HDACs MADS-domain protein interaction: a case study of HDA15 and XAL1 in Arabidopsis thaliana.

Cellular behavior, cell differentiation and ontogenetic development in eukaryotes result from complex interactions between epigenetic and classic molecular genetic mechanisms, with many of these interactions still to be elucidated. Histone deacetylase enzymes (HDACs) promote the interaction of histones with DNA by compacting the nucleosome, thus causing transcriptional repression. MADS-domain transcription factors are highly conserved in eukaryotes and participate in controlling diverse developmental processes in animals and plants, as well as regulating stress responses in plants. In this work, we focused on finding out putative interactions of Arabidopsis thaliana HDACs and MADS-domain proteins using an evolutionary perspective combined with bioinformatics analyses and testing the more promising predicted interactions through classic molecular biology tools. Through bioinformatic analyses, we found similarities between HDACs proteins from different organisms, which allowed us to predict a putative protein-protein interaction between the Arabidopsis thaliana deacetylase HDA15 and the MADS-domain protein XAANTAL1 (XAL1). The results of two-hybrid and Bimolecular Fluorescence Complementation analysis demonstrated in vitro and in vivo HDA15-XAL1 interaction in the nucleus. Likely, this interaction might regulate developmental processes in plants as is the case for this type of interaction in animals.

Phylogeny, Diversification Rate, and Divergence Time of Agave sensu lato (Asparagaceae), a Group of Recent Origin in the Process of Diversification.

Agave sensu lato is one of the most diverse and complex genera of Asparagaceae, with more than 250 species. The morphological, ecological, and evolutionary diversity of the group has complicated its taxonomical study. We conducted phylogenetic analyses of DNA sequence data to reconstruct the phylogenetic relationships of the Agave genus. We included 107 species of the Asparagaceae family from which 83 correspond to the Agave sensu lato clade (Agave sensu stricto + Polianthes + Manfreda and Prochnyanthes, which together represent 30% of the genus) and as outgroups the genera Dasylirion, Hesperoyucca, Chlorogalum, Camassia, Hesperaloe, Yucca, Beschorneria, and Furcraea, in order to estimate the age and propose the history of their diversification. Previous studies postulated the relevance of the Miocene in the speciation rates of the agaves, as well as the relevance of the type of inflorescence in its diversification. However, these assertions have not been well supported. The analysis of chloroplast regions resulted in low resolution, which could be the consequence of the few variable sites. On the other hand, the internal transcribed spacer (ITS) implemented in our analysis ensued in higher resolution and better support values. Our phylogenetic analyses recovered five groups; one is the Striatae group, which is the sister group to Agave sensu stricto clade. Within this clade, we found three main groups with high support; these groups are not related with previous morphological proposals. We also analyzed the dates of origin and diversification rates. A Bayesian analysis of macroevolutionary mixtures indicated two significant shifts; the first was identified at 6.18 Ma, where the speciation rate increased to 4.10 species/Mya, this shift occurred during the late Miocene period, characterized by the emergence of arid biomes in North America. The second was identified at a stem age of 2.68 Ma where the speciation rate increased to 6.04 species/Mya. Concerning the ancestral reconstruction state of the inflorescence type in the Agave sensu stricto clade, the spike inflorescence character was predominant in the early-diverging groups, whereas the late-diverging groups present panicle inflorescences as the predominant character and higher speciation rates.

Prevalencia de personas sordas que cuentan con un intérprete profesional de Lengua de Señas Argentina en la consulta médica de sus hijos / Prevalence of deaf people who have a professional Argentine Sign Language interpreter during their children's medical consultations

