Synthesis and characterization of thiazolium chitosan derivative with enhanced antimicrobial properties and its use as component of chitosan based films.

In this work, chemical modification of chitosan using cationic thiazolium groups was investigated with the aim to improve water solubility and antimicrobial properties of chitosan. Enzymatic synthesis and ethyl-3-(3-dimethylaminopropyl) carbodiimide/N-hydroxysuccinimide (EDC/NHS) chemistry were employed to synthesize and attach to chitosan through the amine groups the molecule bearing thiazolium moieties, quaternized 4-(2-(4-methylthiazol-5-yl) ethoxy)-4-oxobutanoic acid (MTBAQ). On the basis of Fourier transform infrared spectroscopy (FTIR), elemental analysis and solid state nuclear magnetic resonance (ssNMR), around 95 % of the available amine groups of chitosan (of 25 % degree of acetylation) reacted. The resulting derivative was water soluble at physiological pH and exhibit excellent antimicrobial activity against Listeria innocua, Staphylococcus epidermidis, Staphylococcus aureus and Methicillin Resistant S. aureus Gram-positive bacteria (MIC = 8-32 µg/ mL), whereas its efficiency decreases against fungi Candida albicans and Eschericia coli Gram-negative bacterium. Subsequently, the thiazolium chitosan derivative was employed as antimicrobial component (up to 7 wt%) of chitosan/glycerol based films. The incorporation of the chitosan derivative does not modify significantly the characteristics of the film in terms of thermal and mechanical properties, while enhances considerably the antimicrobial activity.

[Translated article] Has the COVID-19 lockdown influenced the mortality of hip fracture? Analysis of one-year mortality.

INTRODUCTION AND OBJECTIVES: The main objective of this study is to analyse the one-year mortality in patients with intracapsular hip fracture who were admitted during severe social confinement in the first months of the COVID-19 lockdown and compare it with previous years. MATERIAL AND METHODS: Retrospective observational study in which a cohort from March 14 to June 21, 2020 (pandemic group, n=62) was compared with a control cohort on the same dates in the years 2017, 2018 and 2019 (control group, n=172). Thirty-day-mortality and one-year-mortality, orthopaedic complications, ASA grade, comorbidities, diagnosis and treatment, time to surgery and mean stay were measured. RESULTS: No significant differences were found in 30-day mortality (p=0.156; 9.7% compared to 4.7%) or in one-year mortality (p=0.47) between the pandemic group (21%) and the control one (16.9%). A decrease in surgical delay and mean stay was observed in the pandemic group, although without statistical significance. CONCLUSION: The State of Alarm modified the distribution of the type of hip fracture with a predominance of intracapsular fracture. Maintaining the same hospital management as prior to the pandemic period made it possible not to increase 30-day mortality and one-year mortality in patients with intracapsular hip fracture.

Has the COVID-19 lockdown influenced the mortality of hip fracture? Analysis of one-year mortality. / ¿Ha influido el confinamiento social por COVID-19 en la mortalidad de la fractura de cadera? Análisis de la mortalidad al año.

INTRODUCTION AND OBJECTIVES: The main objective of this study is to analyze the one-year mortality in patients with intracapsular hip fracture who were admitted during severe social confinement in the first months of the COVID-19 lockdown and compare it with previous years. MATERIAL AND METHODS: Retrospective observational study in which a cohort from March 14 to June 21, 2020 (pandemic group, n = 62) was compared with a control cohort on the same dates in the years 2017, 2018 and 2019 (control group, n = 172). Thirty-day-mortality and one-year-mortality, orthopedic complications, ASA grade, comorbidities, diagnosis and treatment, time to surgery and mean stay were measured. RESULTS: No significant differences were found in 30-day mortality (p = 0.156; 9.7% compared to 4.7%) or in one-year mortality (p = 0.47) between the pandemic group (21%) and the control one (16.9%). A decrease in surgical delay and mean stay was observed in the pandemic group, although without statistical significance. CONCLUSIóN: The State of Alarm modified the distribution of the type of hip fracture with a predominance of intracapsular fracture. Maintaining the same hospital management as prior to the pandemic period made it possible not to increase 30-day mortality and one-year mortality in patients with intracapsular hip fracture.

