High Prevalence of Quorum-Sensing and Quorum-Quenching Activity among Cultivable Bacteria and Metagenomic Sequences in the Mediterranean Sea.

There is increasing evidence being accumulated regarding the importance of N-acyl homoserine lactones (AHL)-mediated quorum-sensing (QS) and quorum-quenching (QQ) processes in the marine environment, but in most cases, data has been obtained from specific microhabitats, and subsequently little is known regarding these activities in free-living marine bacteria. The QS and QQ activities among 605 bacterial isolates obtained at 90 and 2000 m depths in the Mediterranean Sea were analyzed. Additionally, putative QS and QQ sequences were searched in metagenomic data obtained at different depths (15-2000 m) at the same sampling site. The number of AHL producers was higher in the 90 m sample (37.66%) than in the 2000 m sample (4.01%). However, the presence of QQ enzymatic activity was 1.63-fold higher in the 2000 m sample. The analysis of putative QQ enzymes in the metagenomes supports the relevance of QQ processes in the deepest samples, found in cultivable bacteria. Despite the unavoidable biases in the cultivation methods and biosensor assays and the possible promiscuous activity of the QQ enzymes retrieved in the metagenomic analysis, the results indicate that AHL-related QS and QQ processes could be common activity in the marine environment.

Synthesis and Pharmacological Characterization of C4-(Thiotriazolyl)-substituted-2-aminobicyclo[3.1.0]hexane-2,6-dicarboxylates. Identification of (1R,2S,4R,5R,6R)-2-Amino-4-(1H-1,2,4-triazol-3-ylsulfanyl)bicyclo[3.1.0]hexane-2,6-dicarboxylic Acid (LY2812223), a Highly Potent, Functionally Selective mGlu2 Receptor Agonist.

Identification of orthosteric mGlu(2/3) receptor agonists capable of discriminating between individual mGlu2 and mGlu3 subtypes has been highly challenging owing to the glutamate-site sequence homology between these proteins. Herein we detail the preparation and characterization of a series of molecules related to (1S,2S,5R,6S)-2-aminobicyclo[3.1.0]hexane-2,6-dicarboxylate 1 (LY354740) bearing C4-thiotriazole substituents. On the basis of second messenger responses in cells expressing other recombinant human mGlu2/3 subtypes, a number of high potency and efficacy mGlu2 receptor agonists exhibiting low potency mGlu3 partial agonist/antagonist activity were identified. From this, (1R,2S,4R,5R,6R)-2-amino-4-(1H-1,2,4-triazol-3-ylsulfanyl)bicyclo[3.1.0]hexane-2,6-dicarboxylic acid 14a (LY2812223) was further characterized. Cocrystallization of 14a with the amino terminal domains of hmGlu2 and hmGlu3 combined with site-directed mutation studies has clarified the underlying molecular basis of this unique pharmacology. Evaluation of 14a in a rat model responsive to mGlu2 receptor activation coupled with a measure of central drug disposition provides evidence that this molecule engages and activates central mGlu2 receptors in vivo.

Synthesis and pharmacological characterization of C4-disubstituted analogs of 1S,2S,5R,6S-2-aminobicyclo[3.1.0]hexane-2,6-dicarboxylate: identification of a potent, selective metabotropic glutamate receptor agonist and determination of agonist-bound human mGlu2 and mGlu3 amino terminal domain structures.

As part of our ongoing research to identify novel agents acting at metabotropic glutamate 2 (mGlu2) and 3 (mGlu3) receptors, we have previously reported the identification of the C4α-methyl analog of mGlu2/3 receptor agonist 1 (LY354740). This molecule, 1S,2S,4R,5R,6S-2-amino-4-methylbicyclo[3.1.0]hexane-2,6-dicarboxylate 2 (LY541850), exhibited an unexpected mGlu2 agonist/mGlu3 antagonist pharmacological profile, whereas the C4ß-methyl diastereomer (3) possessed dual mGlu2/3 receptor agonist activity. We have now further explored this structure-activity relationship through the preparation of cyclic and acyclic C4-disubstituted analogs of 1, leading to the identification of C4-spirocyclopropane 5 (LY2934747), a novel, potent, and systemically bioavailable mGlu2/3 receptor agonist which exhibits both antipsychotic and analgesic properties in vivo. In addition, through the combined use of protein-ligand X-ray crystallography employing recombinant human mGlu2/3 receptor amino terminal domains, molecular modeling, and site-directed mutagenesis, a molecular basis for the observed pharmacological profile of compound 2 is proposed.

