Waterborne Antifouling Paints Containing Nanometric Copper and Silver against Marine Bacillus Species.

Due to the concern to find an alternative to reduce the colonization (microfouling and macrofouling) or the biocorrosion of surfaces submerged for long periods in water, we evaluated the antifouling activity of a commercial paint added with silver nanoparticles (AgNP's) and copper nanoparticles (CuNP's), beside copper-soybean chelate, by electrolytic synthesis, using them in low concentrations (6.94E - 04 mg Ag g-1 paint, 9.07E - 03 mg Cu g-1 paint, and 1.14E - 02 mg Cu g-1 paint, respectively). The test for paint samples was carried out by JIS Z2801-ISO 22196 for periods of initial time, 6 months, and 12 months, against three bacterial strains of marine origin, Bacillus subtilis, Bacillus pumilus, and Bacillus altitudinis. It was possible to demonstrate, according to the standard, that the sample with the greatest antimicrobial activity was the copper-soybean chelate against two of the three strains studied (B. pumilus with R = 2.11 and B. subtilis with R = 2.41), which represents more than 99% of bacterial inhibition. Therefore, we considered a novel option for inhibiting bacterial growth with nanoparticles as antifouling additives.

Indications related to antidepressant prescribing in the Nivel-PCD database and the SIDIAP database.

BACKGROUND: Antidepressant drug consumption has increased, mainly in the elderly. This trend could be explained by the use for indications other than depression. We aimed to describe the indications related to antidepressant drug new users in two primary care settings. METHODS: A longitudinal study of new antidepressant users aged ≥65 was conducted, with data from the Nivel-PCD (The Netherlands) and SIDIAP (Catalonia) databases (2010-2015). As a proxy for indication, diagnoses registered around the 3 months of antidepressant prescribing were collected. Indications were classified in seven categories and an additional one of non-selected indications. The percentage and incidence calculated over the total population registered was described. RESULTS: A total of 16,537 and 199,168 new antidepressant users were identified in the Nivel-PCD and SIDIAP databases, respectively (women aged 65-69 were the most prevalent). Depression was the most frequent indication (24.0% and 31.3%), followed by anxiety (12.5% and 19.5%) and sleep disorders (10.2% and 26.4%). Tricyclic antidepressants were the most commonly prescribed in Nivel-PCD (48.7%), mainly associated with neuropathic pain, and selective serotonin reuptake inhibitor antidepressants in SIDIAP (63.1%), associated with depression. The non-selected indications category showed an upward trend in the Nivel-PCD database while in the SIDIAP database it decreased. LIMITATIONS: It is not mandatory for physicians to register a diagnosis with each prescription. CONCLUSIONS: Depression was the most common prescribing indication in The Netherlands and Spain, followed by anxiety and sleep disorders. The most commonly prescribed antidepressant differed between the countries and is likely explained by differences in local guidelines.

[Diagnostic agreement of primary care and minor surgery in a basic health area]. / Concordancia diagnóstica entre atención primaria y cirugía menor en una zona básica de salud.

AIM: Minor Surgery (MS) is an ever-increasing programmed activity in Primary Health Care Centres (PHC). The aim of this study is to establish the clinical and histopathology diagnostic agreement between PHC and MS and evaluating the efficacy of this activity. METHODS AND MATERIALS: A retrospective, observational, and reliability study was performed. A total of 234 patient specimens were sent to Histopathology between January 2014 and December 2018 in basic health area of San Benito-La Laguna, Santa Cruz de Tenerife. Of these, 203 specimens met criteria, with 31 being excluded due to death or absence of diagnosis. Sociodemographic and diagnostic variables were analysed, and 10 possible diagnoses were grouped into 3 categories according to their nature. Cohen kappa coefficient was used as the main evaluation measure. RESULTS: The majority of specimens were obtained from women (51.2%), and the mean age was 52.82±17.82 years. The most frequently referred lesion was the epidermoid cyst (20.2-21.67%). A clinical-pathological agreement of 60% was obtained in Minor Surgery, with a specificity of 98.3% and a sensitivity of 61.9%. In Primary Care agreement was 36.1%, with a specificity of 98.4% and a sensitivity of 42.8%. Infectious lesions represented the largest concordance difference obtained, with 27% less in Primary Care compared to Minor Surgery. CONCLUSIONS: Minor Surgery is an effective support in the initial diagnosis of lesions referred for evaluation at Primary Care. However, it is necessary to implement improvements in diagnostic efficacy of Primary Care.

