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To study (16S rRNA-sequencing) the impact of gestational and corrected ages on the microbiota profile of human milk (HM) of mothers that delivered full-term and pre-term children, HM samples were obtained and classified according to the gestational age as group T (full-term births ≥37 weeks), and group P (pre-term births <37 weeks). Group P was longitudinally followed, and the samples were collected at the full-term corrected gestational age: when the chronological age plus the gestational age were ≥37 weeks (PT group). The HM microbiota composition differed depending on the gestational age (T vs. P). Group T had lower levels of Staphylococcus and higher levels of Rothia and Streptococcus, as compared to group P. The alpha Simpson diversity value was higher in group T than in P, whereas no differences were found between groups T and PT, suggesting a microbial evolution of the composition of group P towards group T over chronological age. Full-term delivery was associated with a greater diversity of microbes in HM. The microbial composition of pre-term HM, at the corrected age, did not show significant differences, as compared to the samples obtained from the full-term group, suggesting that it would be appropriate to consider the corrected age in terms of the composition and the diversity of the milk in future studies.
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The human microbiome is an integral component of the human body and a co-determinant of several health conditions1,2. However, the extent to which interpersonal relations shape the individual genetic makeup of the microbiome and its transmission within and across populations remains largely unknown3,4. Here, capitalizing on more than 9,700 human metagenomes and computational strain-level profiling, we detected extensive bacterial strain sharing across individuals (more than 10 million instances) with distinct mother-to-infant, intra-household and intra-population transmission patterns. Mother-to-infant gut microbiome transmission was considerable and stable during infancy (around 50% of the same strains among shared species (strain-sharing rate)) and remained detectable at older ages. By contrast, the transmission of the oral microbiome occurred largely horizontally and was enhanced by the duration of cohabitation. There was substantial strain sharing among cohabiting individuals, with 12% and 32% median strain-sharing rates for the gut and oral microbiomes, and time since cohabitation affected strain sharing more than age or genetics did. Bacterial strain sharing additionally recapitulated host population structures better than species-level profiles did. Finally, distinct taxa appeared as efficient spreaders across transmission modes and were associated with different predicted bacterial phenotypes linked with out-of-host survival capabilities. The extent of microorganism transmission that we describe underscores its relevance in human microbiome studies5, especially those on non-infectious, microbiome-associated diseases.
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Bacterias , Transmisión de Enfermedad Infecciosa , Microbioma Gastrointestinal , Ambiente en el Hogar , Microbiota , Boca , Femenino , Humanos , Lactante , Bacterias/clasificación , Bacterias/genética , Bacterias/aislamiento & purificación , Microbioma Gastrointestinal/genética , Metagenoma , Microbiota/genética , Madres , Boca/microbiología , Transmisión Vertical de Enfermedad Infecciosa , Composición Familiar , Envejecimiento , Factores de Tiempo , Viabilidad MicrobianaRESUMEN
BACKGROUND: Four commercial starter cultures containing Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus (S1, S2, S3 and S4; S3 also contained Limosilactobacillus fermentum) were compared for fermentation, volatile flavor compounds, physicochemical parameters and microbiology, in yogurt prepared from three milk base formulations with increased protein (B1, B2 and B3). RESULTS: The fermentation patterns differed among starters, with Yoflex Mild 1.0 (S4) and SLB95 (S2) showing the longest fermentation time, depending on the formulation. At 21 days, S. thermophilus counts were similar among starters and higher than 8.52 log CFU mL-1 , for all yogurts. The highest counts (6.86 log CFU mL-1 ) for L. delbrueckii subsp. bulgaricus was found for S2 yogurts made from whey protein hydrolysate (B3). Minor water-holding capacity was detected for YF-L811 (S1) yogurts. Yoflex Harmony 1.0 (S3) starter containing Lim. fermentum produced a distinctive volatile profile characterized by aldehydes with respect to yogurts prepared with S1, S2 and S4, which were characterized by ketones. CONCLUSION: Results indicate the usefulness of carrying out studies similar to the present one to select the most appropriate process conditions depending on the desired product. © 2022 Society of Chemical Industry.
