Conjugation of Lysozyme and Epigallocatechin Gallate for Improving Antibacterial and Antioxidant Properties.

One of the main interests in the food industry is the preservation of food from spoilage by microorganisms or lipid oxidation. A novel alternative is the development of additives of natural origin with dual activity. In the present study, a chemically modified lysozyme (Lys) with epigallocatechin gallate (EGCG) was developed to obtain a conjugate (Lys-EGCG) with antibacterial/antioxidant activity to improve its properties and increase its application potential. The modification reaction was carried out using a free radical grafting method for the Lys modification reaction, using ascorbic acid and hydrogen peroxide as radical initiators in an aqueous medium. The synthesis of Lys-EGCG conjugate was confirmed by spectroscopic (FT-IR, 1H-RMN, and XPS) and calorimetry differential scanning (DSC) analyses. The EGCG binding to the Lys biomolecule was quantified by the Folin-Ciocalteu method; the antibacterial activity was evaluated by minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MCB) against Staphylococcus aureus and Pseudomonas fluorescens; the antioxidant activity was evaluated by ABTS, DPPH, and FRAP. The spectroscopic results showed that the Lys-EGCG conjugate was successfully obtained, and the DSC analysis revealed a 20 °C increase (P < 0.05) in the denaturation temperature of Lys due to EGCG modification. The EGCG concentration in Lys-EGCG was 97.97 ± 4.7 µmol of EGCG/g of sample. The antibacterial and antioxidant activity of the Lys-EGCG conjugate was higher (P < 0.05) than pure EGCG and Lys. The chemical modification of Lys with EGCG allows for the bioconjugate with a dual function (antibacterial/antioxidant), broadening the range of Lys and EGCG applications to different areas such as food, cosmetic, and pharmaceutical industries.

Antibiotic resistance of ESKAPE group-microorganisms in health institutions from Hermosillo and Ciudad Obregón, Sonora, México.

Introduction: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. are microorganisms referred as the ESKAPE group pathogens. These microorganisms have generated great concern in health institutions around the world since most of them have resistance to multiple antibiotics and cause most infections associated with healthcare, as well as community infections. The aim of this study was the analysis of antibiotic resistance in microorganisms of the ESKAPE group, recovered from clinical samples in 11 health institutions from Hermosillo and Ciudad Obregón in the State of Sonora, México, during the period from 2019 to 2020. Methods: A cross-sectional, descriptive, observational, and temporality epidemiological study was carried out. A comparative and statistical analysis of antibiotic resistance was carried out using the chi-square test, and small values were analyzed using Fisher's exact test p ≤ 0.05. Results and discussion: All the ESKAPE group microorganisms showed significant differences in antibiotic resistance percentages between both cities. High resistance percentages for some antibiotics, like cephalosporins and ciprofloxacin were detected for Klebsiella pneumoniae and Acinetobacter baumannii.

Fetal Goiter Diagnosed in a Euthyroid Patient: An Unusual Presentation of the Fetal Thyroid Disease.

Fetal thyroid disease is rare, and the disease is mostly contextualized in the setting of a treated maternal thyroid disease. The presentation of thyroid disease in the fetus of a euthyroid mother is unusual. This paper presents the case of a 21-week pregnant woman with an incidental finding from a detailed anatomy ultrasound and evaluates available diagnostic and therapeutic management options. There is no consensus with sufficient evidence given the unusual presentation of this type of pathology. In most cases, the evidence is in the etiology of a mother with previous thyroid pathology that modifies the fetal outcome. Hence, it is important to describe cases to accumulate and, at some point, sufficient evidence of different treatments, with the intention of improving the quality of the recommendations. The management of fetal euthyroid goiter is a complex challenge. Most specialists manage the information on a case-by-case basis, with the same general goals as in patients with other thyroid pathologies.