El sobrepeso y la obesidad como un problema de salud / Overweight and obesity as an universal health problem

Se destaca al sobrepeso y obesidad como el principal condicionante actual de patología crónica no transmisible. Se identifican y discuten las principales comorbilidades asociadas al sobrepeso y obesidad, analizando las evidencias que las apoyan. Se destaca el rol de la adiposidad en la etiopatogenia del síndrome metabólico y en forma muy especial de la DM. Se analiza la asociación entre indicadores de masa corporal y tejido adiposo y tasas de mortalidad, destacando un significativo incremento de la mortalidad a medida que la masa corporal o grasa se incrementa. Se destacan los rangos asociados a la menor mortalidad, nadires que fundamentan los rangos de peso normal. Se discute en forma separada la asociación entre sobrepeso yobesidad en la infancia y adolescencia y salud, en especial su posible rol en la incidencia de patologías crónicas al alcanzar la adultez.

The article highlights overweight and obesity as the main factor in some current chronic diseases. Also it identifies and discusses major co-morbidities associated with overweight and obesity, analyzing the evidence that support them. The role of adiposity in the pathogenesis of metabolic syndrome especially in the development of mellitus diabetes 2 is discussed. We analyze the association between indicators of body mass and adipose tissue and mortality, highlighting a significant increase in mortality as the fat body mass increases and shows the range associated with lower mortality, basing the normal weight ranges. Will be discussing separately the association between overweight and obesity in childhood and adolescence health, especially its possible role in the incidence of chronic diseases that will develop at adulthood.

Rol de la dieta mediterránea en la prevalencia del síndrome metabólico / Mediterranean diet and its role in the prevalence of metabolic syndrome

El Síndrome Metabólico (SM), conocido también como Síndrome X o Síndrome de Insulino Resistencia (IR), se define por la presencia, en un individuo, de un conjunto de factores asociados e interrelacionados entre si que inducen un mayor riesgo de diabetes mellitus (DM) y enfermedad cardiovascular (EC), y cuyo nexo común es posiblemente la resistencia a la insulina (RI) y/ o el hiperinsulinismo. Se ha considerado que el SM obedece a causas genéticas y ambientales, destacando en estas últimas, una dieta desequilibrada, condicionante de muchos de los atributos del SM. Por otro lado, se ha sugerido que los hábitos alimentarios de los países Mediterráneos son los principales determinantes de la baja prevalencia de morbi-mortalidad cardiovascular y general, e incremento de la expectativa de vida de estas poblaciones. Con el objetivo de reforzar las estrategias de prevención cardiovascular en el SM, se ha postulado que pudieran beneficiarse adicionalmente al adoptar una dieta tipo mediterránea. Para ello se requiere realizar simples modificaciones en su estilo de vida, que se traducirán en un incremento substancial de la expectativa de vida. En esta revisión se resume la evidencia científica con respecto al posible efecto de la dieta mediterránea en el desarrollo y control del SM.

The Metabolic Syndrome (MS), also known as Syndrome X or Insulin Resistance Syndrome, is defined by the simultaneous presence, in an individual, of several risk factors which induce a higher risk of contracting diabetes mellitus and cardiovascular disease. Their common link is, probably, insulin resistance (IR) and/or hyperinsulinism. It is considered that the MS is caused by genetic and environmental factors including an imbalanced diet. A food consumption pattern typical of the Mediterranean countries has been proposed as the reason for the low cardiovascular morbidity and mortality and the longer life expectancy in those countries. The present review discusses the characteristics of the Mediterranean diet and its health benefits related to the MS.