Introducción. En Argentina, la discapacidad auditiva representa 18% de las discapacidades. La Lengua de Señas Argentina (LSA) es el sistema de comunicación de elección en personas sordas (PS). La incorrecta comunicación con el médico impide una adecuada asistencia. Las PS precisan a un intérprete profesional de LSA (IPLSA) durante la atención médica de sus hijos. La Ley Nacional 26378 establece ofrecer IPLSA para facilitar el acceso a instalaciones públicas. Sin embargo, la mayoría de las PS no cuentan con intérprete ni conocen este derecho. Objetivos. Describir la prevalencia de PS que cuentan con IPLSA en la consulta médica de sus hijos y que conocen su derecho a tener acceso gratuito a un IPLSA. Material y método. Estudio descriptivo, transversal, con encuesta estructurada autoadministrada. Se incluyeron PS que supieran LSA, con hijos entre 1 mes y 18 años. Variables de resultado: contar con IPLSA y conocer el derecho a tenerlo. Tamaño de muestra calculado: 220. Muestreo por conveniencia en la Ciudad de Buenos Aires y la provincia del Chaco. Se calculó prevalencia e intervalo de confianza del 95% (IC95%). Estudio aprobado y registrado. Resultados. Se analizaron 222 encuestas. Edad: 34,9 ± 10,1 años. El 15,3% (IC95%: 11,1-20,6) contaron con un IPLSA en alguna consulta de sus hijos. El 48,6% (IC95%: 42,1-55,1) conocía su derecho a contar con uno. Conclusión. La prevalencia de PS que han contado con un IPLSA en la consulta médica de sus hijos fue baja. Casi la mitad conocía su derecho de contar con un IPLSA.

Introduction. In Argentina, hearing disability accounts for 18% of disabilities. Argentine Sign Language (ASL) is the communication system of choice used by deaf people (DP). An incorrect communication with physicians hampers the adequate provision of health care. DP require a professional ASL interpreter (PASLI) in the context of health care provided to their children. National Act no. 26378 stipulates the provision of a PASLI to facilitate access to public facilities. However, most DP neither have an interpreter nor know this right. Objectives. To describe the prevalence of DP who have a PASLI present during their children's medical consultations and who know their right to access one at no charge. Material and method. Approved and registered, descriptive, cross-sectional study with a structured, self-administered survey. Participants: DP who knew ASL and had children aged 1 month to 18 years old. Outcome variables: to have a PASLI and to know the right to have one. Estimated sample size: 220. Convenience sampling selected from the Autonomous City of Buenos Aires and the province of Chaco. The prevalence and 95% confidence interval (95% CI) were estimated. Results. Two hundred and twenty-two surveys were analyzed. Age: 34.9 ± 10.1 years old. Among all participants, 15.3% (95% CI: 11.1-20.6) sometimes had a PASLI during their children's medical consultations. Also, 48.6% (95% CI: 42.155.1) knew their right to have one. Conclusion. The prevalence of DP who had a PASLI present during their children's medical consultations was low. Less than a half knew their right to have one.

Prevalence of deaf people who have a professional Argentine Sign Language interpreter during their children's medical consultations. / Prevalencia de personas sordas que cuentan con un intérprete profesional de Lengua de Señas Argentina en la consulta médica de sus hijos.

INTRODUCTION: In Argentina, hearing disability accounts for 18% of disabilities. Argentine Sign Language (ASL) is the communication system of choice used by deaf people (DP). An incorrect communication with physicians hampers the adequate provision of health care. DP require a professional ASL interpreter (PASLI) in the context of health care provided to their children. National Act no. 26378 stipulates the provision of a PASLI to facilitate access to public facilities. However, most DP neither have an interpreter nor know this right. OBJECTIVES: To describe the prevalence of DP who have a PASLI present during their children's medical consultations and who know their right to access one at no charge. MATERIAL AND METHOD: Approved and registered, descriptive, cross-sectional study with a structured, self-administered survey. Participants: DP who knew ASL and had children aged 1 month to 18 years old. Outcome variables: to have a PASLI and to know the right to have one. Estimated sample size: 220. Convenience sampling selected from the Autonomous City of Buenos Aires and the province of Chaco. The prevalence and 95% confidence interval (95% CI) were estimated. RESULTS: Two hundred and twenty-two surveys were analyzed. Age: 34.9 ± 10.1 years old. Among all participants, 15.3% (95% CI: 11.1-20.6) sometimes had a PASLI during their children's medical consultations. Also, 48.6% (95% CI: 42.155.1) knew their right to have one. CONCLUSION: The prevalence of DP who had a PASLI present during their children's medical consultations was low. Less than a half knew their right to have one.

