Incidence of congenital and postnatal cytomegalovirus infection during the first year of life in Mexican preterm infants.

Cytomegalovirus infection occurs commonly during infancy. Postnatal infection in term infants is usually asymptomatic; however, infection in preterm infants can be associated with clinical manifestations during the neonatal period. Nevertheless, few studies to assess the frequency of cytomegalovirus infection in preterm infants have been performed outside of high-income countries. We analyzed the incidence of congenital and postnatal cytomegalovirus infection in a cohort of preterm infants. Cytomegalovirus infection was detected during the neonatal period in four of 178 infants; in three of them, the virus was detected during the first 3 weeks of life and, therefore, congenital infection was confirmed (1.7% incidence). Postnatal infection was detected in 44 (36.4%) of 121 infants who were assessed after discharge from the neonatal intensive care unit. Cytomegalovirus infection was significantly associated with the duration of breastfeeding. In addition, we characterized cytomegalovirus strains detected in infants together with sequences available at GenBank, based on sequences of the UL18 gene. Cytomegalovirus UL18-sequences clustered in five distinct clades (A-E), and sequences obtained from infants in our study were distributed in four of the five clades; 44.4% of these sequences were included in clade E. Breastfeeding duration was shorter on average (5.6 months) in infants with sequences in clade E compared to infants with sequences in the other three clades (8.2 months; p = .07). In conclusion, we provide information regarding the high incidence of cytomegalovirus infection in preterm infants. Further studies are warranted to assess if cytomegalovirus strain characteristics are associated with the risk of infection acquisition during infancy.

Mexican HIV-1 Protease Sequence Diversity.

Protease is one of three enzymes encoded within HIV's pol gene, responsible for the cleavage of viral Gag-Pol polypeptide into mature viral proteins and a target of current anti-retroviral therapy. Protease diversity analysis in Latin America has been lacking in spite of extensive studies of protease-inhibitor resistance mutations. We studied the diversity of 777 Mexican protease sequences and found that all were subtype B except one (CRF02_AG). Phylogenetic analysis suggested the existence of six different clades with geospecific contributions. Thirty-three percent of sites were conserved, 25% had conservative substitutions, and 41% exhibited physicochemical changes. The most conserved regions surrounded the active site, most of the flap domain, and a region between the 60's loop and C-terminal triad. A single sequence exhibited an active site mutation (T26S). Variable sites were mapped to a crystallographic structure, providing further insight into the distribution and functional relevance of variable sites among Mexican isolates.

Prevalence of Drug Resistance Mutations in Protease, Reverse Transcriptase, and Integrase Genes of North Central Mexico HIV Isolates.

This study set out to determine the frequency of antiretroviral drug resistance mutations in treatment-naive subjects of the north central Mexican state of San Luis Potosí. Mexican studies of antiretroviral drug resistance mutations have focused mainly on large metropolitan areas and border towns subjected to intense international migrations. This study set forth to describe the frequency of these mutations in a Mexican region less subjected to such migratory influences and more representative of smaller Mexican cities. Thirty-eight full-length pol sequences spanning the protease, reverse-transcriptase, and integrase-encoding regions were obtained from 42 treatment-naive human immunodeficiency virus (HIV)-infected subjects. Most exhibited subtype B homology, but CRF02_AG was also detected. Evidence of APOBEC3 hypermutation was seen in two samples. Calibrated population analysis revealed a surveillance drug resistance mutation prevalence of 4.9% for protease inhibitors, of 2.7% for nucleoside reverse transcriptase inhibitors, of 8.1% for non-nucleoside reverse transcriptase inhibitors, and an overall prevalence of 9.5%. This corresponds to an intermediate level of transmitted drug resistance according to the World Health Organization. The identification of integrase mutations suggests that transmitted drug mutations are being imported, as inhibitors targeting integrase have not been widely used in Mexico. Our results provide a greater understanding of HIV diversity in Mexico and highlight the way internal migrations allow HIV mutations and genetic features to permeate regions less subjected to international migrations. The implications of these findings will become more evident as Mexico hosts increased repatriations of migrants in the coming years.

Sequence and Phylogenetic Analysis of the Untranslated Promoter Regions for HLA Class I Genes.

