Moringa oleifera leaves alleviated inflammation through downregulation of IL-2, IL-6, and TNF-α in a colitis-associated colorectal cancer model.

New chemopreventive alternatives are needed due to the rising worldwide incidence of colorectal cancer. The objective was to evaluate the chemopreventive activity of Moringa oleifera leaves (MO) in a colitis-associated colon carcinogenesis model. We hypothesized that MO contain bioactive compounds capable of modulating the expression of genes involved in the inflammatory response and carcinogenesis. Forty-eight male mice (CD-1) were divided into six groups; 1: Healthy control; 2: Positive control induced with azoxymethane (AOM, 10 mg/Kg body weight, intraperitoneal injection) and three cycles of dextran sodium sulfate (DSS, 1.5% in drinking water); groups 3, 4, and 5 were induced with AOM/DSS and supplemented with 5%, 10%, and 20% of MO, respectively; group 6: had no disease induction and supplemented with 20% of MO. Mice were treated for 12 weeks and euthanized. Significant differences (p < 0.05) were found for the moringa-administered groups in morphological and histopathological parameters compared to the AOM/DSS control. A decrease in myeloperoxidase activity (~50%) and lipid peroxidation (1.9-3.1 times) were found in groups with 10% and 20% of MO compared to the AOM/DSS control (p < 0.05). The group supplemented with 10% MO showed a significant increase (~3 times) in butyrate and propionate in fecal and cecal content. Groups supplemented with 10%, and 20% MO showed a reduction in proinflammatory cytokines in serum (MCP-1, IL-6, TNF-α) compared to the AOM/DSS control. Treatment with 10% MO induced differential expression of 65 genes in colon tissue such as IL-2, IL-6, TNF, IL-1ß, and INF-γ. MO downregulated proinflammatory mediators showing chemopreventive properties against inflammatory response and colon carcinogenesis.

A dynamic and integrated in vitro/ex vivo gastrointestinal model for the evaluation of the probability and severity of infection in humans by Salmonella spp. vehiculated in different matrices.

The lack of proper gastrointestinal models assessing the inter-strain virulence variability of foodborne pathogens and the effect of the vehicle (food matrix) affects the risk estimation. This research aimed to propose a dynamic and integrated in vitro/ex vivo gastrointestinal model to evaluate the probability and severity of infection of foodborne pathogens at different matrices. An everted gut sac was used to determine the adhesion and invasion of Salmonella enterica and tissue damage. S. Typhimurium ATCC 14028 was used as a representative bacterium, and two matrices (water and cheese) were used as vehicles. No differences (p > 0.05) in the probability of infection (Pinf) were found for intra-experimental repeatability. However, the Pinf of cheese-vehiculated S. Typhimurium was different compared to water- vehiculated S. Typhimurium, 7.2-fold higher. The histological analysis revealed Salmonella-induced tissue damage, compared with the control (p < 0.05). In silico proposed interactions between two major Salmonella outer membrane proteins (OmpA and Rck) and digested peptides from cheese casein showed high binding affinity and stability, suggesting a potential protective function from the food matrix. The results showed that the everted gut sac model is suitable to evaluate the inter-strain virulence variability, considering both physiological conditions and the effect of the food matrix.

Development of standardized method for the quantification of azo dyes by UV-Vis in binary mixtures.

The azo dyes, Yellow 5 (Y5), Red 2 (R2) and Blue 1 (B1), quantified in solutions and in mixtures of binary dyes, were studied by means of UV-Vis spectroscopy. In this work was used a CIE algorithm developed in Visual Basic for Applications (VBA). The CIE algorithm is based on the tristimulus chromaticity diagram, as an alternative to the shielding effect that arises in dye mixtures, and it can also be applied to complex quantification methods such as HPLC (High Performance Liquid Chromatography). The results obtained through of the algorithm, showed a higher accuracy from 97 to 99% in relation with similar UV-Vis quantification methods. In contrast, linear methods only managed to reach an accuracy from 78 to 98%. Additionally, the algorithm yielded significant similar values to the UHPLC reference method. The results showed that the method CIE algorithm was accessible and reliable to quantify binary mixtures of the dyes used which suggests the possibility to apply this method on other dyes, within the limits of quantification obtained in this study (0.076-24.56 mg/L) and the pH values from 2 to 10.

