Quercetin protects against experimentally-induced myocardial infarction in rats by an antioxidant potential and concomitant activation of signal transducer and activator of transcription 3.

This study tested if the protective effect of quercetin (QUR) against experimentally-induced acute myocardial infarction (AMI) in rats involves modulating the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) pathway. Rats were divided into 6 groups as sham-operated (control), control + QUR, AMI, AMI + QUR, AMI + S3I-210 (a STAT3 inhibitor), and AMI + QUR + S31-201. QUR (50 mg/kg/orally) and S3I-201 (a STAT3 inhibitor) (5 mg/kg/i.p.) were administered for 7 days before the induction of AMI and the experiment was ended 24 h post-AMI. Pre-treatment with QUR reduced the infarct size, improved the left ventricular (LV) functions and the structure of the myofibrils and the mitochondria, and reduced circulatory levels of lactate dehydrogenase (LDH), creatinine-kinase MB (CKMB), and troponin-I. QUR also reduced LV levels of reactive oxygen species (ROS) and malondialdehyde (MDA), inhibited the opening of the mitochondria transition pores (mtPTP), and reduced protein levels of cytochrome-C, cleaved caspase-3 and p-JAK2 (Tyr1007/1008) in the LVs of AMI rats. In the LV of both the control and AMI rats, QUR didn't affect the levels of p-JAK2 but significantly increased the levels of total glutathione (GSH) and manganese superoxide dismutase (MnSOD), reduced the levels of Bax and the nuclear levels and activity of NF-κB p65, tumor necrosis-factors-α (TNF-α), interleukin-6 (IL-6), and p-STAT1 (Ser727) but further increased the levels of p-STAT3 (Ser727). All these effects exerted by QUR were partially reversed but the decrease in nuclear protein levels and activity of NFκB, levels of TNF-α and IL-6, and pSTAT3 were completely prevented by co-administration of S3I-201. In conclusion, QUR protects against MI by upregulation of antioxidants and activation of STAT3.

Prophylaxis of early bacterial infections after autologous peripheral blood stem cell transplantation (PBSCT): a matched-pair study comparing oral fluoroquinolones and intravenous piperacillin-tazobactam.

The safety and efficacy of early bacterial prophylaxis with piperacillin-tazobactam were prospectively evaluated in 51 autologous peripheral blood stem cell transplantation (PBSCT) recipients. The results were compared with those obtained in 51 control patients receiving oral fluoroquinolones in a retrospective matched-pair control study. Overall, 76% of the study group and 98% of the control group developed at least one febrile episode during neutropenia (P=0.002). Time from neutropenia to the first febrile episode (FFE) was significantly longer in the study group than in the control group (P=0.04). Once a febrile episode appeared, the duration of fever was significantly longer in cases than in controls (median of 5 and 2 days respectively, P<0.001), and led to a more frequent use of empirical amphotericin B (AmB), not statistically significant (P=0.13). However, the total time of antibiotic administration was significantly greater in the control than in the study group (P=0.05). The duration of AmB treatment shows a trend toward a longer duration in the control than in study group (P=0.2). Overall, 86% of the Gram-positive bacteremia and 85% of the Gram-negative bacteria were susceptible to the tested antibiotics. Our study suggests that a subgroup of patients could benefit from prophylaxis with piperacillin-tazobactam without increasing toxicity or bacterial resistance.

Qualitative plasma PCR assay (AMPLICOR CMV test) versus pp65 antigenemia assay for monitoring cytomegalovirus viremia and guiding preemptive ganciclovir therapy in allogeneic stem cell transplantation.

The performances of a commercially available qualitative plasma PCR assay (AMPLICOR CMV test; Roche Diagnostics) and the pp65 antigenemia assay (AG) were evaluated for the monitoring of cytomegalovirus (CMV) viremia in 43 allogeneic stem cell transplant recipients. In addition, the suitabilities of both assays for triggering the initiation of preemptive ganciclovir therapy were assessed. A total of 37 CMV viremic episodes were detected in 28 patients. Positivity of plasma PCR testing in one or more consecutive specimens was the only marker of CMV viremia in 18 of the 37 episodes (PCR positive and AG negative, n = 50 specimens). Five episodes were diagnosed on the basis of a single positive AG result (AG positive and PCR negative, n = 5 specimens); both assays were eventually positive (PCR positive and AG positive, n = 27 specimens) for 14 viremic episodes; for these episodes, conversion of the PCR assay result to a positive result occurred an average of 1 week before conversion of the AG result. Overall, the concordance between the two methods was 90%, and the sensitivities of the plasma PCR assay and AG for the detection of CMV viremic episodes were 86.5 and 51.3%, respectively. Two patients who tested positive by both assays simultaneously progressed to CMV end-stage organ disease, despite the initiation of preemptive ganciclovir therapy. Conversion of the AG result to a negative result upon administration of preemptive ganciclovir therapy occurred a median of 7.5 days earlier than conversion of the plasma PCR assay result. Nineteen of the 28 patients with CMV viremia received AG-guided preemptive ganciclovir therapy; had the positivity of the plasma PCR assay triggered the initiation of preemptive therapy, 9 additional patients would have been unnecessarily treated since none of them developed CMV end-stage organ disease. Although the AMPLICOR CMV assay is more sensitive than AG, the latter appears to be more suitable both for guiding the initiation of preemptive therapy and for monitoring a patient's response to antiviral therapy.

