Infección por trypanosoma cruzi y bloqueo cardíaco del nodo auriculoventricular en el salvador / Trypanosoma cruzi infection and atrioventricular-nodal heart block in El Salvador

Resumen La enfermedad de Chagas es endémica en América Latina y sigue siendo un problema regional a pesar de que su frecuencia ha disminuido gracias a importantes avances en salud ambiental. Para determinar su frecuencia en pacientes con enfermedades miocárdicas de El Salvador, se llevó a cabo una in vestigación observacional retrospectiva en nuestro hospital que es un centro de referencia de nivel nacional. Se revisó el registro del Laboratorio de Chagas en el período 2013-2015 para conocer cuántos individuos internados en la Unidad Cardiológica eran positivos por serología para infección chagásica y cuáles fueron sus diagnósticos. Se realizó un total de 1472 pruebas a pacientes individuales durante los 36 meses del período de estudio. De los 557 pacientes con serología positiva para Chagas, 97 (17.4%) fueron eventualmente hospitalizados en la Unidad Cardiológica. A su vez, estos 97 pacientes representaron el 33.7% de los 288 pacientes con cardiopatías. Entre los 97 con cardiopatía chagásica, 40 (41.2%) cumplieron criterios para colocación de marcapaso permanente, mientras que solo 13 de 191 (6.8%) enfermos con cardiopatías no chagásicas cumplieron esos criterios. La frecuencia de bloqueos auriculoventriculares asociados a infección por Trypanosoma cruzi resultó mucho mayor que las publicadas en estudios previos realizados en Sudamérica.

Abstract Chagas disease is endemic in Latin America and remains a regional problem despite improvements in en vironmental health conditions that have helped to control its transmission. To know more about its prevalence in heart disease patients, we carried out a survey in our national (El Salvador) reference hospital. We reviewed the Chagas Lab´s records 2013-2015 to find out how many of the patients admitted to the Hospital´s Heart Unit were serologically positives for Trypanosoma cruzi infection and which the associated diagnoses were. A total of 1472 patients were tested along the 36-month study period. Out of 557 (37.8%) patients with positive serology for Chagas infection, 97 (17.4%) were eventually admitted to the Heart Unit. Among these 97 Chagas infected patients with heart disease, 40 (41.2%) met the criteria for permanent pacemaker placement, while only 13 of 191 (6.8%) patients with non-chagasic heart disease met these criteria. The frequency of heart atrioventricular block associated with Trypanosoma cruzi infection was higher than frequencies reported in South American studies.

[Trypanosoma cruzi infection and atrioventricular-nodal heart block in El Salvador]. / Infección por Trypanosoma cruzi y bloqueo cardíaco del nodo auriculo-ventricular en El Salvador.

Chagas disease is endemic in Latin America and remains a regional problem despite improvements in environmental health conditions that have helped to control its transmission. To know more about its prevalence in heart disease patients, we carried out a survey in our national (El Salvador) reference hospital. We reviewed the Chagas Lab's records 2013-2015 to find out how many of the patients admitted to the Hospital's Heart Unit were serologically positives for Trypanosoma cruzi infection and which the associated diagnoses were. A total of 1472 patients were tested along the 36-month study period. Out of 557 (37.8%) patients with positive serology for Chagas infection, 97 (17.4%) were eventually admitted to the Heart Unit. Among these 97 Chagas infected patients with heart disease, 40 (41.2%) met the criteria for permanent pacemaker placement, while only 13 of 191 (6.8%) patients with non-chagasic heart disease met these criteria. The frequency of heart atrioventricular block associated with Trypanosoma cruzi infection was higher than frequencies reported in South American studies.