Hipercolesterolemia familiar heterocigota: diagnóstico molecular y terapia combinada. Caso clínico / Molecular diagnosis and combined lipid lowering therapy of heterozygous familial hypercholesterolemia: Report of one case

Heterozygous familial hypercholesterolemia affects one every 400 individuals, is caused by mutations in the LDL receptor gene and is associated with premature coronary artery disease. Nowadays, LDL cholesterol can be efficiently reduced with the new therapies to reduce blood lipids. We report a female patient who consulted in 1975, when she was 46 years old, for severe hypercholesterolemia. In 2003, a sample of leukocyte DNA was obtained and the uncommon 1705 + 1G >A mutation of the LDL receptor gene was detected. No mutations in the apolipoprotein B gene were found. The patient was treated successfully with simvastatin 80 mg/day and ezetimibe 10 mg/day and LDL cholesterol levels were reduced below 200 mg/dl.

Antimalarial activity of some Colombian medicinal plants.

Antimalarial activity of 10 vegetal extracts (9 ethanolic extracts and 1 crude alkaloid extract), obtained from eight species traditionally used in Colombia to treat malaria symptoms, was evaluated in culture using Plasmodium falciparum chloroquine resistant (FcB2) strain and in vivo on rodent malaria Plasmodium berghei. The activity on ferriprotoporphyrin biomineralization inhibition test (FBIT) was also assessed. Against Plasmodium falciparum, eight extracts displayed good activity Abuta grandifolia (Mart.) Sandwith (Menispermaceae) leaves, Acacia farnesiana (L.) Willd. (Mimosaceae) leaves, Acnistus arborescens (L.) Schltdl. (Solanaceae) aerial part, Croton leptostachyus Kunth (Euphorbiaceae) aerial part, Piper cumanense Kunth (Piperaceae) fruits and leaves, Piper holtonii C. DC. (Piperaceae) aerial part and Xylopia aromatica (Lam.) Mart. (Annonaceae) bark with IC(50) values ranging from <1 to 2.1 microg/ml, while in the in vivo model only Abuta grandifolia alkaloid crude extract exhibits activity, inhibiting 66% of the parasite growth at 250 mg/kg/day. In the FBIT model, five extracts were active (Abuta grandifolia, Croton leptostachyus, Piper cumanense fruit and leaves and Xylopia aromatica).

Terapia hipolepemiante intensiva en el manejo del riesgo cardiovascular ateroesclerótico / Intensive cholesterol lowering therapy to reduce cardiovascular risk

Primary and secondary prevention trials have clearly demonstrated that lowering serum cholesterol levels with statins reduces the incidence of cardiovascular events. Recent studies plus post hoc analysis of previous clinical trials show that risk reduction is proportional to the magnitude of LDL cholesterol lowering. Therefore, new recommendations of the National Cholesterol Education Program (USA) have defined a category of patients with very high cardiovascular risk, who should achieve serum LDL cholesterol levels below 70 mg/dl. This proposal will require new and more efficient pharmacologic strategies to attain the increasingly strict therapeutic goals for LDL cholesterol. This article reviews the clinical studies that support the use of intensive lipid lowering therapy to reduce cardiovascular risk. An effective reduction of serum cholesterol can be obtained using statins in high doses or a combination of hypolipidemic drugs with different mechanisms of action.

[Clinical picture at the onset of type 1 diabetes mellitus in children]. / Cuadro clínico de inicio de la diabetes tipo 1 en el niño.