Lack of association between the kinetics of human cytomegalovirus (HCMV) glycoprotein B (gB)-specific and neutralizing serum antibodies and development or recovery from HCMV active infection in patients undergoing allogeneic stem cell transplant.

The kinetics of the gB-specific and neutralizing antibody responses to human cytomegalovirus (HCMV) were analyzed in 26 allogeneic stem-cell transplant recipients who either did (n = 20) or did not (n = 6) develop asymptomatic HCMV active infection during the study period. Antibody response profiles varied widely among individuals in both groups, irrespective of whether HCMV active infection did or did not occur. Development of HCMV active infection was not preceded by a decline in functional serum antibody levels. Neither the absence nor the presence of HCMV active infection correlated with either high or low serum levels of gB-specific and neutralizing antibodies, respectively. In most patients, episodes of HCMV replication were not followed by a marked increment in functional serum antibody titers. Therefore, resolution of an ongoing HCMV active infection was not associated with a vigorous antibody response to viral replication. In addition, this study supports previous data indicating that passive transfer of human immunoglobulins may result in an increment in gB-specific and neutralizing serum antibody levels, the magnitude of which varies among recipients; however, both patients with and without measurable increments in serum antibody levels developed HCMV active infections with comparable frequency.

[Applications of the polymerase chain reaction (PCR) to the diagnosis of central nervous system infections]. / Aplicaciones de la reacción en cadena de polimerasa (PCR) al diagnóstico de infecciones del sistema nervioso central.

The utility of polymerase chain reaction (PCR) is described for the diagnosis in three patients suffering from central nervous system infections, tuberculous meningitis, herpetic encephalitis and cerebral toxoplasmosis. PCR was performed in the cerebrospinal fluid after processing the specimen by two methods, proteinase K digestion and phenol extraction of DNA. Amplification was realized using primers previously described that amplify specific DNA fragments of each microorganisms (insertion sequence IS6110 of Mycobacterium tuberculosis, B1 gene of Toxoplasma gondii, and DNA polymerase gene of Herpes simplex virus). In all three cases, PCR was positive after amplification of the specimen extracted with proteinase K, as well as when a complete DNA extraction with phenol was realized. In all cases a band of amplified products was observed in agarose gels. In conclusion, in all three patients described, PCR would had allowed the diagnosis in seven hours, and PCR should be consider a rapid sensitive and relatively simple method.

[Preventive and social aspects in medical education, Mexico]. / Aspectos preventivos y sociales en la carrera de medicina, México.

The subject of the article is medical education in Mexico, particularly in the area of preventive and social medicine. It emphasizes the impact on this instruction of the country's economic and cultural dependence. It then presents some important qualitative data such as those on the existence of the administrative academic body responsible for the area, the names of the academic subjects in the area of preventive and social medicine, the educational objectives and study plan of this area; its connection with undergraduate internship and social service; agreements with other institutions for instructions; the semester in which the subjects in the area are taught and the faculty members teaching them. Finally, on the basis of the information presented, several conclusions are reached which make it possible to asseverate that the teaching of preventive and social medicine is not given the importance it merits, in the study plan of any medical school in the country.

Aspectos preventivos y sociales en la carrera de medicina, México / Preventive and social aspects in medical education, Mexico

The subject of the article is medical education in Mexico, particularly in the area of preventive and social medicine. It emphasizes the impact on this instruction of the country's economic and cultural dependence. It then presents some important qualitative data such as those on the existence of the administrative academic body responsible for the area, the names of the academic subjects in the area of preventive and social medicine, the educational objectives and study plan of this area; its connection with undergraduate internship and social service; agreements with other institutions for instructions; the semester in which the subjects in the area are taught and the faculty members teaching them. Finally, on the basis of the information presented, several conclusions are reached which make it possible to asseverate that the teaching of preventive and social medicine is not given the importance it merits, in the study plan of any medical school in the country (Au)