Sampling is decisive to determination of Leishmania (Viannia) species.

BACKGROUND: Accuracy of molecular tools for the identification of parasites that cause human cutaneous leishmaniasis (CL) could largely depend on the sampling method. Non-invasive or less-invasive sampling methods such as filter paper imprints and cotton swabs are preferred over punch biopsies and lancet scrapings for detection methods of Leishmania based on polymerase chain reaction (PCR) because they are painless, simple, and inexpensive, and of benefit to military and civilian patients to ensure timely treatment. However, different types of samples can generate false negatives and there is a clear need to demonstrate which sample is more proper for molecular assays. METHODOLOGY: Here, we compared the sensitivity of molecular identification of different Leishmania (Viannia) species from Peru, using three types of sampling: punch biopsy, filter paper imprint and lancet scraping. Different composite reference standards and latent class models allowed to evaluate the accuracy of the molecular tools. Additionally, a quantitative PCR assessed variations in the results and parasite load in each type of sample. PRINCIPAL FINDINGS: Different composite reference standards and latent class models determined higher sensitivity when lancet scrapings were used for sampling in the identification and determination of Leishmania (Viannia) species through PCR-based assays. This was consistent for genus identification through kinetoplastid DNA-PCR and for the determination of species using FRET probes-based Nested Real-Time PCR. Lack of species identification in some samples correlated with the low intensity of the PCR electrophoretic band, which reflects the low parasite load in samples. CONCLUSIONS: The type of clinical sample can directly influence the detection and identification of Leishmania (Viannia) species. Here, we demonstrated that lancet scraping samples consistently allowed the identification of more leishmaniasis cases compared to filter paper imprints or biopsies. This procedure is inexpensive, painless, and easy to implement at the point of care and avoids the need for anesthesia, surgery, and hospitalization and therefore could be used in resource limited settings for both military and civilian populations.

Association between consumption of nonessential energy-dense food and body mass index among Mexican school-aged children: A prospective cohort study.

BACKGROUND/OBJECTIVES: Obesity prevalence in Mexican children has increased rapidly and is among the highest in the world. We aimed to estimate the longitudinal association between nonessential energy-dense food (NEDF) consumption and body mass index (BMI) in school-aged children 5 to 11 years, using a cohort study with 6 years of follow-up. SUBJECTS/METHODS: We studied the offspring of women in the Prenatal omega-3 fatty acid supplementation, child growth, and development (POSGRAD) cohort study. NEDF were classified into four main groups: chips and popcorn, sweet bakery products, non-cereal based sweets, and ready-to-eat cereals. We fitted fixed effects models to assess the association between change in 418.6 kJ (100 kcal) of NEDF consumption and changes in BMI. RESULTS: Between 5 and 11 years, children increased their consumption of NEDF by 225 kJ/day (53.9 kcal/day). In fully adjusted models, we found that change in total NEDF was not associated with change in children's BMI (0.033 kg/m2, [p=0.246]). However, BMI increased 0.078 kg/m2 for every 418.6 kJ/day (100 kcal/day) of sweet bakery products (p=0.035) in fully adjusted models. For chips and popcorn, BMI increased 0.208 kg/m2 (p=0.035), yet, the association was attenuated after adjustment (p=0.303). CONCLUSIONS: Changes in total NEDF consumption were not associated with changes in BMI in children. However, increases in the consumption of sweet bakery products were associated with BMI gain. NEDF are widely recognized as providing poor nutrition yet, their impact in Mexican children BMI seems to be heterogeneous.

Funcionamiento de la telesalud realizada por los/as terapeutas ocupacionales en chile durante la pandemia de COVID-19 en el año 2020 / Performance of telehealth carried out by occupational therapists from chile during the COVID-19 pandemic in the 2020 year

Introducción: Debido a la pandemia por COVID-19 que comenzó en el 2020 en Chile, la telesalud se introduce como la forma principal de acceso a las diversas formas de salud, incluyéndose la terapia ocupacional en sus respectivos equipos interdisciplinarios. Objetivos: 1) Explorar el funcionamiento de la telesalud realizada por los/as terapeutas ocupacionales de Chile, durante el año 2020. 2) Describir la percepción que tienen los/las terapeutas ocupacionales que se desempeñen en Chile sobre el funcionamiento de las intervenciones realizadas mediante telesalud durante el año 2020. Método: Investigación mixta que recabó información en un cuestionario dirigido a terapeutas ocupacionales trabajando en Chile a través de telesalud durante la pandemia. Resultados: El cuestionario contiene preguntas de opción múltiple y preguntas abiertas respecto al funcionamiento y percepción de la telesalud. Se recibieron 158 respuestas entre noviembre y diciembre del 2020. Conclusión: Este estudio muestra un primer acercamiento al funcionamiento de la telesalud, desde la modalidad de uso más utilizada, condiciones mínimas contextuales que requiere la telesalud y la efectividad percibida por los participantes, hasta las posibles ventajas y desventajas de esta estrategia.

