Modulation of CYP2E1 metabolic activity in a cohort of confirmed caffeine ingesting pregnant women with preterm offspring.

BACKGROUND: To ascertain interactions of caffeine ingestion, food, medications, and environmental exposures during preterm human gestation, under informed consent, we studied a cohort of Mexican women with further preterm offspring born at ≤ 34 completed weeks. At birth, blood samples were taken from mothers and umbilical cords to determine caffeine and metabolites concentrations and CYP1A2 (rs762551) and CYP2E1 (rs2031920, rs3813867) polymorphisms involved in caffeine metabolism. RESULTS: In 90 pregnant women who gave birth to 98 preterm neonates, self-informed caffeine ingestion rate was 97%, laboratory confirmed rate was 93 %. Theobromine was the predominant metabolite found. Consumption of acetaminophen correlated significantly with changes in caffeine metabolism (acetaminophen R2 = 0.637, p = 0.01) due to activation of CYP2E1 alternate pathways. The main caffeine source was cola soft drinks. CONCLUSION: Environmental exposures, especially acetaminophen ingestion during human preterm pregnancy, can modulate CYP2E1 metabolic activity.

Diversity of CRISPR loci in Escherichia coli.

CRISPR (clustered regularly interspaced short palindromic repeats) and CAS (CRISPR-associated sequence) proteins are constituents of a novel genetic barrier that limits horizontal gene transfer in prokaryotes by means of an uncharacterized mechanism. The fundamental discovery of small RNAs as the guides of the defence apparatus arose as a result of Escherichia coli studies. However, a survey of the system diversity in this species in order to further contribute to the understanding of the CRISPR mode of action has not yet been performed. Here we describe two CRISPR/CAS systems found in E. coli, following the analysis of 100 strains representative of the species' diversity. Our results substantiate different levels of activity between loci of both CRISPR types, as well as different target preferences and CRISPR relevances for particular groups of strains. Interestingly, the data suggest that the degeneration of one CRISPR/CAS system in E. coli ancestors could have been brought about by self-interference.

Diversity of CRISPR loci in Escherichia coli.

CRISPR (clustered regularly interspaced short palindromic repeats) and CAS (CRISPR-associated sequence) proteins are constituents of a novel genetic barrier that limits horizontal gene transfer in prokaryotes by means of an uncharacterized mechanism. The fundamental discovery of small RNAs as the guides of the defence apparatus arose as a result of Escherichia coli studies. However, a survey of the system diversity in this species in order to further contribute to the understanding of the CRISPR mode of action has not yet been performed. Here we describe two CRISPR/CAS systems found in E. coli, following the analysis of 100 strains representative of the species' diversity. Our results substantiate different levels of activity between loci of both CRISPR types, as well as different target preferences and CRISPR relevances for particular groups of strains. Interestingly, the data suggest that the degeneration of one CRISPR/CAS system in E. coli ancestors could have been brought about by self-interference.

Short motif sequences determine the targets of the prokaryotic CRISPR defence system.

Clustered regularly interspaced short palindromic repeats (CRISPR) and their associated CRISPR-associated sequence (CAS) proteins constitute a novel antiviral defence system that is widespread in prokaryotes. Repeats are separated by spacers, some of them homologous to sequences in mobile genetic elements. Although the whole process involved remains uncharacterized, it is known that new spacers are incorporated into CRISPR loci of the host during a phage challenge, conferring specific resistance against the virus. Moreover, it has been demonstrated that such interference is based on small RNAs carrying a spacer. These RNAs would guide the defence apparatus to foreign molecules carrying sequences that match the spacers. Despite this essential role, the spacer uptake mechanism has not been addressed. A first step forward came from the detection of motifs associated with spacer precursors (proto-spacers) of Streptococcus thermophilus, revealing a specific recognition of donor sequences in this species. Here we show that the conservation of proto-spacer adjacent motifs (PAMs) is a common theme for the most diverse CRISPR systems. The PAM sequence depends on the CRISPR-CAS variant, implying that there is a CRISPR-type-specific (motif-directed) choice of the spacers, which subsequently determines the interference target. PAMs also direct the orientation of spacers in the repeat arrays. Remarkably, observations based on such polarity argue against a recognition of the spacer precursors on transcript RNA molecules as a general rule.