Introducción. En Argentina, la discapacidad auditiva representa 18% de las discapacidades. La Lengua de Señas Argentina (LSA) es el sistema de comunicación de elección en personas sordas (PS). La incorrecta comunicación con el médico impide una adecuada asistencia. Las PS precisan a un intérprete profesional de LSA (IPLSA) durante la atención médica de sus hijos. La Ley Nacional 26378 establece ofrecer IPLSA para facilitar el acceso a instalaciones públicas. Sin embargo, la mayoría de las PS no cuentan con intérprete ni conocen este derecho. Objetivos. Describir la prevalencia de PS que cuentan con IPLSA en la consulta médica de sus hijos y que conocen su derecho a tener acceso gratuito a un IPLSA. Material y método. Estudio descriptivo, transversal, con encuesta estructurada autoadministrada. Se incluyeron PS que supieran LSA, con hijos entre 1 mes y 18 años. Variables de resultado: contar con IPLSA y conocer el derecho a tenerlo. Tamaño de muestra calculado: 220. Muestreo por conveniencia en la Ciudad de Buenos Aires y la provincia del Chaco. Se calculó prevalencia e intervalo de confianza del 95% (IC95%). Estudio aprobado y registrado. Resultados. Se analizaron 222 encuestas. Edad: 34,9 ± 10,1 años. El 15,3% (IC95%: 11,1-20,6) contaron con un IPLSA en alguna consulta de sus hijos. El 48,6% (IC95%: 42,1-55,1) conocía su derecho a contar con uno. Conclusión. La prevalencia de PS que han contado con un IPLSA en la consulta médica de sus hijos fue baja. Casi la mitad conocía su derecho de contar con un IPLSA.

El punto ciego de la anestesia obstétrica: monitoría fetal intraquirúrgica / The blind spot in obstetric anesthesia: intra-surgical fetal monitoring

Introducción. La monitoría fetal en pacientes obstétricas que son intervenidas de operación cesárea tiene un gran vacío, que corresponde al periodo transoperatorio. Pese al desarrollo vertiginoso de la tecnología en todos los ámbitos de la medicina, no ha sido posible establecer un método práctico para evaluar el bienestar fetal durante la cesárea. Objetivo. Se propone encontrar y diseñar un métodono invasivo y práctico que se pueda aplicar en un sitio distante al campo quirúrgico abdominal y que registre la frecuencia fetal continua como medida indirecta del bienestar fetal. Esta labor no solo atañe al anestesiólogo, sino, también, al obstetra y al pediatra. Metodología. Artículo de reflexión que surge luego de una pregunta realizada por estudiantes de anestesiología en el quirófano (pregrado y posgrado),sobre un método práctico de monitoría fetal no invasiva intraoperatoria. Se realizó busqueda en bases de datos de Medline, Ovid y Science Direct. Resultados. Actualmente, no hay un método de monitoría fetal apropiado (óptimo y práctico) para este periodo en el quirófano; es imperioso encontrar una salida por medio de la tecnología, que permita evaluar el bienestar fetal en el transoperatorio de la cesárea, en primera instancia, porque el tiempo quirúrgico tiene muchos factoresque lo pueden prolongar y ser un determinante en la falta de control de un evento hipóxico o isquémico en el feto; también, porque la seguridaden anestesia obstétrica y fetal debe ser exigente y crítica.

Introduction: There is a big gap in fetal monitoring in obstetric patients undergoing cesarean section during the transoperative period. Despite the astonishing technological developmentsin all medical areas, we have failed todevelop a practical method for the evaluation of the fetus wellbeing during a c-section intervention. Objective. A non-invasive and practical methodis suggested that can be used in a site distant from the abdominal surgical field to record the continuous fetal heart rate as an indicator of fetal wellbeing. This task would not only involve the anesthesiologist, but the obstetrician andthe pediatrician as well. Methodology. Producing an article that should be food for thought, based on a question askedby students of anesthesiology in the OR (graduate and postgraduate students), about a practical method for intraoperative fetal, noninvasivemonitoring. The search was conductedusing the Medline, Ovid and Science Direct data basis. Results. Notwithstanding the absence of an appropriate fetal monitoring method (optimal and practical) for this period of time in the OR, it is mandatory to find a technology-based solution to assess the wellbeing of the fetus during thetransoperative period of the c-section, firstly because there are multiple factors that may extend the surgical time and become a determining factorfor the lack of control of a hypoxic or schemic event of the fetus; secondly, because safety of obstetric and fetal anesthesia must be demandingand is critical.

