A New Synthetic Peptide with In vitro Antibacterial Potential Against Escherichia coli O157:H7 and Methicillin-Resistant Staphylococcus aureus (MRSA).

In this work, we performed the rational design of a cationic antimicrobial peptide, GIBIMPY4, using the software DEPRAMPs developed at the GIBIM research group. GIBIMPY4 has a length of 17 amino acids, it is amphipathic, its structure is α-helix and it has a net charge of (+5). Solid-phase peptide synthesis was performed using the Fmoc strategy in acid medium. The primary structure was confirmed by MALDI-TOF mass spectrometry. The antimicrobial activity of the peptide was evaluated by broth microdilution method by measuring optical density in 96-well microplates. The minimal inhibitory concentration of GIBIMPY4 to kill 50 % of the bacterial cells (MIC50) was 6.20 ± 0.02 µM for MRSA and 4.55 ± 0.02 µM for E. coli O157:H7, while also reporting a bacteriostatic effect for the later. GIBIMPY4 activity was sensitive to salt concentration in E. coli but insignificant effect in its activity against MRSA. The peptide seems to be a broad-spectrum antimicrobial agent based on the results against Gram-positive and Gram-negative bacteria and was specific for bacterial cells E. coli O157:H7 with index of specificity equal to 9.01 in vitro assays.

Age-associated Epstein-Barr virus-specific T cell responses in seropositive healthy adults.

Epstein-Barr virus (EBV) is present in 95% of the world's adult population. The immune response participates in immune vigilance and persistent infection control, and this condition is maintained by both a good quality (functionality) and quantity of specific T cells throughout life. In the present study, we evaluated EBV-specific CD4(+) and CD8(+) T lymphocyte responses in seropositive healthy individuals younger and older than 50 years of age. The assessment comprised the frequency, phenotype, functionality and clonotypic distribution of T lymphocytes. We found that in both age groups a similar EBV-specific T cell response was found, with overlapping numbers of tumour necrosis factor (TNF)-α(+) T lymphocytes (CD4(+) and CD8(+)) within the memory and effector cell compartments, in addition to monofunctional and multi-functional T cells producing interleukin (IL)-2 and/or interferon (IFN)-γ. However, individuals aged more than 50 years showed significantly higher frequencies of IL-2-producing CD4(+) T lymphocytes in association with greater production of soluble IFN-γ, TNF-α and IL-6 than subjects younger than 50 years. A polyclonal T cell receptor (TCR)-variable beta region (Vß) repertoire exists in both age groups under basal conditions and in response to EBV; the major TCR families found in TNF-α(+) /CD4(+) T lymphocytes were Vß1, Vß2, Vß17 and Vß22 in both age groups, and the major TCR family in TNF-α(+) /CD8(+) T cells was Vß13·1 for individuals younger than 50 years and Vß9 for individuals aged more than 50 years. Our findings suggest that the EBV-specific T cell response (using a polyclonal stimulation model) is distributed throughout several T cell differentiation compartments in an age-independent manner and includes both monofunctional and multi-functional T lymphocytes.

[Corticospinal dysfunction in patients with primary and amyotrophic lateral sclerosis]. / Disfunción corticoespinal en pacientes con esclerosis lateral primaria y amiotrófica.

INTRODUCTION: Corticoespinal dysfunction is a common finding in primary and amyotrophic lateral sclerosis (PLS and ALS). AIM. To compare the behaviour of motor evoked potentials (MEP) with transcranial magnetic stimulation (TMS) in patients with ALS and PLS. PATIENTS AND METHODS: It was performed a retrospective analysis of MEP recordings of 11 patients with PLS and 10 patients with sporadic ALS. Central motor conduction time and amplitude ratio were the selected variables for the statistical analysis of MEP from abductor pollicis brevis and tibialis anterior muscle from the four limbs, using non-parametric methods. RESULTS: As a general observation there was a high incidence of abnormal recordings in both groups of patients; in 30% of recording from ALS patients response to TMS was absent, but only the 4.5% in the group of PLS had the same characteristic. In PLS patients abnormal central motor conduction time was the most frequent finding, as it was the low amplitude ratio in ALS patients; both variables showed statistically significant differences between groups (Kruskall-Wallis, H = 6.32, p = 0.011; and Kruskall-Wallis, H = 5.777, p = 0.0163, respectively). CONCLUSION: Corticoespinal dysfunction has different characteristics in ALS and PLS patients, and the analysis of MEP could add useful information for differential diagnosis of these diseases.

