Infección grave de piel y partes blandas por Fusarium oxysporum asociado a la administración subcutánea de insulina / Severe skin and soft tissue infection due to Fusarium oxysporum associated with subcutaneous insulin administration

Resumen La diabetes mellitus (DM) es una enfermedad crónica muy prevalente. Dentro de los tratamientos para la DM se encuentra la insulina que es el agente antidiabético más potente, sin embargo, una proporción significativa de pacientes no logra alcanzar el objetivo de hemoglobina glicosilada (HbA1c). Los errores en la aplicación de insulina son un factor importante y corregible en muchos casos. Se presenta el caso de una paciente con DM, antecedentes de neuropatía diabética, enfermedad renal crónica estadio V en hemodiálisis, hipertensión arterial, estenosis aórtica con recambio por válvula protésica, y anticoagulada, con escasa adherencia a recomendaciones higiénico dietéticas. Debido a la mala técnica de aplicación de insulina y falta de higiene, desarrolló varias infecciones polimicrobianas de piel y partes blandas, con evolución tórpida de las úlceras y mala respuesta al tratamiento indicado. Durante su internación, de una úlcera se aisló Fusarium oxysporum. Es importante jerarquizar la relevancia de la educación diabetológica en pacientes insulinizados y el rol de los educadores en diabetes en el cuidado de los mismos. Por otro lado, destacar la importancia de la toma de cultivos mediante punción de partes blandas ante la aparición de signos locales de infección.

Abstract Diabetes mellitus (DM) is a very prevalent chronic disease. Among the treatments for DM, insulin is the most potent antidiabetic agent. However a significant proportion of patients fail to achieve Errors in the application of insulin are an important and correctable factor in many cases. We present the case of a patient with DM who, due to poor insulin application technique and hygiene, develops a skin and soft tissue infection with subsequent appearance of Fusarium oxysporum. It is important to emphasize the relevance of diabetes education in insulin ized patients and the role of diabetes educators in their care. On the other hand, it is important to emphasize the importance of taking cultures by soft tissue puncture in case of local signs of infection.

[Severe skin and soft tissue infection due to Fusarium oxysporum associated with subcutaneous insulin administration]. / Infección grave de piel y partes blandas por Fusarium oxysporum asociado a la administración subcutánea de insulina.

Diabetes mellitus (DM) is a very prevalent chronic disease. Among the treatments for DM, insulin is the most potent antidiabetic agent. However a significant proportion of patients fail to achieve Errors in the application of insulin are an important and correctable factor in many cases. We present the case of a patient with DM who, due to poor insulin application technique and hygiene, develops a skin and soft tissue infection with subsequent appearance of Fusarium oxysporum. It is important to emphasize the relevance of diabetes education in insulinized patients and the role of diabetes educators in their care. On the other hand, it is important to emphasize the importance of taking cultures by soft tissue puncture in case of local signs of infection.

La diabetes mellitus (DM) es una enfermedad crónica muy prevalente. Dentro de los tratamientos para la DM se encuentra la insulina que es el agente antidiabético más potente, sin embargo, una proporción significativa de pacientes no logra alcanzar el objetivo de hemoglobina glicosilada (HbA1c). Los errores en la aplicación de insulina son un factor importante y corregible en muchos casos. Se presenta el caso de una paciente con DM, antecedentes de neuropatía diabética, enfermedad renal crónica estadio V en hemodiálisis, hipertensión arterial, estenosis aórtica con recambio por válvula protésica, y anticoagulada, con escasa adherencia a recomendaciones higiénico dietéticas. Debido a la mala técnica de aplicación de insulina y falta de higiene, desarrolló varias infecciones polimicrobianas de piel y partes blandas, con evolución tórpida de las úlceras y mala respuesta al tratamiento indicado. Durante su internación, de una úlcera se aisló Fusarium oxysporum. Es importante jerarquizar la relevancia de la educación diabetológica en pacientes insulinizados y el rol de los educadores en diabetes en el cuidado de los mismos. Por otro lado, destacar la importancia de la toma de cultivos mediante punción de partes blandas ante la aparición de signos locales de infección.

Congenital Heart Diseases: Genetic Risk Variants and Their Methylation Status.