Molecular phylogenetics of the Gloeophyllales and relative ages of clades of Agaricomycotina producing a brown rot.

The Gloeophyllales is a recently described order of Agaricomycotina containing a morphologically diverse array of polypores (Gloeophyllum), agarics (Neolentinus, Heliocybe) and resupinate fungi (Veluti-Veluticeps, Boreostereum, Chaetodermella), most of which have been demonstrated to produce a brown-rot mode of wood decay and are found preferentially on coniferous substrates. Multiple phylogenetic studies have included taxa of Gloeophyllales, but none have sampled the order thoroughly, and so far only ribosomal RNA genes have been used. Consequently the limits and higher level placement of the Gloeophyllales are obscure. We obtained sequence data for three protein-coding genes (rpb2, atp6, tef1) and three rRNA regions (nuc-ssu, nuc-lsu, 5.8S) in 19 species of Gloeophyllales representing seven genera and analyzed them together with a diverse set of Agaricomycotina, emphasizing Polyporales. Boreostereum, which is suspected to produce a white rot, is the sister group of the rest of the Gloeophyllales, all of which produce a brown rot. Gloeophyllum contains at least two independent clades, one of which might correspond to the genus Osmoporus. White rot and resupinate fruiting bodies appear to be plesiomorphic in Gloeophyllales. Relaxed molecular clock analyses suggest that the Gloeophyllales arose in the Cretaceous, after the origin of Pinaceae.

IFN-gamma and TNF-alpha regulate human NHE3 gene expression by modulating the Sp family transcription factors in human intestinal epithelial cell line C2BBe1.

Diarrhea associated with inflammatory bowel disease has been attributed to stimulated secretion of proinflammatory cytokines like IFN-gamma and TNF-alpha, which have been shown to downregulate the expression of the sodium-hydrogen exchanger-3 (NHE3) gene. In this study, we have investigated the mechanism of NHE3 gene regulation by IFN-gamma and TNF-alpha in C2BBe1 cells. In response to both IFN-gamma (30 ng/ml) and TNF-alpha (20 ng/ml), the construct containing the bp -95 to +5 region of the human NHE3 promoter, which harbors a number of cis-elements including four potential Sp1 binding sites, showed a maximum repression of 60%. Knockdown of Sp1 and Sp3 expression using small interfering RNA resulted in a significant inhibition of the NHE3 promoter activity and resistance to cytokines effects. These cytokines showed no effects on the expression of Sp1 and Sp3 mRNA and protein levels as assessed by RT-PCR and Western blot analyses, respectively. After treatment with cytokines, the binding of Sp1 and Sp3 proteins to NHE3 promoter decreased significantly, as seen by gel mobility shift assays and chromatin immunoprecipitation assays. The inhibitory effects of both cytokines on the NHE3 promoter were completely blocked by the broad-range kinase inhibitor staurosporine and the selective protein kinase A (PKA) inhibitor 8-bromoadenosine-3',5'-cyclic monophosphorothioate, Rp-isomer. The binding affinity of Sp1 and Sp3 proteins for NHE3 Sp1 probe was significantly decreased after in vitro phosphorylation of nuclear proteins by the alpha-catalytic subunit of PKA. Our data indicate that IFN-gamma and TNF-alpha may repress the NHE3 promoter activity in C2BBe1 cells by PKA-mediated phosphorylation of Sp1 and Sp3 transcription factors.

Transcriptional stimulation of the human NHE3 promoter activity by PMA: PKC independence and involvement of the transcription factor EGR-1.