Factores de riesgo para enfermedad cerebrovascular en el adulto mayor / Risk Factors for Cerebrovascular Disease in the Older Adult

Introducción: La vejez está subvalorada, poco se piensa en el bienestar físico y psicosocial del anciano. La enfermedad cerebrovascular tiene como factores de riesgo comorbilidades como la hipertensión arterial, la diabetes mellitus, la dislipidemia, cardiopatías o malos estilos de vida como el consumo de cigarrillo, la obesidad y la poca actividad física, todos estos comunes en esta etapa de la vida. Objetivo: Identificar los factores de riesgo que presentan los adultos mayores para sufrir enfermedad cerebrovascular de un centro gerontológico de la ciudad de Medellín. Métodos: Fue una investigación descriptiva, de tipo transversal; se indagaron 37 adultos mayores con historias clínicas y exámenes de laboratorio. Se midieron los niveles de hemoglobina glicosilada, colesterol total, colesterol de baja densidad, colesterol de alta densidad y triglicéridos. Resultados: Se evidenció que la población era en su mayoría de sexo masculino con 51,4 por ciento y el sexo femenino con 48,6 por ciento; con rango de edad entre 60 y 70 años el 51,4 por ciento. Los factores de riesgo más relevantes fueron el índice de masa corporal mayor o igual a 25 con (75,7 por ciento), hipertensión arterial y no realizar actividad física. Conclusiones: Se logró determinar los principales factores de riesgo que tienen estos adultos mayores para sufrir enfermedad cerebrovascular; con resultados algunos similares y otros diferentes a estudios a nivel mundial. Con actividades de promoción y prevención se pueden intervenir estilos de vida de la población(AU)

Introduction: Old age is undervalued; little is thought about the physical and psychosocial well-being of the elderly. Among the risk factors of cerebrovascular disease, there are comorbidities, such as high blood pressure, diabetes mellitus, dyslipidemia and cardiopathies, or poor lifestyles like cigarette smoking, obesity and little physical activity, all of which are common at this stage of life. Objective: To identify, in a gerontological center in Medellín City, the risk factors that older adults present for being affected by cerebrovascular disease. Methods: This was a descriptive and cross-sectional research carried out with 37 older adults with medical antecedents and laboratory tests. The levels of glycated hemoglobin, total cholesterol, low-density and high-density cholesterol, as well as triglycerides were measured. Results: It was evidenced that the population was mostly male (51.4 por ciento), while females accounted for 48.6 por ciento. Their age range was mostly between 60 and 70 years (51.4 por ciento). The most relevant risk factors were body mass index greater than or equal to 25 (75.7 por ciento), arterial hypertension and not doing any physical activity. Conclusions: It was possible to determine the main risk factors for these older adults being affected by cerebrovascular disease; in this respect, some results were similar to and others were different from studies worldwide. With promotion and prevention activities, lifestyles of the population can be intervened(AU)

Sustainable-green synthesis of silver nanoparticles using safflower (Carthamus tinctorius L.) waste extract and its antibacterial activity.

Silver nanoparticles have high potential for application in food industry, as they have the ability to inhibit a wide range of bacteria of pathogenic and spoilage origin. They can be obtained from different methods classified in physical and chemical and which are aggressive with the environment since they produce toxic waste. Nowadays, environmentally friendly methods such as green synthesis can be used, through the use of agri-food waste. The use of these wastes is a more sustainable method, because it reduces the environmental pollution, at the same time that silver nanoparticles are obtained. The aim of the present study is the green synthesis of silver nanoparticles using safflower (Carthamus tinctorius L.) aqueous extract from waste and its antibacterial activity on Staphylococcus aureus (Gram positive) and Pseudomonas fluorescens (Gram negative). The analyses by TEM showed that the as-synthesized silver nanoparticles were uniform and spherical particles with an average diameter of 8.67 ± 4.7 nm and confirmed by SEM. The electron diffraction and TEM analyses showed the characteristic crystallinity of silver nanoparticles. FTIR spectroscopy confirmed that various functional groups were responsible for reducing and stabilizing during the biosynthesis process. Nanoparticles inhibited the growth of both types of bacteria from the lowest concentration evaluated (0.9 µg/mL). We conclude that silver nanoparticles synthesized in the present study have potential application as antibacterial agents in food and medicine industry.

Characterization of Epigallocatechin-Gallate-Grafted Chitosan Nanoparticles and Evaluation of Their Antibacterial and Antioxidant Potential.