La enfermedad de Chagas es endémica en América Latina y sigue siendo un problema regional a pesar de que su frecuencia ha disminuido gracias a importantes avances en salud ambiental. Para determinar su frecuencia en pacientes con enfermedades miocárdicas de El Salvador, se llevó a cabo una investigación observacional retrospectiva en nuestro hospital que es un centro de referencia de nivel nacional. Se revisó el registro del Laboratorio de Chagas en el período 2013-2015 para conocer cuántos individuos internados en la Unidad Cardiológica eran positivos por serología para infección chagásica y cuáles fueron sus diagnósticos. Se realizó un total de 1472 pruebas a pacientes individuales durante los 36 meses del período de estudio. De los 557 pacientes con serología positiva para Chagas, 97 (17.4%) fueron eventualmente hospitalizados en la Unidad Cardiológica. A su vez, estos 97 pacientes representaron el 33.7% de los 288 pacientes con cardiopatías. Entre los 97 con cardiopatía chagásica, 40 (41.2%) cumplieron criterios para colocación de marcapaso permanente, mientras que solo 13 de 191 (6.8%) enfermos con cardiopatías no chagásicas cumplieron esos criterios. La frecuencia de bloqueos auriculoventriculares asociados a infección por Trypanosoma cruzi resultó mucho mayor que las publicadas en estudios previos realizados en Sudamérica.

Antiproliferative potential of 3ß,5α,6ß,7α-tetrahydroxyergosta-8(14),22-diene produced by Acremonium persicinum isolated from an alkaline crater lake in Puebla, Mexico.

The sterol 3ß,5α,6ß,7α-tetrahydroxyergosta-8(14),22-diene was obtained from bio-guided fractioning of the chloroform extract of 50 L of liquid culture of Acremonium persicinum. This fungal strain was selected because of its anti-proliferative activity against solid human tumour cell lines (GI50 ≤ 50 µg/mL) in a bio-prospective study of fungi isolated from plant material, sediment and water samples obtained from alkaline lakes Alchichica and Atexcac in Puebla, Mexico. This compound showed GI50 (µM) values of: 16, 24, 18, 15 and 12 against tumour cell lines A-549, HBL-100, HeLa, T-47D and WiDr respectively. GI50 effects against tumour lines T-47D and WiDr were found to be greater than the clinically used drugs Etoposide and Cisplatin. Because of this, the results obtained support the pharmacological importance of the microorganisms that develop in these ecosystems and strengthen the non-invasive bio-prospection studies that our work group has developed in recent years.

Ergosterol exerts a differential effect on AR-dependent LNCaP and AR-independent DU-145 cancer cells.

Androgen-dependent LNCaP and androgen-independent DU-145 cells, were treated with different concentrations of ergosterol (15 µM and 25 µM) and its respective cell viability was measured by MTT bioassay. While ergosterol showed an antiproliferative effect on LNCaP, on DU-145 promoted cell proliferation. This differential effect suggests that the effect of ergosterol might be related to its ability to act as an Androgen Receptor ligand. In silico Molecular Dynamics simulations were performed to analyze the interaction mechanism between androgen receptor and ergosterol, in comparison with natural ligands, 5α-dihydrotestosterone and testosterone. Our model suggests that the binding of androgen receptor with ergosterol is thermodinamically feasible, which is concordant with our experimental results.

Exploring photosensitization as an efficient antifungal method.

Lipid bilayers containing ergosterol show signs of destruction when they are treated with singlet oxygen, due to the conversion of ergosterol into its peroxy derivative. Applying this previous knowledge, an antifungal method was explored using Candida tropicalis as model, and membrane permeation under photosensitization conditions became evident. These data were complemented through AFM images of artificial lipid bilayers, using cholesterol or ergosterol as structural sterols, showing their corresponding morphologies at the nanoscale. Based on these results, an antifungal method was developed, which shows evidence of the extent of membrane permeation during photosensitization. Such photosensitization offers an effective alternative treatment, especially in membranes with a high ergosterol content, suggesting that this procedure constitutes an easy and efficient antifungal method.

Antiproliferative Activity and Cytotoxicity of Some Medicinal Wood-Destroying Mushrooms from Russia.