(1) Background: The interaction between single nucleotide variants (SNVs) associated with congenital heart diseases (CHDs) and their gene methylation status has not been well researched. The aim of the present study was to determine if there is a relationship between the methy lation status (MS) of genes and the allelic variants associated with CHDs. (2) Methods: Seven SNVs of the genes AXIN1, TBX1, TBX20, and MTHFR were selected from the literature. DNA extraction, genotyping, and a methylation analysis were performed on healthy subjects and subjects with CHDs. (3) Results: Twenty-two subjects with CHDs were selected as the case group (15 with ventricular septal defects (VSDs) and 7 with atrial septal defects (ASDs)), and 44 healthy subjects comprised the control group. The MTHFR and AXIN1 genes were hypermethylated in the control group when compared to the case group. When analyzed separately, those with atrial septum defects exhibited greater methylation, except for the gene MTHFR where there were no differences. Only the alternate alleles of MTHFR showed a significantly different methylation status in those without cardiopathy. (4) Conclusions: The MTHFR and AXIN genes were hypermethylated in the control group; however, only the alternate alleles of MTHFR (rs1801133 and rs1801131) showed a significantly different methylation status.

Maternal Folic Acid Intake and Methylation Status of Genes Associated with Ventricular Septal Defects in Children: Case-Control Study.

BACKGROUND: DNA methylation is the best epigenetic mechanism for explaining the interactions between nutrients and genes involved in intrauterine growth and development programming. A possible contributor of methylation abnormalities to congenital heart disease is the folate methylation regulatory pathway; however, the mechanisms and methylation patterns of VSD-associated genes are not fully understood. OBJECTIVE: To determine if maternal dietary intake of folic acid (FA) is related to the methylation status (MS) of VSD-associated genes (AXIN1, MTHFR, TBX1, and TBX20). METHODS: Prospective case-control study; 48 mothers and their children were evaluated. The mothers' dietary variables were collected through a food frequency questionnaire focusing on FA and the consumption of supplements with FA. The MS of promoters of genes was determined in the children. RESULTS: The intake of FA supplements was significantly higher in the control mothers. In terms of maternal folic acid consumption, significant differences were found in the first trimester of pregnancy. Significant differences were observed in the MS of MTHFR and AXIN1 genes in VSD and control children. A correlation between maternal FA supplementation and MS of AXIN1 and TBX20 genes was found in control and VSD children, respectively. CONCLUSIONS: A lower MS of AXIN1 genes and a higher MS of TBX20 genes is associated with FA maternal supplementation.

Efecto de la aplicación de un recubrimiento de almidón de yuca modificado por vía ácida sobre el tomate larga vida / Effect of the application of an acid-modified cassava starch coating on the long-life tomato

RESUMEN Se buscó minimizar el efecto de factores ambientales sobre la calidad pos cosecha del tomate, mediante la aplicación de recubrimiento elaborado con almidón de yuca modificado por vía ácida. La modificación de la estructura original de una suspensión de almidón de yuca variedad SM 707-17, se realizó mediante adición de ácido cítrico, en concentración de 15% p/p respecto al almidón en base seca, bajo condiciones de temperatura y de velocidad de agitación controladas. El efecto de este recubrimiento, se comparó con el efecto de la aplicación de otros elaborados con base en almidón modificado enzimáticamente y almidón nativo. Se midieron las variables: sólidos solubles totales, firmeza, pH, acidez titulable, tasa de respiración, pérdida de peso y color durante 15 días, aplicando un diseño factorial completamente al azar 4x6. Los resultados, se analizaron mediante el software SPSS versión 19, con el cual, se encontró que el factor "Recubrimiento" no influyó sobre las variables de respuesta analizadas, a diferencia del factor "Tiempo", que tuvo efecto decisivo sobre las mismas.

ABSTRACT The aim was to minimize the effect of environmental factors on postharvest of tomato quality by applying a coating made with cassava starch modified by acid route. The modification of the original structure of a suspension of native starch of cassava variety SM 707-17, was carried out by addition of citric acid in concentration of 15% w/w with respect to the starch in dry base, under controlled temperature and speed of controlled agitation. The effect of this coating was compared with the effect of the application of others made on the basis of enzymatically modified starch and native starch. The variables total soluble solids, firmness, pH, titrable acidity, respiration rate, weight loss and color for 15 days were measured, applying a completely randomized 4x6 factorial design. The results were analyzed using SPSS software version 19, which found that the "Coating" factor did not influence the response variables analyzed, unlike the "Time" factor that had a decisive effect on them.

