Association of c.+677 C>T (rs1801133) and c.+1298 A>C (rs1801131) MTHFR genetic variants with cardiometabolic and disease risk in systemic lupus erythematosus patients: A cross-sectional study.

Systemic lupus erythematosus (SLE) patients present a high prevalence of cardiometabolic risk, associated with worse clinical manifestations and mortality. Folate, an essential micronutrient that participates in vital immune cellular functions, could positively affect the cardiometabolic and disease risk in SLE, through the methylenetetrahydrofolate reductase (MTHFR) enzyme, which participates in the folate metabolism, where single nucleotide variants (SNVs) have been described as a potential genetic risk factor for SLE. The aim of this study was to determine the association of the c.+677 C>T (rs1801133) and c.+1298 A>C (rs1801131) MTHFR genetic variants with cardiometabolic risk and clinical disease variables in SLE patients. A case-control study was conducted on 394 unrelated Mexican-mestizo women: 199 with SLE according to the 1997 SLE-ACR criteria and 196 control subjects (CS). Folic acid and homocysteine levels were evaluated by immunoassays. Genotyping of MTHFR genetic variants was carried out by allelic discrimination. No significant differences were found for folic acid (p = .15) and homocysteine serum levels (p = .59) between groups. According to the CC c.+677 MTHFR genotype, this was associated with low cardiovascular disease (CVD) risk by the Castelli index (OR = 0.42; p = .03) in SLE patients. The TC (OR = 1.3; p = .03) and the TA (OR = 1.6; p < .01) haplotypes from c.+677 C>T plus c.+1298 MTHFR were associated with SLE risk, while the CC MTHFR haplotype (OR = 0.5; p = .01) was found as a non-risk factor for the disease. In conclusion, the TC and the TA MTHFR haplotypes are associated with disease risk; meanwhile, the CC c.+677 MTHFR genotype confers lower cardiometabolic risk in Mexican-mestizo SLE patients.

Relationship of serum and dietary vitamin D with high cardiometabolic risk in Mexican systemic lupus erythematosus patients: A cross-sectional study.

Objetive: Serum and dietary vitamin D could influence clinical disease activity and cardiometabolic outcomes in systemic lupus erythematosus (SLE). This study aimed to assess the relationship of serum and dietary vitamin D with cardiometabolic risk in Mexican SLE patients and healthy subjects (HS).Methods: 224 SLE patients and 201 HS were included in this cross-sectional study. Serum calcidiol was measured using a competitive enzyme-linked immunosorbent assay (ELISA). Vitamin D dietary intake was assessed by collecting three 24h food records. Dietary patterns (DPs) were identified using principal component analysis (PCA). Cardiometabolic status was analyzed through biochemical measurements and cardiometabolic indexes.Results: Calcidiol deficiency (<20 ng/mL) was associated with 1.66-fold higher risk of excess weight by body mass index (BMI) (≥25 kg/m2) (p = .02), 2.25-fold higher risk to low high-density lipoprotein-cholesterol (HDL-C) (<40 mg/dL) (p < .001), and 1.74-fold higher risk to high triglycerides (TG) ≥150 mg/dL (p = .02). Inadequate vitamin D dietary intake was associated with 1.92-fold higher risk of presenting non-healthy waist circumference (WC) (>80 cm) (p < .01), 2.05-fold higher risk of android waist to hip ratio (WHR ≥85) (p < .01), and 1.72-fold higher risk to excess weight (p = .02). Non-adherence to a DP rich in vitamin D food sources was associated with higher WC, WHR, triglycerides, and lower high-density lipoprotein-cholesterol (HDL-C); furthermore, in HS, non-adherence to the DP rich in vitamin D food sources provided 2.11-fold higher risk to calcidiol deficiency.In Cconclusion: A pattern of Calcidiol deficiency, inadequate vitamin D dietary intake, and non-adherence to a DP rich in vitamin D food sources was related to high cardiometabolic risk in SLE patients and HS.

Analysis of Potential Vitamin D Molecule Biomarkers: Association of Calcitriol and Its Hydroxylation Efficiency Ratio with Cardiovascular Disease Risk in Rheumatoid Arthritis Patients.