We analyzed the antiproliferative activity of 6 medicinal wood-destroying mushrooms (Fomes fomentarius, Fomitopsis pinicola, Trametes versicolor, Trichaptum biforme, Inonotus obliquus, and Coniophora puteana) that are common in deciduous and mixed coniferous forests in Central Russia. Morphological identification of strains collected from the wild was confirmed based on ribosomal DNA internal transcribed spacer phylogenetic analysis. We observed cytotoxic and cell growth-inhibitory effects of hot water extracts from mycelial biomass of 5 species-T. versicolor, C. puteana, F. fomentarius, F. pinicola, and I. obliquus-on leukemia cell lines (Jukart, K562, and THP-1); the effective extract concentrations were mostly less than 50 µg · mL-1. However, we observed no antiproliferative activity of dry biomass from methanol-chloroform (1:1) extracts of C. puteana and F. fomentarius. A chemosensitivity assay showed that the most effective polypore mushroom extract was the methanol extract of T. versicolor (strain It-1), which inhibited the growth of 6 various solid tumors (A-549 and SWi573 [lung], HBL-100 and T-47D [breast], HeLa [cervix], and WiDr [colon]) at concentrations below 45 µg · mL-1, with a concentration as low as 0.7-3.6 µg · mL-1 causing 50% reduction in the proliferation of cancer cells in lung and cervix tumors. Methanol extracts of F. pinicola and I. obliquus were less effective, with proliferation-inhibiting capacities at concentrations below 70 and 200 µg · mL-1, respectively. Thus, T. versicolor is a prospective candidate in the search for and production of new antiproliferative chemical compounds.

In Vitro Expression of Toll-Like Receptors and Proinflammatory Molecules Induced by Ergosta- 7,22-Dien-3-One Isolated from a Wild Mexican Strain of Ganoderma oerstedii (Agaricomycetes).

Compounds showing pharmacological activity on the immune system are of interest because of their therapeutic potential in the treatment of many diseases. However, data from primary human immune cells and in vivo studies are limited. The aim of this study was to analyze the ability to induce the expression of Toll-like receptors (TLRs) and proinflammatory molecules on cells involved in the immune system using the compound ergosta-7,22-dien-3- one, isolated from a wild Mexican strain of Ganoderma oerstedii. According to our study, ergosta-7,22-dien-3-one did not present any cytotoxic effect on HeLa or J774A.1 cells, and it was able to stimulate nitric oxide production, induce the expression of genes, and induce the production of TLRs, cytokines, chemokines, and cellular adhesion molecules in J774A.1 cells, based on reverse-transcriptase polymerase chain reaction and enzyme-linked immunosorbent assay. Here we report a new pro-inflammatory property of ergosta-7,22-dien-3-one, which should be considered as a possible adjuvant property in view of its biological activity.

Theoretical Study on the Photosensitizer Mechanism of Phenalenone in Aqueous and Lipid Media.

The photosensitizer ability of phenalenone was studied in aqueous and lipid media through the single electron transfer reactions, employing the density functional theory. Although phenalenone is a well-known photosensitizer and is widely used as an (1)O2 reference sensitizer, little is known about the reaction mechanism involved. In this study we carried out a single electron transfer reaction between the basal, excited, oxidized and reduced state of phenalenone with oxygen molecules such as (3)O2 and O2(•-). In aqueous media the photosensitizer capacity of phenalenone was measured through both type I and type II mechanisms. In lipid media the photosensitizer ability of phenalenone was attributed to the type II mechanism. The results indicated that the photosensitizer ability of phenalenone shows a heavy reliance on the media where the reaction occurs whether this is an aqueous or lipid media. Finally, this study supports the idea about that electron transfer reactions can be used to study the photosensitizer ability of molecules.

Antiproliferative effect of extract from endophytic fungus Curvularia trifolii isolated from the "Veracruz Reef System" in Mexico.

CONTEXT: It is well known that marine fungi are an excellent source of biologically active secondary metabolites, and by 2011, it was reported that over 400 bioactive metabolites were derived from marine fungi. OBJECTIVE: This study establishes the basis for future research on antiproliferative compounds of marine endophytes inhabited in the Veracruz Reef System. MATERIALS AND METHODS: Isolation of the 34 fungal strains was carried out by microbiological method from samples of sponges, corals, and other biological material from the Veracruz Reef System. The fungal biomass and broth were separated and extracted with a mixture of solvents MeOH:CHCl3. Characterization and molecular identification of the fungal strains were performed through microbiological methods and the analysis of the ITS-rDNA regions. Antiproliferative activity was tested at a dose of 250 µg/mL on human solid tumor cell lines HBL-100, HeLa, SW1573, T-47D, and WiDr by the SRB assay after 48 h-exposure to the fungal extracts. RESULTS: The extracts from five isolates showed an antiproliferative effect against one or more of the tested cell lines (percentage growth < 50%). The mycelial extract from the isolate LAEE 03 manifested the highest activity against the five cell lines (% PG of 17 HBL-100, 19 HeLa, 23 SW1573, -6 T-47D, and 10 WiDr) and the strain was identified as Curvularia trifolii (Kauffman) Boedijn (Pleosporaceae). DISCUSSION AND CONCLUSION: The results obtained indicate that the extract from a marine derived C. trifolii has the antiproliferative effect, thus suggesting that this organism is a good candidate for further analysis of its metabolites.