Parametric sensibility study of the sinoatrial node math model.

The results of the parametric sensibility study to the sinoatrial node math model was presented. The model was proposed by H. Zhang, A. V. Holden and M.R. Boyett. The sensitivity analysis indicates that the sodium and potassium ionic concentrations need to be controlled in order to maintain the normal behavior of the node. The calcium concentrations changes simulated don't produce significant effects over the operation of the node. One response surface model was developed as a simplification of original model. The diastolic depolarization rate was redefined in order to allow its measure in potential waves for peripheral node cells.

Mecanismos de transmisión de la leishmaniasis / Transmission mechanisms of leishmaniasis

Se revisan conocimientos sobre mecanismos de transmisión de leishmaniasis, haciendo énfasis en la interacción vector-parásito y parásito-célula hospedadora, y se discuten algunos aspectos etiopatogénicos e inmunológicos inherentes a la infección en humanos. Dada la complejidad de los mecanismos de transmisión de la leishmaniasis, se plantea la posibilidad de diseñar un análisis estratégico que incluya al estudio de la interacción vector-parásito, la interacción parásito-célula hospedadora y las barreras de bloqueo para la transmisión, como la posibilidad más plausible para cerrar las puertas de entrada y su ciclo biológico. Existe una necesidad general de tener un conocimiento profundo sobre la biología de los vectores. Antes de iniciar un programa de control, es necesario priorizar el lugar que deben ocupar las comunidades expuestas al riesgo, como entes pilotos al establecimiento de estas medidas. El Estado, a travéz de sus dependencias, estaría comprometido educación relacionada con prevención y también la identificación de los vectores, de los reservorios y otras acciones tendentes al control de esta enfermedad.

Sindrome de Guillain-Barre / Guillain-Barre's syndrome

Objetivo. Hacer una revisión de este trastorno, poniendo énfasis en los cuidados intensivos del paciente con síndrome de Guillain-Barré (SCB) grave. Desarrollo. El SGB es una polineuropatía inflamatoria autoinmune, que puede originar cuadriparesia, fallo respiratorio, disfunción autonómica, así como otras complicaciones graves, que pueden influir notablemente en la evolución del enfermo. Por tal motivo, los pacientes con SGB grave requieren atención en unidades de cuidados intensivos (UCI), en donde también pueden surgir nuevas complicaciones además de las ya anteriormente mencionadas. El neurólogo que pretenda tratar integral y continuamente a estos enfermos deberá estar familiarizado con la terapia antimicrobiana, nutrición del enfermo crítico, equilibrio hidromineral, ciertos aspectos sobre ventilación mecánica, y las indicaciones y complicaciones de la plasmaféresis y de la infusión de inmunoglobulinas. Conclusiones. Con los cuidados intensivos disponibles actualmente, la evolución de estos enfermos suele ser excelente (recuperación en más de un 80 por ciento de los casos), aunque en algunos pacientes persiste cierto grado de paresia residual. Atendiendo a que el SGB es un proceso en gran medida autolimitado, se suele plantear que el cuidado esmerado y diario de estos enfermos y sus complicaciones en la UCI contribuye a la buena evolución de un paciente individual, tanto o más que la terapia inmunomoduladora

[Intensive multifactorial rehabilitation in patients with multiple sclerosis]. / Rehabilitación multifactorial e intensiva en pacientes con esclerosis múltiple.