Polymorphisms located within the MHC have been linked to many disease outcomes by mechanisms not yet fully understood in most cases. Variants located within untranslated regions of HLA genes are involved in allele-specific expression and may therefore underlie some of these disease associations. We determined sequences extending nearly 2 kb upstream of the transcription start site for 68 alleles from 57 major lineages of classical HLA class I genes. The nucleotide diversity within this promoter segment roughly follows that seen within the coding regions, with HLA-B showing the highest (∼1.9%), followed by HLA-A (∼1.8%), and HLA-C showing the lowest diversity (∼0.9%). Despite its greater diversity, HLA-B mRNA expression levels determined in 178 European Americans do not vary in an allele- or lineage-specific manner, unlike the differential expression levels of HLA-A or HLA-C reported previously. Close proximity of promoter sequences in phylogenetic trees is roughly reflected by similarity of expression pattern for most HLA-A and -C loci. Although promoter sequence divergence might impact promoter activity, we observed no clear link between the phylogenetic structures as represented by pairwise nucleotide differences in the promoter regions with estimated differences in mRNA expression levels for the classical class I loci. Further, no pair of class I loci showed coordinated expression levels, suggesting that distinct mechanisms across loci determine their expression level under nonstimulated conditions. These data serve as a foundation for more in-depth analysis of the functional consequences of promoter region variation within the classical HLA class I loci.

Molecular Characterization of Mexican HIV-1 Vif Sequences.

The viral infectivity factor (Vif) is an HIV accessory protein that counteracts host antiviral proteins of the APOBEC3 family. Accumulating evidence highlights the pivotal role that accessory HIV proteins have on disease pathogenesis, a fact that has made them targets of interest for novel therapeutic and preventive strategies. Little is known about Vif sequence diversity outside of African or white populations. Mexico is home to Americas' third largest HIV-affected population and Mexican Hispanics represent an ever-increasing U.S. minority. This study provides a detailed analysis of the diversity seen in 77 Mexican Vif protein sequences. Phylogenetic analysis shows that most sequences cluster with HIV-1 subtype B, while less than 10% exhibit greater similarity to subtype D and A subtypes. Although most functional motifs are conserved among the Mexican sequences, substantial diversity was seen in some APOBEC binding sites, the nuclear localization inhibitory signal, and the CBFß interaction sites.

Multimedia para profesores y estudiantes de 5to año de medicina. Asignatura Salud Pública / Multimedia for Fifth Year Medicine Professors and Students. Public Health Subject

Fundamento: tomando en consideración las potencialidades del uso de las tecnologías de la información, es necesario que cada docente desarrolle métodos de trabajo donde el empleo de la computadora sea un fuerte aliado que le permita mejorar los medios y métodos de enseñanza para ganar en la calidad del aprendizaje. Objetivo: elaborar una multimedia como medio de apoyo a profesores y estudiantes de 5to año de medicina en la asignatura de Salud Pública. Métodos: se realizó una multimedia partiendo del software Creasoft 2.1 creado por un grupo de informáticos de la Universidad de Ciencias Médicas de Holguín. Se concibieron los fundamentos del proyecto para la introducción de documentos, imágenes y videos construidos en función del programa de la asignatura Salud Pública. Para decidir el contenido del software se realizó revisión documental y trabajo en grupo de expertos. Resultados: la multimedia funciona de manera que estudiantes y profesores pueden acceder al software y los semestres validados para su utilización según el programa de la asignatura, están disponibles ejercicios por temas, se accede a videos instructivos, educativos y orientadores de los diferentes contenidos, la literatura es actualizada, cuenta con los programas de salud, acciones de control de foco en enfermedades transmisibles y otros documentos para la preparación de profesores y de estudiantes del 5to año de Medicina.Conclusiones: la multimedia creada debe contribuir a elevar la calidad de la enseñanza pues este medio se ha presentado en el momento y condiciones oportunas, combinados adecuadamente en función del cumplimiento de los objetivos.

Background: taking into consideration the potentialities of the use of information technologies, it is necessary for each teacher to develop methods of work where the use of the computer is a strong ally that permit improving the aids and teaching methods to win the quality of learning. Objective: elaborating a multimedia to support the fifth year Medicine teacher and students in Public Health subject. Methods: a multimedia was created departing from the software Creasoft 2, 1 created by a group of information-technology of Medical Sciences of Holguin. The foundations of the project for the introduction of documents, imagery and videos constructed in terms of the program of Public Health subject were created. Documentary revision and work in group of experts was accomplished in order to decide the contents of the software. Results: the multimedia works so that the students and professors can agree to the software and semesters validated for its utilization according to the program of the subject of study, exercises for themes are available, it is accessed to instructive, educational and counsellors videos of different contents, the literature is updated, counts with the health programs, actions of control of focus in transmissible diseases and other documents for fifth year Medicine professor and students. Conclusions: the created multimedia must contribute to elevate the quality of teaching because this means has been presented at the time and opportune conditions, adequately combined in terms of the fulfilment of the objectives.