Rheumatoid arthritis (RA) is a multifactorial autoimmune disease in which hypovitaminosis D by calcidiol quantification has been associated with disease severity. However, other vitamin D molecules could be implicated in RA pathophysiology and its comorbidities such as cardiovascular disease (CVD), which impacts the severity and mortality of RA patients. This study aimed to assess the relationship between calcidiol, calcitriol, its hydroxylation efficiency ratio, and the soluble vitamin D receptor (sVDR) and clinical and CVD risk variables to propose potential vitamin D molecule biomarkers for RA. A cross-sectional study of females was conducted on 154 RA patients and 201 healthy subjects (HS). Calcidiol, calcitriol, and the sVDR were measured in blood serum, and vitamin D hydroxylation efficiency was estimated using the calcitriol/calcidiol ratio score. CVD risk was calculated by the high-sensitivity C-reactive protein (hs-CRP) cutoff values. Disease activity was evaluated with the Disease Activity Score for 28 standard joints (DAS28-CRP). Results: The hydroxylation efficiency ratio and calcitriol serum levels were higher in RA patients with hypovitaminosis D (p < 0.001). Moreover, RA patients had a higher probability of a high hydroxylation efficiency ratio (OR = 2.02; p = 0.02), calcitriol serum levels (OR = 2.95; p < 0.001), and sVDR serum levels (OR = 5.57; p < 0.001) than HS. This same pattern was also observed in RA patients with high CVD risk using CRP serum levels; they showed a higher hydroxylation efficiency ratio (OR = 4.51; p = 0.04) and higher calcitriol levels (OR = 5.6; p < 0.01). Calcitriol correlates positively with the sVDR (r = 0.21, p = 0.03), CRP (r = 0.28, p < 0.001), and cardiometabolic indexes (p < 0.001) also showed discrimination capacity for CVD risk in RA patients with CRP ≥ 3 mg/L (AUC = 0.72, p < 0.01). In conclusion, hypovitaminosis D in RA patients was characterized by a pattern of a higher hydroxylation efficiency ratio and higher calcitriol and sVDR serum levels. Notably, higher calcitriol serum levels and a higher vitamin D hydroxylation efficiency ratio were associated with higher CVD risk in RA patients.

Nutritional Approaches to Modulate Cardiovascular Disease Risk in Systemic Lupus Erythematosus: A Literature Review.

Systemic lupus erythematosus (SLE) is a chronic pathology characterized by a bimodal mortality pattern attributed to clinical disease activity and cardiovascular disease (CVD). A complex interaction between traditional CVD risk factors such as obesity, dyslipidemia, smoking, insulin resistance, metabolic syndrome, and hypertension, as well as the presence of non-traditional CVD risk factors such as hyperhomocysteinemia, pro-inflammatory cytokines, and C-reactive protein levels, has been suggested as a cause of the high prevalence of CVD in SLE patients. On the other hand, environmental factors, such as nutritional status, could influence the disease's prognosis; several nutrients have immunomodulators, antioxidants, and anti-cardiometabolic risk properties which could reduce SLE severity and organ damage by decreasing the development of traditional and non-traditional CVD risk factors. Therefore, this critical literature review discusses the therapeutic potential of nutritional approaches that could modulate the development of the main comorbidities related to CVD risk in SLE patients.

Methyl Donor Micronutrients: A Potential Dietary Epigenetic Target in Systemic Lupus Erythematosus Patients.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by an aberrant immune response and persistent inflammation. Its pathogenesis remains unknown; however, a complex interaction between environmental, genetic, and epigenetic factors has been suggested to cause disease onset. Several studies have demonstrated that epigenetic alterations, such as DNA hypomethylation, miRNA overexpression, and altered histone acetylation, may contribute to SLE onset and the disease's clinical manifestations. Epigenetic changes, especially methylation patterns, are modifiable and susceptible to environmental factors such as diet. It is well known that methyl donor nutrients, such as folate, methionine, choline, and some B vitamins, play a relevant role in DNA methylation by participating as methyl donors or coenzymes in one-carbon metabolism. Based on this knowledge, this critical literature review aimed to integrate the evidence in animal models and humans regarding the role of nutrients in epigenetic homeostasis and their impact on immune system regulation to suggest a potential epigenetic diet that could serve as adjuvant therapy in SLE.