BACKGROUND: Type 1 diabetes mellitus (DM1) is a disease of increasing incidence among children. The time elapsed between the beginning of symptoms and the diagnosis of the disease is, in most cases, very extended. AIM: To report the clinical picture at onset and laboratory features of children with DM1. MATERIAL AND METHODS: Retrospective review of all medical records of patients admitted to the hospital with a DM1 of recent onset. RESULTS: Sixty three males aged 95+/-47 months and 34 females aged 109+/-51 months, were studied. Males were significantly younger than females (p <0.05). The lapse between symptoms onset and the diagnosis of the disease was longer in girls than in boys (46+/-46 and 26+/-26 days respectively, p <0.02). There was an inverse correlation between plasma glucose and the lapse between symptoms onset and the diagnosis of disease. The most common clinical picture of the disease was the classical symptoms of diabetes (polyuria, polydipsia, weight loss), in 60% of cases. Thirty seven percent had developed ketoacidosis at the time of the diagnosis. Ketoacidosis was more common between 1988 and 1995, as compared with the period 1996-2003 (50% and 28.8%, respectively). The onset of symptoms occurred between April and August (Winter in the Southern Hemisphere) in 38% of cases. CONCLUSIONS: DM1 is a disease of increasing incidence among children, whose diagnosis is delayed, even though symptoms are evident. The lower incidence of ketoacidosis in our patients between 1996 and 2003 is encouraging.

El colesterol HDL: ¿un nuevo objetivo terapéutico en el manejo de las dislipidemias y la ateroesclerosis? / HDL cholesterol: A new target in the treatment of lipid disorders and atherosclerosis?

Low plasma HDL cholesterol levels are an independent risk factor for atherosclerotic cardiovascular disease. During the past years, the study of HDL has been stimulated by the discovery of novel genes and proteins, which have provided new insights into the molecular and cellular mechanisms involved in HDL metabolism. In addition, recent clinical studies focused on treating low HDL as primary objective in high cardiovascular risk patients have been very encouraging. Furthermore, new drugs for raising HDL cholesterol are under development. This article reviews the recent progress in the HDL field and its important implications for the pathophysiology and treatment of atherosclerosis. In the near future, we expect that new drugs with specific and beneficial effects on HDL metabolism and the associated cardiovascular risk should improve the current approach to this disease with high burden on health systems and society.

Enfermedad de Paget en Chile: una serie de 15 pacientes / Paget disease of bone in Chile: report of 15 cases

BACKGROUND: Paget disease of bone (PD) is a localized disorder of bone remodeling, which leads to bone fragility and deformity. In Chile PD is uncommon. AIM: To study clinical and demographic characteristics of patients with PD seen in the Clinical Hospital of the Catholic University. PATIENTS AND METHODS: Patients with typical radiological and clinical features of PD referred to our institution during the last decade were included in this review. RESULTS: We obtained data from 15 patients with PD (ten males, eight Chilean, six European and one Asian), eleven of them were diagnosed during the last 3 years. The mean age at diagnosis was 68.7 +/- 11.1 years old. No one had first degree relatives with PD. Bone pain was the main complaint in 13 patients and elevated total alkaline phosphatases in the other two. The average duration of the symptoms prior to diagnosis was 38.8 months. Eight patients had monostotic lesions; the most commonly involved sites were the pelvis, spine and femur. Radiological evaluation disclosed sclerotic changes in all patients as well as bone deformity and osteoarthritis in eight patients. Total alkaline phosphatases were elevated in 14 cases (mean: 4 times over the upper normal limit). CONCLUSIONS: When compared to series of the Northern hemisphere, PD in Chile is characterized by an older age at diagnosis, a higher frequency of symptomatic presentation, advanced radiological involvement and greater proportion of complications. PD should be suspected in every patient, Chilean or foreigner, with bone pain or elevated alkaline phosphatases.

The role of subclass switching in the pathogenesis of endemic pemphigus foliaceus.