Phytotoxicity of plant extracts of Vismia japurensis cultivated in vivo and in vitro / Fitotoxicidade de extratos de plantas de Vismia japurensis cultivadas in vivo e in vitro

Plants that produce secondary metabolites with allelopathic activity or phytotoxicity can be biotechnologically important, serving as sources of allelochemicals, and thus contributing to the agroindustrial sector. Vismia japurensis (Hypericaceae) is an Amazonian species that grows in clumps called vismiais, from which most other plants are absent. Accordingly, the objective of this study was to identify possible phytotoxicity effects of hexane and methanol extracts of Vismia japurensis leaves and branches in vivo and from seedlings grown in vitro on Lactuca sativa. In addition, fresh and dry leaves were assayed by the sandwich method in order to determine their ability to release allelochemicals. The hexanic extract from in vitro seedlings reduced germination by 10%, while the methanol extract produced a 16% reduction in germination speed. Root growth of Lactuca sativa was inhibited by 64.7% when subjected to hexane leaf extract, by 39.3% under the influence of hexane branch extract, and by 96.09% for in vitro seedling hexanic extract. When analysed by thin layer chromatography and 1H nuclear magnetic resonance, extracts showed evidence of terpenes, anthraquinones and flavonoids, with greater intensity of signals in the aromatic region of in vitro seedling hexanic extract. Clearly, Vismia japurensis has a high biotechnological potential in terms of the production of substances of low polarity with capacity to interfere in plant development.

Plantas que produzem metabólitos secundários com atividade alelopática ou fitotóxica podem ser biotecnologicamente importantes, servindo como fontes de aleloquímicos e, assim, contribuindo para o setor agroindustrial. Vismia japurensis (Hypericaceae) é uma espécie amazônica que cresce em grupos, formando vismiais. Assim, o objetivo deste estudo foi identificar possíveis efeitos fitotóxicos de extratos hexânicos e metanólicos de folhas e ramos de Vismia japurensis in vivo e de plântulas cultivadas in vitro sobre Lactuca sativa. Além disso, folhas frescas e secas foram analisadas pelo método sanduíche, a fim de determinar sua capacidade de liberação de aleloquímicos. O extrato hexânico de plântulas in vitro reduziu a germinação em 10% e o extrato metanólico promoveu uma redução de 16% na velocidade de germinação. O crescimento radicular de Lactuca sativa foi inibido em 64,7% quando submetido ao extrato hexânico das folhas, em 39,3% sob influência do extrato hexânico dos galhos e em 96,09% para o extrato de hexânico das plântulas in vitro. Quando analisados por cromatografia em camada delgada e ressonância magnética nuclear de 1H, os extratos mostraram evidências de terpenos, antraquinonas e flavonoides, com maior intensidade de sinais na região aromática do extrato hexânico das plântulas in vitro. Assim, Vismia japurensis possui elevado potencial biotecnológico em termos de produção de substâncias de baixa polaridade com capacidade de interferência no desenvolvimento de plantas.

Phytotoxicity of plant extracts of Vismia japurensis cultivated in vivo and in vitro

Abstract Plants that produce secondary metabolites with allelopathic activity or phytotoxicity can be biotechnologically important, serving as sources of allelochemicals, and thus contributing to the agroindustrial sector. Vismia japurensis (Hypericaceae) is an Amazonian species that grows in clumps called vismiais, from which most other plants are absent. Accordingly, the objective of this study was to identify possible phytotoxicity effects of hexane and methanol extracts of Vismia japurensis leaves and branches in vivo and from seedlings grown in vitro on Lactuca sativa. In addition, fresh and dry leaves were assayed by the sandwich method in order to determine their ability to release allelochemicals. The hexanic extract from in vitro seedlings reduced germination by 10%, while the methanol extract produced a 16% reduction in germination speed. Root growth of Lactuca sativa was inhibited by 64.7% when subjected to hexane leaf extract, by 39.3% under the influence of hexane branch extract, and by 96.09% for in vitro seedling hexanic extract. When analysed by thin layer chromatography and 1H nuclear magnetic resonance, extracts showed evidence of terpenes, anthraquinones and flavonoids, with greater intensity of signals in the aromatic region of in vitro seedling hexanic extract. Clearly, Vismia japurensis has a high biotechnological potential in terms of the production of substances of low polarity with capacity to interfere in plant development.