NHE3 (Na+/H+ exchanger 3) is essential for Na+ absorption in the ileum and is expressed in a cell-specific manner in the apical membrane of the intestinal epithelial cells. In the present study, we report the stimulatory effect of PMA on the hNHE3 (human NHE3) transcription. Pretreatment with actinomycin D or cycloheximide blocked the up-regulation of the NHE3 mRNA by PMA, indicating that the increased level of NHE3 mRNA expression is regulated by transcriptional activation and is dependent on de novo protein synthesis. 5'-Deletion of the promoter region and transfection analysis in C2BBe1 cells revealed that the PMA effect is mediated through a GC-rich DNA region between nt -88 and -69. Gel mobility-shift assays demonstrated that in nuclear extracts from C2BBe1 cells grown under the basal growth conditions, Sp1 (stimulating protein-1) and Sp3 interact with this GC-rich DNA region, while, in PMA-treated nuclear extracts, PMA-induced EGR-1 (early growth response gene product 1) transcription factor binds to the same site. Binding of EGR-1 diminished the Sp1 and Sp3 interactions with this promoter region significantly. Co-transfection of Sp1 or Sp3 into SL2 cells activated the NHE3-reporter constructs, suggesting that Sp1 and Sp3 act as positive regulators of the NHE3 expression. In addition, overexpression of EGR-1 was sufficient to transactivate the NHE3-reporter gene activity, and knockdown of EGR-1 with gene-specific small interfering RNA resulted in inhibition of the PMA-induced up-regulation of the endogenous NHE3 mRNA expression. Furthermore, the PKC (protein kinase C) inhibitor chelerythrine chloride did not affect PMA-induced NHE3 promoter activity, suggesting that PMA stimulation of the hNHE3 gene expression may be PKC-independent.

Correlación entre la caminata Shuttle y el cuestionario de St. George's en pacientes con enfermedad pulmonar crónica / Correlation between the Shuttle test and St George's questionnaire in patients with respiratory diseases

Mejorar la calidad de vida en enfermos con neumopatía es una meta de los programas de rehabilitación pulmonar. El cuestionario de St George's (CSG), ha demostrado confiabilidad en pacientes con limitación al flujo aéreo para medir capacidad funcional y disnea, así como calidad de vida. Para evaluar la tolerancia al ejercicio se utilizaron la caminata de 6 minutos y la caminata incremental Shuttle (CIS), quienes demuestran correlación con el consumo de oxígeno como indicador de la capacidad aeróbica. Objetivo: Evaluar la correlación entre CSG y CIS en enfermedad obstructiva (EPOC) y restrictiva. Material y métodos: Estudio retrospectivo, observacional y transversal. Se revisaron enfermos que ingresaron por primera vez a rehabilitación pulmonar con diagnósticos de EPOC y neumopatía intersticial; se midió espirometría, CSG y CIS. Resultados: Se incluyeron 95 pacientes, 58 con patología restrictiva, 37 con EPOC. Se observó correlación positiva en los de enfermedad intersticial con la distancia caminada y el CSG en los rubros de actividades, impacto y el total del cuestionario. Correlacionó también con la FVC y FEV1 en valores absolutos y porcentajes. En pacientes obstructivos se encontró mayor correlación de la CIS y CSG. Conclusión: El deterioro de la calidad de vida en pacientes con enfermedad intersticial correlacionó bien con la distancia caminada así como con las pruebas de función pulmonar. En pacientes con EPOC el deterioro de la calidad de vida fue independiente del resultado del FVC y FEV1 y CIS.

Improving quality of life, functional capacity and dyspnea in lung diseases is the main goal in pulmonary rehabilitation programs. St George's questionnaire (SGRQ), has demonstrated reliability in patients with air flow limitation. Exercise tolerance is evaluated with the 6 minute walk test and the incremental Shuttle test (1ST); it correlates with oxygen consumption VO2and indicates aerobic capacity. Objective: The goal of this study is to evaluate the correlation between SGRQ and 1ST in COPD and interstitial lung diseases (ILD). Material and methods: Retrospective, observational, transversal study. We reviewed first time admissions into the Pulmonary Rehabilitation Program of patients with COPD and ILD by means of spirometry, SGRQ and 1ST. Results: We included 95 patients, 58 with ILD, and with 37 COPD. We found a positive correlation in ILD (1ST) and the SGRQ in the activity items, impact disease and the total of the questionnaire; also with FVC and FEV^ in absolute values and percentage. In COPD patients we found a better correlation between 1ST and the SGRQ but not with spirometry. Conclusion: Patients with interstitial lung diseases and poor function tests demonstrate a reduced exercise capacity and poor quality of life (QOL). Patients with COPD and poor QOL showed no correlation with the results of lung function tests.