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Lactobacillus delbrueckii , Limosilactobacillus fermentum , Yogur , Fermentación , Streptococcus thermophilusRESUMEN
AIMS: To characterize the fermentation process and bacterial diversity of sorghum silage inoculated with Lactiplantibacillus plantarum LpAv, Pediococcus pentosaceus PpM and Lacticaseibacillus paracasei LcAv. METHODS AND RESULTS: Chopped sorghum was ensiled using the selected strains. Physicochemical parameters (Ammonia Nitrogen/Total Nitrogen, Dry Matter, Crude Protein, Acid Detergent Fibre, Neutral Detergent Fibre, Acid Detergent Lignin, Ether Extract and Ashes), bacterial counts, cell cytometry and 16sRNA sequencing were performed to characterize the ensiling process and an animal trial (BALB/c mice) was conducted in order to preliminary explore the potential of sorghum silage to promote animal gut health. After 30 days of ensiling, the genus Lactobacillus comprised 68.4 ± 2.3% and 73.5 ± 1.8% of relative abundance, in control and inoculated silages respectively. Richness (Chao1 index) in inoculated samples, but not in control silages, diminished along ensiling, suggesting the domination of fermentation by the inoculated LAB. A trend in conferring enhanced protection against Salmonella infection was observed in the mouse model used to explore the potential to promote gut health of sorghum silage. CONCLUSIONS: The LAB strains used in this study were able to dominate sorghum fermentation. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first report using metaprofiling of 16sRNA to characterize sorghum silage, showing a microbiological insight where resident and inoculated LAB strains overwhelmed the epiphytic microbiota, inhibiting potential pathogens of the genus Klebsiella.
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Lactobacillales , Sorghum , Amoníaco/metabolismo , Animales , Bacterias/genética , Bacterias/metabolismo , Detergentes , Grano Comestible/metabolismo , Éteres , Fermentación , Lactobacillales/genética , Lactobacillales/metabolismo , Lignina/metabolismo , Ratones , Nitrógeno/metabolismo , Extractos Vegetales , Ensilaje/microbiología , Sorghum/microbiologíaRESUMEN
Domesticated horses live under different conditions compared with their extinct wild ancestors. While housed, medicated and kept on a restricted source of feed, the microbiota of domesticated horses is hypothesized to be altered. We assessed the fecal microbiome of 57 domestic and feral horses from different locations on three continents, observing geographical differences. A higher abundance of eukaryota (p < 0.05) and viruses (p < 0.05) and lower of archaea (p < 0.05) were found in feral animals when compared with domestic ones. The abundance of genes coding for microbe-produced enzymes involved in the metabolism of carbohydrates was significantly higher (p < 0.05) in feral animals regardless of the geographic origin. Differences in the fecal resistomes between both groups of animals were also noted. The domestic/captive horse microbiomes were enriched in genes conferring resistance to tetracycline, likely reflecting the use of this antibiotic in the management of these animals. Our data showed an impoverishment of the fecal microbiome in domestic horses with diet, antibiotic exposure and hygiene being likely drivers. The results offer a view of the intestinal microbiome of horses and the impact of domestication or captivity, which may uncover novel targets for modulating the microbiome of horses to enhance animal health and well-being.
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Microbioma Gastrointestinal , Microbiota , Animales , Animales Salvajes , Domesticación , Heces , Microbioma Gastrointestinal/genética , CaballosRESUMEN
RESUMEN El deterioro microbiológico de alimentos conduce a productos no aptos para consumo, y su descarte, a importantes pérdidas económicas para la industria alimenticia. Durante su almacenamiento, los alimentos frescos representan nichos atractivos para la supervivencia y el crecimiento de microorganismos indeseables. En productos lácteos, la presencia de alterantes o patógenos bacterianos está mejor documentada que la de mohos y levaduras. Estos productos son menos proclives al deterioro por mohos que otros, como frutas y verduras, debido a su almacenamiento refrigerado, su elaboración a partir de leche tratada térmicamente y, para fermentados, a la microbiota dominante, que acidifica el medio. Sin embargo, incluso quesos y yogures pueden sufrir deterioro por mohos. Este trabajo presenta casos atípicos de muestras de yogur con desarrollo de mohos gasógenos y bacterias del géneroGluconobactercomo microorganismos alterantes no reportados previamente como tales en leches fermentadas argentinas. Los organismos alterantes «clásicos¼ de yogur fueron siempre levaduras y, en otros países, mohos del géneroAspergillus.
