtrates were used. For E. coli O157:H7 and Salmonella maximum inhibitions of 12 and 11.5 mm were observed, respectively. On broth, 43 strains reduced L. monocytogenes up to 9.06 log10 CFU/ml, 41 reduced E. coli O157:H7 up to 0.84 log10 CFU/ml, and 32 reduced Salmonella up to 0.94 log10 CFU/ml 24 h after co-inoculation. Twenty-eight LAB isolates that exhibited the highest inhibitory effect among pathogens were further analyzed to determine their antimicrobial resistance profile, adhesion potential, and cytotoxicity to Caco-2 cells. All LAB strains tested were susceptible to ampicillin, linezolid, and penicillin. Twenty-six were able to adhere to Caco-2 cells, five were classified as highly adhesive with > 40 bacterial cells/Caco-2 cells. Low cytotoxicity percentages were observed for the candidate LAB strains with values ranging from -5 to 8%. Genotypic identification by whole genome sequencing confirmed all as members of the LAB group; Enterococcus was the genus most frequently isolated with 21 isolates, followed by Pediococcus with 4, and Lactobacillus with 3. In this study, a systematic approach was used for the improved identification of novel LAB strains able to exert antagonistic effect against important foodborne pathogens. Our findings suggest that the selected panel of LAB probiotic strains can be used as biocontrol cultures to inhibit and/or reduce the growth of L. monocytogenes, Salmonella, and E. coli O157:H7 in different matrices, and environments.

In vitro activity of bedaquiline against slow-growing nontuberculous mycobacteria.

Bedaquiline (BDQ) is a recently approved antibiotic for the treatment of multidrug-resistant tuberculosis, but its potential against slow-growing mycobacteria (SGM) is still unknown. The objective of this study was to determine the in vitro activity of BDQ on SGM by assessing their MIC and minimal bactericidal concentration (MBC). The MIC of BDQ against 17 clinical isolates including Mycobacterium avium, Mycobacterium intracellulare, Mycobacterium chimaera, Mycobacterium kansasii and Mycobacterium simiae species was determined by the resazurin microtitre assay and the MBC by the c.f.u. determination on 7H10 agar plates. BDQ has a bacteriostatic activity on all SGM tested with a MIC range from 0.03 to 0.007 µg ml-1 and surprisingly a good bactericidal activity on the majority of the isolates tested with an MBC of 1-2 µg ml-1 . Based on these preliminary results BDQ seems to be very promising for treatment of diseases caused by SGM.

Three-dimensional Doppler ultrasonography for the assessment of fetal liver vascularization in fetuses with intrauterine growth restriction.

OBJECTIVE: To demonstrate changes in hepatic volume and vascular indices in fetuses with intrauterine growth restriction (IUGR) compared with normal-growth fetuses, using a noninvasive method (three-dimensional power Doppler ultrasound). METHODS: The present cross-sectional study was conducted between September 1 and November 30, 2014, at a maternal-fetal medicine unit in Bogotá, Colombia; it included consecutive women at 24-34 weeks of pregnancy. The fetal liver volume and indices of hepatic vascularization were determined with three-dimensional power Doppler ultrasonography and compared between fetuses with and without a diagnosis of IUGR. Results A total of 119 women met study inclusion criteria; 97 fetuses had no growth restriction, whereas 22 fetuses had IUGR. The latter group had decreased liver volume (57.85 ± 29.71 mL vs 86.99 ± 31.24 mL; P=0.010) and increased vascular indices (vascularization index, 47.92 ± 34.44 versus 22.46 ± 18.95; flow index, 71.39 ± 42.01 versus 41.11 ± 23.24; vascularization flow index, 47.94 ± 47.96 versus 13.67 ± 22.38; P=0.003 for all comparisons). CONCLUSION: Liver volume was decreased and liver vascular indices values were increased in fetuses with IUGR. These findings imply that evaluation of hepatic vascularization with three-dimensional hepatic Doppler could be useful in the diagnosis of IUGR.