Severe Respiratory Illness Associated with Human Metapneumovirus in Nursing Home, New Mexico, USA.

Human metapneumovirus is an emerging pathogen that causes upper and lower respiratory illness. Nursing home outbreaks of infection with this virus can cause severe illness and lead to poor patient outcomes. We report an outbreak investigation in a nursing home during 2018 and infection control guidelines to assist in disease control.

JAG1, MEF2C and BDNF polymorphisms associated with bone mineral density in women from Northern México

Introduction: Osteoporosis is characterized by a low bone mineral density. Genetic composition is one of the most influential factors in determining bone mineral density (BMD). There are few studies on genes associated with BMD in the Mexican population. Objective: To investigate the association of eight single nucleotide polymorphisms (SNP) of JAG1, MEF2C and BDNF genes with BMD in women of Northern México. Materials and methods: This study involved 124 unrelated Mexican women between 40 and 80 years old. BMD was determined by dual X-ray absorptiometry. Genotyping was performed using allelic discrimination by real time PCR. We analyzed the SNP of JAG1 (rs6514116, rs2273061, rs2235811 and rs6040061), MEF2C (rs1366594, rs12521522 and rs11951031), and BDNF (rs6265) and the data using linear regression. Results: The JAG1 SNP rs2235811 was associated with the BMD of the total body under the dominant inheritance model (p=0,024). Although the other SNPs were not associated with BMD in any of the inheritance models studied, a trend was observed. Conclusion: Our results suggest that the SNP rs2235811 in the JAG1 gene might contribute to the variation in BMD in women from northern México.

Polimorfismos de los genes JAG1, MEF2C y BDNF asociados con la densidad mineral ósea en mujeres del norte de México / JAG1, MEF2C and BDNF polymorphisms associated with bone mineral density in women from Northern México

Resumen Introducción. La osteoporosis se caracteriza por una baja densidad mineral ósea; la composición genética es uno de los factores que más influyen en ella, pero hay pocos estudios de genes asociados con esta condición en la población mexicana. Objetivo. Investigar la posible asociación de ocho polimorfismos de un solo nucleótido (Single Nucleotide Polymorphism, SNP) de los genes JAG1, MEF2C y BDNF con la densidad mineral ósea en mujeres del norte de México. Materiales y métodos. Participaron 124 mujeres de 40 a 80 años, sin parentesco entre ellas. Su densidad mineral ósea se determinó mediante absorciometría dual de rayos X y la genotipificación se hizo utilizando discriminación alélica mediante PCR en tiempo real; se estudiaron cuatro de los SNP del gen JAG1 (rs6514116, rs2273061, rs2235811 y rs6040061), tres del MEF2C (rs1366594, rs12521522 y rs11951031) y uno del BDNF (rs6265). El análisis estadístico de los datos obtenidos se hizo por regresión lineal. Resultados. El SNP rs2235811 presentó asociación significativa con la densidad mineral ósea de todo el cuerpo bajo el modelo de herencia dominante (p=0,024) y, aunque los otros SNP no tuvieron relación significativa con esta densidad, en ninguno de los modelos de herencia estudiados, se observó una tendencia hacia esta asociación. Conclusión. Los resultados sugieren que el SNP rs2235811 del gen JAG1 podría contribuir a la variación en la densidad mineral ósea de las mujeres del norte de México.

Abstract Introduction: Osteoporosis is characterized by a low bone mineral density. Genetic composition is one of the most influential factors in determining bone mineral density (BMD). There are few studies on genes associated with BMD in the Mexican population. Objective: To investigate the association of eight single nucleotide polymorphisms (SNP) of JAG1, MEF2C and BDNF genes with BMD in women of Northern México. Materials and methods: This study involved 124 unrelated Mexican women between 40 and 80 years old. BMD was determined by dual X-ray absorptiometry. Genotyping was performed using allelic discrimination by real time PCR. We analyzed the SNP of JAG1 (rs6514116, rs2273061, rs2235811 and rs6040061), MEF2C (rs1366594, rs12521522 and rs11951031), and BDNF (rs6265) and the data using linear regression. Results: The JAG1 SNP rs2235811 was associated with the BMD of the total body under the dominant inheritance model (p=0,024). Although the other SNPs were not associated with BMD in any of the inheritance models studied, a trend was observed. Conclusion: Our results suggest that the SNP rs2235811 in the JAG1 gene might contribute to the variation in BMD in women from northern México.