Zinc finger transcription factor Egr-1 is involved in stimulation of NHE2 gene expression by phorbol 12-myristate 13-acetate.

The apical membrane Na(+)/H(+) exchanger isoforms NHE2 and NHE3 are involved in transepithelial Na(+) absorption in the intestine. However, they exhibit differences in their pattern of tissue expression and regulation of their activity by various molecular signals. To study the mechanisms involved in the transcriptional regulation of these genes, we characterized cis-acting elements within the human NHE2 promoter that regulate NHE2 promoter expression in C2BBe1 cells. A small DNA region (-85/+249) was involved in the regulation of basal transcriptional activity of the NHE2 promoter as determined by transient transfection assays. RT-PCR analysis showed that NHE2 mRNA was upregulated in response to phorbol 12-myristate 13-acetate (PMA). Results from actinomycin D-treated cells indicated that the regulation of the NHE2 gene by PMA occurs in part at the transcriptional level. Furthermore, PMA treatment led to a 100% increase in promoter activity through elements located on the -415/+249 DNA fragment. A PMA-induced nuclear factor that bound to the NHE2 promoter was identified as the transcription factor Egr-1. We identified two PMA response elements in the -415/+1 promoter region that bind to Sp1 and Sp3 in untreated nuclear extracts and to Egr-1 in PMA-treated nuclear extracts. In cotransfection experiments, Egr-1 was able to transactivate the NHE2 promoter. Our data indicate that Egr-1 may play a key role in regulated expression of the human NHE2 gene.

Rotavirus in El Salvador: an outbreak, surveillance and estimates of disease burden, 2000-2002.

BACKGROUND: In December 2000, a large outbreak of gastroenteritis occurred in El Salvador that was associated with hospitalizations and deaths among children nationwide. Public concern was raised because the etiology was initially unknown and enteric control measures seemed ineffective. The outbreak was eventually linked to rotavirus, control measures were redirected to improving treatment with oral rehydration and surveillance was initiated to characterize the etiologic agents of gastroenteritis. METHODS: Demographic and clinical data and fecal specimens were collected from a systematic sample of children younger than 5 years old with acute gastroenteritis. Stools were tested for rotavirus, bacteria and parasites. Surveillance results were extrapolated to national data to estimate the national burden of rotavirus disease. RESULTS: Surveillance between May 2001 and April 2002 demonstrated that rotavirus has winter seasonality, was associated with vomiting and dehydration and accounted for an estimated 27% of 12,083 consultations for diarrhea. Children with rotavirus gastroenteritis were younger (median, 9 months) than those with gastroenteritis caused by other agents (median, 13 months for bacteria, 16 months for parasites). Extrapolating to national data, we estimated the risk of a child experiencing a rotavirus-related medical visit, hospitalization and death by the age of 5 years as 1:7, 1:56 and 1:531, respectively. CONCLUSIONS: The outbreak of gastroenteritis among children younger than 5 years of age between December 2000 and February 2001 represented an exaggerated rotavirus season. The surveillance activity after the outbreak suggests that rotavirus is the most common cause of diarrheal disease in El Salvador. Further surveillance could provide a sound basis for improving the response to epidemics of gastroenteritis and could provide data needed to decide whether rotavirus vaccination should be included in the national program for childhood immunizations.

[Impact of mass communication media on an anti-smoking campaign]. / Impacto de los medios de comunicación masiva en una campaña antitabaco.

OBJECTIVE: To assess the impact of the mass media (MM) on smoking cessation process in Mexico. MATERIAL AND METHODS: Between June 1998 and May 1999, the effects of an anti-smoking mass media campaign and alternative strategies were evaluated, by comparing the monthly sales average of all smoking-cessation aid products before and after marketing a new nicotine patch. Student's t paired and unpaired t tests were used to compare sales. RESULTS: Total sales increased from 24,206 +/- 4,558 to 55,604 +/- 8,993 (p < 0.0001). It was estimated that 1,853 smokers tried to quit and 96 per day succeeded with a single product after the campaign. Alternative strategies to get similar results indicate that the programs of a single public sector institution could help 501 persons attempt quitting smoking and six to accomplish it per day. CONCLUSIONS: The mass media have a powerful effect on smoking cessation practices; the involvement of more public institutions may accomplish similar results as the private sector.