Nutritional, biochemical, and clinical determinants of hyperuricemia in systemic lupus erythematosus patients: Relationship with clinical and renal disease activity.

Systemic lupus erythematosus (SLE) is the prototypical autoimmune disease considered as an independent risk factor for mortality by cardiovascular disease. Currently, uric acid is described as a novel biomarker associated with cardiometabolic risk. However, nutritional and serum determinants that influence hyperuricemia development in autoimmune diseases have not been fully elucidated. This study aimed to assess the nutritional, biochemical, and cardiometabolic determinants of hyperuricemia and its relationship with clinical variables in SLE patients. A cross-sectional study was conducted in 167 SLE patients and 195 control subjects (CS). Nutrient intake, anthropometry, biochemical, and cardiometabolic indexes were evaluated. In SLE patients, adequate protein (OR = 0.4; p = 0.04) and carbohydrate (OR = 0.2; p = 0.01) intakes were associated with a lower risk of hyperuricemia. SLE patients with hyperuricemia presented a higher risk of clinical (OR = 2.2; p = 0.03) and renal activity (OR = 3.4; p < 0.01), as well as triglycerides ≥150 mg/dL (OR = 3.6; p < 0.01), hs-CRP ≥1 mg/L (OR = 3.1; p < 0.01), Kannel score ≥3 (OR = 2.5; p = 0.02), and BMI ≥25 kg/m2 (OR = 2.2; p = 0.02). Oppositely, serum levels of HDL-C ≥40 mg/dL (OR = 0.2; p < 0.01) were associated with a lower risk of hyperuricemia. According to the pharmacotherapy administered, prednisone treatment was associated with a high risk of hyperuricemia (OR = 4.7; p < 0.001). In contrast, the hydroxychloroquine treatment was associated with a lower risk of hyperuricemia (OR = 0.4; p = 0.02). In conclusion, SLE patients with hyperuricemia presented a high risk of clinical and renal activity as well as worse cardiometabolic status. Notably, an adequate intake of protein, carbohydrates, healthy HDL-C serum levels, and hydroxychloroquine treatment could be determinants of lower risk of hyperuricemia.

Association of - 717 A > G (rs2794521) CRP polymorphism with high cardiovascular risk by C-reactive protein in systemic lupus erythematosus patients.

INTRODUCTION: Systemic lupus erythematosus (SLE) is an autoimmune disease where genetic factors have been related to SLE susceptibility and disease severity. CRP polymorphisms have been associated with high C-reactive protein (CRP) serum levels, cardiovascular disease (CVD), and high clinical disease activity in SLE patients; however, the evidence is still inconclusive. OBJECTIVE: This study was aimed to assess the association of the - 717 A > G, - 409 G > A, + 1444 C > T, and + 1846 C > T CRP polymorphisms with genetic susceptibility, clinical disease activity, and CVD risk in Mexican-mestizo SLE patients. METHODS: A comparative cross-sectional study was conducted on 369 unrelated women: 183 with SLE according to the 1997 SLE-ACR criteria and 186 healthy subjects (HS). The clinical disease activity was assessed by the Mex-SLEDAI score; CRP and lipid profile were quantified by turbidimetry and colorimetric-enzymatic assays, respectively. The CRP polymorphisms genotyping was carried out by allelic discrimination. RESULTS: SLE patients with - 717 AA genotype had higher CRP serum levels than SLE carriers of AG and GG genotypes (AA = 5 mg/L vs. AG = 3.2 mg/L vs. GG = 2.4 mg/L; p = 0.01), and the AA genotype was associated with high CVD risk by CRP in SLE patients (OR = 3; CI: 1.2-7.6; p < 0.01). CONCLUSIONS: The - 717 A > G CRP polymorphism is a risk factor for high CRP levels and high CVD risk in Mexican-mestizo SLE patients. Key Points • Cardiovascular disease is one of the major causes of death in SLE patients due to the higher prevalence of traditional and non-traditional cardiovascular risk factors. • C-reactive protein is a liver-derived acute-phase protein suggested as one powerful independent risk predictor factor for cardiovascular disease. • Single nucleotide polymorphisms in CRP have been suggested as genetic susceptibility factors that could modify the SLE pathophysiology outcomes. • Mexican-mestizo SLE patients carrying the -717 A>G CRP AA genotype had 3-fold high cardiovascular disease risk than SLE patients with AG or GG genotypes.