[Depressive symptoms and serum levels of polyunsaturated fatty acids omega-3 and omega-6 among college students from Northern Mexico]. / Síntomas depresivos y niveles séricos de ácidos grasos poliinsaturados omega-3 y omega-6 en universitarios del norte de México.

INTRODUCTION: Previous studies suggest that low consumption as well as low serum levels of polyunsaturated fatty acids (PUFA) omega-3 and a high omega-6/omega-3 ratio may be implicated in the etiology of depressive disorders, however, epidemiologic evidence is inconclusive. OBJECTIVE: To assess the relationship of serum levels of omega-3 fatty acids (docosahexaenoic [DHA], eicosapentaenoic [EPA], alpha-linolenic fatty acid [ALA]) and the omega-6 (arachidonic acid [AA])/EPA ratio with depressive symptoms among Mexican college students. MATERIAL AND METHODS: A cross-sectional study that included 60 male and female participants (ages 18 to 24 years) with serum levels of EPA, DHA, ALA and AA. Depressive symptoms were ascertained with the Center for Epidemiologic Studies Depression (CES-D) scale validated for Mexican students. Linear regression was used to assess the relationship between depressive symptoms and serum PUFA omega-3 and omega-6. RESULTS: Serum levels of EPA, DHA and EPA/DHA ratio were not related to depressive symptoms, high serum ALA was related with lower depressive symptoms before and after covariate adjustment; however, these results were not statistically significant. Among women, 1% increase in EPA resulted in 5.5. (p = 0.57) increase in the depressive scale scores while 1% increase in ALA resulted in 6.7 decrease (p = 0.39) in the scores. CONCLUSIONS: Our results did not confirm the relationship of serum levels of PUFA omega-3 and omega-6/omega-3 ratio with depressive symptoms; the negative correlation of serum ALA with depressive symptoms remains to be confirmed in prospective studies.

Análisis de los eventos desfavorables como resultado de la atención en cirugía oral / Analysis of Unfavorable Events Resulting from the Oral Surgery Health Care

Antecedentes: La cirugía oral es una especialidad que requiere preparación teórica y habilidad quirúrgica para efectuar los procedimientos. Durante el proceso de aprendizaje, los estudiantes, al efectuar cirugías, pueden enfrentar dificultades que dañen involuntariamente al paciente. A pesar de cumplirse los protocolos, es posible que se presenten eventos desfavorables durante la atención. Por este motivo, es necesario caracterizar y analizar dichos eventos en instituciones como una facultad de odontología para mejorar la calidad de la atención. Objetivo-, Analizar los eventos desfavorables que se presentaron en el área quirúrgica de la Facultad de Odontología de la Pontificia Universidad Javeriana en un periodo de dos años. Métodos: En este estudio observado nal-descriptivo se evaluaron todas las historias clínicas de pacientes atendidos entre el 1 de enero de 2014 y el 31 de diciembre de 2015, a fin de identificar y analizar los eventos desfavorables en cirugía oral. Resultados: De 1062 historias clínicas, 74 (7 %) tenían reportes de eventos desfavorables, 41 (56 %) de las cuales se tipificaron como complicaciones, 22 (30 %) como indicios de atención insegura y 11 (14 %) como eventos adversos. De ellos, 9 (82 %) fueron prevenibles y 2 (18 %) no prevenibles, todos relacionados con exodoncias. Conclusiones: Los eventos adversos en el área quirúrgica se presentaron en baja frecuencia y se relacionaron con exodoncias. Para reducir la ocurrencia de estas situaciones, es preciso realizar planeación prequirúrgica, elaborar meticulosamente las historias clínicas y, en caso de presentarse algún tipo de evento, informarlo. Palabras clave: atención en salud, cirugía oral, complicación en cirugía oral, error en cirugía ora, evento adverso,