A rock-inhabiting ancestor for mutualistic and pathogen-rich fungal lineages.

Rock surfaces are unique terrestrial habitats in which rapid changes in the intensity of radiation, temperature, water supply and nutrient availability challenge the survival of microbes. A specialised, but diverse group of free-living, melanised fungi are amongst the persistent settlers of bare rocks. Multigene phylogenetic analyses were used to study relationships of ascomycetes from a variety of substrates, with a dataset including a broad sampling of rock dwellers from different geographical locations. Rock-inhabiting fungi appear particularly diverse in the early diverging lineages of the orders Chaetothyriales and Verrucariales. Although these orders share a most recent common ancestor, their lifestyles are strikingly different. Verrucariales are mostly lichen-forming fungi, while Chaetothyriales, by contrast, are best known as opportunistic pathogens of vertebrates (e.g. Cladophialophora bantiana and Exophiala dermatitidis, both agents of fatal brain infections) and saprophytes. The rock-dwelling habit is shown here to be key to the evolution of these two ecologically disparate orders. The most recent common ancestor of Verrucariales and Chaetothyriales is reconstructed as a non-lichenised rock-inhabitant. Ancestral state reconstructions suggest Verrucariales as one of the independent ascomycetes group where lichenisation has evolved on a hostile rock surface that might have favored this shift to a symbiotic lifestyle. Rock-inhabiting fungi are also ancestral to opportunistic pathogens, as they are found in the early diverging lineages of Chaetothyriales. In Chaetothyriales and Verrucariales, specific morphological and physiological traits (here referred to as extremotolerance) evolved in response to stresses in extreme conditions prevailing on rock surfaces. These factors facilitated colonisation of various substrates including the brains of vertebrates by opportunistic fungal pathogens, as well as helped establishment of a stable lichen symbiosis.

Surgical repair of superior vena cava syndrome.

We present the case of a 53-year-old woman with a history of breast cancer, chemotherapy, and a long-term central venous access catheter, who presented with acute, severe superior vena cava syndrome. Angiography showed fibrous obstruction of the superior vena cava with thrombosis of the innominate, both axillary subclavian and internal jugular veins. Surgical repair consisted of thrombectomy of all the involved vessels and patch repair of superior vena cava and innominate vein. The patient had an uneventful recovery and remains asymptomatic 12 months after the procedure.

Late development of aortic pseudoaneurysm after coarctation repair with fistulization to the bronchial tree. A case report.

BACKGROUND: Fistulous communication between the aorta and the tracheobronchial tree is an uncommon and serious cause of hemoptysis secondary to complications of a previous operation performed on the aorta. In cases in which an appropriate surgical intervention is carried out, the survival rate approaches 76%. This surgery is considered one of the most risky operations on the aorta, challenging the surgeon's ability to resolve the problem. METHODS: We present the case report of a 43-year-old female with massive hemoptysis. Her medical history disclosed repair of coarctation of the aorta (15 years before). She underwent emergency left thoracotomy; surgical exploration revealed a false aneurysm from the previous aortic patch repair which communicated to a subsegmental bronchus of the left upper lobe. RESULTS: The thoracic aorta was isolated and clamped, and the previous patch was removed. The bronchial side of the fistula was managed with left superior lobectomy and the aorta was repaired with the placement of a coated woven dacron graft onto healthy aortic tissue. CONCLUSIONS: The patient had an uneventful recovery and remains asymptomatic six months after discharge.

The aberrant cell walls of boron-deficient bean root nodules have no covalently bound hydroxyproline-/proline-rich proteins.

B-deficient bean (Phaseolus vulgaris L.) nodules examined by light microscopy showed dramatic anatomical changes, mainly in the parenchyma region. Western analysis of total nodule extracts examined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that one 116-kD polypeptide was recognized by antibodies raised against hydroxyproline-rich glycoproteins (HRGPs) from the soybean (Glycine max) seed coat. A protein with a comparable molecular mass of 116 kD was purified from the cell walls of soybean root nodules. The amino acid composition of this protein is similar to the early nodulin (ENOD2) gene. Immunoprecipitation of the soybean ENOD2 in vitro translation product showed that the soybean seed coat anti-HRGP antibodies recognized this early nodulin. Furthermore, we used these antibodies to localize the ENOD2 homolog in bean nodules. Immunocytochemistry revealed that in B-deficient nodules ENOD2 was absent in the walls of the nodule parenchyma. The absence of ENOD2 in B-deficient nodules was corroborated by performing hydroxyproline assays. Northern analysis showed that ENOD2 mRNA is present in B-deficient nodules; therefore, the accumulation of ENOD2 is not affected by B deficiency, but its assembly into the cell wall is. B-deficient nodules fix much less N2 than control nodules, probably because the nodule parenchyma is no longer an effective O2 barrier.