Vitamin D Receptor (VDR) Genetic Variants: Relationship of FokI Genotypes with VDR Expression and Clinical Disease Activity in Systemic Lupus Erythematosus Patients.

Vitamin D (VD) deficiency is more frequent in systemic lupus erythematosus (SLE) patients than in control subjects (CS); genetic variants in the VD receptor (VDR) could contribute to the clinical disease activity. This study was aimed to determine the association of the VDR variants FokI (rs2228570), BsmI (rs1544410), ApaI (rs7975232), and TaqI (rs731236) with susceptibility to the disease, VD status, VDR mRNA expression, and clinical disease activity in SLE patients. A cross-sectional study was conducted in 194 SLE and 196 CS Mexican women. Immunoassays quantified serum calcidiol and calcitriol. Genotyping was performed by allelic discrimination assays and mRNA VDR expression by qPCR. The FokI variant was not in linkage disequilibrium with BsmI, ApaI, and TaqI VDR variants. SLE patient carriers of the TT FokI genotype showed higher clinical disease activity scores. Notably, the mRNA VDR expression was higher in SLE patients vs. CS, in active vs. inactive SLE patients, and in participants of both study groups with vitamin D deficiency, higher calcitriol levels, and TT FokI genotype carriers. In conclusion, the TT FokI VDR genotype was related to high VDR expression and clinical disease activity in systemic lupus erythematosus patients.

CRP Serum Levels Are Associated with High Cardiometabolic Risk and Clinical Disease Activity in Systemic Lupus Erythematosus Patients.

Systemic lupus erythematosus (SLE) patients have a higher frequency of cardiovascular risk factors such as high C-reactive protein (CRP) levels than the general population. CRP is considered a cardiovascular disease marker that could be related to SLE clinical disease activity. This study aimed to assess the association between CRP with cardiometabolic risk and clinical disease activity in SLE patients. A comparative cross-sectional study was conducted in 176 female SLE patients and 175 control subjects (CS) with median ages of 38 and 33 years, respectively; SLE patients were classified by the 1997 SLE-ACR criteria, and the clinical disease activity by the Mexican-SLEDAI (Mex-SLEDAI). CRP and lipid profile (triglycerides, cholesterol, HDL-C, and LDL-C) were quantified by turbidimetry and colorimetric-enzymatic assays, respectively. SLE patients had higher CRP levels than CS (SLE: 5 mg/L vs. CS = 1.1 mg/L; p < 0.001). In SLE patients, CRP levels ≥ 3 mg/L were associated with a higher risk of cardiometabolic risk status assessed by LAP index (OR = 3.01; IC: 1.04−8.7; p = 0.04), triglycerides/HDL-C index (OR = 5.2; IC: 2.1−12.8; p < 0.001), Kannel index (OR = 3.1; IC: 1.1−8.1; p = 0.03), Castelli index (OR = 6.6; IC: 2.5−17.8; p < 0.001), and high clinical disease activity (OR = 2.5: IC: 1.03−6.2; p = 0.04; and ß coefficient = 5.8; IC: 2.5−9.4; R2 = 0.15; p = 0.001). In conclusion, high CRP levels were associated with high cardiometabolic risk and clinical disease activity in SLE patients.

Association of cardiometabolic risk status with clinical activity and damage in systemic lupus erythematosus patients: A cross-sectional study.

Cardiometabolic status is a key factor in mortality by cardiovascular disease (CVD) in systemic lupus erythematosus (SLE). This study evaluated the association of cardiometabolic risk status with clinical activity and damage in SLE patients. A cross-sectional study was conducted in 158 SLE patients and 123 healthy subjects (HS). Anthropometry, glucose, hs-CRP, lipid profile, oxLDL, sCD36, anti-oxLDL antibodies, and cardiometabolic indexes were evaluated. SLE patients had dyslipidemia, higher sCD36, anti-oxLDL antibodies, hs-CRP, and risk (OR > 2) to present Castelli score ≥ 4.5, HDL-C < 40 mg/dL and LDL-C ≥ 100 mg/dL. Disease evolution time was correlated with glucose and BMI, damage with TG, and clinical activity with TG, TG/HDL-C ratio, and Kannel index. Active SLE patients had risk (OR > 2) to present a Castelli score ≥ 4.5, Kannel score ≥ 3, TG/HDL-C ratio ≥ 3 and HDL-C < 40 mg/dL. In conclusion, SLE patients have high cardiometabolic risk to CVD related to disease evolution time, and clinical activity.