Due to the COVID-19 worldwide pandemic, which began affecting us the 2020 in Chile, telehealth is introduced as the main form of access to various forms of health, including occupational therapy in the respective interdisciplinary teams. Aims: 1) To explore the performance of telehealth, carried out by occupational therapists from Chile, during the 2020 year. 2) To describe occupational therapists' perception about the performance of interventions carried out by telehealth during 2020 Method: This mixed method study is executed via survey so as to know the perspective of occupational therapists working in Chile through telehealth during the pandemic. Results: The survey contains multiple-choice questions and open-ended questions about the performance and perception regarding telehealth. 158 answers were received between november and december 2020. Conclusion: This study shows a first approach to the way telehealth works, from the most used modality, the minimal contextual conditions that telehealth requires and the effectiveness perceived by the participants, to the possible advantages and disadvantages of this strategy.

Genetic diversity and population structure of Leishmania (Viannia) braziliensis in the Peruvian jungle.

BACKGROUND: Human cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis is highly prevalent in the Peruvian jungle, where it affects military forces deployed to fight against drug trafficking and civilian people that migrate from the highland to the lowland jungle for economic activities such as mining, agriculture, construction, and chestnut harvest. We explored the genetic diversity and population structure of 124 L. (V.) braziliensis isolates collected from the highland (Junín, Cusco, and Ayacucho) and lowland Peruvian jungle (Loreto, Ucayali, and Madre de Dios). All samples were genotyped using Multilocus Microsatellite Typing (MLMT) of ten highly polymorphic markers. PRINCIPAL FINDINGS: High polymorphism and genetic diversity were found in Peruvian isolates of L. (V.) braziliensis. Most markers are not in Hardy-Weinberg equilibrium; this deviation is most likely caused by local inbreeding, as shown by the positive FIS values. Linkage Disequilibrium in subpopulations was not strong, suggesting the reproduction was not strictly clonal. Likewise, for the first time, two genetic clusters of this parasite were determined, distributed in both areas of the Peruvian jungle, which suggested a possible recent colonization event of the highland jungle from the lowland jungle. CONCLUSIONS: L. (V.) braziliensis exhibits considerable genetic diversity with two different clusters in the Peruvian jungle. Migration analysis suggested a colonization event between geographical areas of distribution. Although no human migration was observed at the time of sampling, earlier displacement of humans, reservoirs, or vectors could have been responsible for the parasite spread in both regions.

Mental health outcomes and experiences of family caregivers of children with disabilities during the COVID-19 pandemic in Bolivia.

This study examined whether certain demographic characteristics, caregiver strain, and coping behaviors were associated with the mental health outcomes of family caregivers of children with disabilities in Bolivia during the COVID-19 pandemic. A mixed-methods convergent study design was used with virtual interviews to quantitatively assess caregivers' demographic characteristics, caregiver strain, coping behaviors, and mental health outcomes, as well as qualitatively assess how the pandemic affected their family. Approximately 32%-71% of caregivers experienced poor mental health outcomes (stress, anxiety, and depression), especially among those experiencing poor health, high caregiver strain, and those using maladaptive coping strategies. Qualitative responses revealed that they experienced several unique stressors during the pandemic that affected them and their children. These findings highlight the need for culturally tailored prevention and treatment interventions to help offset the adverse effects of the COVID-19 pandemic on the mental health outcomes of this at-risk population.

Doxycycline-induced cholestatic liver injury.

Doxycycline-induced liver injury is a rare phenomenon, with an unclear clinical course and etiopathogenesis. The onset of injury may be acute-to-subacute, with a pattern ranging from hepatocellular or cholestatic to mixed, and it often lasts up to several weeks. We present a case of cholestatic liver injury secondary to doxycycline use in a middle-aged woman. In patients with a history of doxycycline exposure and subsequent hepatic injury, an adverse drug reaction due to doxycycline should remain on the differential, and immediate removal of the offending agent with close monitoring of the clinical condition should be pursued.