Nanoparticles based on chitosan modified with epigallocatechin gallate (EGCG) were synthetized by nanoprecipitation (EGCG-g-chitosan-P). Chitosan was modified by free-radical-induced grafting, which was verified by Fourier transform infrared (FTIR). Furthermore, the morphology, particle size, polydispersity index, and zeta potential of the nanoparticles were investigated. The grafting degree of EGCG, reactive oxygen species (ROS) production, antibacterial and antioxidant activities of EGCG-g-chitosan-P were evaluated and compared with those of pure EGCG and chitosan nanoparticles (Chitosan-P). FTIR results confirmed the modification of the chitosan with EGCG. The EGCG-g-chitosan-P showed spherical shapes and smoother surfaces than those of Chitosan-P. EGCG content of the grafted chitosan nanoparticles was 330 µg/g. Minimal inhibitory concentration (MIC) of EGCG-g-chitosan-P (15.6 µg/mL) was lower than Chitosan-P (31.2 µg/mL) and EGCG (500 µg/mL) against Pseudomonas fluorescens (p < 0.05). Additionally, EGCG-g-chitosan-P and Chitosan-P presented higher Staphylococcus aureus growth inhibition (100%) than EGCG at the lowest concentration tested. The nanoparticles produced an increase of ROS (p < 0.05) in both bacterial species assayed. Furthermore, EGCG-g-chitosan-P exhibited higher antioxidant activity than that of Chitosan-P (p < 0.05) in 2,2'-azino-bis (3-ethyl-benzothiazoline-6-sulfonic acid) (ABTS), 2,2-diphenyl-1-picrylhydrazyl radical (DPPH) and ferric-reducing antioxidant power assays. Based on the above results, EGCG-g-chitosan-P shows the potential for food packaging and biomedical applications.

Clinical Characteristics and Predictors of Short-Term Outcome in Mexican Adult Patients with Guillain-Barré Syndrome.

BACKGROUND: Information regarding the clinical presentation and outcome of Guillain-Barré Syndrome (GBS) in adults from Latin America is limited. OBJECTIVE: To identify clinical characteristics and short-term outcome predictors in adult Mexican patients with GBS. PATIENTS AND METHODS: We included adult patients with clinical and electrophysiological data with confirmed GBS, admitted to a tertiary hospital in Western Mexico, from January 2002 to February 2011. A good outcome at hospital discharge was considered if patients had a Hughes score of 0-2 and at 3 and 6 months, a Hughes score of 0-1. RESULTS: A total of 115 patients were analyzed (68% men, mean age 44 years old, range 18-84). Previous infection occurred in 63% of cases. Descendent pattern of weakness was observed in 40 (35%) patients. GBS subtypes were: acute motor axonal neuropathy in 31%, acute inflammatory demyelinating polyneuropathy in 29%, sensory axonal neuropathy (AMSAN) in 18%, and equivocal in 22%. A total of 73 (63%) patients received induction therapy: 50 (68%) received plasmapheresis and 13 (18%) received intravenous immunoglobulin (IVIG). In-hospital mortality occurred in 14 (12%) patients. Early gait complaints and emergency room admission with mild Hughes score (0-2) were predictors for a good outcome at hospital discharge (P < 0.05); meanwhile, age >75 years; dysarthria and higher Hughes score were associated with a poor outcome(P < 0.05). CONCLUSIONS: Axonal pattern, motor involvement, and the descendent pattern of presentation were the main clinical GBS findings in our cohort. Higher Hughes scale scores at hospital admission were a strong predictor for a bad outcome at hospital discharge and short-term follow-up, independently of treatment type or in-hospital management. GBS in Mexico still carries considerable mortality.

Combined hypoxia and high temperature affect differentially the response of antioxidant enzymes, glutathione and hydrogen peroxide in the white shrimp Litopenaeus vannamei.

