Identificación de Helicobacter pylori a partir de lesión aterosclerótica coronaria humana / Identification of Helicobacter pylori from human coronary aterosclerótica injury

Introducción:El principal mecanismo patogénico que subyace la génesis y desarrollo de enfermedades del sistema circulatorio es la aterosclerosis. Es un proceso patológico complejo y progresivo de la pared arterial que afecta especialmente a las arterias coronarias, cerebrales y periféricas.Actualmente se habla sobre "La hipótesis infecciosa de la aterosclerosis". La infección por Helicobacter pyloriha sido una de las más investigadas a nivel global. Objetivo:Identificar H. pyloria partir de lesiones ateroscleróticas de pacientes que acuden a los servicios de cirugía cardiovascular y angiología de la ciudad de Barranquilla.Métodos:Se realizó un estudio descriptivo de corte transversal.En una muestra de 102 participantes.Los ateromas fueron tomados por personal experto en endarterectomía y disección de vasos sanguíneos. Los especímenes fueron embebidos en solución formaldehído al 4%.Se realizó extracción de ADN a partir de ateromas. El diagnóstico molecular de H. Pylorise realizó por PCR ANIDADA, evidenciando un fragmento de 120 pb posterior a la electroforesis en gel de agarosa al 3,5% en TBE 0,5X. Resultados:Se obtuvieron 102 muestras de ateromas. Una muestra resultó positiva para H. pylori(Muestra #14; 1/102).El tejido aterosclerótico fue obtenido a partir de arteria coronaria derecha. Conclusión: La hipótesis infecciosa de la aterosclerosis ha sido uno de los principales temas de investigación a nivel mundial en las últimas décadas. La infección por H. pylori es un factorde riesgo, sin embargo, varios estudios son necesarios para poder concluir de manera más precisa.

Introduction:The main pathogenic mechanism underlying the genesis and development of diseases of the circulatory system is atherosclerosis. It is a complex and progressive pathological process of the arterial wall that affects especially the coronary, cerebral and peripheral arteries. Currently, there is talk about "The infectious hypothesis of atherosclerosis". Helicobacter pyloriinfection has been one of the most researched worldwide. Objective:To identify H. pylori from atherosclerotic lesions of patients who attend the cardiovascular and angiology services of the city of Barranquilla. Methods:A descriptive cross-sectional study was carried out. In a sample of 102 participants. The atheromas were taken by expert personnel in endarterectomy and dissection of blood vessels. The specimens were embedded in 4% formaldehyde solution. DNA extraction was performed from atheromas. The molecular diagnosis of H. pyloriwas performed by ANIDADA PCR, evidencing a 120 bp fragment after electrophoresis in a 3.5% agarose gel in 0.5X TBE. Results:102 samples of atheromas were obtained. One sample was positive for H. pylori (Sample # 14, 1/102). The atherosclerotic tissue was obtained from the right coronary artery. Conclusion:The infectious hypothesis of atherosclerosis has been one of the main research topics worldwide in recent decades. H. pyloriinfection is a risk factor, however, several studies are necessary to be able to conclude more accurately

Comparative gene expression analysis of Porphyromonas gingivalis ATCC 33277 in planktonic and biofilms states.

BACKGROUND AND OBJECTIVE: Porphyromonas gingivalis is a keystone pathogen in the onset and progression of periodontitis. Its pathogenicity has been related to its presence and survival within the subgingival biofilm. The aim of the present study was to compare the genome-wide transcription activities of P. gingivalis in biofilm and in planktonic growth, using microarray technology. MATERIAL AND METHODS: P. gingivalis ATCC 33277 was incubated in multi-well culture plates at 37°C for 96 hours under anaerobic conditions using an in vitro static model to develop both the planktonic and biofilm states (the latter over sterile ceramic calcium hydroxyapatite discs). The biofilm development was monitored by Confocal Laser Scanning Microscopy (CLSM) and Scanning Electron Microscopy (SEM). After incubation, the bacterial cells were harvested and total RNA was extracted and purified. Three biological replicates for each cell state were independently hybridized for transcriptomic comparisons. A linear model was used for determining differentially expressed genes and reverse transcription quantitative polymerase chain reaction (RT-qPCR) was used to confirm differential expression. The filtering criteria of ≥ ±2 change in gene expression and significance p-values of <0.05 were selected. RESULTS: A total of 92 out of 1,909 genes (4.8%) were differentially expressed by P. gingivalis growing in biofilm compared to planktonic. The 54 up-regulated genes in biofilm growth were mainly related to cell envelope, transport, and binding or outer membranes proteins. Thirty-eight showed decreased expression, mainly genes related to transposases or oxidative stress. CONCLUSION: The adaptive response of P. gingivalis in biofilm growth demonstrated a differential gene expression.

