Trasplante de microbiota fecal como tratamiento de la infección por Clostridioides difficile recidivante: a propósito de un caso / Fecal transplantation for the treatment of Clostridioides difficile recurrent infection

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Trichilones A-E: New Limonoids from Trichilia adolfi.

In addition to the trichilianones A-D recently reported from Trichilia adolfi, a continuing investigation of the chemical constituents of the ethanol extract of the bark of this medicinal plant yielded the five new limonoids 1-5. They are characterized by having four fused rings and are new examples of prieurianin-type limonoids, having a ε-lactone which in 4 and 5 is α, ß- unsaturated. The structures of the isolated metabolites were determined by high field NMR spectroscopy and HR mass spectrometry. The new metabolites were shown to have the ε-lactone fused with a tetrahydrofuran ring which is connected to an oxidized hexane ring joined with a cyclo-pentanone having a 3-furanyl substituent. As the crude extract possesses antileishmanial activity, the compounds were assayed for cytotoxic and antiparasitic activities in vitro in murine macrophage cells (raw 264.7 cells) and in Leishmania amazoniensis as well as L. braziliensis promastigotes. Metabolites 1-3 and 5 showed moderate cytotoxicity (between 30-94 µg/mL) but are not responsible for the antileishmanial effect of the extract.

Trichilianones A-D, Novel Cyclopropane-Type Limonoids from Trichilia adolfi.

The fractionation of an ethanol extract of the bark of Trichilia adolfi yielded four novel limonoids (trichilinones A-D, 1-4), with five fused rings and related to the hortiolide-type limonoids. Starting with an ε-lactone, which is α,ß-unsaturated in trichilinones A and D (1 and 4), attached to a tetrahydrofuran ring that is connected to an unusual bicyclo [5.1.0] hexane system, joined with a cyclopentanone with a 3-furanyl substituent [(2-oxo)-furan-(5H)-3-yl in trichilinone D (4)], the four compounds isolated display a new 7/5/3/5/5 limonoid ring system. Their structures were established based on extensive analysis of NMR spectroscopic data. As the crude extract possessed anti-leishmanial properties, the compounds were assayed for cytotoxic and anti-parasitic activities in vitro in murine macrophages cells (Raw 264.7) and leishmania promastigotes (L. amazoniensis and L. braziliensis), respectively. The compounds showed moderate cytotoxicity (approximately 70 µg/mL), but are not responsible for the leishmanicidal effect of the extract.

Abandono escolar en medicina: análisis de tres promociones / School dropout in Medicine: analysis of three generations

INTRODUCCIÓN: El abandono escolar representa desde hace años uno de los grandes problemas a los que se enfrenta la educación en México, principalmente a nivel superior y en licenciaturas de alta exigencia académica como es el caso de medicina. SUJETOS Y MÉTODOS: Se realizó un análisis cuantitativo de tres promociones de la licenciatura de médico cirujano de la Universidad Nacional Autónoma de México con el fin de comparar el abandono escolar según sexo y promoción. RESULTADOS: Se observó que el primer año de la licenciatura de médico cirujano es donde se presenta un mayor porcentaje de abandono escolar (77%), con un predominio de población femenina y abandono definitivo. CONCLUSIÓN: Se estudió el comportamiento estudiantil de la licenciatura de Médico Cirujano para replantear métodos y estrategias institucionales en términos de abandono escolar

INTRODUCTION: For years, school dropout has represented one of the greatest problems that education in Mexico faces, mainly at the higher level and in highly demanding academic degrees such as Medicine. SUBJECTS AND METHODS: We carried out a quantitative analysis of three generations enrolled in Medicine Bachelor of the UNAM's School of Medicine in order to compare school dropouts by sex and generation. RESULTS: It was observed that the Medicine Bachelor's first year is where the highest percentage of school dropouts (77%) occurs, with a predominance of female population and definitive dropout. CONCLUSION: Medicine Bachelor's student behavior was studied to rethink institutional methods and strategies focused on scholar dropout

Exposure to UV-B Radiation Leads to Increased Deposition of Cell Wall-Associated Xerocomic Acid in Cultures of Serpula himantioides.