Relationship of Excess Weight with Clinical Activity and Dietary Intake Deficiencies in Systemic Lupus Erythematosus Patients.

Obesity and nutrients intake deficiencies may contribute to the clinical manifestations and inflammatory processes in systemic lupus erythematosus (SLE). The aim of this study was to assess the relationship between nutritional status and dietary intake with clinical variables in Mexican-mestizo SLE patients. A cross-sectional study was conducted in 130 female SLE patients, classified by the 1997 SLE American College of Rheumatology (ACR) criteria; the clinical activity was evaluated by the Mexican-Systemic Lupus Erythematosus-Disease Activity Index (Mex-SLEDAI); body mass index (BMI) by the World Health Organization (WHO) criteria; the energy calculation and nutritional intake were performed by Nutritionist Pro Diet software. SLE patients with excess weight (BMI > 25 kg/m2) showed a higher score of clinical activity (Mex-SLEDAI = 2; p = 0.003), higher clinical activity prevalence (40.9%; p = 0.039) and a significant association for high clinical activity (odds ratio (OR) = 2.52; 95% confidence interval (CI) = 1.08-5.9; p = 0.033), in comparison with patients without excess weight (BMI < 25 kg/m2). In particular, the excess weight increased the Mex-SLEDAI score (ß coefficient = 1.82; R2 = 0.05; p = 0.005). Also, the SLE patients presented a high prevalence (%) of deficient consumption (cut-off point: <67% of dietary adequacy) of vitamin E (100%), iodine (96%), omega 3 (93.44%), biotin (78%), vitamin K (73.33%), iron (67%), vitamin D (63.3%), potassium (59%), folic acid (56.67%), pantothenic acid (43.3%), vitamin A (41.67%) and zinc (32%). In conclusion, in SLE patients the excess weight was associated with increased clinical activity and to the presence of deficiencies in some essential nutrients ingested.

Apoyo social y familiar al adulto mayor del área urbana en Angelópolis, Colombia 2011 / Social and family support to the elderly in urban areas

Objetivo Describir las redes de apoyo social y familiar con que cuenta el adulto mayor del área urbana del Municipio de Angelópolis, Antioquia durante el año 2011. Materiales Se realizó un estudio descriptivo transversal, que determinó a través de la experiencia de la población, el apoyo social recibido por los 239 adultos mayores del área urbana del Municipio de Angelópolis, Antioquia. Los datos se obtuvieron por medio de fuentes primarias y se realizó análisis univariado y bivariado de la información. Resultados Los adultos encuestados fueron en su mayoría mujeres (59,8 %), con edad entre 60-74 años (66,9 %). El estado civil con mayor porcentaje fue casado (47,3 %) aunque en las mujeres el estado civil viuda tuvo mayor proporción (40,6 %). El 69,5 % tenían nivel de educación primaria y un 16,7 % sin ningún nivel educativo; El 60,3 % estaban afiliados al régimen subsidiado. El apoyo recibido por la familia y los amigos fue valorado como satisfactorio, se encontró una relación estadísticamente significativa entre el sexo y la no realización de actividades diferentes a las cotidianas (valor de p=0,004). Conclusiones El estudio mostró que la soledad es un aspecto que lleva a los adultos mayores a sentirse desamparados y vulnerables. A pesar de encontrarse satisfechos por el apoyo de la familia, algunos manifiestan, en especial las mujeres, sentirse maltratados. Los anteriores aspectos junto con la falta de actividad que les ocupe el tiempo deben ser tenidos en cuenta para plantear estrategias de intervención efectiva en redes de apoyo.(AU)