Effect of the in vitro gastrointestinal digestion on free-phenolic compounds and mono/oligosaccharides from Moringa oleifera leaves: Bioaccessibility, intestinal permeability and antioxidant capacity.

Moringa oleifera is a plant recognized for its compounds such as dietary fiber (oligosaccharides, amongst others) and polyphenols, with biological activities. These properties depend on bioactive compounds (BC) interactions with food matrix/digestion conditions, which have not been evaluated. Thus, the aim of this study was to evaluate the bioaccessibility, intestinal permeability and antioxidant capacity of BC (free-phenolic compounds (PC); and mono/oligosaccharides (MOS)) from Moringa oleifera leaves (ML) powder during in vitro gastrointestinal digestion. The gallic/caffeic acids, morin, kaempferol, mannose and stachyose showed the highest bioaccessibilities (~6-210%). The PC correlated with the antioxidant capacity (R2: 0.59-0.98, p < .05), whereas gallic/caffeic acids were the highest. The apparent permeability coefficients of bioactive compounds (0.62-36.65 × 10-4 cm/s) and water flux/glucose transport confirmed the model similarity to in vivo experiments. The results suggest that ML digestion dynamically modifies PC/MOS bioaccessibility/antioxidant capacity while most of them are not completely absorbed in the small intestine.

Fermented non-digestible fraction from combined nixtamalized corn (Zea mays L.)/cooked common bean (Phaseolus vulgaris L.) chips modulate anti-inflammatory markers on RAW 264.7 macrophages.

Chronic non-communicable diseases (NCDs) are low-level inflammation processes affected by several factors including diet. It has been reported that mixed whole grain and legume consumption, e.g. corn and common bean, might be a beneficial combination due to its content of bioactive compounds. A considerable amount would be retained in the non-digestible fraction (NDF), reaching the colon, where microbiota produce short-chain fatty acids (SCFAs) and phenolic compounds (PC) with known anti-inflammatory effect. The aim of this study was to estimate the anti-inflammatory potential of fermented-NDF of corn-bean chips (FNDFC) in RAW 264.7 macrophages. After 24 h, FNDFC produced SCFAs (0.156-0.222 mmol/l), inhibited nitric oxide production > 80% and H2O2 > 30%, up-regulated anti-inflammatory cytokines (I-TAC, TIMP-1) > 2-fold, and produced angiostatic and protective factors against vascular/tissue damage, and amelioration of tumor necrosis factor signalling and inflammatory bowel disease. These results confirm the anti-inflammatory potential derived from healthy corn-bean chips.

Physicochemical and nutraceutical properties of moringa (Moringa oleifera) leaves and their effects in an in vivo AOM/DSS-induced colorectal carcinogenesis model.

Moringa (Moringa oleifera) is a plant that has generated great interest in recent years because of its attributed medicinal properties. The aim of this study was to characterize the bioactive compounds of moringa leaves (MO) and evaluate their effect on a colorectal carcinogenesis model. Twenty-four male CD-1 mice were divided into 4 groups: Group 1 fed with basal diet (negative control/NC); Group 2 received AOM/DSS (positive control); Groups 3 and 4 were fed with basal diet supplemented with moringa leaves (2.5% w/w and 5% w/w, respectively) for 12weeks. Moringa leaves exhibited a high content of dietary fiber (~18.75%) and insoluble dietary fiber (2.29%). There were identified 9 phenolic compounds whereas the chlorogenic and ρ-coumaric acid showed the higher contents (44.23-63.34µg/g and 180.45-707.42µg/g, respectively). Moringa leaves decreased the activity of harmful fecal enzymes (ß-glucosidase, ß-glucuronidase, tryptophanase and urease up to 40%, 43%, 103% and 266%, respectively) as well tumors incidence in male CD1-mice (~50% with 5% w/v of moringa dose). These findings suggest that the bioactive compounds of moringa such as total dietary fiber and phenolic compounds may have chemopreventive capacity. This is the first study of the suppressive effect of moringa leaves in an in vivo model of AOM/DSS-induced colorectal carcinogenesis.