Multimedia para profesores y estudiantes de 5to año de medicina: asignatura Salud Pública / Multimedia for fifth year medicine professors and students: public health subject

Fundamento: tomando en consideración las potencialidades del uso de las tecnologías de la información, es necesario que cada docente desarrolle métodos de trabajo donde el empleo de la computadora sea un fuerte aliado que le permita mejorar los medios y métodos de enseñanza para ganar en la calidad del aprendizaje. Objetivo: elaborar una multimedia como medio de apoyo a profesores y estudiantes de 5to año de medicina en la asignatura de Salud Pública. Métodos: se realizó una multimedia partiendo del software Creasoft 2.1 creado por un grupo de informáticos de la Universidad de Ciencias Médicas de Holguín. Se concibieron los fundamentos del proyecto para la introducción de documentos, imágenes y videos construidos en función del programa de la asignatura Salud Pública. Para decidir el contenido del software se realizó revisión documental y trabajo en grupo de expertos. Resultados: la multimedia funciona de manera que estudiantes y profesores pueden acceder al software y los semestres validados para su utilización según el programa de la asignatura, están disponibles ejercicios por temas, se accede a videos instructivos, educativos y orientadores de los diferentes contenidos, la literatura es actualizada, cuenta con los programas de salud, acciones de control de foco en enfermedades transmisibles y otros documentos para la preparación de profesores y de estudiantes del 5to año de Medicina. Conclusiones: la multimedia creada debe contribuir a elevar la calidad de la enseñanza pues este medio se ha presentado en el momento y condiciones oportunas, combinados adecuadamente en función del cumplimiento de los objetivos(AU)

Background: taking into consideration the potentialities of the use of information technologies, it is necessary for each teacher to develop methods of work where the use of the computer is a strong ally that permit improving the aids and teaching methods to win the quality of learning. Objective: elaborating a multimedia to support the fifth year Medicine teacher and students in Public Health subject.Methods: a multimedia was created departing from the software Creasoft 2, 1 created by a group of information-technology of Medical Sciences of Holguin. The foundations of the project for the introduction of documents, imagery and videos constructed in terms of the program of Public Health subject were created. Documentary revision and work in group of experts was accomplished in order to decide the contents of the software. Results: the multimedia works so that the students and professors can agree to the software and semesters validated for its utilization according to the program of the subject of study, exercises for themes are available, it is accessed to instructive, educational and counsellors videos of different contents, the literature is updated, counts with the health programs, actions of control of focus in transmissible diseases and other documents for fifth year Medicine professor and students. Conclusions: the created multimedia must contribute to elevate the quality of teaching because this means has been presented at the time and opportune conditions, adequately combined in terms of the fulfilment of the objectives(AU)

Trabajo didáctico metodológico e investigativo de coordinación intermaterias sociomédicas

Se realizó una investigación-acción cualitativa de perfil pedagógico fundamentada en un trabajo didáctico metodológico e investigativo de coordinación inter.-materias en asignaturas socio médicas de la carrera de Medicina mediante un trabajo de mesa de varias sesiones que conllevó a la revisión de los programas y los objetivos vigentes de las asignaturas Introducción a Medicina General Integral, Filosofía y Salud, Sanología, Salud Pública y Medicina General Integral Il, mediante la observación documental a través de la técnica de análisis de contenido de los diferentes programas. Se realizaron las correcciones oportunas a fin de evitar la reiteración u omisión de contenidos afines en primero, cuarto y quinto años de la carrera. Se dejó claro, qué enseñar y cómo hacerlo, no solo en el manejo de las diferentes invariantes sino en lo que se quiere que domine el futuro Médico Gneral Integral. Posteriormente al cotejamiento de los diferentes programas se elaboró una propuesta al Comité Vertical y Horizontal de reajuste didáctico metodológico a poner en práctica en el curso 2004-2005(AU)