Streptomyces effect on the bacterial microbiota associated to Crassostrea sikamea oyster.

AIM: To determine the composition and diversity of the microbiota associated to Crassostrea sikamea treated during 30 days with Streptomyces strains N7 and RL8. METHODS AND RESULTS: DNA was extracted from oysters followed by 16S rRNA gene amplification and pyrosequencing. The highest and lowest species diversity richness was observed in the initial and final control group, whereas Streptomyces-treated oysters exhibited intermediate values. Proteobacteria was the most abundant phylum (81·4-95·1%), followed by Bacteroidetes, Actinobacteria and Firmicutes. The genera Anderseniella, Oceanicola, Roseovarius, Ruegeria, Sulfitobacter, Granulosicoccus and Marinicella encompassed the core microbiota of all experimental groups. The genus Bacteriovorax was detected in all groups except in the final control and the depurated N7, whereas Vibrio remained undetected in all Streptomyces-treated groups. RL8 was the only group that harboured the genus Streptomyces in its microbiota. Principal component analysis showed that Streptomyces strains significantly changed oyster microbiota with respect to the initial and final control. CONCLUSIONS: Crassostrea sikamea treated with Streptomyces showed high species diversity and a microbiota composition shift, characterized by keeping the predator genus Bacteriovorax and decreasing the pathogenic Vibrio. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first culture-independent study showing the effect of Streptomyces over the oyster microbiota. It also sheds light about the potential use of Streptomyces to improve mollusc health and safety for consumers after the depuration process.

Determinants of resistive index shortly after transplantation: independent relationship with delayed graft function.

Measurement of the vascular resistive index (RI) by Doppler ultrasonography has been proposed as a non-invasive method to evaluate renal allograft dysfunction, but there are conflicting reports about its clinical utility. The aim of our study was to analyse the donor and recipient characteristics related to RI measured at days 2 and 3 after renal transplantation and the relationship between RI and allograft outcome. RI was measured by Doppler ultrasonography in 333 patients at days 2 or 3 post-transplantation. Donor and recipient variables and allograft outcome were collected from a prospectively maintained institutional database. In patients with RI higher than 0.7, donor age, recipient age, duration of renal replacement therapy, incidence of diabetes, hypertension and atherosclerosis in the recipient, pulse pressure, initial creatinine and the incidence of delayed graft function (DGF) were higher. After multivariate analysis, the only variables that remained significant for an increased risk of higher RI were recipient age over 55 years, presence of diabetes in the recipient and DGF. Recipient age, previous diabetes mellitus and DGF are the most important determinants of transplant kidney RI in the first days after transplantation. So both the graft recipient and the graft itself, but not the donor, determine intra-renal Doppler indices.

[Analysis of the literature on the relatives of the critical patient: research in effective care needs to be performed]. / Análisis de la literatura sobre los familiares del paciente crítico: es necesario desarrollar investigación en cuidados efectivos.

AIM: To explore the nature of studies on families and the Intensive Care Unit context and the issues they deal with. DESIGN AND METHODS: This is a qualitative, methodological study that makes a documental analysis of 24 articles (between 1993-2004) located by descriptors in journals and databases. A double analysis was conducted: quality assessment and content analysis. RESULTS: The articles analyzed were mainly descriptive and reviews of the literature. Six categories were found: environment hostility, family needs, design of interventions, nursing care, experience of the families, and decision making autonomy. CONCLUSIONS: The nursing staff wants to establish care aimed at the patient's family. To do so, they need to be trained in psychological aspects such as handling of emotional stress, strategies and skills for coping and communication strategies and skills. Research should change its focus from being description to proposing and evaluating intervention strategies. Research findings should translate into recommendations for this change.