Estado del arte de los estudios sobre conducta suicida en población privada de la libertad / State of the art of studies on suicidal behavior in the population deprived of freedom

Resumen El suicidio en población privada de la libertad (PPL) en centros de reclusión de la ciudad de Bogotá, por la comisión de diferentes delitos, trae consigo una serie de preguntas y cuestionamientos que generan inquietud, duda y en ocasiones temor. El objetivo del estudio fue establecer el estado del arte de los estudios realizados y las tendencias halladas sobre conducta suicida en esta población. En esta investigación se encontrarán los principales estudios, investigaciones y documentos tecnicos realizados por funcionarios y académicos, recopilados en trece documentos. Se pudo establecer que son pocos los documentos encontrados (13), pocas las investigaciones y en su mayoría de tipo descriptivo.

Abstract The suicide in the population deprived of freedom (PPL, for its initials in Spanish) in prisons in the city of Bogotá, for the commission of different crimes, brings with it a series of questions and issues that generate concern, doubt and sometimes fear. The purpose of the study was to establish the state of the art of studies carried out and trends found on suicidal behavior in this population. In this research we will find the main studies, research and technical documents made by officials and academics, compiled in thirteen documents. It could be established that there are few documents found (13), few investigations and most of them are descriptive.

Parents' Perceptions Regarding the Implementation of a Physical Therapy Stimulation Program for Children with Disabilities in Bolivia: A Qualitative Study.

The purpose of this study was to explore how parents of children with neuromotor disorders in the department of Chuquisaca (Bolivia) perceive attendance to a physical therapy stimulation program and the expectations they place on the therapy and professional care provided to their children. Semi-structured interviews were conducted with the parents, related to their role in supporting the recommended exercise program for the child, generating topics such as benefits of the therapy for the child, impact on the family, and role of the project in terms of therapy and the physical therapists providing treatment, including both positive and negative aspects of the overall process. This study revealed the importance of understanding the feelings of families receiving intervention under a pioneering program in Bolivia for the detection and treatment of children with neuromotor disorders. Being able to access these types of services provides them with extensive personal, social, and economic support. Knowing their concerns, desires, and demands will allow us to continue to improve and offer the best care for children and families. The professionals involved should also be encouraged to develop effective teaching techniques to promote the inclusion of parents in the stimulation program.

Factors and Beliefs that Condition the Attitude of Health Science Students towards End of Life in Spain and Bolivia: A Multicenter Study.

Health Science students in Spain and Bolivia should be trained in the management of the processes of death and dying of patients. The aim of this study was to examine the degree of training, self-perceived safety and preferences in relation to the care of terminal and non-terminal patients. It was a descriptive, cross-sectional, multicenter study with students of Medicine, Nursing and Physiotherapy in Spain and Bolivia. The following variables were evaluated: care preparation and emotional preparation to caring for terminally ill and non-terminally ill patients, the Death Attitude Profile Revised (PAM-R) and the Bugen Scale for Facing Death. The self-perceived preparation of students for caring for terminally ill patients can be considered "fair" (mean 2.15, SD 0.756), and this was also the case for their perceived emotional preparation (mean 2.19, SD 0.827). In contrast, the score obtained for their preparedness for treating non-terminal patients was higher (mean 2.99 and 3.16, respectively). Working with terminally ill patients, including terminal or geriatric cancer patients, was the least preferred option among future health professionals. The results obtained show a limited preference for end-of-life care and treatment, highlighting a lack of preparation and motivation among health science students in Spain and Bolivia for working with these patients.

Exploring the attitudes of health science students in Spain and Bolivia towards death. A cross sectional survey.