Background-. Oral surgery is a specialty requiring both theoretical formation and training in surgical skills in order to carry out the procedures. During the learning process when students carry out surgeries, they may face difficulties that involuntarily harm the patient. Despite adhering to the protocols, it is possible that unfavorable events occur while providing dental care to the patients.Therefore, there is a need to characterize and analyze those events in institutions such as the dentistry schools in order to improve t he health care quality. Objective-. To analyze the unfavorable events that occurred in the surgery room of the Pontificia Universidad Javeriana Dentistry School during a two-year study term. Methods-. In this observational-descriptive study all the medical records taken to patients who attended to the dentistry school from January 1, 2014 to December 31, 2015 were evaluated in order to i dentify and analyze the unfavorable events occurred during the oral surgeries. Results: Out of 1 062 medical records, 74 (7%) reported unfavorable events and 41 (56%) of them were characterized as complications, 22 (30 %) as a lack of self-confidence by the health care giver, and 11 (14%) as adverse events. In addition, 9 (82 %) were preventable and 2 (18%) non-preventable events, all of them related to dental extractions. Conclusions: Adverse events in the oral surgery area were infrequent and related mostly with dental extractions. To reduce their occurrences, it is important to do a preoperative planning, to prepare carefully the medical r ecords and, in the case of any occurrence, to report it.

[ANTHROPOMETRIC INDICATORS AND CARDIOMETABOLIC EVENTS AMONG SCHOOL-AGED CHILDREN FROM SONORA, MEXICO]. / INDICADORES ANTROPOMÉTRICOS Y SU ASOCIACIÓN CON EVENTOS CARDIOMETABÓLICOS EN ESCOLARES DE SONORA, MÉXICO.

INTRODUCTION: obesity in childhood is predictive of obesity in adulthood and it is associated with adverse health effect apparent since childhood; however, the joint assessment of obesity and adverse events among children in clinical settings is unusual. OBJECTIVES: to assess the association of overweight and obesity, abdominal obesity, and excess body fat with systolic [SBP] and diastolic [DBP] blood pressure, lipid profile and glucose levels; and to identify the best anthropometric indicator of such events. MATERIAL AND METHODS: we conducted a cross-sectional study in a sample of 412 schoolchildren. The presence of overweight and obesity, abdominal obesity and excess body fat was determined among all participants; levels of total cholesterol, triglycerides, high and low density lipoproteins, and glucose were measured in a subsample (n = 133). The associations of interest were assessed using adjusted linear and logistic regression models. RESULTS: 33% of the children were overweight or obese. Overall, overweight, obesity, abdominal obesity, and excess body fat were associated with elevated SBP and DBP and with a lipid profile and glucose levels that could indicate health risks among these children. Overweight and obesity were the best predictors of such events. CONCLUSIONS: among these school-aged children, we observed that obesity was associated with high odds of having adverse health outcomes such as high blood pressure, lipids and glucose. Such adverse events can be predicted by the presence of obesity measured by BMI, which is a noninvasive, inexpensive and easy to implement measure.

Introducción: la obesidad durante la niñez es predictiva de obesidad en la adultez y se asocia a eventos adversos para la salud observables desde etapas tempranas; sin embargo, la evaluación conjunta de obesidad y eventos adversos en los menores no es parte de la atención médica habitual. Objetivos: evaluar la asociación de sobrepeso y obesidad, obesidad abdominal y exceso de grasa corporal con la presión arterial sistólica [PAS] y diastólica [PAD], y el perfil de lípidos y glucosa; e identificar el mejor indicador antropométrico de dichos eventos. Material y métodos: estudio transversal en 412 escolares a quienes se les determinó la presencia de sobrepeso y obesidad, obesidad abdominal y exceso de grasa corporal. Los niveles de colesterol total, triglicéridos, lipoproteínas de alta y baja densidad y glucosa se determinaron en una submuestra (n = 133). Las asociaciones se evaluaron con modelos de regresión lineal y logística ajustados. Resultados: el 33% de los participantes tuvieron sobrepeso u obesidad. El sobrepeso, la obesidad, la obesidad abdominal y el exceso de grasa corporal se asociaron con un incremento de PAS y PAD, y con un perfil de lípidos y glucosa que representan riesgos para la salud. El sobrepeso y la obesidad fueron los mejores predictores de dichos eventos. Conclusiones: en nuestra población, la obesidad se asoció con mayor posibilidad de presentar eventos adversos para la salud como PA elevada, niveles de lípidos y glucosa altos. La obesidad puede ser determinada con el IMC, que es un índice de bajo coste, no invasivo y de fácil implementación.