INTRODUCTION: Studies have been published recommending rehabilitation in multiple sclerosis (EM), but in practice this is often not indicated. PATIENTS AND METHODS: We made a retrospective analysis of 41 patients diagnosed as definitely having EM (clinical form of relapse remission, in phase of remission) according to the criteria of Poser et al. These patients carried out a programme of intensive multifactorial rehabilitation of 41 hours per week with a minimum duration of 10 days and a maximum of 178 days. There were classified on the EDSS scale of Kurztke and Hanser s ambulatory index on admission and when their treatment had finished. These results were compared using the Wilcoxon test for paired series and we analysed the relation between the time of treatment and final score on the scales applying the Spearman s multiple range correlation test. RESULTS: The differences were statistically significant between the scores for initial and final evaluations of the Kurztke and Hauser scales (Z: 3.17, p: 0.001475 and Z: 3.29, p: 0.000983 respectively). No correlation was shown between total duration of treatment or total duration of the disorder and the final score on the scale (p > 0.05). CONCLUSION: Intensive multifactorial rehabilitation treatment may have a positive effect in patients with Em with the clinical form of relapse remission, according to the scales applied. We therefore recommend their indication in patients during the remission phase.

[Bioethical considerations in the approach to patients with amyotrophic lateral sclerosis]. / Algunas consideraciones bioéticas en el abordaje de los pacientes con esclerosis lateral amiotrófica.

INTRODUCTION: The traditional doctor-patient relation has become a great bioethical challenge due to the advances in science in recent years. This is particularly true when patients suffer diseases such as amyotrophic lateral sclerosis (ALS), a neurodegenerative disease with a relentless course and in spite of modern treatment 50% of the patients die within three years of first having symptoms of the disease. It therefore causes great psychological and social impact. OBJECTIVE: To analyze the great bioethical challenge which arises when diagnosing and treating a patient with ALS. DEVELOPMENT: In this paper we analyze the doctor-patient relationship, the principles of doing no harm and of being beneficial, and more modern concepts such as informed consent, biomedical investigations and euthanasia, as well as the importance of palliative medicine and rehabilitation to alleviate suffering and improve quality of life. Biomedical investigations should conform to the relevant national and international rules. We discuss the right of patients to be given truthful information. CONCLUSIONS: We recommend better training of doctors in all aspects of attention to these patients, with emphasis on the diagnosis and importance of rehabilitation, palliative medicine and the management of psychological aspects. Biomedical investigations should fulfil current regulations. We recommend discretion, complete or partial, with regard to information given to the patients and their relatives so as not to cause despair.

[The importance of multifactorial rehabilitation treatment in amyotrophic lateral sclerosis]. / Importancia del tratamiento rehabilitador multifactorial en la esclerosis lateral amiotrófica.

INTRODUCTION: The treatment of amyotrophic lateral sclerosis (ALS) is still a major challenge. Rehabilitation treatment is scarcely considered and its usefulness in these patients continues to be controversial. PATIENTS AND METHODS: A multidisciplinary team made up of neurologists, physiotherapists, logopaedists, defectologists, psychologists and specialist physicians treated six patients with ALS in an intensive rehabilitation programme of 41 hours per week for four weeks. We follow certain basic principles in rehabilitation including: 1. Treatment by a multidisclipinary team; 2. Treatment tailored to the individual; 3. Avoidance of muscle fatigue and vigorous exercise, and 4. Intensive treatment with carefully measured amounts of different activities (logophoniatrics, occupational therapy, psychology, physical therapy, etc.) to avoid fatigue. The patients fulfilled the criteria of E1 Escorial for the diagnosis of definite ALS, and gave their informed consent to undergo the treatment. Forced Vital Capacity (FVC) and ALS Functional Rating Scale (ALSFRS) tests were done on all patients at the beginning and end of the treatment. The Wilcoxon test for paired series, comparing scores at the start and finish, were done in each case. RESULTS: In all patients the FVC and ALSFRS improved after the treatment. The results were statistically significant (Z: 2.2013; p= 0.027) on the Wilcoxon paired series test and no complications were seen. CONCLUSIONS: Intensive, multifactorial rehabilitation treatment for four weeks improved the FVC and ALSFRS in all patients with ALS and no complications were seen. Until there is a curative treatment for ALS, multifactorial rehabilitation remains the best hope for these patients.