BACKGROUND: One of the most difficult and stressful tasks faced by health science students is having to cope with death and dying due to the emotional burden of the same. Furthermore, the moral, ethical and professional values of future health professionals are influenced by the cultures where they live. PURPOSE: This study sought to compare and analyze the perception on end of life among a sample of health science students in Spain and Bolivia. METHODS: A descriptive, cross-sectional and multi-centric study. The total sample (548 students) was comprised of three groups: medical, nursing and physiotherapy students, of whom 245 were from Bolivia, and 303 were Spanish students. The measurement instruments used were the Bugen's Coping with Death Scale and the Death Self-Efficacy Scale by Robbins. RESULTS: No statistically significant differences were observed between Spanish and Bolivian students (t (546) = - 0.248, p = 0.804) using the Bugen scale. This implies that there are no differences between the perception of both groups of students and that both groups use similar strategies to cope with death. Additionally, the beliefs and attitudes of both groups were similar, with Bolivian students presenting a trend towards improved scores. No differences were found between Spain and Bolivia in the results obtained on the Robbins scale, with students from both countries displaying similar skills and capabilities for facing death. CONCLUSIONS: The beliefs on death of health science students from Spain and Bolivia were not affected by the respective cultures, type of degree studied, students' age, or the country of origin, however, we found that students in Bolivia value death as something more natural than their Spanish counterparts. PRACTICE IMPLICATIONS: To appropriately prepare students for this topic, education on coping with death and dying must be included within the university curriculum. TRIAL REGISTRATION: 2016DEC018.

Study of Psychomotor Development and Environmental Quality at Shelter Homes for Children Aged 0 to 2 in the Department of Chuquisaca (Bolivia).

Children in situations of destitution who become institutionalized commonly display developmental disorders, including delayed growth. The aim was to evaluate the environmental quality of the casas cuna of the Department of Chuquisaca (Plurinational state of Bolivia) in children aged 0 to 2 years old after receiving an early stimulation program based on psychomotor therapy. Thirty-six children who were institutionalized at shelter homes in the Department of Chuquisaca were selected to receive sessions of psychomotricity over a five-month period. The Infant/Toddler Home Observation for Measurement of the Environment (IT-HOME) scale and the Attachment During Stress Scale (ADS) were used. The adult-child relationship with factors of responsiveness (-0.89; p = 0.037), acceptance (0.57; p = 0.024), organization (-1.03; p < 0.001), learning material (-2.57; p < 0.001) and involvement (-1.92; p < 0.001) scored below expectations, showing that environmental indicators are a poor stimulation for children growing up in shelter homes. Improvements were found in the children's development after receiving this therapy. In conclusion, an early stimulation program based on psychomotor therapy over five months provided favorable results for the acquisition of skills for communication, motor development and social skills, which positively affect the psychomotor development.

Endoscopic Algorithm for Management of Gastrointestinal Bleeding in Patients With Continuous Flow LVADs: A Prospective Validation Study.

BACKGROUND: Gastrointestinal bleeding (GIB) is a common complication of left ventricular assist device (LVAD) therapy accounting for frequent hospitalizations and high resource utilization. METHODS: We previously developed an endoscopic algorithm emphasizing upfront evaluation of the small bowel and minimizing low-yield procedures in LVAD recipients with GIB. We compared the diagnostic and therapeutic yield of endoscopy, health-care costs, and re-bleeding rates between conventional GIB management and our algorithm using chi-square, Fisher's exact test, Wilcoxon-Mann-Whitney, and Kaplan-Meier analysis. RESULTS: We identified 33 LVAD patients with GIB. Presentation was consistent with upper GIB in 20 (61%), lower GIB in 5 (15%), and occult GIB in 8 (24%) patients. Forty-one endoscopies localized a source in 23 (56%), resulting in 14 (34%) interventions. Algorithm implementation compared with our conventional cohort was associated with a 68% increase in endoscopic diagnostic yield (P< .01), a 113% increase in therapeutic yield (P= .01), a 27% reduction in the number of procedures per patient (P < .01), a 33% decrease in length of stay (P < .01), and an 18% reduction in estimated costs (P < .01). The same median number of red blood cell transfusions were used in the 2 cohorts, with no increase in re-bleeding events in the algorithm cohort (33.3%) compared with our conventional cohort (43.7%). CONCLUSIONS: Our endoscopic management algorithm for GIB in LVAD patients proved effective in reducing low-yield procedures, improving the diagnostic and therapeutic yield of endoscopy, and decreasing health-care resource utilization and costs, while not increasing the risk of a re-bleeding event.