Endemic pemphigus foliaceus, like the sporadic form seen in the developed world, is mediated by IgG antibodies to desmoglein-1. We studied an endemic focus in Limao Verde, Brazil, where disease prevalence is 3.4%. We previously detected IgG antibodies to desmoglein-1 in 97% of patients, but also in 55% of normal subjects in the endemic focus, with progressively lower levels in normal subjects in surrounding areas. An environmental trigger is hypothesized to explain these and other findings. In this study we sought to determine if patients and enzyme-linked-immunosorbent-assay-positive normal subjects in Limao Verde differ in IgG subclass response to desmoglein-1. We developed a sensitive and specific subclass enzyme-linked immunosorbent assay using recombinant desmoglein-1 and standardized the assay to enable comparability between the four subclasses. We found that normal subjects have an IgG1 and IgG4 response, whereas patients have similar levels of IgG1 but a mean 19.3-fold higher IgG4 response. Patients in remission have a weak IgG4 response, and a 74.3-fold higher IgG4 response is associated with active disease. Finally, in five patients in whom we had blood samples from both before and after the onset of clinical disease, a mean 103.08-fold rise in IgG4 was associated with onset of clinical disease, but only a mean 3.45-fold rise in IgG1. These results suggest that the early antibody response in normal subjects living in the endemic area and in patients before the onset of clinical disease is mainly IgG1. Acquisition of an IgG4 response is a key step in the development of clinical disease.

Susceptibility of spiny rats (Proechimys semispinosus) to Leishmania (Viannia) panamensis and Leishmania (Leishmania) chagasi.

The role of Proechimys semispinosus as reservoir of Leishmania (Viannia) panamensis on the Colombian Pacific coast was experimentally evaluated. The susceptibility to L. chagasi also was assessed to determine the utility of this rodent as a model for studying reservoir characteristics in the laboratory. Wild-caught animals were screened for natural trypanosomatid infections, and negative individuals were inoculated intradermally (ID) in the snout or feet with 10(7) promastigotes of L. panamensis. L. chagasi was inoculated intracardially (10(7) promastigotes) or ID in the ear (10(8) promastigotes). PCR-hybridization showed that 15% of 33 spiny rats were naturally infected with L. Viannia sp. Animals experimentally infected with L. panamensis developed non-ulcerated lesions that disappeared by the 7th week post-infection (p.i.) and became more resistant upon reinfection. Infectivity to sand flies was low ((1/2)0-(1/4)8 infected/fed flies) and transient, and both culture and PCR-hybridization showed that L. panamensis was cleared by the 13th week p.i. Animals inoculated with L. chagasi became subclinically infected and were non-infective to sand flies. Transient infectivity to vectors of spiny rats infected with L. panamensis, combined with population characteristics, e.g., abundance, exploitation of degraded habitats and high reproductive rates, could make them epidemiologically suitable reservoirs.

Susceptibility of spiny rats (Proechimys semispinosus) to Leishmania (Viannia) panamensis and Leishmania (Leishmania) chagasi

The role of Proechimys semispinosus as reservoir of Leishmania (Viannia) panamensis on the Colombian Pacific coast was experimentally evaluated. The susceptibility to L. chagasi also was assessed to determine the utility of this rodent as a model for studying reservoir characteristics in the laboratory. Wild-caught animals were screened for natural trypanosomatid infections, and negative individuals were inoculated intradermally (ID) in the snout or feet with 10(7) promastigotes of L. panamensis. L. chagasi was inoculated intracardially (10(7) promastigotes) or ID in the ear (10(8) promastigotes). PCR-hybridization showed that 15 percent of 33 spiny rats were naturally infected with L. Viannia sp. Animals experimentally infected with L. panamensis developed non-ulcerated lesions that disappeared by the 7th week post-infection (p.i.) and became more resistant upon reinfection. Infectivity to sand flies was low (1/20-1/48 infected/fed flies) and transient, and both culture and PCR-hybridization showed that L. panamensis was cleared by the 13th week p.i. Animals inoculated with L. chagasi became subclinically infected and were non-infective to sand flies. Transient infectivity to vectors of spiny rats infected with L. panamensis, combined with population characteristics, e.g., abundance, exploitation of degraded habitats and high reproductive rates, could make them epidemiologically suitable reservoirs

Inhibitory effect of N(G)-nitro-L-arginine methyl ester on the anti-adrenergic response elicited by ayanin in the pithed rat.