Soporte hepático extracorpóreo / Extracorporeal hepatic support

La sobrevida por insuficiencia hepática fulminante, es menor al 50/100, siendo el edema cerebral la principal causa de muerte. El transplante de hígado ortotópico es el único método de tratamiento con que se dispone actualmente de manera rutinaria con una sobrevida de hasta 70/100, sin embargo, muchos pacientes mueren antes de poder ser transplantados y otros mueren después del transplante tardío, debido a daño cerebral irreversible, por lo tanto, entendemos que existe la necesidad de utilizar algún método de soporte hepático en el período de espera del transplante. Existen para resolver este problema: la siembra de hepatocitos en reservorios hemáticos, la utilización de hígados cadavéricos a los que se les recircula la sangre del paciente, puentes circulatorios, hemadsorción, hemodiálidis, intercambio plasmático, lavado total orgánico, enzimas microsomales unidas a transportadores artificiales, así como otras técnicas actualmente en desarrollo. El presente artículo tiene la finalidad de exponer la perfusión hepática extracorpórea, como una alternativa más, ya que en los últimos años ha adquirido dimensiones clínicas importante; la técnica permite la recirculación a través de un hígado de donación cadavérica, logrando transitoriamente ladestoxificación del paciente. Mencionamos el uso creciente de hígados de otras especies, por la gran disponibilidad de órganos que esto implica. El soporte hepático bio-artificial, utiliza la separación plasmática y perfusión, a través de un filtro de carbón y un módulo de fibra hueco, con una matriz de hepatocitos porcinos. Los últimos informes indican que el mejor método de soporte hepático, es la combinación de varias técnicas como en el SISTEMA DE SOPORTE HEPATICO ARTIFICIAL EXTRACORPOREO HIBRIDO, en el cual se utiliza la separación plasmática y la perfusión secuencial de alto rendimiento, a través de una columna con cubierta de celulosa activada, así como partículas de carbón a través de un módulo de fibra hueca que tiene una matriz con hepatocitos xenogénicos

Ultrasound: advantages, disadvantages, and controversies.

Ultrasound (US) is a safe, noninvasive, diagnostic tool with widespread applications in health care. In ambulatory care, especially in obstetrics and gynecology, NPs are often the providers designated to perform US studies. This raises questions about informed consent, standards of care, and training and qualifications of those performing US studies. This article addresses these questions as they apply to NP practice, and it discusses the advantages and disadvantages of ultrasound in a variety of diagnostic situations.