Resumo Plantas que produzem metabólitos secundários com atividade alelopática ou fitotóxica podem ser biotecnologicamente importantes, servindo como fontes de aleloquímicos e, assim, contribuindo para o setor agroindustrial. Vismia japurensis (Hypericaceae) é uma espécie amazônica que cresce em grupos, formando vismiais. Assim, o objetivo deste estudo foi identificar possíveis efeitos fitotóxicos de extratos hexânicos e metanólicos de folhas e ramos de Vismia japurensis in vivo e de plântulas cultivadas in vitro sobre Lactuca sativa. Além disso, folhas frescas e secas foram analisadas pelo método sanduíche, a fim de determinar sua capacidade de liberação de aleloquímicos. O extrato hexânico de plântulas in vitro reduziu a germinação em 10% e o extrato metanólico promoveu uma redução de 16% na velocidade de germinação. O crescimento radicular de Lactuca sativa foi inibido em 64,7% quando submetido ao extrato hexânico das folhas, em 39,3% sob influência do extrato hexânico dos galhos e em 96,09% para o extrato de hexânico das plântulas in vitro. Quando analisados por cromatografia em camada delgada e ressonância magnética nuclear de 1H, os extratos mostraram evidências de terpenos, antraquinonas e flavonoides, com maior intensidade de sinais na região aromática do extrato hexânico das plântulas in vitro. Assim, Vismia japurensis possui elevado potencial biotecnológico em termos de produção de substâncias de baixa polaridade com capacidade de interferência no desenvolvimento de plantas.

Phytotoxicity of plant extracts of Vismia japurensis cultivated in vivo and in vitro / Fitotoxicidade de extratos de plantas de Vismia japurensis cultivadas in vivo e in vitro

Plants that produce secondary metabolites with allelopathic activity or phytotoxicity can be biotechnologically important, serving as sources of allelochemicals, and thus contributing to the agroindustrial sector. Vismia japurensis (Hypericaceae) is an Amazonian species that grows in clumps called vismiais, from which most other plants are absent. Accordingly, the objective of this study was to identify possible phytotoxicity effects of hexane and methanol extracts of Vismia japurensis leaves and branches in vivo and from seedlings grown in vitro on Lactuca sativa. In addition, fresh and dry leaves were assayed by the sandwich method in order to determine their ability to release allelochemicals. The hexanic extract from in vitro seedlings reduced germination by 10%, while the methanol extract produced a 16% reduction in germination speed. Root growth of Lactuca sativa was inhibited by 64.7% when subjected to hexane leaf extract, by 39.3% under the influence of hexane branch extract, and by 96.09% for in vitro seedling hexanic extract. When analysed by thin layer chromatography and 1H nuclear magnetic resonance, extracts showed evidence of terpenes, anthraquinones and flavonoids, with greater intensity of signals in the aromatic region of in vitro seedling hexanic extract. Clearly, Vismia japurensis has a high biotechnological potential in terms of the production of substances of low polarity with capacity to interfere in plant development.

