Neumonías atípicas / Atypical pneumoniae

Atypical pneumonias are a significant percentage of causal agents of pneumonia in children. Dominate over 5years of age, although in the last three years there is an increase in cases in children three years of age, especially secondary to Mycoplasma. In this review, we will refer to Mycoplasma pneumoniae, as the atypical germ most common and important in the epidemiology of children with pulmonary involvement. Mycoplasma pneumonia, can explain 20-25 percent of pneumonia in children, especially in preschool and school age.

Las neumonías atípicas constituyen un porcentaje importante de agentes causales de neumonía en niños. Predominan en mayores de 5 años de edad, aunque en los últimos años, existe un incremento de casos en niños de 3años de edad, sobre todo secundario al Mycoplasma. En esta revisión, nos referiremos al Mycoplasma pneumoniae, como el germen de los atípicos más frecuente e importante en la epidemiología del niño con afectación pulmonar. Las neumonías por mycoplasma, pueden explicar del 20 al 25 por ciento de las neumonías en niños, sobre todo en edades preescolares y escolares.

Prevention of cancer and non-communicable diseases.

Cancer is a leading cause of death worldwide, accounting for approximately 7.6 million deaths (13% of all deaths) in 2008. Cancer mortality is projected to increase to 11 million deaths in 2030, with the majority occurring in regions of the world with the least capacity to respond. However, cancer is not only a personal, societal and economic burden but also a potential societal opportunity in the context of functional life - the years gained through effective prevention and treatment, and strategies to enhance survivorship. The United Nations General Assembly Special Session in 2011 has served to focus attention on key aspects of cancer prevention and control. Firstly, cancer is largely preventable, by feasible means. Secondly, cancer is one of a number of chronic, non- communicable diseases that share common risk factors whose prevention and control would benefit a majority of the world's population. Thirdly, a proportion of cancers can be attributed to infectious, communicable causal factors (e.g., HPV, HBV, H.pylori, parasites, flukes) and that strategies to control the burden of infectious diseases have relevance to the control of cancer. Fourthly, that the natural history of non-communicable diseases, including cancer, from primary prevention through diagnosis, treatment and care, is underwritten by the impact of social, economic and environmental determinants of health (e.g., poverty, illiteracy, gender inequality, social isolation, stigma, socio-economic status). Session 1 of the 4th International Cancer Control Congress (ICCC-4) focused on the social, economic and environmental, as well as biological and behavioural, modifiers of the risk of cancer through one plenary presentation and four interactive workshop discussions. The workshop sessions concerned 1) the Global Adult Tobacco Survey and social determinants of tobacco use in high burden low- and middle-income countries; 2) the role of diet, including alcohol, and physical activity in modifying the risk of cancer and other non-communicable diseases; 3) the role of infections in modifying the risk of cancer; and 4) the public policies and actions that can be implemented to effectively reduce the risk of cancer at population levels. Workshop discussions highlighted the need for high quality data on the prevalence of modifiable factors in different settings, as well as the social, economic and environmental drivers of these factors, in order to inform prevention and control programs. For some factors, further work needs to be done to develop simple and valid measurement tools. Given that many of these factors are common to both cancer and other non-communicable diseases, cancer prevention should be viewed within the broader perspective of the prevention of non-communicable diseases and should engage all relevant actors, including the general public, health and other professionals, workplaces and institutions, the media, civil society, schools, governments, industry, and multinational bodies. Many policies and plans have been implemented in various settings to control the drivers of modifiable factors and promote health and well-being. Mapping, analysis, and contextualization of those policies that are relevant would be helpful to promote action around cancer prevention in different settings.

ShAR1alpha and ShAR1beta: novel putative nicotinic acetylcholine receptor subunits from the platyhelminth blood fluke Schistosoma.