La salud pública en México 1959-1982 / Public health in Mexico 1959-1982

El presente libro constituye un análisis, por una parte, de la evolución histórica de las condiciones de salud, las instituciones públicas de salud y asistencia social, la infraestructura y de los servicios de salud, las acciones realizadas y de la legislación en el campo de la salud pública en México, desde 1917 a 1982; mientras que por la otra, se hace un análisis exhaustivo de la evolución organicoadministrativa de la Secretaría de Salud, su infraestructura de servicios y juridicosanitaria, así como de las acciones de prevención, atención y educación en salud realizadas, durante el mismo lapso. El análisis proporcionado en el libro comprende los siguientes apartados: CAPITULO I. Proemio. 1) Evolución de las condiciones de la salud pública en México. 2) Indicadores de las condiciones de salud en el país. CAPITULO II. 1) Introducción. 2) Principio de la organización sanitaria nacional en 1917. CAPITULO III. 1) Tendencias de la salud pública en México durante el lapso 1959-1964. 2) Actividades de la Secretaría de Salubridad y Asistencia. 3) Instituto Nacional de Protección a la Infancia. 4) Instituto Mexicano del Seguro Social. 5) Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado 1959-1964. 6) Ley de Seguridad Social de las Fuerzas Armadas, 1962. 7) Salubridad general en los informes presidenciales 1959-1964. CAPITULO IV. 1) Objetivo, filosofía y política de la salud pública en México, 1965-1970. 2) Actividades de la Secretaría de Salubridad y Asistencia. 3) Funcionarios de la Secretaría de Salubridad y Asistencia, 1964-1970. 4) Instituto Nacional de Protección a la Infancia, 1965-1970. 5) Disposiciones legislativas, 1970. 6) Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, 1965-1970. 7) Instituto Mexicano del Seguro Social, 1965-1970. 8) La salud en los informes presidenciales. CAPITULO V. 1) Política sanitaria asistencial, 1971-1976. 2) Las condiciones de salud en México entre 1970-1975. 3) Organización y actividades de la Secretaría de Salubridad y Asistencia. 4) Disposiciones legales relacionadas con la Secretaría de Salubridad y Asistencia, expedidas de 1970 a febrero 1976. 5) Institución mexicana de asistencia a la niñez, 1971-1976. 6) Actividades del Instituto Mexicano del Seguro Social. 7) Actividades del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado. 8) La salubridad en los informes presidenciales, 1971-1976. CAPITULO VI. 1) Política sanitaria asistencial, 1976-1982. 2) Plan de gobierno en salud, nutrición y seguridad social. 3) La condición de la salud en México, 1976-1982. 4) Organización y actividades de la Secretaría de salubridad y Asistencia. 5) Evaluación de la Secretaría de Salubridad y Asistencia, 1977-1981. 6) Disposiciones legislativas. 7) Funcionarios de La Secretaría de Salubridad y Asistencia, 1976-1982. 8) Actividades del Instituto Mexicano del Seguro Social relacionadas con la salud pública, 1976-1982. 9) Actividades del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, 1976-1982. 10) Sistema Nacional para el Desarrollo Integral de la Familia (DIF). CAPITULO VII. La salud pública en los Estados. 1) Introducción. 2) Aguascalientes. 3) Baja California Norte. 4) Baja California Sur. 5) Coahuila. 6) Colima. 7) Campeche. 8) Chiapas. 9) Chihuahua. 10) Durango. 11) Estado de México. 12) Guanajuato. 13) Guerrero. 14) Hidalgo. 15) Jalisco. 16) Michoacán. 17) Morelos. 18) Nayarit. 19) Nuevo León. 20) Oaxaca. 21) Puebla. 22) Querétaro. 23) Quintana Roo. 24) San Luis Potosí. 25) Sinaloa. 26) Sonora. 27) Tabasco. 28) Tamaulipas. 29) Tlaxcala. 30) Veracruz. 31) Yucatán. 32) Zacatecas. 33) Jefes de servicios coordinados de salud pública en los Estados durante el período 1956-1981. CAPITULO VIII. Principales estadísticas vitales de los Estados Unidos Mexicanos, 1959-1980. 1) Introducción. 2) Cuadros estadísticos. 3) Gráficas

La salud publica en Mexico 1959-1982 / Public health in Mexico 1959-1982

Habla de la historia de la salud publica en Mexico, hacendo un alto en el camino y tratando de entender como se realizaba la relacion hombre-hombre entre los antepasados, comprender sus avances y asimilar sus frustraciones, como unico camino para superar deficiencias. Retoma el esfuerzo de los antecesores en el campo de la salud publica, quienes legaron la Historia de la Salubridad y de la Asistencia en Mexico.(AU)

eltrabajo que a continuación se presenta retoma el esfuerzo de nuestros antecesores en el campo de la salud pública, quienes nos legaron la historia de la Salubridad y de la Asistencia en México, la cual nos permite comprender la filosofia que de la vida tenían las culturas prehispánicas; los acontecimientos patológicos y prácticas médicas desarrolladas a partir del amalgamamiento de las culturas americana e hispánica; las vivencias de quienes actuaron en los momentos de efervescencia social en el país, como fueron la Guerra de Independencia y la Revolución Mexicana, hasta llegar a los momentos en que se consolida nuestra estructura política y nacen las instituciones que, hoy en día, encauzan a México hacia una sociedad más justa.(AU)