ABSTRACT Microbial food alterations lead to unfit products for consumption, and their discarding, to significant economic losses for the food industry. During storage, fresh foods offer available niches for the survival and growth of undesirable microorganisms. In dairy products, data regarding spoilage and/or pathogenic bacteria is better documented than those for molds and yeasts. Dairy products are less susceptible to mold's contamination than products such as fruits and vegetables, due to their refrigerated storage; their elaboration from heat-treated milk and, for fermented ones, the dominant microbiota that acidifies the medium. However, even cheeses and yogurts may be susceptible to mold contamination. Atypical cases of yogurt samples containing spoilage microorganisms not previously reported (molds producing gas and bacteria of the genusGluconobacter) in Argentinean fermented milks are presented here. For yogurt, in particular, the "classic" altering organisms were always being yeasts, and in other countries, molds belonging to the genusAspergillus.
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Yogur , Gluconobacter , Bacterias , Levaduras , Yogur/análisis , Microbiología de Alimentos , HongosRESUMEN
Elderly people are an important part of the global population who suffer from the natural processes of senescence, which lead to changes in the gut microbiota composition. These modifications have a great impact on their quality of life, bringing a general putrefactive and inflammatory status as a consequence. Some of the most frequent conditions related to this status are constipation, undernutrition, neurodegenerative diseases, susceptibility to opportunistic pathogens, and metabolic disbalance, among others. For these reasons, there is an increasing interest in improving their quality of life by non-invasive treatments such as the consumption of probiotics, prebiotics, and synbiotics. The aim of the present mini-review is to describe the benefits of these functional supplements/food according to the most recent clinical and pre-clinical studies published during the last decade. In addition, insights into several aspects we consider relevant to improve the quality of future studies are provided.
RESUMEN
Microbial food alterations lead to unfit products for consumption, and their discarding, to significant economic losses for the food industry. During storage, fresh foods offer available niches for the survival and growth of undesirable microorganisms. In dairy products, data regarding spoilage and/or pathogenic bacteria is better documented than those for molds and yeasts. Dairy products are less susceptible to mold's contamination than products such as fruits and vegetables, due to their refrigerated storage; their elaboration from heat-treated milk and, for fermented ones, the dominant microbiota that acidifies the medium. However, even cheeses and yogurts may be susceptible to mold contamination. Atypical cases of yogurt samples containing spoilage microorganisms not previously reported (molds producing gas and bacteria of the genus Gluconobacter) in Argentinean fermented milks are presented here. For yogurt, in particular, the "classic" altering organisms were always being yeasts, and in other countries, molds belonging to the genus Aspergillus.
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Gluconobacter , Yogur , Bacterias , Microbiología de Alimentos , Hongos , Levaduras , Yogur/análisisRESUMEN
As for hypertension, chronic pain, epilepsy and other disorders with particular symptoms, a commonly accepted and unambiguous definition provides a common ground for researchers and clinicians to study and treat the problem. The WHO's ICD11 definition only mentions tinnitus as a nonspecific symptom of a hearing disorder, but not as a clinical entity in its own right, and the American Psychiatric Association's DSM-V doesn't mention tinnitus at all. Here we propose that the tinnitus without and with associated suffering should be differentiated by distinct terms: "Tinnitus" for the former and "Tinnitus Disorder" for the latter. The proposed definition then becomes "Tinnitus is the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source, which becomes Tinnitus Disorder "when associated with emotional distress, cognitive dysfunction, and/or autonomic arousal, leading to behavioural changes and functional disability.". In other words "Tinnitus" describes the auditory or sensory component, whereas "Tinnitus Disorder" reflects the auditory component and the associated suffering. Whereas acute tinnitus may be a symptom secondary to a trauma or disease, chronic tinnitus may be considered a primary disorder in its own right. If adopted, this will advance the recognition of tinnitus disorder as a primary health condition in its own right. The capacity to measure the incidence, prevalence, and impact will help in identification of human, financial, and educational needs required to address acute tinnitus as a symptom but chronic tinnitus as a disorder.