Isolation and Characterization of Bioactive Metabolites from Fruiting Bodies and Mycelial Culture of Ganoderma oerstedii (Higher Basidiomycetes) from Mexico.

Various species of the genus Ganoderma have been used for centuries according to oriental tradition as a source of medicines and nutrients. A chemical study of the fruiting bodies and mycelial culture of G. oerstedii was carried out with the idea of isolating and characterizing active natural components present to make use of their potential pharmaceutical application in Mexico. The fruiting bodies and mycelial culture of G. oesrtedii were lyophylized and extracted one after the other with hexane, chloroform, and methanol. Following this process, each substance was extracted separately by using column chromatography. From fruiting bodies eight metabolites, five sterols (ergosta-7,22-dien-3ß-ol, ergosterol peroxide, ergosterol, cerevisterol, and ergosta-7,22-dien-3-one) as well as three terpene compounds (ganodermanondiol, ganoderic acid Sz, and ganoderitriol M) were obtained from fruiting bodies. From the mycelial culture three metabolites, two sterols (ergosterol and cerevisterol), and a new terpene compound (ganoderic acetate from the acid) were obtained. These structures were established based on a spectroscopic analysis mainly using nuclear magnetic resonance and a comparison with data already established.

Inhibition of bacterial quorum sensing by extracts from aquatic fungi: first report from marine endophytes.

In our search for quorum-sensing (QS) disrupting molecules, 75 fungal isolates were recovered from reef organisms (endophytes), saline lakes and mangrove rhizosphere. Their QS inhibitory activity was evaluated in Chromobacterium violaceum CVO26. Four strains of endophytic fungi stood out for their potent activity at concentrations from 500 to 50 µg mL-1. The molecular characterization, based on the internal transcribed spacer (ITS) region sequences (ITS1, 5.8S and ITS2) between the rRNA of 18S and 28S, identified these strains as belonging to four genera: Sarocladium (LAEE06), Fusarium (LAEE13), Epicoccum (LAEE14), and Khuskia (LAEE21). Interestingly, three came from coral species and two of them came from the same organism, the coral Diploria strigosa. Metabolic profiles obtained by Liquid Chromatography-High Resolution Mass Spectrometry (LC-HRMS) suggest that a combination of fungal secondary metabolites and fatty acids could be the responsible for the observed activities. The LC-HRMS analysis also revealed the presence of potentially new secondary metabolites. This is, to the best of our knowledge, the first report of QS inhibition by marine endophytic fungi.

Antiproliferative activity of epi-cercosporin in human solid tumor cell lines.

From cultures of Cercospora piaropi, a phytopathogenic fungus isolated from symptomatic leaves of water hyacinth was obtained a red compound, which, according to the spectroscopic data, was epi-cercosporin. It showed in vitro antiproliferative activity against the panel of human solid tumor cells HBL-100, HeLa, SW1573 and WiDr. Cell cycle studies revealed that epi-cercosporin induces accumulation of cells in G2/M phase.

Ceguera bilateral y manifestaciones hemato-neurológicas producidas durante un accidente botrópico / Bilateral blindness and hematoneurological signs after bothropic bite