In this study we evaluated the anti-adrenergic response elicited by ayanin, a flavonoid compound isolated from Croton schiedeanus Schlecht, in the pithed rat, and the inhibitory effect of NO synthase inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME), and its acute toxicity profile in mice. In pithed rats ayanin (5 - 50 mg/kg i. v.) caused a dose-dependent decrease in the pressor and chronotropic responses induced by intravenous noradrenaline administration (0.25 microg/kg). This anti-adrenergic response was completely abolished by prior treatment with L-NAME (10 mg/kg i.v ) and the inhibitory effect of L-NAME was reversed after intravenous administration of L-arginine (100 mg/kg, i. v.). No lethal or major toxic effects were observed in mice receiving i. p. administration of ayanin up to a dose of 500 mg/kg. Our findings confirm that ayanin exerts protective cardiovascular effects against the increase in blood pressure and heart rate mainly through a mechanism that depends on the NO/cyclic guanosine monophosphate (cGMP) pathway without acute toxic effects. These results suggest that extracts of Croton schiedeanus, the native south American plant from which ayanin was isolated, might be beneficial in cardiovascular disease.

Assessment of the antihypertensive and vasodilator effects of ethanolic extracts of some Colombian medicinal plants.

The antihypertensive and vasodilator effects of ethanolic extracts prepared from Calea glomerata Klatt, Croton schiedeanus Schlecht, Curatella americana L., Lippia alba (Mill)n N.E.Br. and Lupinus amandus, which are medicinal plants used in Colombian folk medicine for the treatment of hypertension, were assayed both in SHR and Wistar rats and in rat isolated aortic rings. At a dose of 20 mg/kg, intravenous bolus administration of the ethanolic extracts, from C. schiedeanus, C. americana and L. amandus showed significant antihypertensive activity in SHR, C. schiedeanus being the most active. C. schiedeanus elicited dose-dependent decreases in mean arterial pressure and heart rate (5-100 mg/kg, i.v.) in SHR but 200 mg/kg administered orally did not show any significant effects, even after 3 h of observation. In intact rat aortic rings, ethanolic extracts from C. schiedeanus and Calea glomerata relaxed the contractions induced by KCl (80 mM) and phenylephrine (10(-6) M) in a concentration-dependent manner (10(-6)-3x10(-4) g/ml), with IC(50) of 6.5x10(-5) (7.3-5.8) g/ml and 7.1x10(-5) (7.9-6.4) g/ml, respectively. Bioguided phytochemical fractionation of the ethanolic extract from C. schiedeanus was started. More than one active principle seems to be present, flavonoids and terpenoids compounds were detected.

Inhibition of acute and chronic inflammatory responses by the hydroxybenzoquinonic derivative rapanone.

Rapanone (2,5-dihydroxy-3-tridecyl-1,4-benzoquinone), a natural compound isolated from Myrsine guianensis growing in the Andean highlands of Colombia, was studied in different in vitro and in vivo models as a potential antioxidant and anti-inflammatory drug. Rapanone showed a mild anti-lipoperoxidative profile in rat liver microsomes and inhibited potently degranulation (IC(50) of 9.8 microM) and superoxide chemiluminescence (IC(50) of 3.0 microM) in human neutrophils. In addition, rapanone is a selective and potent human synovial PLA(2) inhibitor (IC(50) of 2.6 microM). In vivo experiments using the carrageenan paw oedema and the zymosan air pouch model in mice as well as the adjuvant arthritis model in rats have proved that rapanone is very efficient in controlling the inflammatory process by different administration routes.