[Analysis on the ambulatory usage of antibiotics at general hospitals in Asturias (2006-2015)]. / Análisis del uso ambulatorio de antibióticos en los hospitales generales de Asturias entre 2006 y 2015.

OBJECTIVE: The Organization for Economic Co-operation and Development (OECD) emphasize, in its report on health policies from 2017 that, Spain is one of the countries with largest consumption of antibiotics, 21.6 DHD (defined daily dose per 1000 inhibitants per day) in 2014 greater than the average 20.5 DHD in their countries, ranking according to the European Center for Disease Prevention and Control (ECDC) in the 11th place out of 30 European countries in 2016. The outpatient prescription of specialized care is analyzed less frequently, due to the greater contribution in consumption and expenditure of primary care. METHODS: A descriptive, observational, and retrospective study of the consumption and expenditure of the J01 group derived from outpatient prescription (outpatient and urgent care) of public hospitals in Asturias, in a period of ten years (2006-2015). Consumption data were obtained using the database of prescription billing of the Health Service of the Principality of Asturias, demographic data were provided by the National Institute of Statistics. Consumption was expressed in DHD and antibiotics expenditure in: expenditure per capita and expenditure in euros per defined daily dose. RESULTS: The average global ambulatory consumption for the period was 23.4 DHD, corresponding 11.5% (2.7 DHD) to the ambulatory specialty care prescription. In terms of expenditure, it accounted for 13.6% of overall outpatient spending on antibiotics. CONCLUSIONS: Outlay and consumption had opposite tendencies, the expenditure control measures did not have or had little impact on consumption, therefore, independent and spe-cific rationalization measures are required in this area.

Eficacia del tratamiento con oligoelementos de la enfermedad de meniere / Efficacy of the treatment with olygoelements of the ménière' s diseases

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[Otoacoustic emissions in sudden deafness]. / Emisiones otoacústicas en sorderas súbitas.

UNLABELLED: The idiopathic type of sudden deafness installed in few hours become evident in audiometry as deafness perceptive of loud tones, neurosensorial deafness of loud tones and completely of treble sounds or cofosis. The otoacoustic emissions are modificated in sudden deafness. OBJECTIVES: To know and describe how are the otoacoustic emissions and the audition in sudden deafness. To analyse a possible relationship between audition, otovestibular and clinic participation with the parameters of the graphoelements of the otoacoustic emissions. PATIENTS AND METHODS: We study 52 patients with diagnostic of sudden deafness with a backward, observational and descriptive and analytic design of the results. Patients with ORL diagnostic were selectioned and audiometric, vestibular test and otoacoustic emissions were made. RESULTS: In our research we find quantitative and qualitative variations statistically significative in the otoacoustic emissions design. Its presence in the different frequencies is altered or is missing in any case of sudden deafness in which there are damages of the inner ear. There is not associative correlation between the alterations of otoacoustic emissions and the kind of sudden deafness, neither its provoking factors, anigiohematical, viral or traumatic. DISCUSSION AND CONCLUSIONS: There are modifications of the otoacoustic emissions but not specificals or the kinds of sudden deafness and its provoking factors. Another publications agree and underwrite our discoveries. We thought that our aportation with this study is fundamental for the clinic application of the otoacoustic emissions in the processes of sudden deafness.