Estudio comparativo de la producción de biomasa en fermentación superficial y en estado líquido de macromicetos con diferentes fuentes nutrimentales / Comparative study of the production of biomass in surface fermentation and in the liquid state of macromycetes with different nutrient sources

RESUMEN Los macromicetos han adquirido gran interés por su importancia alimenticia, terapéutica y económica, razón por la cual es necesario enfocar esfuerzos en la búsqueda de optimizar su producción de biomasa. El presente trabajo buscó determinar y comparar el efecto de la fermentación líquida (FEL) y superficial (FeSup) (medio solido) sobre la producción de biomasa de Flammulina velutipes, Hypsizigus tessulatus y Grifola frondosa empleando seis fuentes de nutrientes de bajo costo: harina de soja, trigo integral, maíz blanco, maíz amarillo precocido, salvado de trigo y semillas de linaza molida. Los resultados de la FeSup permitieron determinar que la especie de mayor crecimiento radial, indistintamente de la fuente de nutrientes, es F. velutipes seguida de H. tessulatus y por ultimo G. frondosa. Adicionalmente, la mayor producción de biomasa con FeSup se observa para F. velutipes y H. tessulatus (6,4480 g/L y 5,7320 g/L, respectivamente) Por el contrario, para la FEL, G. frondosa (11,4620 g/L) es la especie de mayor producción. La comparación en la producción de biomasa empleando FEL y FeSup, evidenció que los resultados son dependientes de la técnica de cultivo y que la FeSup no puede ser empleada para la selección preliminar de hongos macromicetos, enfocada en la producción de biomasa por FEL.

ABSTRACT Macromycetes have acquired great interest because of their nutritional, therapeutic and economic importance, which is why it is necessary to focus efforts in the search to optimize their biomass production. The present work sought to determine and compare the effect of liquid fermentation (FEL) and surface fermentation (FeSup) (solid medium) on the biomass production of Flammulina velutipes, Hypsizigus tessulatus and Grifola frondosa using six sources of low cost nutrients: soybeans, whole wheat, white corn, precooked yellow corn, wheat bran and ground flax seed. The results of the FeSup allowed to determine that the species with the highest radial growth, indistinctly from the nutrient source, is F. velutipes followed by H. tessulatus and finally G. frondosa. Additionally, the highest biomass production with FeSup is observed for F. velutipes and H. tessulatus (6.4480 g/L and 5.7320 g/L, respectively) On the contrary, for the FEL, G. frondosa (11.4620 g/L) is the species with the highest production. The comparison in the production of biomass using FEL and FeSup, showed that the results are dependent on the culture technique and that the FeSup cannot be used for the preliminary selection of fungi macromycetes, focused on the production of biomass by FEL.

Trainee colonoscopy quality is influenced by the independent and unobserved performance characteristics of supervising physicians.

Background Endoscopy training remains an apprenticeship, and the characteristics that facilitate transfer of high quality procedural skills from role models to trainees are unknown. We sought to determine whether unobserved supervisor performance influences the quality of colonoscopy performed by trainees, by studying how supervisors perform alone and how trainees perform while under those same supervisors. Methods This was a retrospective cross-sectional study conducted among ambulatory adults ≥ 50 years old who underwent colonoscopy for cancer screening or polyp surveillance from 2006 to 2015 at one academic medical center. The primary exposures were the colonoscopy withdrawal time (WT) and adenoma detection rate (ADR) of supervisors while performing colonoscopies alone. The primary outcomes were the WT and ADR of trainees performing colonoscopies under supervision. Results Data were included from 22 attending gastroenterologist supervisors, 56 gastroenterology fellow trainees, and 2777 adults undergoing 3094 colonoscopy procedures. Among all supervised colonoscopies, mean trainee WT was 12.7 minutes (SD 4.9) and trainee ADR was 33.5 %. The trainee WT was 0.42 minutes longer (standard error = 0.16, P  = 0.01) per minute increase in supervisor WT. Similarly, trainee ADR was higher under a high ADR supervisor, and the odds ratio of high compared to low supervisor ADR category was 1.28 (95 %CI 1.01 - 1.62, P  = 0.04) after adjusting for other factors. Conclusions The unobserved performance characteristics of supervising endoscopists may influence the quality of colonoscopy performed by trainees.

Limited usefulness of endoscopic evaluation in patients with continuous-flow left ventricular assist devices and gastrointestinal bleeding.