[CONSUMPTION OF OMEGA- 3 FATTY ACIDS AND DEPRESSIVE SYMPTOMS IN COLLEGE STUDENTS FROM SONORA, MEXICO]. / CONSUMO DE ÁCIDOS GRASOS OMEGA-3 Y SÍNTOMAS DEPRESIVOS EN UNIVERSITARIOS DE SONORA, MÉXICO.

INTRODUCTION: recent studies suggest that low serum levels of polyunsaturated fatty acids omega-3 are associated with a higher prevalence of depression. OBJECTIVE: to evaluate whether low consumption of Omega-3 fatty acids is associated with a higher prevalence of depressive symptoms in a sample of college students from the Northwest of Mexico, and to assess the potential effect modification by alcohol consumption. METHODS: we conducted a cross-sectional study in a sample of 706 college students (males and females) aged 18 to 24. The presence of depressive symptoms was identified with the Depression Scale of the Center for Epidemiologic Studies (CES-D), using a cutoff point of ≥ 24. The intake of omega-3 was obtained by a food frequency questionnaire validated for Mexican population. We estimated the weekly intake of alpha-linolenic fatty acid (ALA), eicosapentaenoic (EPA) and docosahexaenoic (DHA) derived from the diet in mg/g of food. The association between omega-3 from diet and the presence of depressive symptoms was assessed using logistic regression models adjusted for potential confounders. RESULTS: 67% of the participants were females; 16.6% were classified as having depressive symptoms. A low intake of ALA and EPA + DHA was not associated with depressive symptoms before and after adjusting for confounders. Median levels of ALA (from nuts only) were significantly lower among those with depressive symptoms compared to those without these symptoms. CONCLUSIONS: in this population of Mexican college students, a low intake of omega-3 fatty acids was not associated with depressive symptoms. The potential association between nut consumption and depressive symptoms deserve more attention.

Introducción: estudios recientes sugieren que los niveles bajos de acidos grasos poliinsaturados omega-3 se relacionan con una mayor prevalencia de depresion; sin embargo, los resultados no son concluyentes. Objetivo: evaluar la asociacion entre el bajo consumo de acidos grasos omega-3 y la presencia de sintomas depresivos en jovenes universitarios del noroeste de Mexico. Métodos: se realizo un estudio transversal en una muestra de 706 universitarios de 18 a 24 anos de edad de ambos sexos. La presencia de sintomatologia depresiva se estimo con la escala de Depresion del Centro de Estudios Epidemiologicos (CES-D) empleando un punto de corte ≥ 24. El consumo semanal de acidos grasos alfalinolenico (ALA) y de eicosapentaenoico (EPA) mas docosahexaenoico (DHA) en mg/g de alimento se estimo por medio de un cuestionario de frecuencia de consumo de alimentos validado para la poblacion mexicana. La asociacion del consumo de omega-3 con la presencia de sintomas depresivos se evaluo con modelos de regresion logistica. Resultados: el 67% de los participantes fueron mujeres; en general, el 16,6% presentaron sintomatologia depresiva. El consumo bajo de ALA y EPA + DHA no se asocio con mayor prevalencia de sintomatologia depresiva antes y despues de ajustar por confusores. En aquellos casos con sintomatologia depresiva, los niveles ALA derivados solo de las nueces fueron significativamente menores. Conclusiones: en esta poblacion no se observo asociacion entre el bajo consumo de acidos grasos omega-3 y la sintomatologia depresiva. La posible asociacion entre el consumo de nueces y la sintomatologia depresiva requiere de mas estudios.

Gliomas del tallo cerebral / Brain Stem Gliomas

Los gliomas de tallo cerebral (GTC) son neoplasias con gran morbilidad, de difícil abordaje quirúrgico por su patrón infiltrativo, y las muestras de patología por biopsia estereotáxica pueden no ser representativas, pues estos tumores son heterogéneos. La radiología ylos avances en resonancia magnética (RM) han permitido mejorar la clasificación y orientar el tratamiento; éste puede realizarse, incluso,sin estudios de patología. La quimioterapia y la radioterapia no han mejorado la sobrevida de los pacientes; en algunos casos, sólo selogra un impacto en la calidad de vida. El presente artículo revisa aspectos generales del tema, pero pretende aclarar dudas sobre el tratamiento, definir las recomendaciones de procedimientos quirúrgicos y los beneficios de la quimioterapia y la radioterapia.