Early origin of parental care in Mesozoic carrion beetles.

The reconstruction and timing of the early stages of social evolution, such as parental care, in the fossil record is a challenge, as these behaviors often do not leave concrete traces. One of the intensely investigated examples of modern parental care are the modern burying beetles (Silphidae: Nicrophorus), a lineage that includes notable endangered species. Here we report diverse transitional silphids from the Mesozoic of China and Myanmar that provide insights into the origins of parental care. Jurassic silphids from Daohugou, sharing many defining characters of Nicrophorinae, primitively lack stridulatory files significant for parental care communications; although morphologically similar, Early Cretaceous nicrophorines from the Jehol biota possess such files, indicating that a system of parental care had evolved by this early date. More importantly, burying beetles of the genus Nicrophorus have their earliest first record in mid-Cretaceous Burmese amber, and document early evolution of elaborate biparental care and defense of small vertebrate carcasses for their larvae. Parental care in the Early Cretaceous may have originated from competition between silphids and their predators. The rise of the Cretaceous Nicrophorinae implies a biology similar to modern counterparts that typically feed on carcasses of small birds and mammals.

[Prevention of ulcers by pressure as a universal right]. / Prevención de las úlceras por presión como derecho universal.

The title of the article matches the of the "Declaration of Rio de Janeiro on the prevention of ulcers by pressure as a Universal right" [ 1], promoted by numerous groups and associations related to the problematic of ulcers by pressure (UPP) at the international level, and is a decisive step for joint efforts to give visibility to a problem of global dimension. Efforts previously, and in what refers to our country, have been left reflected in statements [2] pressure driven by the National group for study and advice on ulcers and wounds chronicles (GNEAUPP). The Declaration dealt with masterfully what will be our thesis, beyond a clinical problem--that is--the UPP, and specifically its prevention, constitute a problem primarily ethical character and, more specifically, minimum ethics, as we already reflected more widely in another article [3], by what remains essential to influencing this aspect often underestimated.

New and revised maimetshid wasps from Cretaceous ambers (Hymenoptera, Maimetshidae).

New material of the wasp family Maimetshidae (Apocrita) is presented from four Cretaceous amber deposits - the Neocomian of Lebanon, the Early Albian of Spain, the latest Albian/earliest Cenomanian of France, and the Campanian of Canada. The new record from Canadian Cretaceous amber extends the temporal and paleogeographical range of the family. New material from France is assignable to Guyotemaimetsha enigmatica Perrichot et al. including the first females for the species, while a series of males and females from Spain are described and figured as Iberomaimetsha Ortega-Blanco, Perrichot & Engel, gen. n., with the two new species Iberomaimetsha rasnitsyni Ortega-Blanco, Perrichot & Engel, sp. n. and Iberomaimetsha nihtmara Ortega-Blanco, Delclòs & Engel, sp. n.; a single female from Lebanon is described and figured as Ahiromaimetsha najlae Perrichot, Azar, Nel & Engel, gen. et sp. n., and a single male from Canada is described and figured as Ahstemiam cellula McKellar & Engel, gen. et sp. n. The taxa are compared with other maimetshids, a key to genera and species is given, and brief comments made on the family.

Historia de la protección social de la salud en Chile / History of health social protection in Chile

Este ensayo tiene por objeto describir la historia de la protección social de la salud (PSS) en Chile desde la Independencia a nuestros tiempos e intentar encontrar relaciones causales que expliquen los cambios significativos en esta materia. Definimos la protección social en salud como: "la garantía que la sociedad otorga, a través de los poderes públicos, para que un individuo o grupo de individuos pueda satisfacer sus demandas [o necesidades] de salud a través del acceso a los servicios en condiciones adecuadas de calidad, oportunidad y dignidad, sin que la capacidad de pago sea un factor restrictivo". En consecuencia, el "seguimiento"de la PSS que se hace en este artículo incluye aspectos sanitarios, políticos y económicos. El enfoque de este documento es ser una revisión de la historia de la protección social de la salud antes que de la salud. En consecuencia, el ensayo parte de la premisa que "el derecho a la salud es parte fundamental de nuestros derechos humanos y de nuestra comprensión de una vida en dignidad. El derecho a la salud es un derecho inclusivo, es decir, incluye todos los aspectos que pueden ayudar o conducir a mejores estados de salud; contiene libertades o derecho a elegir, por ejemplo tratamientos; contiene garantías para sus titulares (igualdad de oportunidades, de acceso a la prevención, etc.).