Agricultor de 20 años, procedente de San Miguel de Callería (Ucayali- Perú: selva nor-oriental a 842 km de Lima), mordido por una serpiente Bothrops spp, en el tobillo izquierdo, quien pese a recibir 18 horas después una única infusión de 25 mg de suero antiofídico polivalente desarrolla desde las primeras horas dolor, edema, equimosis de pierna izquierda, gingivorragia, hematuria, oliguria, cefalea, alteraciones de la conciencia, afasia, disartria, signos meníngeos, amaurosis, hemiparesia del hemicuerpo derecho, paresia de músculos oculomotores a predominio izquierdo y midriasis paralítica bilateral. Retinografía bilateral: discos retinales ópticos pálidos y vasos sanguíneos adelgazados. Respuestas visuales evocadas: ausentes, bilateral. Tomografía (TEM), cerebral: hemorragia intracerebral parieto-occipital izquierda. Resonancia magnética (RM) de vías ópticas: inflamación y tortuosidad del trayecto de ambos nervios ópticos, a predominio derecho. 50 días después del accidente botrópico, aunque el paciente camina solo, no ve nada con el ojo derecho, mientras que con el ojo izquierdo ve personas como sombras.

20 years old farmer, coming from San Miguel of Calleria (Ucayali, Perú: north-eastern jungle 842 km from Lima), bitten by a Bothrops spp snake in his left ankle, who in spite of receiving 18 hours later a unique infusion of 25 mg of antisnake polyvalent serum, develops from the first hours pain, edema and swelling of his left ankle, upward bruising of his left leg, oral bleeding, hematuria, oliguria, headache, altered consciousness, aphasia, dysarthria, meningeal signs, amaurosis, hemiparesis of his right body, ocular muscle paresis to left predominance and bilateral paralytic mydriasis. Bilateral Retinography: pale optic disc and thinned retinal blood vessels. Visual evoked response: absent waves, bilaterally. Brain Tomography (TEM): left parieto-occipital intrabrain hemorrhage. Magnetic resonance imaging (MRI), of optic pathways: inflammation and pathÆs tortuosity of both optic nerves, to right predominance. 50 days after the bothropic accident, although the patient walk alone, he does not see anything with the right eye while with the left eye sees people as shadows.

Isolation, characterization, and production of red pigment from Cercospora piaropi a biocontrol agent for waterhyacinth.

A red pigment produced by a Mexican isolate of Cercospora piaropi (waterhyacinth pathogen) has been isolated and identified as cercosporin. The kinetic of cercosporin production in culture media during dark/light regimes was evaluated. When C. piaropi was cultivated in continuous light and potato dextrose broth culture, a maximum of cercosporin production was observed (72.59 mg/l). Despite other reports, C piaropi Mexican isolate produce cercosporin in dark conditions (25.70 mg/l). The results suggest that production of cercosporin in C. piaropi-waterhyacinth pathogenesis is an important factor to take into account in biocontrol strategies.

Sangrado faríngeo por actinomicosis amigdalina: reporte de un caso / Pharyngeal bleeding due to actinomycotic tonsilitis: a case report

Paciente femenino de 38 años de edad, se presenta con sangrado faríngeo al toser de pocas horas de evolución, sin otra sintomatología. Se practica amigdalectomía, resolviéndose el problema. El estudio histopatológico fue de amigdalitis crónica secundaria a actinomicosis. La entidad es poco común en la literatura mundial; es importante tenerla presente en el diagnóstico de afecciones amigdalinas y de sangrados faríngeos

Estudio comparativo de taponamiento nasal / Comparative study of nasal packing

El taponamiento nasal es un método de rutina en la cirugía rinológica; su uso se ha prestado a múltiples controversias, debido a la posibilidad de complicaciones o reacciones secundarias. Realizamos el presente estudio comparando el tiempo de colocación de taponamiento de gasa en períodos que van de 2 a 7 días y se observó que se obtienen los mismos resultados en taponamientos empleados por corto tiempo que en un período largo, y además se disminuyen notablemente las reacciones indeseables.

Dirofilariasis humana pulmonar: reportaje del primer caso nacional / Human pulmonar dirofilariasis: nacional first case report

La dirofilariasis pulmonar humana es una zoonosis transmitida por un mosquito del perro al hombre, que se presenta a nivel mundial. El presente artículo es el reporte del primer caso nacional de dirofilariasis pulmonar humana que se tenga conocimiento, donde se analiza el cuadro clínico, los exámenes auxiliares y el estudio anatomopatológico realizados y se revisa la literatura actual correspondiente. En nuestro medio es preciso considerarla en el diagnóstico diferencial de otras patologías pulmonares como cáncer, tuberculosis y quiste hidatídico complicado.