Many fungi are thought to have developed morphological and physiological adaptations to cope with exposure to UV-B radiation, but in most species, such responses and their protective effects have not been explored. Here, we study the adaptive response to UV-B radiation in the widespread, saprotrophic fungus Serpula himantioides, frequently found colonizing coniferous wood in nature. We report the morphological and chemical responses of S. himantioides to controlled intensities of UV-B radiation, under in vitro culture conditions. Ultraviolet radiation induced a decrease in the growth rate of S. himantioides but did not cause gross morphological changes. Instead, we observed accumulation of pigments near the cell wall with increasing intensities of UV-B radiation. Nuclear magnetic resonance (NMR) and high-performance liquid chromatography-mass spectrometry (HPLC-MS) analyses revealed that xerocomic acid was the main pigment present, both before and after UV-B exposure, increasing from 7 mg/liter to 15 mg/liter after exposure. We show that xerocomic acid is a photoprotective metabolite with strong antioxidant abilities, as evidenced by DPPH (2,2-diphenyl-1-picrylhydrazyl), ABTS [2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt], and oxygen radical absorbance capacity (ORAC) assays. Finally, we assessed the capacity of xerocomic acid as a photoprotective agent on HEK293 cells and observed better photoprotective properties than those of ß-carotene. Xerocomic acid is therefore a promising natural product for development as a UV-protective ingredient in cosmetic and pharmaceutical products.IMPORTANCE Our study shows the morphological and chemical responses of S. himantioides to controlled doses of UV-B radiation under in vitro culture conditions. We found that increased biosynthesis of xerocomic acid was the main strategy adopted by S. himantioides against UV-B radiation. Xerocomic acid showed strong antioxidant and photoprotective abilities, which has not previously been reported. Our results indicate that upon UV-B exposure, S. himantioides decreases its hyphal growth rate and uses this energy instead to increase the biosynthesis of xerocomic acid, which is allocated near the cell wall. This metabolic switch likely allows xerocomic acid to efficiently defend S. himantioides from UV radiation through its antioxidant and photoprotective properties. The findings further suggest that xerocomic acid is a promising candidate for development as a cosmetic ingredient to protect against UV radiation and should therefore be investigated in depth in the near future both in vitro and in vivo.

Clinical and sociodemographic characterization of patients with temporomandibular dysfunction of the University Hospital of Maracaibo

Objective: To describe the clinical and sociodemographic characteristics of patients with temporomandibular joint ( TMJ) dysfunction at the University Hospital of Maracaibo. Methods: A retrospective study was conducted by assessing the clinical history of patients with TMJ dysfunction who underwent orthopedic treatment in the Oral Surgery Unit of the Dentistry Service of the University Hospital of Maracaibo. Information was collected on socio-demographic characteristics (age, gender, origin, and occupation) and clinical findings related to the presence, location, area, beginning, frequency, cause, and duration of pain, and signs present during mandibular dynamics; additionally, a structural and functional diagnosis was made. The data were processed and analyzed using SPSS v.9. Results: 221 patients were included, with only 10% of the disorders observed in males. Regarding occupation, 39.1% worked at home and 28.3% were students. 97.2% of patients presented pain, and of these, pain was localized in 75%. During mandibular movement with maximum opening, 47.4% showed some difficulty, which was more significant in males. TMJ noises were noted in 74.9%, more often in females. In addition, the previous partial displacement of a disk with recapture presented an incidence of 66.4%. Conclusion: The prevalence of TMJ dysfunction was higher in female patients and in adulthood. Noises were present with a high frequency, as was limited mandibular movement.

A Natural Benzofuran from the Patagonic Aleurodiscus vitellinus Fungus has Potent Neuroprotective Properties on a Cellular Model of Amyloid-ß Peptide Toxicity.

Alzheimer's disease (AD) is characterized by amyloid plaques that form due to an increase in amyloid-ß peptide (Aß) aggregation. One strategy in the search of new treatments for AD focuses on compounds that decrease Aß accumulation. Compounds containing a benzofuran ring have been described to play an important role in decreasing Aß-induced toxicity; however, only synthetic benzofurans have been tested thus far. The aim of the present study was to examine the in vitro neuroprotective properties of fomannoxin (Fx), a natural benzofuran isolated from cultures of the Andean-Patagonian fungi Aleurodiscus vitellinus, and evaluate its effect on Aß peptide. We tested the effect of Fx at a wide concentration range (10-11-10-4 M) in PC-12 cells, and found the compound did not alter cellular viability. Fx also showed a concentration-dependent effect on the Aß-induced toxicity in PC12 cells, showing viability above 100% at 10-6 M. We then measured the effect of Fx (10-7-10-5 M) on the frequency of cytosolic Ca2+ transients in rat hippocampal neurons at both acute and chronic (24 h) times. Acute incubation with Fx increased the frequency of cytosolic Ca2+ transients to values around 200%, whereas chronic incubation with Fx increased the frequency of Ca2+ transients. Finally, the Aß-induced decrease in intracellular Ca2+ transients was prevented when Fx (10-6 M) was co-incubated with Aß (5×10-6 M). The results suggest a potent neuroprotective effect of this naturally occurring benzofuran against Aß peptide toxicity that could be mediated by an interference with it binding to plasma membrane, and lead Fx as new chemical entity to develop pharmacological tools against Aß peptide neurotoxicity.

Reemergencia de sarampión en la provincia de Guadalajara. ¿Es el momento de establecer nuevas estrategias para su eliminación? / Re-emergence of measles in the province of Guadalajara, Spain. Is it time to establish new strategies for its elimination?