BACKGROUND: Gastrointestinal bleeding (GIB) is a frequent cause of re-admission in patients with continuous-flow left ventricular assist devices (CF-LVADs) and is associated with multiple endoscopic procedures and high resource utilization. Our aim was to determine the diagnostic and therapeutic yield of endoscopy and to develop a more cost-effective approach for the management of GIB in CF-LVAD recipients. METHODS: We retrospectively reviewed 428 patients implanted with a CF-LVAD between 2009 and 2016 at the Columbia University Medical Center and identified those hospitalized for GIB. Patients were categorized into upper GIB (UGIB), lower GIB (LGIB) and occult GIB (OGIB), based on clinical presentation. RESULTS: Eighty-seven CF-LVAD patients underwent a total of 164 GIBs, resulting in 239 endoscopies. Index presentation was consistent with UGIB in 30 (34.5%), LGIB in 19 (21.8%) and OGIB in 38 (43.7%) patients. On the first GIB, 147 endoscopies localized a bleeding source in 49 (30%), resulting in 24 (16.3%) endoscopic interventions. Of 45 lesions identified, arteriovenous malformations (AVMs) were the most common (22, 48.9%). A gastric or small bowel source (HR 2.8, p = 0.003) and an endoscopic intervention (HR 1.9, p = 0.04) predicted recurrent GIB. The proposed algorithm may reduce the number of endoscopic procedures by 45% and costs by 35%. CONCLUSIONS: Occult GIB is the most common presentation in CF-LVAD patients and carries the lowest diagnostic and therapeutic yield of endoscopy. Performing an intervention was among the strongest predictors of recurrent GIB. Our proposed algorithm may decrease the number of low-yield procedures and improve resource utilization.

Evaluation of a method using high performance liquid chromatography with ultraviolet detection for the determination of statins in macromycetes of the genus Pleurotus cultivated by fermentation processes.

The applicability of high-performance liquid chromatography with ultraviolet light (HPLC-UV) for the determination of the presence of statins in macromycetes of the genus Pleurotus was analyzed. The fungi were obtained by liquid-state fermentation (LSF) using unconventional sources of carbon as substrates and solid-state fermentation (SSF) employing agro industrial wastes. Five statins were used as standards: lovastatin and simvastatin in the lactone form (LOVL and SIML), their corresponding hydro-acidic forms (LOVH and SIMH) and pravastatin (PRA). The following measures were evaluated: the linearity, accuracy and precision, detection limit (DL) and quantification limit (QL). The results demonstrated HPLC-UV to be an effective tool for detecting the presence of statins in extracts of LSF and SSF products. Likewise, it was hypothesized that the strains that were used for the study do not produce statins. This finding highlights the importance of continuing to evaluate other strains of the same genus by using techniques such as HPLC to first separate sufficient quantities of the compounds that were detected using the standard technique but that did not match the retention time (tR) of any of the standards used.

Las estatinas: química, técnicas analíticas, biosíntesis y farmacocinética / Statins: chemistry, analytical techniques, biosynthesis and pharmacokinetics

Antecedentes: Las estatinas presentan principalmente un efecto hipocolesterolémico, pero asimismo acciones biológicas adicionales, como efecto antiinflamatorio e inmunomodulador, actividad antioxidante, reducción de la incidencia de algunos tipos de cáncer, efectos benéficos en el metabolismo óseo y en el tratamiento de enfermedades neurodegenerativas y el SIDA. Se dividen en dos clases: las estatinas naturales y las sintéticas, las cuales surgen como producto de la necesidad de potencializar el efecto de las primeras. Estas propiedades han impulsado las investigaciones encaminadas a la comprensión de su comportamiento químico y sus propiedades fisicoquímicas, así como la comprensión de la relación entre sus estructuras y las ya mencionadas actividades. Su estudio ha permitido el desarrollo de técnicas analíticas eficientes tanto para su determinación en diferentes matrices, como la optimización de los procesos de extracción, separación, cuantificación y elucidación estructural, así como ahondar en el planteamiento de sus rutas biosintéticas, lo que aportará herramientas para poder intervenir, mediante la biotecnología, en los procesos biosintéticos, buscando el aumento de su producción por un organismo específico. Objetivos: El objetivo de este trabajo es presentar una revisión de la química, biosíntesis, farmacocinética y técnicas analíticas para la determinación de las estatinas con el fin de aportar, de manera rápida, conocimientos a quienes realizan investigaciones sobre estos metabolitos. Métodos: La revisión abarcó los últimos 12 años y se efectuó realizando la selección de aquellas investigaciones más relevantes que permiten conocer la química, las variaciones estructurales, las técnicas analíticas empleadas para la determinación de las estaninas y sus rutas biosintéticas. Asimismo, se pretendió abarcar un conocimiento general de sus acciones biológicas, farmacología y farmacocinética, tópicos estrechamente relacionados con sus diferencias estruc...