[Bioethics: a proposal for decision making. Towards a weighed syncretism]. / Bioética. Una propuesta para la toma de decisiones. Hacia un sincretismo ponderado.

The professional nursing business bears with it ethical problems related to scientific and technical development, the ethical-cultural plurality in our society and changes in clinical relationships. This situation has generated a crisis in classical decision-making models which has led to a point where we confront a new reality that requires an adequate adjustment not only to technical criteria but, moreover, to moral criteria. The challenge we undertake implies a search for concrete solutions to concrete problems in concrete instances, and what is most important, related to concrete persons. The procedures for decision making which have been proposed up until now should not be viewed as exclusive rather as complementary and enriching ones in the quest to find the best possible solutions; along this line we propose, from a weighed syncretism aspect, a procedure not thought of only for use in great conflicts but rather and mainly, to resolve daily problems.

Actuaciones emergentes y urgentes del personal sanitario / Emerging and urgent actions of the sanitary personnel

Este trabajo tiene el objetivo de servir como guía al personal sanitario de nuestras unidades para que puedan brindar acciones e intervenciones terapéuticas con una competencia y desempeño adecuadas durante la ejecución de las medidas del apoyo vital básico y del socorrismo. Ha sido diseñado también como material de apoyo docente para el adiestramiento del personal de aseguramiento de las instituciones médicas con vistas a elevar su competencia en la ejecución de las maniobras de apoyo vital básico durante la recepción masiva de víctimas de catástrofes naturales y en tiempo de guerra.

This paper is intended to serve as a guide for the sanitary personnel of our units, so that they can carry out therapeutic actions and interventions with an adequate competence and performance during the accomplishment of the measures of basic vital support and first aid. It has also been designed as a supporting material to train the securing personnel of the medical institutions in order to increase their capacity in the execution of the maneuvers of basic vital support during the mass reception of victims of natural catastrophes in war time.

[Evaluation of bioethical aspects in health professionals]. / Evaluación de aspectos bioéticos en los profesionales de la salud.

OBJECTIVE: To evaluate training in bioethics, as well as knowledge and perceptions of bioethical issues, among health professionals. METHOD: A descriptive cross-sectional study was performed in 2005 by means of a validated questionnaire. The study population consisted of the health team working in the cardiology area in the Marqués de Valdecilla University Hospital. RESULTS: There were 186 health professionals, and 117 questionnaires were returned, representing 63.5% of the study population: 58 nurses (49.5%), 23 physicians (19.6%), and 34 nursing auxiliaries. More than half (64.6%) had no training in bioethics. The health professionals with the most training in bioethics were those with more than 20 years' experience (p = 0.019). Less than half (45.7%) knew of the existence (p = 0.004) or the content (p = 0.03) of law 41/2002. A total of 12.8% believed that users knew their rights. Health professionals with no bioethics training were those most likely to believe that users' confidentiality (p = 0.002) and privacy (p = 0.039) were always or usually respected. More than one third (37.8%) reported facing bioethical problems in their professional activity. CONCLUSION: The members of the health team have insufficient knowledge of bioethics parallel to low levels of training in this discipline and perceive insufficient respect for users' basic rights. Training in bioethics should be increased, and information pathways should be established in institutions to allow continual adaptation to ethical and legal requirements.

[The ethics of treatment: a proposal having a future for nurses and health companies]. / La ética del cuidado: una propuesta con futuro para las enfermeras y las empresas sanitarias.

This article is the fruit of various circumstances. In the first place, it is the result of a long reflection shared by its authors; it is also the proof of the primary interests the authors hold specific time; and lastly, it is the reflection of our opinion regarding how nurses should with their compromise a future treating patients.

Comportamiento de la leptospirosis grave en la unidad de cuidados intensivos / Behavior of severe leptospirosis at the intensive care unit

Se describió el comportamiento de la leptospirosis grave en 35 pacientes ingresados en la Unidad de Cuidados Intensivos de Adultos del Instituto de Medicina Militar Dr. Luis Díaz Soto. Se recogieron los datos de las historias clínicas de los afectados con este diagnóstico comprobado por pruebas serológicas. Se realizó análisis univariado para cada variable mediante la prueba de la t de Student y de Chi cuadrado. Se usó el método de regresión logística para determinar factores asociados a la mortalidad. El 20 por ciento de las personas con leptospirosis grave falleció, no se halló relación significativa de la tenencia de animales o vivir en zona rural con respecto a la mortalidad. Se comprobó el 71,4 por ciento de errores diagnósticos en el grupo de fallecidos, el principal fue la sepsis urinaria. Los factores pronósticos de mayor relación con la mortalidad (p < 0,05; 95 por ciento de confianza) fueron: a) días de inicio de los síntomas, b) estancia en la UCIA, c) días de ventilación mecánica, d) relación PO2/FiO2, f) valor del APACHE II, g) requerimiento de fármacos inotrópicos, h) presencia de insuficiencia renal aguda, i) existencia de coagulopatías, j) exigencia de transfusiones de glóbulos, k) necesidad de depuración extrarrenal, l) manifestaciones de disfunción múltiple de órganos. Se concluyó que la leptospirosis se comportó como una urgencia médica y precisa de una adecuada atención por parte de los servicios de atención al grave