The cDNAs for two novel neuronal-type nicotinic acetylcholine receptor (nAChR) subunits have been cloned and characterised from the parasitic trematode blood fluke Schistosoma haematobium. One of these encodes a putative nAChR alpha-subunit named ShAR1alpha, whilst the second encodes a potential non-alpha subunit, ShAR1beta. These ShARs possess the key structural features common to all nAChRs, but they are unusual in that they have very large cytoplasmic domains spanning M3 and M4. Overall, the ShAR1alpha and ShAR1beta proteins share 37% identity and 53% similarity, but excluding the residues of the M3-M4 domain this rises to 52% identity and 71% similarity. Sequence comparisons with other nAChR polypeptides indicate that both ShARs are most similar to the invertebrate alpha7-like subunits identified in insects and nematodes, and to the vertebrate subunits alpha7 and alpha8. Outside of the M3-M4 domain, 45% and 40%, respectively, of the ShAR1alpha and ShAR1beta residues are conserved in the ACR-16 subunit from Caenorhabditis elegans. Phylogenetic analysis suggests that the ShARs share a common lineage with members of the ACR-16 group as well as alpha7 and alpha8. Immunolocalisation studies revealed distinct and non-overlapping patterns of distribution for ShAR1alpha and ShAR1beta within the parasite. ShAR1beta was localised within the musculature and on discrete cell bodies within the connective parenchyma. In contrast, ShAR1alpha was localised exclusively to the surface membranes, suggesting it may contribute to the regulatory nAChR we have characterised previously. In Xenopus oocyte expression studies, ShAR1alpha did not form functional channels on its own or in combination with ShAR1beta or the chick beta2 subunit. Furthermore, a chimera in which the M3-M4 domain of ShAR1alpha was replaced with that of chick alpha7 was also non-functional. We discuss our findings in the context of the proposed role for surface nAChRs in the regulation of glucose uptake in the parasite, and the potential exploitation of these receptors as targets for cholinergic schistosomicides.

Molecular characterization of an acetylcholinesterase implicated in the regulation of glucose scavenging by the parasite Schistosoma.

Acetylcholinesterase (AChE) present on the surface of the trematode blood fluke Schistosoma has been implicated in the regulation of glucose scavenging from the host blood. Determination of the molecular structure and functional characteristics of this molecule is a crucial first step in understanding the novel function for AChE and in evaluating the potential of schistosome AChE as a target of new parasite control methods. We have determined the primary structure of acetylcholinesterase from Schistosoma haematobium. Immunolocalization studies confirmed that the enzyme was present on the parasite surface as well as in the muscle. The derived amino acid sequence possesses features common to acetylcholinesterases: the catalytic triad, six cysteines that form three intramolecular disulphide bonds, and aromatic residues lining the catalytic gorge. An unusual feature is that the fully processed native enzyme exists as a glycoinositol phospholipid (GPI)-anchored dimer, but the sequence of the C?terminus does not conform to the current consensus for GPI modification. The enzyme expressed in Xenopus oocytes showed conventional substrate specificity and sensitivity to established inhibitors of AChE, although it is relatively insensitive to the peripheral site inhibitor propidium iodide. Distinctions between host and parasite AChEs will allow the rational design of schistosome-specific drugs and vaccines.

Neumonía asociada al ventilador / Ventilator-Associated Pneumonia

La neumonía es la segunda infección nosocomial más frecuente, superada sólo por las infecciones del tracto urinario, con la mayor tasa de mortalidad entre las infecciones nosocomiales. Los pacientes de mayor riesgo son aquellos que reciben asistencia ventilatoria ya que se incrementa el riesgo de infección, por lo que se denomina neumonía asociada al ventilador. Se sabe que el riesgo de esta neumonía utilizando los criterios clínicos y radiológicos está entre 21 y 24 por ciento aproximadamente. Alrededor del 15 por ciento de todas las muertes que ocurren en pacientes hospitalizados, está directamente relacionada con la neumonía nosocomial. Los criterios clínicos para el diagnóstico no tienen una adecuada correlación, por lo cual los métodos de aislamiento captados son el cultivo cuantitativo con cepillo protegido (10

Estudios moleculares en pacientes colombianos con Fibrosis quística

La fibrosis quística (FQ), la enfermedad autosómica recesiva más frecuente en poblaciones caucásicas, tiene una incidencia promedio de 1/2.500 recién nacidos