Objective To describe the social and family support networks available to the elderly living in urban areas of the municipality of Angelópolis-Antioquia during the year 2011. Materials A descriptive transversal study was conductedusing the population experience to determine the social support received by the 239 seniors in the urban area of Angelópolis-Antioquia. The data was obtained from primary sources and univariate and bivariate analysis was conducted. Results Mostly women were interviewed (59.8 %) aged between 60 and 74 (66.9 %). The social status that appeared with the highest percentage was "married" (47.3 %) though with the interviewed women the social status with the highest occurrence was "widow" (40.6 %). 69,5 % had an elementary school educational level and 16,7 % had no formal education at all. 60.3 % were registered in the subsidized program. The support from families and friends was qualified as satisfactory. A statistically significant connection was found between gender and undertaking different activities in free time (value of p=0,004). Conclusions the study indicates that loneliness is an aspect that makes the elderly feel unprotected and vulnerable. Despite the general feeling of satisfaction regarding family support, some of them, especially women, expressed feeling mistreated. The data along with the lack of activities for spare time must be taken into account to formulate intervention strategies for effective support networks to improve the situation of this vulnerable population of the municipality.(AU)

[Social and family support to the elderly in urban areas]. / Apoyo social y familiar al adulto mayor del área urbana en Angelópolis, Colombia 2011.

Objective To describe the social and family support networks available to the elderly living in urban areas of the municipality of Angelópolis-Antioquia during the year 2011. Materials A descriptive transversal study was conductedusing the population experience to determine the social support received by the 239 seniors in the urban area of Angelópolis-Antioquia. The data was obtained from primary sources and univariate and bivariate analysis was conducted. Results Mostly women were interviewed (59.8 %) aged between 60 and 74 (66.9 %). The social status that appeared with the highest percentage was "married" (47.3 %) though with the interviewed women the social status with the highest occurrence was "widow" (40.6 %). 69,5 % had an elementary school educational level and 16,7 % had no formal education at all. 60.3 % were registered in the subsidized program. The support from families and friends was qualified as satisfactory. A statistically significant connection was found between gender and undertaking different activities in free time (value of p=0,004). Conclusions the study indicates that loneliness is an aspect that makes the elderly feel unprotected and vulnerable. Despite the general feeling of satisfaction regarding family support, some of them, especially women, expressed feeling mistreated. The data along with the lack of activities for spare time must be taken into account to formulate intervention strategies for effective support networks to improve the situation of this vulnerable population of the municipality.

Epidemiología de bacterias nosocomiales resistentes a los antimicrobianos: [revisión] / Epidemiology of nosocomial bacteria resistant to antimicrobials: [review]

Nosocomial infections are a major challenge for public health because of the high rates of morbidity and mortality generated. It was considered that the excessive or inappropriate use of antibiotics triggers the emergence of resistant strains. Among the clinically important bacteria that most commonly cause nososcomial infections, Gram positive multiresistant pathogens stand out such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus spp (VRE), and the Gram negative strains of Klebsiella pneumoniae, Escherichia coli, Pseudomonas spp. and Acinetobacter baumannii producing expanded spectrum b-lactamases (ESbL). This review describes the behavior of the main bacterial pathogens resistant to antibiotics that cause infections in Europe, United States, and Latin America, emphasizing studies of molecular epidemiology on a global scale, including the major epidemiological studies in Colombia. The genetic structure of S. aureus and Enterococcus spp strains shows a clonal characteristic favored by the predominance of a small number of clones with the capacity to spread globally, due probably to cross-infection. However, the introduction of MRSA strains from the community encourages genetic diversity, tending to establish a genetic polyclonal endemic structure in places like the United States. In Gram negative bacteria, the high genetic diversity among isolates, mainly in Latin American countries, indicates that the polyclonal spread is influenced by horizontal transfer of plasmids, by excessive exposure to antibiotics, and prolonged hospital stays. In Colombia, there is information on nosocomial resistant pathogens, but molecular epidemiological information is still scarce.