Low oxygen concentration in water (hypoxia) and high temperature are becoming more frequent due to climate change, forcing animals to endure stress or decease. Hypoxia and high temperature stress can lead to reactive oxygen species (ROS) accumulation and oxidative damage to the organisms. The shrimp Litopenaeus vannamei is the most cultivated crustacean worldwide. The aim of this study was to evaluate the expression and enzymatic activity of glutathione peroxidase (GPx), catalase (CAT) and cytosolic manganese superoxide dismutase (cMnSOD) in gills and hepatopancreas from L. vannamei in response to two combined stressors: hypoxia and reoxygenation at control and high temperature (28 vs 35 °C, respectively). In addition, glutathione and hydrogen peroxide content were analyzed. The changes were mainly tissue-specific. In gills, cMnSOD expression and enzymatic activity increased in response to the interactions between oxygen variation and thermal stress, while GPx and CAT were maintained. More changes occurred in GPx, CAT and MnSOD in hepatopancreas than in gills, mainly due to the effect of the individual stress factors of thermal stress or oxygen variations. On the other hand, the redox state of glutathione indicated that during high temperature, changes in the GSH/GSSG ratio occurred due to the fluctuations of GSSG. Hydrogen peroxide concentration was not affected by thermal stress or oxygen variations in hepatopancreas, whereas in gills, it was not detected. Altogether, these results indicate a complex pattern of antioxidant response to hypoxia, reoxygenation, high temperature and their combinations.

Refolding and Activation from Bacterial Inclusion Bodies of Trypsin I from Sardine (Sardinops sagax caerulea).

BACKGROUND: Trypsin from fish species is considered as a cold-adapted enzyme that may find potential biotechnological applications. In this work, the recombinant expression, refolding and activation of Trypsin I (TryI) from Monterey sardine (Sardinops sagax caerulea) are reported. METHODS: TryI was overexpressed in Escherichia coli BL21 as a fusion protein of trypsinogen with thioredoxin. Refolding of trypsinogen I was achieved by dialysis of bacterial inclusion bodies with a recovery of 16.32 mg per liter of Luria broth medium. RESULTS: Before activation, the trypsinogen fusion protein did not show trypsin activity. Trypsinogen I was activated by adding 0.002 U of native TryI purified from the sardine pyloric caeca (nonrecombinant). The activated recombinant trypsin showed three times more activity than the nonrecombinant trypsin alone. CONCLUSION: The described protocol allowed obtaining sufficient amounts of recombinant TryI from Monterey sardine fish for further biochemical and biophysical characterization of its coldadaptation parameters.

GLUCOSA 6 FOSFATO DESHIDROGENASA EN INDÍGENAS PIAROAS EN ZONA ENDÉMICA DE MALARIA / GLUCOSE 6-PHOSPHATE DEHYDROGENASE ON INDIAN PIAROAS IN MALARIA-ENDEMIC AREA

La Glucosa-6-fosfato deshidrogenasa (G6PD) mantiene intactos los grupos sulfidrilos y ayuda en la detoxificación de radicales libres y peróxidos, por tanto, el déficit provoca daño oxidativo irreversible y destrucción de los eritrocitos cuando estos son sometidos a sustancias oxidativas y al estrés. La infección por Plasmodium spp., produce anemia como consecuencia de la ruptura del eritrocito por parte de este parásito, misma que puede verse agravada en personas infectadas con deficiencia de G6PD al ser expuestos a drogas. Estudio de campo y descriptivo en que se determinó por pruebas bioquímicas la actividad enzimática de G6PD en una comunidad de indígenas Piaroa del municipio Atures, estado Amazonas. La muestra estuvo conformada por 186 individuos, 100 mujeres y 86 hombres. La concentración promedio de hemoglobina fue de 10,6 g/dL, 88,6% de los sujetos resultaron con anemia moderada y ninguno presento deficiencia de G6PD. Se concluye que la anemia es común en indígenas Piaroas, de tipo moderada y carencial; que por prueba bioquímicas no se detecta deficiencia de G6PD; y que este estudio provee información útil a los organismos del Estado encargados de administrar los cuidados de la salud en Venezuela.

Glucose-6-phosphate dehydrogenase (G6PD) remains intact sulfhydryl groups and assist in the detoxification of free radicals and peroxides, therefore deficit irreversible oxidative damage and destruction of the erythrocyte when these are subjected to oxidative substances and stress. Plasmodium spp. infection causes anemia as a result of the rupture of the erythrocyte by this parasite, it can be aggravated in people infected with G6PD deficiency when exposed to drugs. Descriptive field study in which the enzymatic activity of G6PD in an indigenous community of Piaroa municipality of Atures, Amazonas state, was determined by biochemical tests. The sample consisted of 186 individuals, 100 women and 86 men. The average concentration of hemoglobin was 10.6 g/dL, 88, 6% of the subjects were moderately anemic and none had G6PD deficiency. It is concluded that anemia is common in indigenous Piaroas, moderate and deficiency type; no biochemical test that G6PD deficiency is detected; and that this study provides useful information to state agencies responsible for administering health care in Venezuela information.