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Acúfeno , Nivel de Alerta , Estado de Conciencia , Humanos , Acúfeno/complicacionesRESUMEN
We aimed at isolating lactic acid bacteria (LAB) from different plant materials to study their crossed-fermentation capacity in silos and to find strains able to confer enhanced aerobic stability to silage. A total of 129 LAB isolates were obtained from lucerne (alfalfa), maize, sorghum, ryegrass, rice, barley, canola, Gatton panic, Melilotus albus, soy, white clover, wheat, sunflower, oat, and moha. Four Lactiplantibacillus plantarum subsp. plantarum strains (isolated from oat, lucerne, sorghum, or maize) were selected for their growth capacity. Identity (16S sequencing) and diversity (RAPD-PCR) were confirmed. Fermentative capacity (inoculated at 104, 105, 106, 107 CFU/g) was studied in maize silage and their cross-fermentation capacity was assessed in oat, lucerne, sorghum, and maize. Heterofermentative strains with the highest acetic acid production capacity conferred higher aerobic stability to maize silages. Regardless the source of isolation, L. plantarum strains, inoculated at a rate of 106 CFU/g, were effective to produce silage from different plant materials. From more than 100 isolates obtained, the application of a succession of experiments allowed us to narrow down the number of potential candidates of silage inoculants to two strains. Based on the studies made, L. plantarum LpM15 and Limosilactobacillus fermentum LfM1 showed potential to be used as inoculants, however further studies are needed to determine their performance when inoculated together. The former because it positively influenced different quality parameters in oat, lucerne, sorghum, and maize silage, and the latter because of its capacity to confer enhanced aerobic stability to maize silage. The rest of the strains constitute a valuable collection of autochthonous strains that will be further studied in the future for new applications in animal or human foods.
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Exopolysaccharides (EPS) production is a characteristic that has been widely described for many lactic acid bacteria (LAB) of different genera and species, but little is known about the relationship between the functional properties of the producing bacteria and EPS synthesis. Although many studies were addressed towards the application of EPS-producing LAB in the manufacture of several dairy products (fermented milk, cheese) due to their interesting technological properties (increased hardness, water holding capacity, viscosity, etc.), there are not many reports about the functional properties of the EPS extract itself, especially for the genus Lactobacillus. The aim of the present revision is to focus on the species Lactobacillus fermentum with reported functional properties, with particular emphasis on those strains capable of producing EPS, and try to establish if there is any linkage between this property and their functional/probiotic roles, considering the most recent bibliography.
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Productos Lácteos Cultivados/microbiología , Microbiología de Alimentos , Limosilactobacillus fermentum/fisiología , Polisacáridos Bacterianos/biosíntesis , Animales , Antibiosis , Bacterias/patogenicidad , Fenómenos Fisiológicos Bacterianos , Fermentación , Factores Inmunológicos , Limosilactobacillus fermentum/química , Probióticos/metabolismoRESUMEN
Under optimized conditions, the lactic acid bacterium Lactobacillus fermentum Lf2 secretes up to 2 gL-1 of a mixture of polysaccharides into the fermentation medium when grown on sucrose. Earlier studies had shown that the mixture is biologically active and work was undertaken to characterise the polysaccharides. Preparative size exclusion chromatography was used to separate a high molecular mass ß-glucan (weight average mass of 1.23 × 106 gmol-1) from two medium molecular mass polysaccharides (weight average mass of 8.8 × 104 gmol-1). Under optimized growth conditions, the medium molecular mass polysaccharides accounted for more than 75% of the mixture by weight. Monomer, linkage analysis and NMR spectroscopy of the medium molecular mass polysaccharides, and material isolated after their Smith degradation, was used to identify the structure of the component polysaccharides. The mixture contains two novel polysaccharides. The first has a main chain of ß-1,6-linked galactofuranoses which is non-stoichiometrically 2-O-glucosylated. The degree of substitution at the 2-position, with α-D-Glcp, depends on the fermentation conditions; under optimized conditions greater than 80% 2-O-α-D-glucosylation was observed. The second polysaccharide is a heteroglycan with four monosaccharides in the repeat unit: residual signals in the NMR suggest that the sample also contains trace amounts (<3%) of cell wall polysaccharides.
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Limosilactobacillus fermentum/crecimiento & desarrollo , Polisacáridos Bacterianos/química , beta-Glucanos/química , Secuencia de Carbohidratos , Fermentación , Limosilactobacillus fermentum/química , Peso MolecularRESUMEN
When grown in a semi-defined medium, L. fermentum Lf2 synthesizes significant quantities (â¼2â¯g/L) of two exopolysaccharides (EPS). The two EPS were separated by preparative size exclusion chromatography to give a high molecular mass ß-glucan (1.23â¯×â¯106â¯Da) and a medium molecular mass heteroglycan (8.8â¯×â¯104â¯Da). The structure of the high molecular mass ß-glucan was determined using a combination of NMR spectroscopy, monomer and linkage analysis. The EPS has the following structure: The immunomodulatory activity of the high molecular mass EPS was studied in peripheral blood mononuclear cells (PBMC). Exposure of PBMC to an aqueous solution of the EPS for 24â¯h led to increased cell proliferation, changes in expression of the cytokines CD14 and TLR2, and to an increase in production of TNF-α compared to controls. In contrast, when cells that had been treated with EPS for 24â¯h and from which the EPS had been removed, were subsequently exposed to the bacterial antigen LPS very low levels of TNF-α production were observed. This result indicates that the EPS imparts immunotolerance in PBMC. An ability to modulate the release of the proinflammatory mediators, such as TNF-α, is an important goal in the development of therapies for the treatment of diseases, such as Crohn's disease and ulcerative colitis, associated with excessive release of inflammatory mediators.