Las estatinas: Actividad biologica y produccion biotecnologica / Statins: Biological activity and biotechnological production

Las estatinas de tipo I son metabolitos f¨²ngicos de gran inter¨¦s no s¨®lo por su efecto hipocolesterolemiante sino por el n¨²mero de efectos pleiotr¨®picos que presentan. El papel de las estatinas en la reducci¨®n de l¨ªpidos en la sangre est¨¢ ampliamente documentado. En la actualidad, los estudios cl¨ªnicos han puesto en evidencia que las estatinas impactan positivamente en varios ¨®rganos y en diferentes estados de algunas enfermedades, independientemente de la reducci¨®n en los niveles de colesterol. Exhiben efecto antiinflamatorio, antioxidante y acci¨®n inmunomoduladora, lo que les confiere potencial impacto terap¨¦utico en el tratamiento de varias enfermedades. Estudios recientes las posicionan como antirretrovirales, impidiendo la replicaci¨®n del virus de inmunodeficiencia adquirida (VIH). El hecho de que generan pro-apoptosis, inhibici¨®n en el crecimiento y respuesta a favor de la diferenciaci¨®n de las c¨¦lulas neopl¨¢sicas de diversos or¨ªgenes, las hace ¨²tiles en el tratamiento de leucemia, c¨¢ncer de mama, c¨¢ncer colo-rectal, de pulm¨®n, de pr¨®stata y de p¨¢ncreas. No se deben dejar de lado los efectos ben¨¦ficos sobre el metabolismo ¨®seo, gracias a su asociaci¨®n con el aumento en la densidad mineral ¨®sea y el efecto protector contra el Alzheimer y otros tipos de demencia, posiblemente debido a su participaci¨®n en la relaci¨®n entre el ¦Â-amiloide y los niveles de colesterol.

Statins of type I are fungic metabollites of great importance not only by its hypocholestorolemic but also by its number pleoitropic effects that they show. The role of statins in the reduction of lipids in the blood is broadly reported. Currently, clinic surveys have put into evidence that statins both impact in a positive manner on several organs and in different stages of some diseases, regardless of the cholesterol reduction levels. They show an anti-inflammatory effect, anti-oxidant, and immune modulator action, which give them a therapeutic potential in the treatment of several diseases. Recent studies place them as anti-retrovirus avoiding the replication of the human immunodeficiency virus (HIV). The fact that they generate pro-apoptosis, inhibition on growing, and an favorable effect of the neo-plastic cell differentiation of diverse origins make them useful in the leukemia treatment, breast-cancer, colorectal, lung cancer, prostate cancer, and pancreas cancer. The beneficial side effects on bone metabolism should not be left aside due to its association with the increase of bone mineral density, the protector effect against Alzheimer and other types of dementia, possibly due to its participation in the relationship between ¦¢-amyloid and the cholesterol levels.

Peptidoglycan from Staphylococcus aureus induces the overexpression of TRLs 1-8 mRNA in corneal fibroblasts, but its lipoteichoic acid and muramyl dipeptide only induced the overexpression of TLR5 or TRL9

Lipopolysaccharide induces TLR-1-8 mRNAs over-expression in corneal fibroblast. Analyzing if other TLR-ligands can do the same, we found that peptidoglycan does, but not muramyldipeptide, lipoteichoic acid and polyI:C. This suggests that the recognition of lipopolysaccharide and peptidoglycan is enough to alert these cells against microorganisms through the over-expression of the majority TLRs.

Peptidoglycan from Staphylococcus aureus induces the overexpression of TRLs 1-8 mRNA in corneal fibroblasts, but its lipoteichoic acid and muramyl dipeptide only induced the overexpression of TLR5 or TRL9.

Lipopolysaccharide induces TLR-1-8 mRNAs over-expression in corneal fibroblast. Analyzing if other TLR-ligands can do the same, we found that peptidoglycan does, but not muramyldipeptide, lipoteichoic acid and polyI:C. This suggests that the recognition of lipopolysaccharide and peptidoglycan is enough to alert these cells against microorganisms through the over-expression of the majority TLRs.