Plan para la recepción masiva de heridos y lesionados / Plan for the mass admission of wounded and injured patients

Se expone la necesidad para las instituciones hospitalarias de la confección, actualización y conocimiento del Plan para la Recepción Masiva de Heridos y Lesionados (PRMHL), sus características y principios, así como recomendaciones para su puesta en funcionamiento. Dadas las especificaciones y requerimientos de cada unidad asistencial, el PRMHL deberá adecuarse a las condiciones de ella y se observarán los aspectos básicos en su confección: interrelación con el territorio, dirección y mando, comunicaciones, personal, clasificación o "triage" y documentación que todo PRMHL debe cumplir. El PRMHL es una herramienta imprescindible para mejorar la calidad de la asistencia ante contingencias y su amplio conocimiento asegura una elevada disposición de la unidad hospitalaria

Protocolo para el diagnóstico y tratamiento de la enfermedad cerebrovascular isquémica en fase aguda / Protocol for the diagnosis and treatment of the ischemic cerebrovascular disease in acute phase

Se presenta el protocolo utilizado en el Instituto Superior de Medicina Militar "Dr. Luis Díaz Soto" y en su Unidad de Cuidados Intermedios, para la atención de los pacientes afectados de enfermedad cerbrovascular isquémica en fase aguda. Se basa en la experiencia del manejo de 832 pacientes. Las pautas y recomendaciones que se ofrecen han sido rigurosamente avaladas de acuerdo con los resultados de la aplicación del protocolo en la institución, así como con los lineamientos y sugerencias para la toma de decisiones de la bibliografía médica internacional

Análisis de un sistema predictivo para el paciente crítico / Predictive system for critical patients an analysis

Se realizó un estudio para determinar las posibilidades de aplicación del sistema predictivo Acute Physiology and Chronic Health Evaluation (APACHE II) en 184 pacientes de la Unidad de Cuidados Intensivos del Instituto Superior de Medicina Militar "Dr. Luis Díaz Soto". Se obtuvo con su uso una especificidad del 100 % y una sensibilidad del 95,8 %; el 98,9 % de las predicciones fueron correctas y los valores predictivos positivos y negativos, fueron de 100 y 99,3 % respectivamente. Los valores medios de los rangos de puntuación utilizando APACHE II fueron de 5 y 26, para los pacientes egresados vivos con y sin intervención quirúrgica previa a su ingreso, y de 32 y 23 puntos para los operados o no, antes de su ingreso que no sobrevivieron. La utilización de este sistema predictivo en las Unidades de Cuidados Intensivos Polivalentes puede ser de valor en el seguimiento evolutivo de los pacientes y de gran ayuda al juicio clínico y a la experincia del equipo de trabajo

Insuficiencia renal aguda en el paciente crítico / Acute renal failure in the critically ill

Se presenta un estudio acerca de la frecuencia, mortalidad, factores de riesgo y utilidad de las pruebas de función renal en 165 pacientes considerados críticos, ingresados en la Unidad de Cuidados Intensivos Polivalente del Instituto Superior de Medicina Militar "Dr. Luis Díaz Soto", de los cuales 20 (12,1 %) desarrollaron insuficiencia renal aguda durante su estadía en la misma. Los estados posquirúrgicos complejos, los politraumatismos y los cuadros graves de sangramiento gastrointestinal fueron las entidades con mayor incidencia de insuficiencia renal aguda; la edad, hipotensión mamtenida o choque y la utilización de drogas nefrotóxicas, intervinieron conjuntamente con la sepsis y la presencia de falla multiorgánica en la disminución de la sobrevida de los pacientes. La prevención de estos factores, combinado con el seguimiento diario de la función renal en el paciente crítico, es la mejor opción para disminuir la mortalidad debida a esta entidad. El aclaramiento de agua libre fue la prueba más sensible de las utilizadas para la detección precoz de la falla renal