Micosis superficiales en pacientes embarazadas en un hospital general de segundo nivel de atención / Superficial mycosis in pregnant patients in a general hospital

Resumen: ANTECEDENTES: Las micosis superficiales se generan por contacto directo con el hongo o con una persona o animal infectado, y afectan la piel, los anexos y las mucosas; las pacientes embarazadas son susceptibles a cambios cutáneos fisiológicos y patológicos. OBJETIVO: Describir las micosis superficiales en pacientes embarazadas del Servicio de Obstetricia del Hospital General Dr. Manuel Gea González. MATERIAL Y MÉTODO: Estudio descriptivo, observacional, prospectivo y transversal realizado en pacientes embarazadas de la consulta externa del Servicio de Gineco-obstetricia del Hospital General Dr. Manuel Gea González de julio de 2016 a julio de 2017. RESULTADOS: Se incluyeron 23 pacientes que acudieron al Servicio de Micología; el grupo de edad más afectado fue de 21 a 40 años de edad (86.9%); 17 tuvieron tiña plantar (73.9%) y 4 (17.9%) tuvieron onicomicosis distrófica total. Dos cultivos fueron positivos para Trichophyton rubrum. CONCLUSIONES: Las micosis superficiales fueron poco frecuentes en el grupo estudiado: 17 pacientes con tiña de los pies y 4 con onicomicosis. El agente aislado fue Trichophyton rubrum.

Abstract: BACKGROUND: Superficial mycoses are generated by direct contact with the fungus or with an infected person or animal, and affect the skin, the attachments and mucous membranes; pregnant patients are susceptible to skin changes, both physiological and pathological. OBJECTIVE: To know the frequency of superficial mycoses in pregnant patients from the obstetrics service of the Hospital General Dr. Manuel Gea González. MATERIAL AND METHOD: A descriptive, observational, prospective and crosssectional study carried out in pregnant patients of the Gineco-Obstetrics Service of the Hospital General Dr. Manuel Gea González, Mexico City, from July 2016 to July 2017. RESULTS: Twenty-three patients were included in the mycology department for their physical examination; the most affected group was between 21 and 40 age years (86.9%); 17 patients presented tinea pedis (73.9%) and 4 (17.9%) onychomycosis. CONCLUSIONS: Superficial mycosis were not frequent in the group of study: 17 patients had tinea pedis and 4 onychomycosis. The causal agent isolated was Trichophyton rubrum.

Differential Expression of Adhesion-Related Proteins and MAPK Pathways Lead to Suitable Osteoblast Differentiation of Human Mesenchymal Stem Cells Subpopulations.

Cellular adhesion enables communication between cells and their environment. Adhesion can be achieved throughout focal adhesions and its components influence osteoblast differentiation of human mesenchymal stem cells (hMSCs). Because cell adhesion and osteoblast differentiation are closely related, this article aimed to analyze the expression profiles of adhesion-related proteins during osteoblastic differentiation of two hMSCs subpopulations (CD105(+) and CD105(-)) and propose a strategy for assembling bone grafts based on its adhesion ability. In vitro experiments of osteogenic differentiation in CD105(-) cells showed superior adhesion efficiency and 2-fold increase of α-actinin expression compared with CD105(+) cells at the maturation stage. Interestingly, levels of activated ß1-integrin increased in CD105(-) cells during the process. Additionally, the CD105(-) subpopulation showed 3-fold increase of phosphorylated FAK(Y397) compared to CD105(+) cells. Results also indicate that ERK1/2 was activated during CD105(-) bone differentiation and participation of mitogen-activated protein kinase (MAPK)-p38 in CD105(+) differentiation through a focal adhesion kinase (FAK)-independent pathway. In vivo trial demonstrated that grafts containing CD105(-) showed osteocytes embedded in a mineralized matrix, promoted adequate graft integration, increased host vascular infiltration, and efficient intramembranous repairing. In contrast, grafts containing CD105(+) showed deficient endochondral ossification and fibrocartilaginous tissue. Based on the expression of α-actinin, FAKy,(397) and ERK1/2 activation, we define maturation stage as critical for bone graft assembling. By in vitro assays, CD105(-) subpopulation showed superior adhesion efficiency compared to CD105(+) cells. Considering in vitro and in vivo assays, this study suggests that integration of a scaffold with CD105(-) subpopulation at the maturation stage represents an attractive strategy for clinical use in orthopedic bioengineering.

Characterization of mesenchymal stem cell subpopulations from human amniotic membrane with dissimilar osteoblastic potential.

Human fetal mesenchymal stem cells can be isolated from the amniotic membrane (AM-hMSCs) by enzymatic digestion. The biological properties of this cell population have been characterized; however, few studies have focused on the presence of stem cell subpopulations and their differentiation potential. The aim of the present study was to isolate homogeneous AM-hMSC subpopulations based on the coexpression of surface markers. In addition, we aimed to characterize stem cell subpopulations through the detection of typical stem cell markers and its differentiation potential. In this study, fluorescence-activated cell sorting (FACS) was used to positively select for the surface markers CD44, CD73, and CD105. Two subpopulations were isolated: CD44+ / CD73+ / CD105+ (CD105+), and CD44+ / CD73+ / CD105- (CD105-). To characterize the cell subpopulations, the expression of pluripotency-associated markers was analyzed by reverse transcriptase-polymerase chain reaction and immunofluorescence. Our results showed positive expression of SOX2, SOX3, PAX6, OCT3/4, and NANOG in the CD105+ and CD105(-) cell subpopulations. In contrast, we did not detect expression of SSEA4 or FOXD3 in either subpopulation. Immunophenotypes, such as mesenchymal and hematopoietic markers, were studied by FACS analyses. Our data revealed the expression of the CD49a, CD49d, CD29, integrin α9ß1, CD44, CD73, and CD105 antigens in both subpopulations. In contrast, CD90, CD45, CD34, CD14, and HLA-DR expression was not detected. The ability of both subpopulations to differentiate into osteoblasts, adipocytes, and chondrocytes was evidenced using Alizarin red, Oil-Red, and Alcian blue staining, respectively. Furthermore, neuronal differentiation was demonstrated by the expression of GFAP and NEURO-D. Interestingly, we observed a dissimilar osteoblastic differentiation potential between the subpopulations. CD105- cells showed stronger expression of secreted protein acidic and rich in cysteine (SPARC) and osteonectin, which was associated with more effective calcium deposition, than CD105+ cells. In conclusion, we described a systematic method for the isolation of hMSCs that was highly reproducible and generated homogeneous cultures for osteoblast differentiation with an efficient capacity for mineralization.