The brain stem gliomas are neoplasm tumors that affect the patient’s skills and body functions. The surgical approach is difficult, even for stereotactic biopsy with high morbidity rates caused by its infiltrative patron. The MRI (magnetic resonance imaging) has helped to guide the treatment and improved the tumor classification. Chemotherapy and radiation therapy haven’t shown improvement in survival rates, and only in some cases show some impact in quality life. This article pretends to clarify some doubts in treatment, defines recommendations in surgical procedures and chemotherapy and radiation benefits.

[Phagocytosis of promastigotes and amastigotes of Leishmania mexicana by the FSDC dendritic cell line: ultrastructural study]. / Estudio ultraestructural de la fagocitosis de promastigotes y amastigotes de Leishmania mexicana por la línea de células dendríticas FSDC.

INTRODUCTION: Dendritic cells, which capture and present antigen to activate unprimed T cell, are found in most tissues. OBJECTIVE: This work describes the ultrastructure of Leishmania mexicana phagocytosis by the fetal skin dendritic cell (FSDC) line, a Langerhans cell line isolated from mouse fetal epidermis immortalized by retroviral transduction of the v-myc oncogene. MATERIALS AND METHODS: Leishmania amastigotes were obtained from mouse (BALB/c) lesion and promastigotes from culture (24 degrees C) of the lesion. FSDC cells were cultured with parasites (5 parasites per cell) using IMDM medium, during 24 hours. Control and infected cultures were processed for transmission electron microscopy. Semi-thin sections counterstained with toluidine blue to evaluate phagocytosis and thin sections counterstained with uranyl acetate and lead citrate were made. RESULTS: 13.42% of the FSDC phagocytosed promastigotes; 8% contained a single parasite and 5.2% phagocytosed 2 or more. 20% of the FSDC phagocytosed amastigotes; 10% contained a single parasite and 10% phagocytosed 2 or more. Ultrastructurally, promastigotes in contact with FSDC by the flagellum or the posterior pole were observed. The parasitophorous vacuoles harbouring promastigotes were small organelles containing one or two parasites each. Parasitophorous vacuoles containing amastigotes were larger (8 microm diameter) with one or several parasites free or attached to the vacuole at the posterior pole. CONCLUSION: The low rate of infected FSDC cells was characteristic and the parasitophorous vacuole showed similar characteristics to those observed in macrophages. The parasite density in the infected cells was 1 to 3 parasites per cell. These observations highlight the need to study the relationship between phagocytic capacity and function.

Promoción de la convivencia y prevención de violencia interpersonal mediante actividades lúdicas y humorísticas: El proceso de implementación de la estrategia ¿Y del respeto qué? / Promotion of conviveny and interpersonal violence prevention by ludic and humoristic activities: the implantation process of the strategy

La estrategia ¿Y del respeto qué?, es una propuesta de intervención, basada en el juego y el humor para prevenir los malos tratos la agresión o violencia interpersonal y promover escenarios de sana convivencia y rescate de valores de la comunidad. Se implementó en áreas urbanas de la ciudad de Cali; las comunas 18 y 20 y en zona rural del área de Jamundi en el Valle del Cauca. Inicialmente se capacitó a 205 agentes educativos que multiplicaron la estrategia en sus comunidades. Los resultados obtenidos a través de entrevistas, grupos focales y observación directa del trabajo de los agentes con su comunidad muestran una apropiación e introducción de los juegos de la estrategia en las prácticas cotidianas de las personas, así como una reflexión y transformación de las conductas que dificultan la convivencia hacia otras que anteponen el respeto por el otro y brindan alternativas de relación y de resolución de conflictos no violentas

La célula de Langerhans / Langerhans cell

La célula de Langerhans es una presentadora de antígenos profesional que juega un papel clave en el inicio y en la regulación de la respuesta inmune. Se localiza en la epidermis y en otros epitelios estratificados desde donde emigra a los órganos linfoides secundarios para presentar a los linfocitos T aquellos antígenos que penetran por la piel e iniciar la respuesta inmune específica. Presentamos una serie de imágenes de microscopía de luz y electrónica de estas células tal y como se encuentran en la epidermis y su morfología después de emigrar al medio de cultivo. Se reseñan algunos factores que inducen su migración, así como los usos terapéuticos potenciales como moduladoras de la respuesta inmune, ya sea para generarla, como en el caso del tratamiento del melanoma; aumentarla, en infecciones causadas por microorganismos intracelulares, o evitarla para el tratamiento de alergias.