Emisiones otoacústicas en sorderas súbitas / Otoacustic emissions in sudden deafness

La forma idiopática de sordera súbita instalada en pocas horas se manifiesta en audiometría como sordera perceptiva de tonos graves, sordera neurosensorial de tonos graves y total de tonos agudos o cofosis. Están codificadas las emisiones otoacústicas en las sorderas súbitas. Objetivos. 1º Conocer y describir cómo estás las emisiones otoacústicas y la audición en las sorderas súbitas. 2º Analizar una posible relación asociativa entre audición, participación otovestibular y clínica con los parámetros de los grafoelementos de las emisiones otoacústicas. Pacientes (material y métodos). Estudiamos 52 pacientes con diagnóstico de sordera súbita con un diseño retrospectivo, observacional y descriptivo, y analítico de resultados. Se seleccionaron los pacientes con diagnóstico ORL y se les practicaron pruebas audiométricas, vestibulares y emisiones otoacústicas. Resultados. En nuestra investigación hallamos unas variaciones cuantitativas y cualitativas estadísticamente significativas en los trazados de emisiones otoacústicas. Su presencia en las diversas frecuencias está alterada o falta en todos los casos de sorderas súbitas en que hay lesiones de oído interno. No existe correlación asociativa entre las alteraciones de emisiones otoacústicas y tipo de sordera súbita ni sus factores desencadenantes angiohemático, viral o traumético. discusión/conclusiones. Existen modificaciones de las emisiones otoacústicas pero no específicas de las variedades de sorderas súbitas y sus factores desencadenantes. Otras publicaciones coinciden y avalan nuestros hallazgos. Pensamos que nuestra aportación con este estudio es básica para la aplicación clínica de las emisiones otoacústicas en los procesos de sorderas súbitas (AU)

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[Efficacy of the treatment of Ménière's disease with oligoelements]. / Eficacia del tratamiento con oligoelementos de la enfermedad de Ménière.

OBJECTIVES: 1st To study and know better the therapeutical action of the olygoelements in the Ménière's diseases. 2nd To analyse if there are significative statistical associations of therapeutical response to the olygoelements in the Ménière's sickness. MATERIAL AND METHODS: We make a design of observational study of 68 patients with the diagnostic of Ménière's sickness, with classical therapeutic and 34 treated with and without litium olygoelements and manganese&cupper. RESULTS: In the descriptive statistics we find better results in the Ménières treated with olygoelements than in those that were not treated. In the analytic associative statistics we find that for 3 degrees of freedom a chi-square of 13.20 that is equal to 0.00459 (less than 0.05) that indicate that there's significative differences between both treatments not due to casuality. DISCUSSION: There are significative differences of better results in Ménières treated with olygoelements. The new aspect of potentiate the therapeutical arsenal of Ménières evidences a new possibility of soon clinical aplication.

Evolution of resistance among clinical isolates of Acinetobacter over a 6-year period.

The aim of this report was to study the evolution of susceptibilities of 1532 clinical isolates of Acinetobacter recovered over a period of 6 years. The minimal inhibitory concentrations (MICs) of 15 antimicrobial agents were determined for all the isolates. The respective percentages of resistant strains in the years 1991 and 1996 were as follows: ciprofloxacin, 54.4% and 90.4%; tobramycin, 33% and 71.8%; amikacin, 21% and 83.7%; ampicillin plus sulbactam, 65.7% and 84.1%; ceftazidime, 57.4% and 86.8%; ticarcillin, 70% and 89.4%; trimethoprim plus sulfamethoxazole, 41.1% and 88.9%; and imipenem, 1.3% and 80%. The MIC90s of ciprofloxacin, sparfloxacin, biapenem, meropenem, imipenem, cefepime, cefpirome, and rifampicin against 250 imipenem-resistant Acinetobacter strains were >32, >32, 128, >256, 256, >256, 256, and 16 mg/l, respectively. With serious infections, it was necessary to resort to the use of colistin, the only antibiotic active in vitro.

[New indication for adenoidectomy-tonsillectomy in children: elimination of obstruction in obstructive sleep apnea syndrome]. / Nueva indicación de adenoidoamigdalectomía infantil: desobstrucción en el síndrome de apnea obstructiva del sueño.