Análisis de la literatura sobre los familiares del paciente crítico: es necesario desarrollar investigación en cuidados efectivos / Analysis of the literature on the relatives of the critical patient: research in effective care needs to be performed

Objetivos. Conocer cómo son los estudios sobre losfamiliares y el contexto de la Unidad de CuidadosIntensivos y qué temas abordan.Material y métodos. Se trata de un estudio demetodología cualitativa. Análisis documental de 24artículos, localizados por descriptores en revistas ybases de datos. La búsqueda se acotó entre 1993 y2004. Se realizó un doble análisis: calidad de losestudios y análisis de contenido.Resultados. Respecto a la calidad, la mayor partefueron trabajos de corte descriptivo o revisiones de laliteratura. Respecto a los contenidos, emergieron 6temas: hostilidad del entorno, necesidades de losfamiliares, diseño de intervenciones, prácticaenfermera, experiencia de las familias y autonomía enla toma de decisiones.Conclusiones. Las enfermeras desean establecercuidados dirigidos a los familiares del paciente y paraello es necesario completar su formación en aspectospsicológicos tales como el manejo del estrésemocional y habilidades y estrategias deafrontamiento y comunicación.La investigación debe cambiar su foco de atención ypasar de ser descriptiva a proponer y evaluarestrategias de intervención.Los resultados de investigación deben traducirse enrecomendaciones para el cambio

Aim. To explore the nature of studies on familiesand the Intensive Care Unit context and the issuesthey deal with.Design and methods. This is a qualitative,methodological study that makes a documentalanalysis of 24 articles (between 1993-2004) locatedby descriptors in journals and databases. A doubleanalysis was conducted: quality assessment andcontent analysis.Results. The articles analyzed were mainlydescriptive and reviews of the literature. Sixcategories were found: environment hostility,family needs, design of interventions, nursing care,experience of the families, and decision makingautonomy.Conclusions. The nursing staff wants to establishcare aimed at the patient’s family. To do so, theyneed to be trained in psychological aspects such ashandling of emotional stress, strategies and skillsfor coping and communication strategies and skills.Research should change its focus from beingdescription to proposing and evaluatingintervention strategies.Research findings should translate intorecommendations for this change

[Emphysematous cystitis in a patient with renal transplant]. / Cistitis enfisematosa en un paciente trasplantado renal.

We describe a renal transplant patient who developed an abdominal pain in the hypogastrium area and a urinary tract infection. An abdominal RX, and later, a computerized tomography showed an air collection in the bladder wall. Emphysematous cystitis is a rare complication of the urinary tract infection, more frequently in patients with diabetes mellitus. It is important to treat it since the beginning, so we can avoid several complications.

Cistitis enfisematosa en un paciente trasplantado renal / Emphysematous cystitis in a patient with renal transplant

Describimos el caso de una paciente trasplantada renal que desarrolla un dolor abdominal hipogástrico y una infección urinaria. Tras realizarse una radiografía abdominal y, posteriormente, una tomografía axial computerizada, se observó una colección de aire en la pared vesical. La cistitis enfisematosa es una rara complicación dela infección urinaria, más prevalente en pacientes con diabetes mellitus. Es importante tratarlo a tiempo para evitar posibles complicaciones (AU)

We describe a renal transplant patient who developed an abdominal pain in the hypogastrium area and a urinary tract infection. An abdominal RX, and later, a computerized tomography showed an air collection in the bladder wall. Emphysematous cystitis is a rare complication of the urinary tract infection, more frequently in patients with diabetes mellitus. It is important to treat it since the beginning, so we can avoid several complications (AU)

[Abscess colon diverticular disease produced for Actinomyces israelii in a renal transplant recipient]. / Diverticulitis abscesificante por Actinomyces israelii en un trasplante renal.

We present the case of a 53 years old man with a cadaveric kidney transplant under cyclosporin A and prednisolone therapy. Clinical transplant course was uneventful until 15 years after transplant, when he was admitted in our hospital with fever and a perirenal mass of unknown origin. Cyclosporin A was removed and a left sided colon was carried out and a abscess colon diverticular disease produced for Actinomyces israelii was diagnosed. The development was satisfactory after medical and surgical treatment.

Diverticulitis abscesificante por Actinomyces israelii en un trasplante renal / Abscess colon diverticular disease produced for actinomyces israelii in a renal transplant recipient

Paciente de 53 años, trasplantado renal en tratamiento con Ciclosporina A y esteroides, con buena función renal, que ingresa 15 años después del trasplante por fiebre y una masa perirrenal a estudio. Al ingreso, se retiró la Ciclosporina A y, tras realizar diversas pruebas de imagen, se hizo una hemicolectomía izquierda detectándose una diverticulitis abscesificante por Actinomyces israelii con evolución favorable

We present the case of a 53 years old man with a cadaveric kidney transplant under cyclosporin A and prednisolone therapy. Clinical transplant course was uneventful until 15 years after transplant, when he was admitted in our hospital with fever and a perirenal mass of unknown origin. Cyclosporin A was removed and a left sided colon was carried out and a abscess colon diverticular disease produced for Actinomyces israelii was diagnosed. The development was satisfactory after medical and surgical treatment