Estrategia pedagógica para la superación de los docentes

Los resultados en la labor docente del profesional se materializan en la evaluación profesoral anual, el profesor es evaluado según los indicadores que la rigen. En correspondencia con lo antes planteado es necesario que el trabajo metodológico de los centros universitarios se proyecte en función de dar solución a las dificultades detectadas en los procesos de evaluación, para que se propicie el correcto desarrollo del proceso docente en este sentido y se pueda cumplir el fin y el objetivo que se plantea en este nivel de enseñanza. Se realizó un estudio descriptivo cualitativo de corte pedagógico, en el que se hace un análisis documental actualizado sobre las principales dificultades metodológicas de los profesores del Área VI en la evaluación profesoral correspondiente al curso 2013-2014, con el objetivo de diseñar una estrategia pedagógica para la superación de los docentes del Policlínico Área VI, perteneciente al municipio de Cienfuegos, que permita obtener mejores resultados en las evaluaciones profesorales y elevar el desempeño profesional pedagógico de los docentes que intervienen en este proceso. La estrategia metodológica diseñada se corresponde con el diagnóstico realizado y los problemas que se afrontan y contribuye al desarrollo de las competencias docentes(AU)

The results in the professional's educational work are materialized in the annual professorial evaluation; the professor is evaluated according to the indicators that govern it. In correspondence with the before outlined it is necessary that the methodological work of the university centers is projected in function of giving solution to the difficulties detected in the evaluation processes, so that the correct development of the educational process is propitiated in this sense and you can complete the end and the objective that he/she thinks about in this teaching level.He/she was carried out a qualitative descriptive study of pedagogic court, in which one makes an up-to-date documental analysis on the main methodological difficulties of the professors of the Area VI in the professorial evaluation corresponding to the course 2013 - 2014, with the objective of designing a pedagogic strategy for the superation of the educational ones of the Policlinic Área VI, belonging to the municipality of Cienfuegos that allows to obtain better results in the professorial evaluations and the pedagogic professional acting of the educational ones that you/they intervene in this process to rise.The designed methodological strategy belongs together with the carried out diagnosis and the problems that are confronted and it contributes to the development of the educational competitions(AU)

Estrategia pedagógica para la superación de los docentes / Pedagogic strategy for the upgrading of professors

Los resultados en la labor docente del profesional se materializan en la evaluación profesoral anual, el profesor es evaluado según los indicadores que la rigen. En correspondencia con lo antes planteado es necesario que el trabajo metodológico de los centros universitarios se proyecte en función de dar solución a las dificultades detectadas en los procesos de evaluación, para que se propicie el correcto desarrollo del proceso docente en este sentido y se pueda cumplir el fin y el objetivo que se plantea en este nivel de enseñanza. Se realizó un estudio descriptivo cualitativo de corte pedagógico, en el que se hace un análisis documental actualizado sobre las principales dificultades metodológicas de los profesores del Área VI en la evaluación profesoral correspondiente al curso 2013-2014, con el objetivo de diseñar una estrategia pedagógica para la superación de los docentes del Policlínico Área VI, perteneciente al municipio de Cienfuegos, que permita obtener mejores resultados en las evaluaciones profesorales y elevar el desempeño profesional pedagógico de los docentes que intervienen en este proceso. La estrategia metodológica diseñada se corresponde con el diagnóstico realizado y los problemas que se afrontan y contribuye al desarrollo de las competencias docentes.

The results in the professional's educational work are materialized in the annual professorial evaluation; the professor is evaluated according to the indicators that govern it. In correspondence with the before outlined it is necessary that the methodological work of the university centers is projected in function of giving solution to the difficulties detected in the evaluation processes, so that the correct development of the educational process is propitiated in this sense and you can complete the end and the objective that he/she thinks about in this teaching level. He/she was carried out a qualitative descriptive study of pedagogic court, in which one makes an up-to-date documental analysis on the main methodological difficulties of the professors of the Area VI in the professorial evaluation corresponding to the course 2013 - 2014, with the objective of designing a pedagogic strategy for the superation of the educational ones of the Policlinic Área VI, belonging to the municipality of Cienfuegos that allows to obtain better results in the professorial evaluations and the pedagogic professional acting of the educational ones that you/they intervene in this process to rise. The designed methodological strategy belongs together with the carried out diagnosis and the problems that are confronted and it contributes to the development of the educational competitions.