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Factores Inmunológicos/química , Factores Inmunológicos/farmacología , Limosilactobacillus fermentum/química , beta-Glucanos/química , beta-Glucanos/farmacología , Humanos , Factores Inmunológicos/aislamiento & purificación , Leucocitos Mononucleares/efectos de los fármacos , Leucocitos Mononucleares/inmunología , Leucocitos Mononucleares/metabolismo , Receptores de Lipopolisacáridos/metabolismo , Receptor Toll-Like 2/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , beta-Glucanos/aislamiento & purificaciónRESUMEN
We aimed at isolating and characterising microorganisms present in human breast milk with probiotic potential. In an 8-week postpartum sampling period, two strains of bifidobacteria (Bifidobacterium longum LM7a and Bifidobacterium dentium LM8a') and four strains of lactobacilli were isolated, all during the first 4-week postpartum. B. longum LM7a and B. dentium LM8a', together with four strains previously isolated from breast milk (Bifidobacterium lactis INL1, INL2, INL4 and INL5), were considered for further studies. Susceptibility of the strains to tetracycline, erythromycin, clindamycin, streptomycin, vancomycin and chloramphenicol was evaluated and the isolates exhibited, in general, the same properties as previously reported for bifidobacteria. All isolates showed low hydrophobicity and B. lactis and B. longum strains had satisfactory resistance to gastric digestion and bile shock, but not to pancreatin. B. lactis INL1, B. longum LM7a and B. dentium LM8a' were selected for some comparative technological studies. In particular, B. lactis INL1 displayed technological potential, with satisfactory growth in cheese whey-based media in biofermentor and resistance to freeze-drying, accelerated storage conditions and simulated gastric digestion.
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Bifidobacterium/aislamiento & purificación , Medios de Cultivo/química , Lactobacillus/aislamiento & purificación , Leche Humana/microbiología , Probióticos/efectos adversos , Probióticos/aislamiento & purificación , Suero Lácteo/metabolismo , Antibacterianos/farmacología , Bifidobacterium/efectos de los fármacos , Bifidobacterium/crecimiento & desarrollo , Bifidobacterium/metabolismo , Ácidos y Sales Biliares/toxicidad , Femenino , Ácido Gástrico/metabolismo , Humanos , Lactobacillus/efectos de los fármacos , Lactobacillus/crecimiento & desarrollo , Lactobacillus/metabolismo , Pruebas de Sensibilidad Microbiana , Viabilidad Microbiana/efectos de los fármacos , Pancreatina/toxicidadRESUMEN
Vertigo is defined as an abnormal sensation of body motion or of its surrounding objects. It is a common chief complaint in emergency departments comprising 2 to 3% of these consultations worldwide. Vertigo is classified as peripheral or central, according to its origin, and can also be occasionally mixed, the most common cause of peripheral involvement being benign paroxysmal positional vertigo. The initial findings on clinical evaluation of patients are the clues for making a correct diagnosis. The differentiation between central and peripheral vertigo can be optimized by analysing nystagmus, by using the skew test and the head impulse test (HINTS), as also by performing the appropriate tests to evaluate the integrity of the vestibular-cerebellar pathway. In addition, tonal threshold audiometry could raise the diagnostic sensibility from 71 to 89% on initial approach. Appropriate diagnosis is the principal key for managing this clinical condition.