Cambio de pareja progenitora en puérperas de un hospital de la Región Metropolitana: frecuencia y factores asociados / Change in reproductive partner among women delivering at a Metropolitan Santiago public hospital

Background: Previus studies in Metropolitan Santiago, showed that at least 10 percent of mothers changed their reproductive partner. Aim. To study the frequency of reproductive partner change and its associated factors among women delivering in a public hospital. Subjects and methods: We interviewed 859 non primiparous women that gave birth to a child in a public hospital of Metropolitan Santiago, between March 2001 and February 2002. Results: Mean maternal age rose according to birth order from 27.4 to 33.6 years from the second to the fourth sibling. Married women were the largest group and single ones decreased from the second to the third sibling. Twenty two percent had some activity out of home and those with a high birth order (fourth or more) exhibited poorer schooling. Unwanted pregnancies increased with birth order, reaching 55 percent among ½fourth and over¼ births. Thirty four percent of women delivering their second child, changed their partner. Among women delivering their third child, 38.6 percent had one sibling with a different father; 20.4 percent had changed partner during their second pregnancy and 20 percent during the current one. Among those in the ½fourth and over¼ group, 56.1 percent had at least one sibling with a different father; 18.3 percent had changed partner in the second sibling; 15 percent, in the third and 27.8 percent, in the fourth and over. In all birth orders, mothers with activity out of home exhibited a higher frequency of partner change. The most common reasons to change partner were infidelity, abandon or a personal decision, while economic reasons were uncommon. Conclusions: A great number of children are exposed to bonding ruptures and to the consequential mental health or behavioral problems (Rev Méd Chile 2004; 132: 719-24).

[Prevalence of hypertension in Valparaíso. Results of the base survey of the CARMEN project (Set of measures for the multifactorial reduction of non-transmissible diseases)]. / Prevalencia de hipertensión arterial en Valparaíso. Resultados de la encuesta de base del programa CARMEN (conjunto de acciones para la reducción multifactorial de las enfermedades no transmisibles).

BACKGROUND: There is little information about the real prevalence of hypertension in Chile. AIM: To assess the adjusted prevalence of hypertension and its main therapeutic measures among adults living in Valparaiso, Chile. MATERIALS AND METHODS: A random sample of dwellings in Valparaiso was chosen. Among these, an individual of 25 to 64 years old was randomly surveyed for risk factors for chronic diseases and sociodemographic parameters. Blood pressure, weight, height, oral glucose tolerance test, fasting cholesterol and triglycerides were also measured. Prevalence was pondered according to age, sex, and probability of selection in the dwelling interior. RESULTS: Three thousand one hundred twelve individuals were studied. The adjusted prevalence of hypertension was 11.4% (11.6% among females and 10.6% among men). The prevalence increased along with age from 3 and 1.9% in men and women of 25 to 34 years old respectively, to 18.2 and 27.4% among men and women of 55 to 64 years old (p < 0.01). People of low socioeconomic level had a higher prevalence of hypertension than those of high socioeconomic level (14.2 and 9.3% respectively, P < 0.05). Diabetes, obesity and hypercholesterolemia were significantly more frequent in subjects with hypertension than in the general population. Forty-four percent of diagnosed hypertensives were receiving medications (angiotensin converting enzyme inhibitors 40%, calcium antagonists 34%, beta blockers 22%). Twenty five percent of patients were treated with a combination of medications. Of those treated, only 22% had normal blood pressure levels at the moment of examination. CONCLUSIONS: High blood pressure is an important public health problem that requires more efficient detection and treatment programs.

Prevalence of the angiotensin I converting enzyme insertion/deletion polymorphism, plasma angiotensin converting enzyme activity, and left ventricular mass in a normotensive Chilean population.