Obstructive sleep apnea syndrome (OSAS) in children produces serious organic consequences that affect pharyngeal breathing and functional development. The high rate of incidence of this problem is important. In children, the most frequent cause of OSAS is hypertrophy of the tonsils, adenoids, or both. We think that a new indication for pediatric adenoidectomy and tonsillectomy is pharyngeal breathing obstruction by hypertrophic lymphoid formations in the Waldeyer ring. In a statistical analysis of 180 children with OSAS who underwent tonsillectomy and adenoidectomy, the disappearance of most symptoms 7 months after surgery was significant.

Appearance of resistance to meropenem during the treatment of a patient with meningitis by Acinetobacter.

A case is reported of a patient who developed Acinetobacter meningitis after an external ventricular drainage system had been fitted for control of intracranial pressure. During the process, nine strains of Acinetobacter isolated from her cerebrospinal fluid were indistinguishable by analysis of total genomic DNA by pulse-field gel electrophoresis. The first eight strains were sensitive to meropenem and imipenem (MICs < 1 g/l). The MIC of the last one, which had been recovered after 32 days during two courses of treatment with meropenem, increased to > 32 g/l for meropenem, while with imipenem the increase was minimal (MIC = 1.5 g/l). The microorganism persisted in the central nervous system despite the administration of different antimicrobials, including intraventricular aminoglycosides and six changes in the external ventricular system. The patient died 68 days after admission to the intensive care unit from bilateral cerebral ischemic lesions, intraventricular hemorrhage and cerebral edema with endocraneal hypertension, the Acinetobacter ventriculitis also contributing to this state.

Impact of invasive and noninvasive quantitative culture sampling on outcome of ventilator-associated pneumonia: a pilot study.

We performed an open, prospective, randomized clinical trial in 51 patients receiving mechanical ventilation for more than 72 h, in order to evaluate the impact of using either invasive (protected specimen brush [PSB] and bronchoalveolar lavage [BAL] via fiberoptic bronchoscopy) or noninvasive (quantitative endotracheal aspirates [QEA]) diagnostic methods on the morbidity and mortality of ventilator-associated pneumonia (VAP). Patients were randomly assigned to two groups: Group A patients (n = 24) underwent QEA, PSB, and BAL; Group B patients (n = 27) underwent only QEA cultures. Empiric antibiotic treatment was given according to the attending physician and was modified according to the results of cultures and sensitivity in Group A using PSB and BAL results and in Group B based upon QEA cultures. Bacteriologic cultures were done quantitatively for EA, PSB, and BAL. Thresholds of > or = 10(5), > or = 10(3), and > or = 10(4) CFU/ml were used for QEA, PSB, and BAL, respectively. Microbial cultures from Group A patients were positive in 16 (67%) BAL samples, 14 (58%) PSB samples, and 16 (67%) QEA samples. In Group B patients, QEA microbial cultures yielded positive results in 20 of 27 (74%) samples. In Group A, there was total agreement between culture results of the three techniques on 17 (71%) occasions. In five (21%) cases, QEA coincided with either BAL or PBS. In only two (8%) cases, QEA cultures did not coincide with either PSB or BAL. No cases of positive BAL or PSB cultures had negative QEA cultures. Initial antibiotic treatment was modified in 10 (42%) patients from Group A and in four (16%) patients from Group B (p < 0.05). The observed crude mortality rate was 11 of 24 (46%) in Group A, and 7 of 27 (26%) in Group B, whereas the adjusted mortality rates (observed crude minus predicted at admission) for Groups A and B were 29 and 10%, respectively. There were no statistically significant differences when comparing crude and adjusted mortality rates of Groups A and B. There were no differences in mortality between both groups when comparing pneumonia, considering together Pseudomonas aeruginosa and Acinetobacter spp. (Group A, 33% versus Group B, 27%). There were no differences between Groups A and B with regard to ICU stay duration and total duration of mechanical ventilation. In this pilot study, the impact of bronchoscopy was to lead to more frequent antibiotic changes with no change in mortality. Further studies with larger population samples are warranted to confirm these findings.

Performance of six culture media for isolation of Salmonella species from stool samples.