Structure of nucleoside diphosphate kinase from pacific shrimp (Litopenaeus vannamei) in binary complexes with purine and pyrimidine nucleoside diphosphates.

Nucleoside diphosphate kinase (NDK; EC 2.7.4.6) is an enzyme that catalyzes the third phosphorylation of nucleoside diphosphates, leading to nucleoside triphosphates for DNA replication. Expression of the NDK from Litopenaeus vannamei (LvNDK) is known to be regulated under viral infection. Also, as determined by isothermal titration calorimetry, LvNDK binds both purine and pyrimidine deoxynucleoside diphosphates with high binding affinity for dGDP and dADP and with no heat of binding interaction for dCDP [Quintero-Reyes et al. (2012), J. Bioenerg. Biomembr. 44, 325-331]. In order to investigate the differences in selectivity, LvNDK was crystallized as binary complexes with both acceptor (dADP and dCDP) and donor (ADP) phosphate-group nucleoside diphosphate substrates and their structures were determined. The three structures with purine or pyrimidine nucleotide ligands are all hexameric. Also, the binding of deoxy or ribonucleotides is similar, as in the former a water molecule replaces the hydrogen bond made by Lys11 to the 2'-hydroxyl group of the ribose moiety. This allows Lys11 to maintain a catalytically favourable conformation independently of the kind of sugar found in the nucleotide. Because of this, shrimp NDK may phosphorylate nucleotide analogues to inhibit the viral infections that attack this organism.

Rapid and simultaneous detection of the chlorhexidine and mupirocin resistance genes qacA/B and mupA in clinical isolates of methicillin-resistant Staphylococcus aureus.

We describe a real-time PCR-based assay capable of simultaneously detecting femA (Staphylococcus aureus-specific), mecA (methicillin resistance), qacA/B (chlorhexidine tolerance), and mupA (high-level mupirocin resistance) from bacterial cells in less than 90 minutes. The assay was validated with 1968 clinical MRSA submitted to a surveillance network.

Detection of New Delhi metallo-ß-lactamase (encoded by blaNDM-1) in Acinetobacter schindleri during routine surveillance.

A carbapenem-resistant Alcaligenes faecalis strain was isolated from a surveillance swab of a service member injured in Afghanistan. The isolate was positive for bla(NDM) by real-time PCR. Species identification was reevaluated on three identification systems but was inconclusive. Genome sequencing indicated that the closest relative was Acinetobacter schindleri and that bla(NDM-1) was carried on a plasmid that shared >99% identity with one identified in an Acinetobacter lwoffii isolate. The isolate also carried a novel chromosomally encoded class D oxacillinase.

ABC para los cuidados de enfermería a pacientes con enfermedad terminal en Atención Primaria de Salud / ABC for Nursing Care to Terminal Patients in Primary Health Care

Fundamento: el enfermo terminal padece un proceso agudo o crónico que lo sumerge en una situación crítica y lo conduce a la muerte. Cuando curar ya no es posible, el objetivo se centra en proporcionar al moribundo bienestar y alivio, por eso es muy importante la adecuada orientación a las enfermeras encargadas de cuidar a estos enfermos. Objetivo: elaborar un ABC para los cuidados de enfermería a pacientes con enfermedad terminal en Atención Primaria de Salud. Métodos: investigación realizada en el Policlínico Docente Área VI del municipio de Cienfuegos, en el periodo de enero a junio de 2012, para confeccionar el ABC para cuidados de enfermería a pacientes con enfermedad terminal en Atención Primaria de Salud. Se emplearon los métodos teóricos de análisis y síntesis e inducción deducción y empíricos: análisis de documentos y tormenta de ideas. Resultados: el ABC para el cuidado de enfermería al enfermo terminal quedó conformado para las etapas: inicial o de estabilidad, sintomática o de estado, de declive y final de agonía; en cada una de ellas se incluyeron los posibles diagnósticos, objetivos y acciones. El documento está confeccionado para que pueda ser utilizado por todo el personal de enfermería que atienda a estos pacientes, independientemente de su categoría ocupacional. Conclusiones: el ABC confeccionado pudiera ser de utilidad para facilitar los cuidados de enfermería al enfermo terminal en la atención primaria de salud.