[Identification of Lutzomyia spp. (Diptera: Psychodidae) verrucarum group through electron microscopy of its eggs]. / Identificación de Lutzomyia spp. (Diptera: Psychodidae) grupo verrucarum por medio de microscopía electrónica de sus huevos.

The value of Colombian phlebotomine eggs for species determination was studied with a scanning electron microscope. The species diversity and medical importance of the verrucarum group were the bases to select Lutzomyia youngi, Lutzomyia evansi, Lutzomyia columbiana and Lutzomyia longiflocosa. The egg surface was poligonal. Lutzomyia youngi, and Lutzomyia columbiana had pentagonal or hexagonal patterns; Lutzomyia evansi elongated polygons and Lutzomyia longiflocosa irregular polygonal sculpturing, frequently rectangular. Egg scanning electron microscopy is reliable to identify species of the verrucarum group.

[Juvenile amyotrophic lateral sclerosis. Apropos of a case]. / Esclerosis lateral amiotrófica juvenil. A propósito de un caso.

INTRODUCTION: There are scanty reports on juvenile forms of amyotrophic lateral sclerosis, specially amyotrophic lateral sclerosis and deafness, and it is known as Madras pattern of motor neurone disease. CLINICAL CASE: We describe an sporadic case of juvenile amyotrophic lateral sclerosis with deafness in a young person who started with hearing loss at 21 years old, loss of strength in upper limbs and muscular atrophy. He was seen by a neurologist when he was 25 years old, there were evident generalized fasciculation activity in proximal and distal muscles in the four limbs and the tongue, with swallowing troubles, and increased tendon reflexes in lower limbs with abnormal plantar extensor responses. All the paraclinical test were normal, except the electromyogram, showing a classical pattern of lower motor neuron disease, and the auditory brain stem response with absence of the main components of this evoked response, as expression of VIII cranial nerve damage. DISCUSSION: Patients like this one were first described in Madras (India), and the evolution of this kind of juvenile form of amyotrophic lateral sclerosis is chronically progressive and relative benign, in relation to the classical form of amyotrophic lateral sclerosis and other forms of motor neurone disease which begin in childhood, adolescence or young adulthood. CONCLUSION: Its recognition is very important in order to diminish misleading therapies in these patients.

[Bilateral cyclic sciatica caused by endometriosis. Apropos of a case]. / Ciática cíclica bilateral por endometriosis. A propósito de un caso.

INTRODUCTION: Cyclical sciatica due to implantation of endometrial tissue in the sciatic nerve in the region of the sciatic notch is a very unusual cause of sciatica. It occurs in women of childbearing age, as episodes of pain in the distribution of the sciatic nerve, which present in a cyclic manner and coincide with menstruation. If it is not treated, a sensomotor mononeuropathy of the sciatic nerve develops. CLINICAL CASE: The patient had complained of right-sided sciatic pain from the age of 36 years. Over the years a motor deficit had slowly and progressively appeared causing foot drop. The painful crises were related to her menstrual periods. At the age of 44 years a pyramidal muscle syndrome was diagnosed and treated surgically. This was followed by increase in the crises of sciatic pain. A year later, she started to have sciatic pain on the left side, which was similar to that of the right side. The clinical, imaging and electrophysiological findings are reported. The patient improved. She is still being treated with depot medroxyprogesterone and her pain has disappeared. CONCLUSIONS: Cyclical sciatica due to endometriosis is little known and may lead to permanent disability. Computerized axial tomography of the pelvis using contrast material is very useful for diagnosis. The use of depot medroxyprogesterone seems to be a satisfactory treatment in some patients.