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Vértigo/diagnóstico , Vértigo/fisiopatología , Vértigo Posicional Paroxístico Benigno/diagnóstico , Vértigo Posicional Paroxístico Benigno/fisiopatología , Vértigo Posicional Paroxístico Benigno/terapia , Mareo/diagnóstico , Mareo/fisiopatología , Mareo/terapia , Humanos , Enfermedad de Meniere/diagnóstico , Enfermedad de Meniere/fisiopatología , Enfermedad de Meniere/terapia , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/fisiopatología , Trastornos Migrañosos/terapia , Nistagmo Patológico/diagnóstico , Nistagmo Patológico/fisiopatología , Nistagmo Patológico/terapia , Vértigo/terapia , Neuronitis Vestibular/diagnóstico , Neuronitis Vestibular/fisiopatología , Neuronitis Vestibular/terapiaRESUMEN
The aim of this study was to isolate, identify and characterize lactic acid bacteria (LAB) from spontaneously fermented maize silage, and evaluate their performance as spray-dried (SD) cultures to enhance the fermentation and the aerobic stability of maize micro-silos. Eleven strains of LAB were characterized for growth kinetics, the capability to grow in vegetable-based medium (VBM), production of organic acids and the ability to tolerate heat-stress. Three strains (Lactobacillus plantarum Ls71, Pediococcus acidilactici Ls72, and Lactobacillus buchneri Ls141) were selected and further characterized for the ability to grow as single strain or in co-culture in MRS and VMB medium, to survive at freeze and spray-drying process, for their performance as SD bacteria in micro-silos and for the aerobic stability in bucket silos. L. buchneri Ls141 showed the highest growth capability in VBM and produced the highest amount of acetic acid, while L. plantarum Ls71 produced the highest amounts of lactic acid. P. acidilactici Ls72 was the most heat-resistant strain, with a reduction of 0.2 log10 CFU/mL (15 min at 55°C). The three strains satisfactorily tolerated both spray and freeze-drying. After 4 days of fermentation, all the samples reached a pH value of about 3.7-3.8. A significantly lower cell load of filamentous fungi and yeasts (< 3 log10 CFU/g) and a higher concentration of total LAB (> 8.7 log10 CFU/g) was observed after 30 days of fermentation. A greater amount of acetic acid, crude protein, ash and ammonia nitrogen/total nitrogen was detected in inoculated silages. A significant reduction of filamentous fungi and yeasts was also observed in inoculated bucket silos after 50 d of fermentation. The aerobic stability was significantly improved in inoculated silage since the temperature remained stable after 16 days (384 h). On the contrary, an increase of 5°C was observed in control samples after 1 day. The selected strains have the potential to be produced as SD silage inoculant as they were able to accelerate the fermentation process, to control filamentous fungi and yeasts, to improve some nutritional and chemical parameters of silage and to improve aerobic stability.
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Lactobacillus fermentum Lf2, an Argentine cheese isolate, can produce high concentrations of exopolysaccharides (EPS). These EPS were shown to improve the texture and rheology of yogurt, as well as to play a protective role in mice exposed to Salmonella enterica serovar Typhimurium. Three gene clusters potentially involved in EPS production were identified in different locations of the L. fermentum Lf2 genome.
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El vértigo es definido como la sensación de movimiento ilusorio del cuerpo o de los objetos que le rodean. Es una de las causas más comunes de consulta en los departamentos de emergencia, y 2 a 3% de la población mundial consulta anualmente por este síntoma. De acuerdo al compromiso vestibular en el oído interno o en el sistema nervioso central o ambos, puede clasificarse en vértigo periférico, central o de origen mixto, siendo la principal causa del periférico el vértigo posicional paroxístico benigno. La valoración semiológica y anamnesis es fundamental para el diagnóstico. En el examen físico inicial, la diferenciación de un vértigo de origen central de otro de origen periférico, puede realizarse mediante el análisis del nistagmo, la valoración del impulso cefálico y la desviación ocular, que se integran en un sistema denominado HINTS, por sus siglas en inglés (Head Impulse, Nystamus type, Test of Skew), y por la realización de pruebas que evalúen también la vía vestíbulo-cerebelosa. Además, la realización de una audiometría tonal, aumentaría la sensibilidad diagnóstica de 71 a 89% en la evaluación inicial. El diagnóstico apropiado es la base para el tratamiento y control de esta condición clínica en el mediano y largo plazo.
Vertigo is defined as an abnormal sensation of body motion or of its surrounding objects. It is a common chief complaint in emergency departments comprising 2 to 3% of these consultations worldwide. Vertigo is classified as peripheral or central, according to its origin, and can also be occasionally mixed, the most common cause of peripheral involvement being benign paroxysmal positional vertigo. The initial findings on clinical evaluation of patients are the clues for making a correct diagnosis. The differentiation between central and peripheral vertigo can be optimized by analysing nystagmus, by using the skew test and the head impulse test (HINTS), as also by performing the appropriate tests to evaluate the integrity of the vestibular-cerebellar pathway. In addition, tonal threshold audiometry could raise the diagnostic sensibility from 71 to 89% on initial approach. Appropriate diagnosis is the principal key for managing this clinical condition.