INTRODUCCIÓN: El sarampión es una infección casi erradicada que en los últimos años está reemergiendo en España y en Europa. El objetivo del estudio fue describir las características microbiológicas y clínico-epidemiológicas de un brote de sarampión ocurrido en la provincia de Guadalajara de junio a agosto de 2012. MÉTODOS: Estudio descriptivo y retrospectivo. Se analizaron 117 muestras (suero, orina y exudado faríngeo) de 52 casos sospechosos de sarampión. RESULTADOS: Se confirmaron 50 casos de sarampión, 41 por laboratorio y 9 por vínculo epidemiológico, agrupados en 4 brotes comunitarios. No se observaron casos importados. La IgM y la PCR fueron positivas en 25 pacientes, solo PCR en 11 y solo IgM en 5. El genotipo fue D4 en 13/14 cepas y genotipo A en un caso posvacunal. Los grupos de edades más afectados fueron adultos entre 20 y 34 años (38%) y menores de 15 meses (26%). El 88% de pacientes no estaban vacunados (43% etnia gitana, 27% menores de 15 meses, 11% razones ideológicas), y el 6% había recibido una dosis. La clínica fue exantema y fiebre (100%), tos (82%) y conjuntivitis (50%). El 32% requirió hospitalización y el 28% presentó complicaciones. CONCLUSIÓN: Es de especial importancia intensificar la vigilancia epidemiológica en infecciones en fase de eliminación. El aumento de la incidencia de sarampión estuvo asociado a bolsas de no vacunados que representan un desafío para la salud pública, que deberá elaborar estrategias para conseguir una elevada cobertura vacunal y alcanzar la erradicación del sarampión

BACKGROUND: Measles is a viral infection that was almost eradicated, but it is re-emerging in Spain and Europe in recent years. The aim of this study was to describe the microbiological, clinical and epidemiological characteristics of a measles outbreak that occurred in Guadalajara (Spain) from June to August 2012. METHODS: A descriptive and retrospective study was conducted. A total of 117 samples (including serum, urine and pharyngeal swabs) from 52 patients were analyzed for measles. RESULTS: Measles was diagnosed in 50 patients, 41 of them by microbiological diagnosis, and 9 by epidemiological link. The patients were grouped in four community outbreaks. No imported cases were observed. Positive IgM and positive CRP were detected in 25 patients, positive CRP only in 11 and positive IgM only in 5. The genotype D4 was identified in 13 patients and the genotype A in a post-vaccine case. The age groups most affected were adults between 20-34 years of age (38%) and younger than 15 months (26%). The large majority (86%) of patients were unvaccinated (44% Roma population, 27% younger than 15 months, 11% ideological reasons), 6% had one vaccine dose. The signs/symptoms were: rash and fever, 100%, cough, 82%, and conjunctivitis 50%. Almost one-third (32%) of patients were hospitalized, and 28% had complications. CONCLUSIONS: It is very important to intensify the epidemiological surveillance of infections in the elimination phase. The increased incidence of measles was associated to unvaccinated pockets, presenting a challenge for Public Health Centers. These agencies should prepare strategies to obtain a higher vaccine coverage for the eradication of measles

[Re-emergence of measles in the province of Guadalajara, Spain. Is it time to establish new strategies for its elimination?]. / Reemergencia de sarampión en la provincia de Guadalajara. ¿Es el momento de establecer nuevas estrategias para su eliminación?

BACKGROUND: Measles is a viral infection that was almost eradicated, but it is re-emerging in Spain and Europe in recent years. The aim of this study was to describe the microbiological, clinical and epidemiological characteristics of a measles outbreak that occurred in Guadalajara (Spain) from June to August 2012. METHODS: A descriptive and retrospective study was conducted. A total of 117 samples (including serum, urine and pharyngeal swabs) from 52 patients were analyzed for measles. RESULTS: Measles was diagnosed in 50 patients, 41 of them by microbiological diagnosis, and 9 by epidemiological link. The patients were grouped in four community outbreaks. No imported cases were observed. Positive IgM and positive CRP were detected in 25 patients, positive CRP only in 11 and positive IgM only in 5. The genotype D4 was identified in 13 patients and the genotype A in a post-vaccine case. The age groups most affected were adults between 20-34 years of age (38%) and younger than 15 months (26%). The large majority (86%) of patients were unvaccinated (44% Roma population, 27% younger than 15 months, 11% ideological reasons), 6% had one vaccine dose. The signs/symptoms were: rash and fever, 100%, cough, 82%, and conjunctivitis 50%. Almost one-third (32%) of patients were hospitalized, and 28% had complications. CONCLUSIONS: It is very important to intensify the epidemiological surveillance of infections in the elimination phase. The increased incidence of measles was associated to unvaccinated pockets, presenting a challenge for Public Health Centers. These agencies should prepare strategies to obtain a higher vaccine coverage for the eradication of measles.

Aspectos biosociales presentes en las gestantes en un área de salud / Biosocial aspects present in pregnant women from health area

Se estudiaron los principales aspectos biosociales presentes en las 210 gestantes del policlínico Docente "Victoria de Girón "durante el período comprendido desde el 1 de enero hasta el 30 de junio de 1994.La mayoría de ellas tenían entre 20 y 29 años(edad óptima para el parto).La anemia, el parasitismo vaginal, la sepsis urinaria y el incremento inadecuado del peso fueron los factores de riesgo o afecciones asociadas al embarazo que predominaron.Se constató un ascenso de las cifras de hemoglobina al final del embarazo. Las condiciones de la vivienda se catalogaron de buenas en su mayoría, así como la percápita familiar (AU)