Conocimientos, creencias y manejo de la fiebre entre los padres consultantes en un Hospital Pediátrico de Tercer nivel en Pasto, Colombia, 2017

Introducción: En Colombia existen muchos mitos, y se observa diferentes abordajes de la fiebre. Sin embargo, no hay datos locales que muestren esta situación. El Objetivo de este estudio es Identificar los conocimientos, creencias, y manejos de la fiebre entre los padres consultantes. Materiales y Métodos: Estudio descriptivo, observacional, transversal, se aplicó un cuestionario a una muestra tomada conveniencia de 200 padres que consultaron al servicio de urgencia del hospital. Resultados: Se realizaron 200 encuestas. El 59% de los padres se encontraban en secundaria. El 84,5% de la población pertenecía a los estratos 1 y 2 y vivía en zona urbana. El 52% utilizaban termómetros o tiras plásticas para medir la temperatura. El 81,5% administró antibiótico solo cuando el médico lo prescribe. Las variables sociodemográficas de los padres, que tuvieron una relación estadísticamente significativa se relacionaron en el conocimiento, manejo y creencias de la fiebre fueron: edad de los padres, nivel educativo, estrato socieconomico y número de hijos. Conclusiones: Se encontraron falencias en el conocimiento de los padres en conceptos de fiebre y toma de temperatura. Los padres se basan en consultas previas al médico para la administración de medicamentos. En el manejo de la fiebre, la mayoría de padres utilizan medios físicos para disminuirla concomitante con el uso de antipiréticos; con respecto a las creencias, en nuestra región (Pasto - Nariño) siguen siendo utilizadas las terapias tradicionales para el manejo de fiebre.

Introduction: In Colombia there are many myths, and different approaches to fever are observed. However, there is no local data describing this situation. The objective of this study is to identify the knowledge, beliefs, and management of fever among parents requesting consultation. Materials and Methods: This was a descriptive, observational and cross-sectional study. A questionnaire was applied to a convenience sample of 200 parents who consulted at the emergency department of the hospital. Results: 200 surveys were carried out. 59% of parents were in high school. 84.5% of the population belonged to stratas 1 and 2 and lived in an urban area. 52% used thermometers or plastic strips to measure the temperature. 81.5% administered antibiotics only when the doctor prescribed it. The sociodemographic variables of the parents, which were significantly statistically e related to the knowledge, management and beliefs of the fever were: age of the parents, educational level, socioeconomic status and number of children. Conclusions: We found knowledge gaps in parents regarding fever and temperature measurement. Parents administer medications after consulting with a physician. In managing fever, most parents used physical means to reduce fever along with antipyretics. Regarding beliefs, in our region (Pasto - Nariño) traditional therapies for the management of fever are still used.

Asleep blood pressure: significant prognostic marker of vascular risk and therapeutic target for prevention.

Aims: Sleep-time blood pressure (BP) is a stronger risk factor for cardiovascular disease (CVD) events than awake and 24 h BP means, but the potential role of asleep BP as therapeutic target for diminishing CVD risk is uncertain. We investigated whether CVD risk reduction is most associated with progressive decrease of either office or ambulatory awake or asleep BP mean. Methods and results: We prospectively evaluated 18 078 individuals with baseline ambulatory BP ranging from normotension to hypertension. At inclusion and at scheduled visits (mainly annually) during follow-up, ambulatory BP was measured for 48 consecutive hours. During the 5.1-year median follow-up, 2311 individuals had events, including 1209 experiencing the primary outcome (composite of CVD death, myocardial infarction, coronary revascularization, heart failure, and stroke). The asleep systolic blood pressure (SBP) mean was the most significant BP-derived risk factor for the primary outcome [hazard ratio 1.29 (95% CI) 1.22-1.35 per SD elevation, P < 0.001], regardless of office [1.03 (0.97-1.09), P = 0.32], and awake SBP [1.02 (0.94-1.10), P = 0.68]. Most important, the progressive attenuation of asleep SBP was the most significant marker of event-free survival [0.75 (95% CI 0.69-0.82) per SD decrease, P < 0.001], regardless of changes in office [1.07 (0.97-1.17), P = 0.18], or awake SBP mean [0.96 (0.85-1.08), P = 0.47] during follow-up. Conclusion: Asleep SBP is the most significant BP-derived risk factor for CVD events. Furthermore, treatment-induced decrease of asleep, but not awake SBP, a novel hypertension therapeutic target requiring periodic patient evaluation by ambulatory monitoring, is associated with significantly lower risk for CVD morbidity and mortality.