Las infecciones nosocomiales constituyen un gran desafío para la salud pública por las altas tasas de morbilidad y mortalidad que generan. Se ha considerado que el uso inapropiado o excesivo de antibióticos desencadena la aparición de cepas resistentes. Entre las bacterias de importancia clínica que con mayor frecuencia causan infecciones nososcomiales, se destacan los patógenos Gram positivos multiresistentes como Staphylococcus aureus con resistencia a meticilina (SARM) y Enterococcus spp. resistentes a vancomicina (ERV). En los Gram negativos, hay resistencia sobre todo con las cepas de Klebsiella pneumoniae, Escherichia coli, Pseudomonas spp. y Acinetobacter baumannii productoras de b-lactamasas de espectro extendido (BLEEs, en inglés: ESbL expanded spectrum b-lactamases). Esta revisión tiene como finalidad realizar una decripción del estado de la resistencia bacteriana a los antibióticos en los principales patógenos que causan infecciones nosocomiales en países de Europa, Estados Unidos y de Latinoamérica, destacando los estudios de epidemiología molecular a escala global e incluyendo los principales estudios epidemiológicos realizados en Colombia. La estructura genética de las cepas de Staphylococus aureus y Enterococcus spp. evidencia una característica clonal favorecida por el predominio de un número pequeño de clones con capacidad de diseminarse en forma global, debida probablemente a infecciones cruzadas. Sin embargo, la introducción de cepas SARM desde la comunidad está favoreciendo la diversidad genética, tendiendo a establecerse una estructura genética policlonal en lugares endémicos como los Estados Unidos. En Colombia se dispone de información sobre los patógenos nosocomiales resistentes, pero la información epidemiológica molecular aún es escasa.

Relación entre virulencia y resistencia antimicrobiana en Acinetobacter baumannii: [revisión] / Relationship between virulence and antimicrobial resistance in Acinetobacter baumannii: [review]

Acinetobacter baumanni causa frecuentemente infecciones intrahospitalarias y actualmente se ha relacionado con el desarrollo de infecciones severas adquiridas en la comunidad. La capacidad de colonizar diversos hábitats y la versatilidad en su metabolismo ha influido en el incremento del número de infecciones nosocomiales, siendo responsable del desarrollo de enfermedades como: sepsis, neumonías y meningitis. Estas infecciones aparecen en forma de brotes, dominados por clones epidémicos con multirresistencia a los antibióticos que causan altas tasas de morbilidad y mortalidad. Las Unidades de Cuidados Intensivos son las más afectadas por el uso masivo de antibióticos que ocasiona la aparición de cepas multirresistentes. Es importante estudiar los mecanismos de patogénesis y la resistencia a los antibióticos, como factores directos que determinan el problema de salud. Por otra parte, las islas de patogenecidad que corresponde a material genético exógeno que ha sido integrado al genoma de la bacteria, explicaría en gran medida el carácter patogénico de la bacteria. Estas transportan genes que confieren multirresistencia a los antibióticos y son responsables directos de llevar genes involucrados en mecanismos patogénicos como son: el sistema de captación de hierro, el sistema para la formación de biopelículas en superficies abióticas, el mecanismo de formación de la proteína de membrana externa 38 y los sistemas de secreción de proteínas tipo IV, que han sido demostrados como responsables directos de la patogénesis de diversos patógenos. En este artículo se revisa la situación actual de la incidencia de las infecciones nosocomiales causadas por A. baumannii multirresistente a los antibióticos, los principales mecanismos de resistencia a fármacos y la asociación de ésta con los mecanismos de patogenicidad. El conocimiento de los elementos involucrados en la patogénesis de A. baumannii permitirá establecer los mecanismos que lleven a controlar su diseminación.

Desarrollo de una formulación de tabletas revestidas de secnidazol 500 mg / Development of a formulation of coated secnidazole tablets 500 mg

Se describe el desarrollo de una formulación de tabletas revestidas de secnidazol 500 mg. Durante el desarrollo de esta se evaluaron 2 métodos: la granulación seca y la granulación húmeda. En el revestimiento de las tabletas se empleó un sistema hidroalcohólico con el preparado comercial Policoat YS 1-7003 (Opadry)®. Los lotes sometidos a ensayos de estabilidad fueron elaborados a escala piloto, por la vía de granulación húmeda, lo que demostró la factibilidad del proceso de fabricación a esta escala. Las tabletas revestidas presentaron adecuadas propiedades físico-mecánicas y tecnológicas y estas fueron envasadas en frascos de polietileno de alta densidad y en sobres termoconformados de polivinilcloruro/aluminio. La estabilidad química y microbiológica de las tabletas de secnidazol fue estudiada durante 24 meses; los resultados demostraron que estas cumplían con los requisitos establecidos durante este periodo(AU)