The aim of this study was to estimate the prevalence of the different alleles of the angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and associated plasma ACE activity, as well as cardiac echocardiographic structure, in a healthy Chilean population. We selected 117 healthy normotensive subjects (aged 45 to 60 years, middle socioeconomic status, nonobese, and nondiabetic) from a population-based study concerning the prevalence of risk factors for chronic diseases (Conjunto de Acciones Para la Reducción Multifactorial de las Enfermedades no Transmisibles [CARMEN]). The frequencies of the I and D alleles were 0.57 and 0.43, respectively. Mean plasma ACE activity was 15.3 +/- 3.9 U/mL. Compared with subjects with the II genotype, plasma ACE activity was significantly higher in subjects with the ID and DD genotypes with no difference between them. No correlation was observed between blood pressure and plasma ACE activity. Among the three different genotypes there was no difference in left ventricular (LV) dimensions or in LV mass. No correlation between plasma ACE activity and LV mass was observed for either gender or different genotypes. Multivariate linear regression analysis using LV mass and LV mass index as dependent variables showed independent effects (P < .05) for gender (higher LV mass in men) and diastolic blood pressure, but not for the DD genotype. In conclusion, in this population, the presence of the D allele on the ACE gene determined higher circulating ACE activity. However, in this normotensive healthy population, male gender and diastolic blood pressure, but not the presence of the D allele, were associated with increased LV mass.

[Risk factors for non communicable diseases: methods and global results of the CARMEN program basal survey]. / Factores de riesgo para las enfermedades no transmisibles: metodología y resultados globales de la encuesta de base del programa CARMEN (Conjunto de Acciones para la Reducción Multifactorial de las Enfermedades no Transmisibles).

BACKGROUND: In the last decades, chronic non communicable diseases are becoming the main cause of disability and mortality among adults. The risk factor surveillance and management is the most efficient mean of reducing the impact of these diseases. AIM: To report the results of a non communicable disease risk factor surveillance program in Valparaiso, Chile. MATERIAL AND METHODS: A random samples of people aged 25 to 64 years old living in Valparaiso, Chile was studied. Subjects were questioned about smoking and physical activity habits. Blood pressure, height and weight were measured using standardized techniques at their homes and blood samples were obtained to measure serum lipid levels and oral glucose tolerance test at the nearest outpatient clinic. RESULTS: Of the initial 3852 homes selected, 752 individuals did no agree to answer the inquiry, therefore 3120 subjects were finally interviewed. Of these, 40.6% were smokers, 15% drank alcohol in two or more occasions per month, 84.6% were physically inactive, 19.7% had a body mass index over 30 kg/m2, 11.1% had high blood pressure, 3.9% were diabetic and 46.9% had high serum cholesterol levels. CONCLUSIONS: The basal survey for the CARMEN program shows a high prevalence of cardiovascular risk factors among Chileans.

[Synchronous intestinal, tonsillar and pulmonary tuberculosis]. / Tuberculosis intestinal, amigdalar y pulmonar sincrónicas.

OBJECTIVES: To emphasize the unusual synchronous presentation of intestinal, pulmonary and tonsillar tuberculosis in the same patient. CLINICAL CASE: A 43 years old male consults for abdominal pain and alternating episodes of diarrhoea-constipation. Based on radiologic, endoscopic and pathologic studies the diagnosis of Crohn's ileo-cecal disease is achieved and a treatment with salazosulphapyridine and corticosteroid is started. Two months later the patient presents with a tonsilar ulceration that is diagnosed as tuberculosis on biopsy material. At the same time, chest x-rays film reveal active tuberculous lesions, and tuberculous bacili are seen in the sputum. Simultaneously the intestinal disease worsens and complicates with incomplete occlusion that requires a right hemicolectomy. Pathologic study of the specimen shows evident tuberculous lesions. Specific treatment for tuberculosis is started, and the patient remains free of disease one year later. CONCLUSIONS: Due to the increase in the prevalence of tuberculous diseases, we must keep it in mind in the differential diagnosis of intestinal strictures, even though they are suggestive of Crohn's disease, and a radical surgical procedure must also be evaluated.

Immune-genetic study of the new populations of Sierra Morena (Spain) through HLA polymorphisms of class I.

We have studied the HLA antigenes of class I in 50 families from Andalusia and in 50 families from some towns of Sierra Morena (La Carolina among others), in which an important settlement took place by individuals from Central Europe over 200 years ago, by comparing the allele frequencies with the German population. The obtained results allowed us to conclude that a real mixture of population has occurred. The frequencies of some HLA alleles of class I in the population of Sierra Morena are intermediate to those observed in the original populations, though some phenomena of drifting have been noticed. The study of gametic associations also shows that the population of Sierra Morena behaves as an intermediate population between the two original populations. This is evident in relation to the A1-B8 haplotype, in which the population of Sierra Morena is similar to the original Andalusian population, regarding the frequency of the haplotype, and the German population, because of the intensity of disequilibrium. The study of the genetic distances shows that the ones existing between the populations of Andalusia, Germany and Sierra Morena are small, although they reveal that these populations are clearly defined.