[Treatments to quit smoking, available in Mexico]. / Tratamientos para dejar de fumar, disponibles en México.

OBJECTIVE: To describe smoking cessation therapies available in Mexico. MATERIAL AND METHODS: Literature review of meta-analysis, controlled clinical trials, and behavioral therapy studies. RESULTS: Smoking cessation pharmacotherapy interventions showed a good chance of success on average, expressed as the ratio of the active drug vs. placebo cessation therapy outcomes (ratios of 39, 78, 79, 117, and 119%, for nicotine chewing gum, bupropion, nicotine patch, inhaler, and nicotine nasal spray, respectively). Behavioral therapy showed satisfactory results, (OR = 3.8) however, more research is needed to establish its effectiveness. CONCLUSIONS: Emphasis is made on the need to combine behavioral therapy with pharmacotherapy, to increase the likelihood of successful smoking cessation.

Impacto de los medios de comunicación masiva en una campaña antitabaco / x

Objetivo. Determinar en México el impacto de los medios de comunicación masiva (MCM) en el proceso de dejar de fumar. Material y métodos. Evaluamos, entre junio de 1998 y mayo de 1999, el efecto de una campaña en los MCM de México, así como el de estrategias alternas, comparando el promedio mensual de ventas de todos los productos auxiliares para dejar de fumar antes y después del lanzamiento de un Parche Nuevo de nicotina. Se usó t pareada o de Student para comparar las ventas. Resultados. Las ventas totales aumentaron de 24 206±4 558 a 55 604±8 993 (p<0.0001). Estimamos que 1 853 fumadores intentaron dejar de fumar y 96 lo consiguieron diariamente con un solo producto después de la promoción. Estrategias alternas para conseguir resultados similares indican que programas de una institución del sector público podrían conseguir que seis personas dejaran de fumar y 501 lo intentaran diariamente. Conclusiones. Los MCM tienen un efecto poderoso en el proceso para dejar de fumar y la inclusión de más instituciones del sector público podría igualar lo obtenido por el sector privado.

Abstract Objective To assess the impact of the mass media (MM) on smoking cessation process in Mexico. Material and Methods. Between June 1998 and May 1999, the effects of an anti-smoking mass media campaign and alternative strategies were evaluated, by comparing the monthly sales average of all smoking-cessation aid products before and after marketing a new nicotine patch. Student's t paired and unpaired t tests were used to compare sales. Results. Total sales increased from 24 206±4 558 to 55 604±8 993 (p<0.0001). It was estimated that 1 853 smokers tried to quit and 96 per day succeeded with a single product after the campaign. Alternative strategies to get similar results indicate that the programs of a single public sector institution could help 501 persons attempt quitting smoking and six to accomplish it per day. Conclusions. The mass media have a powerful effect on smoking cessation practices; the involvement of more public institutions may accomplish similar results as the private sector.

Tratamientos para dejar de fumar, disponibles en México / x

Objetivo. Describir las estrategias terapéuticas disponibles para ayudar a los fumadores a dejar de fumar. Material y métodos. Estudio realizado en el Instituto Nacional de Enfermedades Respiratorias, México. Se hizo una revisión en Medline con el encabezado de meta-análisis y se consultó el Cochrane Library, de 1990 a 2001. Resultados. La farmacoterapia muestra una buena probabilidad promedio de éxito para dejar de fumar expresada como una relación entre el medicamento activo y el placebo (índice de 39, 78, 79, 117 y 119 por ciento para los chicles de nicotina, los parches de nicotina, el bupropión, el inhalador de nicotina y el spray nasal de nicotina, respectivamente). El éxito de la terapia conductual puede ser buena (RM=3.8), sin embargo, se requiere más investigación. Conclusiones. Se hace énfasis en la necesidad de combinar la terapia cognitivo-conductual con el uso de fármacos, así como la combinación de éstos entre sí para incrementar las posibilidades de éxito para dejar de fumar.