The relative performance of five plating media [Rambach agar; salmonella-shigella (SS) agar, novobiocin-brilliant green-glycerol-lactose (NBGL), modified semisolid Rappaport-Vassiliadis medium (MSRV), and Salmonella Detection and Identification-2 (SM2)] and selenite broth (SB) subcultured in SS agar in the recovery of Salmonella spp. from 500 human stool specimens was evaluated. On Rambach agar and SS agar, the C8-esterase test was also used for selection of suspicious colonies. Eighty-one samples were positive for salmonellae on at least one of the six media. Sensitivities and specificities of MSRV, SB, NBGL, SS, Rambach agar, and SM2 were 95.1 and 98.1%, 87.6 and 99.8%, 79 and 91.9%, 69.1 and 99.3%, 56.8 and 96.9%, and 54.3 and 92.4%, respectively. There were statistically significant differences between MSRV and NBGL, Rambach agar, SS agar, and SM2 (p < 0.005), between SB and SS agar, Rambach agar, and SM2 (p < 0.05), and between NBGL and SM2 and Rambach agar (p < 0.005). The greatest number of isolates was recovered with MSRV, whose performance surpassed that of enrichment in selenite broth, probably because the subcultures were not repeated on MSRV. This hypothesis is now under investigation. The specificity of each of the five solid media was greater than 90%.

Note: comparison of media for the isolation of lactose-positive Salmonella.

We studied the capacity of 10 selective media (Rambach agar, RB; salmonella-shigella agar, SS; SM-ID medium, SM; Hektoen enteric agar, HE; modified semisolid Rappaport-Vassiliadis agar, MSRV; bismuth sulphite agar, BS; MacConkey agar, MC; brilliant green agar, BG; novobiocin-brilliant green-glucose agar, NBG; and novobiocin-brilliant green-glycerol-lactose agar, NBGL), and the C8-esterase test (MUCAP test, Biolife, Italy) to detect the growth of 14 strains of lactose-positive Salmonella (12 Salm. virchow and two Salm. montevideo) and 16 Salm. arizonae. Suspensions of pure strain were plated on the aforementioned media and on Mueller-Hinton, used as a control, with inocula of 3 x 10(2) cfu ml-1. The performance of BS was excellent, determining the 30 strains as typical Salmonella colonies (H2S+). On NBG, 27 strains were detected. On MSRV, only some strains grew and only one produced swarming. On the other media, the two Salm. montevideo and the 12 Salm. virchow strains produced coliform colonies. Some of these latter were inhibited on BG and NBGL. The 16 Salm. arizonae strains produced typical colonies on all the media, except on RB, SM and MSRV. On NBGL, two strains did not produce H2S. The C8-esterase test was only successful with Salm. montevideo and Salm. virchow on NBG and RB (with a few exceptions on the latter). However, with Salm. arizonae the test was positive on SS, MC, HE, BG and NBG. In summary, BS was the best medium of those used (all the 30 strains were isolated), followed by NBG (27 isolates).

The influence of the opinion of an infectious disease consultant on the appropriateness of antibiotic treatment in a general hospital.

The antibiotics chosen in hospitals are not always the most appropriate. A comparative prospective study with sequential analysis was designed to assess how the opinion of an infectious disease consultant affected the clinical efficacy of antimicrobial treatment in a general hospital. We studied 250 patients who had microbiologically documented infections according to Center for Disease Control criteria. The patients were divided in two groups with similar initial characteristics. Group G1 comprised 100 patients without infectious disease consultation, and group G2 contained 150 patients with infectious disease consultation. The influence of the consultant's opinion was assessed as the percentage of initially appropriate treatments, and by the number of inappropriate ones that were changed after the microbiological results were known. The appropriateness of initial treatment was significantly higher in group G2 (66% vs 55%), as were the number of treatments changed on the basis of the microbiological results (57.6% vs 33.3%). This lead to higher rates of cure, fewer deaths, and fewer cases of persistent infection in group G2. In 42.4% of G2 patients, antibiotic treatment was not changed in spite of the microbiological results and the opinion of an infectious disease consultant. We conclude that antibiotic treatment for the most clinically significant infections can be optimized if it is dispensed according to carefully developed guidelines.