Background: Terminal patients suffer from an acute or chronic process that immerses them in a critical situation leading to death. When providing a cure is no longer possible, the focus is on providing comfort and relief for the dying. Therefore, it is very important to provide an appropriate orientation to the staff nurses taking care of these patients. Objective: To develop an ABC for nursing care to terminally ill patients in Primary Health Care. Methods: A research was conducted in Area VI Polyclinic, in the municipality of Cienfuegos, from January to June 2012, in order to conform the ABC for nursing care to terminally ill patients in Primary Health Care. Theoretical methods of analysis and synthesis and induction-deduction as well as empirical methods were used: document analysis and brainstorming. Results: The ABC for nursing care to terminal patients was conformed for the following stages: initial or stability, symptomatic or state, and decline and final agony. In each of them possible diagnoses, objectives and actions were included. The document was created in such a way that it can be used by all nurses who attend these patients, regardless of their occupational category. Conclusions: This ABC could be useful to facilitate nursing care to terminally ill patients in primary health care.

ABC para los cuidados de enfermería a pacientes con enfermedad terminal en atención primaria de salud / ABC for nursing care to terminal patients in primary health care

Fundamento: el enfermo terminal padece un proceso agudo o crónico que lo sumerge en una situación crítica y lo conduce a la muerte. Cuando curar ya no es posible, el objetivo se centra en proporcionar al moribundo bienestar y alivio, por eso es muy importante la adecuada orientación a las enfermeras encargadas de cuidar a estos enfermos.Objetivo: elaborar un ABC para los cuidados de enfermería a pacientes con enfermedad terminal en Atención Primaria de Salud. Métodos: investigación realizada en el Policlínico Docente Área VI del municipio de Cienfuegos, en el periodo de enero a junio de 2012, para confeccionar el ABC para cuidados de enfermería a pacientes con enfermedad terminal en Atención Primaria de Salud. Se emplearon los métodos teóricos de análisis y síntesis e inducción deducción y empíricos: análisis de documentos y tormenta de ideas. Resultados: el ABC para el cuidado de enfermería al enfermo terminal quedó conformado para las etapas: inicial o de estabilidad, sintomática o de estado, de declive y final de agonía; en cada una de ellas se incluyeron los posibles diagnósticos, objetivos y acciones. El documento está confeccionado para que pueda ser utilizado por todo el personal de enfermería que atienda a estos pacientes, independientemente de su categoría ocupacional. Conclusiones: el ABC confeccionado pudiera ser de utilidad para facilitar los cuidados de enfermería al enfermo terminal en la atención primaria de salud(AU)

Background: Terminal patients suffer from an acute or chronic process that immerses them in a critical situation leading to death. When providing a cure is no longer possible, the focus is on providing comfort and relief for the dying. Therefore, it is very important to provide an appropriate orientation to the staff nurses taking care of these patients. Objective: To develop an ABC for nursing care to terminally ill patients in Primary Health Care. Methods: A research was conducted in Area VI Polyclinic, in the municipality of Cienfuegos, from January to June 2012, in order to conform the ABC for nursing care to terminally ill patients in Primary Health Care. Theoretical methods of analysis and synthesis and induction-deduction as well as empirical methods were used: document analysis and brainstorming. Results: The ABC for nursing care to terminal patients was conformed for the following stages: initial or stability, symptomatic or state, and decline and final agony. In each of them possible diagnoses, objectives and actions were included. The document was created in such a way that it can be used by all nurses who attend these patients, regardless of their occupational category. Conclusions: This ABC could be useful to facilitate nursing care to terminally ill patients in primary health care(AU)

Detection of bacterial 16S rRNA and identification of four clinically important bacteria by real-time PCR.

