Anti-inflammatory effect of two Lactobacillus strains during infection with Gardnerella vaginalis and Candida albicans in a HeLa cell culture model.

Lactobacilli are the dominant bacteria of the vaginal tract of healthy women and they play a major role in the maintenance of mucosal homeostasis, preventing genital infections, such as bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC). It is now known that one mechanism of this protection is the influence that lactobacilli can exert on host immune responses. In this context, we evaluated two Lactobacillus strains (L. plantarum 59 and L. fermentum 137) for their immunomodulatory properties in response to Gardnerella vaginalis (BV) or Candida albicans (VVC) infections in a HeLa cell infection model. G. vaginalis and C. albicans triggered the secretion of pro-inflammatory cytokines (TNF-α, IL-1ß, IL-6 and IL-8) and the activation of NF-κB in HeLa cells, in contrast to L. plantarum 59 and L. fermentum 137. Treatments with the Lactobacillus strains or their cell-free supernatants before (pre-treatment) or after (post-treatment) the challenge with the pathogens resulted in decreased secretion of pro-inflammatory cytokines and decreased activation of NF-κB. The treatments with Lactobacillus strains not only decreased the secretion of IL-8, but also its expression, as confirmed by gene reporter luciferase assay, suggesting transcription-level control by lactobacilli. In conclusion, L. plantarum 59 and L. fermentum 137 were confirmed to have an anti-inflammatory effect against G. vaginalis and C. albicans and they were able to influence signalling in NF-κB pathway, making them interesting candidates as probiotics for the prevention or treatment of BV and VVC.

Selection of Lactobacillus strains as potential probiotics for vaginitis treatment.

Lactobacilli are the dominant bacteria of the vaginal tract of healthy women, and imbalance of the local microbiota can predispose women to acquire infections, such as bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC). Although antimicrobial therapy is generally effective, there is still a high incidence of recurrence and increase of microbial resistance due to the repetitive use of antimicrobials. Thus, it has been suggested that administration of probiotics incorporating selected Lactobacillus strains may be an effective strategy for preventing vaginal infections. Accordingly, the in vitro probiotic potential of 23 lactobacilli isolated from the vaginal ecosystem of healthy women from Cuba was evaluated for use in BV and VVC treatments. Eight strains were selected based on their antagonist potential against Gardnerella vaginalis, Candida albicansor both. In vitro assays revealed that all these strains reduced the pathogen counts in co-incubation, showed excellent adhesive properties (biofilm formation and auto-aggregation), were able to co-aggregate with G. vaginalis and C. albicans, yielded high amounts of hydrogen peroxide and lactic acid and demonstrated high adhesion rates to epithelial HeLa cells. Interference tests within HeLa cells showed that all strains were able to reduce the adherence of pathogens by exclusion or displacement. Lactobacilli were able to inhibit HeLa cell apoptosis caused by pathogens when the cells were incubated with the probiotics prior to challenge. These results suggest that these strains have a promising probiotic potential and can be used for prevention or treatment of BV and VVC.

Evaluación de conocimientos sobre políticas de salud del país en médicos egresados de la carrera de medicina / Evaluation of knowledge on polices of health of pais in medicos withdrawn of the medicine discipline

En el marco de las constantes reformas y tendencias actuales en las áreas de Educación y Salud a nivel mundial y regional, las recomendaciones están dirigidas a lograr una integración dirigidas a lograr una interrelación porductiva entre la salud y educación, consideradas pilares fundamentales de Desarrollo Humano. En este sentido los retos de la Educación Médica Superior com "práctica social" debe enfrentar problemas políticos, sociales, económicos, demográficos al interior del fenómeno de la pobreza y la tendencia hacia la "globalización".Para responder a estos retos la Educación Superior deberá conbinar las exigencias del proceso de enseñanza-aprendizaje en el tercer nivel con indicadores de pertinencia, calidad, eficiencia para responder a las expectativas de la sociedad y a las políticas de salud del país, a través de los productos o resultados finales del proceso docente-educativo, es decir de los profecionales médicos. En este contexto, la presente investigación está catalogada como un estudio evaluativo tipo inductivo y transversal, que busca determinar al nivel de conocimientos sobre Políticas de Salud del País, en médicos egresados de la Carrera de Medicina de la Universidad Mayor de San Andrés en 1999 y Habilitados para el desempeño como médicos en el Servicio Social de Salud Obligatorio, modalidad periurbana de la ciudad de La Paz. Para alcanzar los objetivos planteados en la investigación, se recurrio a información primaria, que fue obtenida a través de la aplicación de una encuesta individual autoadministrada a médicos (unidad de análisis), que fueron previamente seleccionados según "criterio" durante Enero a Marzo de 2000. Los resultados obtenidos nos permiten concluir que los medios egresados de la carrera de Medicina (UMSA) en 1999, tienen un pesimo nivel de conocimientos sobre Políticas de Salud del País, que no guardan relacion con el contexto actual de salud del país, ni con el perfil médico de la universidad, ni con la Vision de la Disiplina de Salud Pública; tampoco con la estrategía de Ateción Primaria en Salud, como fundamento de las reformas en salud y actuales políticas de salud del país.