The development of a formulation of coated Secnidazole tablets 500mg was described. During its development, 2 methods were evaluated: dry granulation and humid granulation. A hydroalcoholic system was used with the Policoat YS 1-7003 (Opadry)® commercial preparation for coating the tablets. The batches subjected to stability assays were made at pilot scale by humid granulation, which showed the feasibility of the manufacturing process at this scale. The coated tablets had adequate physicomechanical and technological properties and they were packed in polyethylene flasks of high density and in polyvinyl chloride/aluminium thermoconformed envelopes. The chemical and microbiological stability of the secnidazole tablets were studied during 24 months. The results demonstrated that these tablets met the requirements established during this period(AU)

Desarrollo de una formulación de tabletas revestidas de secnidazol 500 mg / Development of a formulation of coated secnidazole tablets 500 mg

Se describe el desarrollo de una formulación de tabletas revestidas de secnidazol 500 mg. Durante el desarrollo de esta se evaluaron 2 métodos: la granulación seca y la granulación húmeda. En el revestimiento de las tabletas se empleó un sistema hidroalcohólico con el preparado comercial Policoat YS 1-7003 (Opadry)®. Los lotes sometidos a ensayos de estabilidad fueron elaborados a escala piloto, por la vía de granulación húmeda, lo que demostró la factibilidad del proceso de fabricación a esta escala. Las tabletas revestidas presentaron adecuadas propiedades físico-mecánicas y tecnológicas y estas fueron envasadas en frascos de polietileno de alta densidad y en sobres termoconformados de polivinilcloruro/aluminio. La estabilidad química y microbiológica de las tabletas de secnidazol fue estudiada durante 24 meses; los resultados demostraron que estas cumplían con los requisitos establecidos durante este periodo.

The development of a formulation of coated Secnidazole tablets 500mg was described. During its development, 2 methods were evaluated: dry granulation and humid granulation. A hydroalcoholic system was used with the Policoat YS 1-7003 (Opadry)® commercial preparation for coating the tablets. The batches subjected to stability assays were made at pilot scale by humid granulation, which showed the feasibility of the manufacturing process at this scale. The coated tablets had adequate physicomechanical and technological properties and they were packed in polyethylene flasks of high density and in polyvinyl chloride/aluminium thermoconformed envelopes. The chemical and microbiological stability of the secnidazole tablets were studied during 24 months. The results demonstrated that these tablets met the requirements established during this period.

Estudio fitoquímico comparativo de 4 taxa de agave / Coparative phytochemical study of four taxa of agave

Se inicia la evaluación del contenido de las sapogeninas principales en taxa de agave: Agave fourcroydes L. (henequén); híbrido de Tanzania No. 11 648; Agave Sp. (Katuca) y Agave Sp. (burro), colectados en la Estación Experimental de Fibras de Boyeros, Ciudad de La Habana, con el objetivo de brindar elementos quimiotaxonómicos para el estudio y clasificación botánica de los 2 taxa en proceso de identificación. Se analizan cuantitativamente las sapogeninas y mayoritariamente en estos taxas: tigogenina y hecogenina: se detecta por cromatografía en capa delgada (CCD) la presencia de fitoesteroles, diosgenina y rockogenina. Solamente se observa la gentrogenina en cantidades apreciables en la especia A. fourcroydes L.

Estudio fitoquímico comparativo de 4 taxa de agave / Comparative phytochemical study of four taxa of agave

Se inicia la evaluación del contenido de las sapogeninas principales en taxa de agave: Agave fourcroydes L. (henequén); híbrido de Tanzania No. 11 648; Agave Sp. (Katuca) y Agave Sp. (burro), colectados en la Estación Experimental de Fibras de Boyeros, Ciudad de La Habana, con el objetivo de brindar elementos quimiotaxonómicos para el estudio y clasificación botánica de los 2 taxa en proceso de identificación. Se analizan cuantitativamente las sapogeninas y mayoritariamente en estos taxas: tigogenina y hecogenina: se detecta por cromatografía en capa delgada (CCD) la presencia de fitoesteroles, diosgenina y rockogenina. Solamente se observa la gentrogenina en cantidades apreciables en la especia A. fourcroydes L.