Within the paradigm of clinical infectious disease research, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa represent the four most clinically relevant, and hence most extensively studied bacteria. Current culture-based methods for identifying these organisms are slow and cumbersome, and there is increasing need for more rapid and accurate molecular detection methods. Using bioinformatic tools, 962,279 bacterial 16S rRNA gene sequences were aligned, and regions of homology were selected to generate a set of real-time PCR primers that target 93.6% of all bacterial 16S rRNA sequences published to date. A set of four species-specific real-time PCR primer pairs were also designed, capable of detecting less than 100 genome copies of A. baumannii, E. coli, K. pneumoniae, and P. aeruginosa. All primers were tested for specificity in vitro against 50 species of Gram-positive and -negative bacteria. Additionally, the species-specific primers were tested against a panel of 200 clinical isolates of each species, randomly selected from a large repository of clinical isolates from diverse areas and sources. A comparison of culture and real-time PCR demonstrated 100% concordance. The primers were incorporated into a rapid assay capable of positive identification from plate or broth cultures in less than 90 minutes. Furthermore, our data demonstrate that current targets, such as the uidA gene in E.coli, are not suitable as species-specific genes due to sequence variation. The assay described herein is rapid, cost-effective and accurate, and can be easily incorporated into any research laboratory capable of real-time PCR.

Shrimp oncoprotein nm23 is a functional nucleoside diphosphate kinase.

Biosynthesis of nucleoside triphosphates is critical for bioenergetics and nucleic acid replication, and this is achieved by nucleoside diphosphate kinase (NDK). As an emerging biological model and the global importance of shrimp culture, we have addressed the study of the Pacific whiteleg shrimp (Litopenaeus vannamei) NDK. We demonstrated its activity and affinity towards deoxynucleoside diphosphates. Also, the quaternary structure obtained by gel filtration chromatography showed that shrimp NDK is a trimer. Affinity was in the micro-molar range for dADP, dGDP, dTDP and except for dCDP, which presented no detectable interaction by isothermal titration calorimetry, as described previously for Plasmodium falciparum NDK. This information is particularly important, as this enzyme could be used to test nucleotide analogs that can block white spot syndrome virus (WSSV) viral replication and to study its bioenergetics role during hypoxia and fasting.

Cirugía anti-reflujo laparoscópica para el tratamiento de la enfermedad por reflujo gastro-esofágico: experiencia en 125 casos / Laparoscopic anti-reflux surgery for the treatment of disease gastroesophageal reflux: experience in 125 cases

Evaluar la cirugía anti-reflujo laparoscòpica para el tratamiento de la enfermedad por reflujo gastro-esofágico. Se realizaron 125 operaciones anti-reflujo en igual número de pacientes, 62 (49,6 por ciento correspondieron al sexo masculino y 63 (50,4 por ciento) al sexo femenino. Edad promedio de 46,63 años ± 7,25 años. Los síntomas más frecuentes fueron pirosis (98,4 por ciento) y regurgitación (97,6 por ciento). La mayoría de los pacientes 85 (68 por ciento), tenían 10 años o más de tratamiento médico. Se realizó la operación de Nissen modificada "Floppy Nissen" en 76 pacientes (60,8 por ciento), en 23 pacientes (18,4 por ciento) se realizó la técnica de Toupet y en 4 pacientes (3,2 por ciento) la técnica de Dor. Las patologías asociadas (29 en total) estuvieron presentes en 28 pacientes (22,4 por ciento). Todas estas patologías fueron resueltas en el mismo acto operatorio. Las complicaciones fueron leves en su mayoría (infecciones locales, seromas, etc). Hubo una perforación de la unión gastro-esofágica que ameritó conversión. Un paciente (0,8 por ciento), ameritó reintervención por disfagia severa. No hubo mortalidad post-operatoria. Centro Médico "Dr. Rafael Guerra Méndez", Valencia-Venezuela. Tasa de éxito del 91,2 por ciento para la desaparición de los síntomas. La cirugía anti-reflujo es el método más eficaz para el tratameito de la enfermedad por reflujo gastro-esofágico de curso progresivo y con respuesta deficiente al tratamiento médico. Es necesario establecer con exactitud el defecto funcional del esófago a fin de seleccionar la técnica más adecuada. La estancia hospitalaria, los costos, la morbilidad y la mortalidad se reducen con el abordaje laparoscópico.