Objective. To describe smoking cessation therapies available in Mexico. Material and Methods. Literature review of meta-analysis, controlled clinical trials, and behavioral therapy studies. Results. Smoking cessation pharmacotherapy interventions showed a good chance of success on average, expressed as the ratio of the active drug vs. placebo cessation therapy outcomes (ratios of 39, 78, 79, 117, and 119 percent, for nicotine chewing gum, bupropion, nicotine patch, inhaler, and nicotine nasal spray, respectively). Behavioral therapy showed satisfactory results, (OR= 3.8) however, more research is needed to establish its effectiveness. Conclusions. Emphasis is made on the need to combine behavioral therapy with pharmacotherapy, to increase the likelihood of successful smoking cessation.

Tratamiento de escleroma respiratorio y rinitis atrófica primaria con factor de transferencia / Respiratory scleroma and atrophic rhinitis treatment with transfer factor

El esceroma respiratorio (ER) y la rintis atrófica primaria (RAP), son enfermedades infecciosas crónicas del tracto respiratorio en cuya etiología se reconoce la intervención de bacterias del género Klebsiella y un estado de inmunodeficiencia que afecta principalmente la inmunidad celular, siendo éste la respuesta más eficaz para el control de infecciones intracelulares de este tipo. Dentro de la gama terapéutica existen más medicamentos inmunosupresores que inmunoestimuladores. Sin embargo, hace aproximadamente 25 años Lawrence describió un extracto dializable de leucocitos (EDL) o factores de transferencia (FT) con la propiedad de elevar selectivamente la respuesta inmanitaria celular. Con base en este antecedente y el previamente conocido de inmunodeficiencia celula, decidió probarse la inmunoterapia a base de EDL combinada con actibióticos. Se estudiaron 30 pacientes 15 con ER y 15 con RAP. a los que se les valoró el estado de su respuesta inmune celular, cuantificando las poblaciones celulares de linfocitos T, y la evolución clínica derivada del tratamiento. Los resultados son alentadores ya que 17 pacientes (56% del total) fuero evaluados como asintomáticos al final del tratamiento, además, en el 100% de los casos se registró involución de las lesiones existentes en la mucosa nasal y faríngeo, lo que se tradujo en la recuperación de los sentidos del gusto y olfato. La evaluación inmunológica confirmó la inmunodepresión celular esperada. Los linfocitos T total estuvieron disminuidos 9% en el ER y 8% en la RAP. Esta disminución fué más significativa en los linfocitos T cooperadores,18% y 15% respectivamente, mientras que en las células T supresoras se registró un incremento de aproximadamente 7% en ambos padecimientos. Al finalizar la terapia los linfocitos T totales se normalizaron por completo, mientras que los cooperadores y supresores experimentaron restablecimientos importantes pero sin alcanzar los valores normales. Suponemos que la desnutrición existente en la población afectada es una de las principales causas de la inmunodepresión, y consecuentemente de los padecimientos aquí descritos, aunque tampoco se descarta una posible predisposición genética asociada. Además del efecto favorable del tratamiento administrado, su bajo costo de obtención y su total inocuidad lo hacen altamente recomendable para aplicarlo a personas pobres en países en vías de desarrollo.

Current immunological concepts in respiratory scleroma: immunological concepts in scleroma

EL escleroma respiratorio es una enfermedad crónica del tracto respiratorio que ocurre en estados de inmunodeficiencia. Cuarenta pacientes fueron estudiados con el interés de conocer más de su etiología, estudiando la inmunodeficiencia a través de las subpoblaciones de linfocitos T, así como las IgA,IgG e IgM, circulantes y el C3; para estudiar la posible predisposición hereditaria se determinaron los antígenos de histocompatibilidad. Los resultados no mostraron anormalidades en las proteínas plasmáticas, encontrándose alteraciones en la inmunidad celular. Las frecuencias en los antígenos de histocompatibilidad no mostraron un desequilibrio para confirmar la suceptibilidad genética, hubo un incremento inesperado de antígenos indeterminados , nosotros sugerimos que esta expresión defectuosa está relacionada con la depresión de la inmunidad celular.