Plantas que produzem metabólitos secundários com atividade alelopática ou fitotóxica podem ser biotecnologicamente importantes, servindo como fontes de aleloquímicos e, assim, contribuindo para o setor agroindustrial. Vismia japurensis (Hypericaceae) é uma espécie amazônica que cresce em grupos, formando vismiais. Assim, o objetivo deste estudo foi identificar possíveis efeitos fitotóxicos de extratos hexânicos e metanólicos de folhas e ramos de Vismia japurensis in vivo e de plântulas cultivadas in vitro sobre Lactuca sativa. Além disso, folhas frescas e secas foram analisadas pelo método sanduíche, a fim de determinar sua capacidade de liberação de aleloquímicos. O extrato hexânico de plântulas in vitro reduziu a germinação em 10% e o extrato metanólico promoveu uma redução de 16% na velocidade de germinação. O crescimento radicular de Lactuca sativa foi inibido em 64,7% quando submetido ao extrato hexânico das folhas, em 39,3% sob influência do extrato hexânico dos galhos e em 96,09% para o extrato de hexânico das plântulas in vitro. Quando analisados por cromatografia em camada delgada e ressonância magnética nuclear de 1H, os extratos mostraram evidências de terpenos, antraquinonas e flavonoides, com maior intensidade de sinais na região aromática do extrato hexânico das plântulas in vitro. Assim, Vismia japurensis possui elevado potencial biotecnológico em termos de produção de substâncias de baixa polaridade com capacidade de interferência no desenvolvimento de plantas.

Utilidad de la Determinación de CD25 Soluble en Pacientes con sospecha de Síndrome de Activación Macrofágica / Usefulness of the determination of soluble CD25 in patients with suspected macrophage activation syndrome

El síndrome de activación macrofágica (SAM) presenta criterios clínicos y de laboratorio establecidos. Presentamos el caso de un adolescente varón con debut de Lupus eritematoso generalizado pediátrico grave, donde su manifestación principal fue un SAM y el receptor de interleucina 2 soluble en suero (IL-2rs) o CD25 soluble (CD25s) aumentado resultó clave en la confirmación diagnóstica, en el tratamiento y pronóstico de su enfermedad. Sin embargo, este receptor de citocinas no se mide habitualmente en la práctica clínica.

Macrophage activation syndrome (MAS) presents established clinical and laboratory criteria. We present the case of a male adolescent with the onset of severe pediatric systemic Lupus erythematosus, manifested mainly by MAS and how a laboratory marker, serum soluble interleukin-2 receptor (IL-2rs) or altered soluble CD25(CD25s), played a key role in treatment and prognosis of the disease. However, this cytokine receptor is rarely measured in clinical practice.

Carcinoma adenoideo quístico pulmonar primario con metástasis precoces exclusivas hepáticas, un caso inusual / Primary adenoid cystic carcinoma of bronchus with early liver metastases, an unusual case

RESUMEN El carcinoma adenoideo quístico (CAQ) es una patología propia de las glándulas salivales, casos excepcionales se han descrito como primarios en otras partes de la economía. Este es un caso de CAQ primario pulmonar (CAQPP), con respuesta parcial a radioterapia, además, presenta metástasis hepáticas, sin evidenciarse lesiones de metástasis en otras partes del organismo. Tales características hacen que debamos prestar atención a las formas atípicas de CAQ sobre todo al CAQPP y a su comportamiento poco predecible.

ABSTRACT Adenoid cystic carcinoma (ACC) is a pathology of the salivary glands, exceptional cases have been described as primary of the bronchus. This is a case of primary adenoid cystic carcinoma of the tracheobronchial tree (PACCTBT), with partial response to radiation therapy, in addition, presents liver metastases, without evidence of metastasis injuries in other parts of the body. Such characteristics mean that we should pay attention to the atypical forms of ACC, especially PACCTBT and its unpredictable behavior.

RpoS controls the expression and the transport of the AlgE1-7 epimerases in Azotobacter vinelandii.

Azotobacter vinelandii produces differentiated cells, called cysts, surrounded by two alginate layers, which are necessary for their desiccation resistance. This alginate contains variable proportions of guluronate residues, resulting from the activity of seven extracytoplasmic epimerases, AlgE1-7. These enzymes are exported by a system secretion encoded by the eexDEF operon; mutants lacking the AlgE1-7 epimerases, the EexDEF or the RpoS sigma factor produce alginate, but are unable to form desiccation resistant cysts. Herein, we found that RpoS was required for full transcription of the algE1-7 and eexDEF genes. We found that the AlgE1-7 protein levels were diminished in the rpoS mutant strain. In addition, the alginate produced in the absence of RpoS was more viscous in the presence of proteases, a phenotype similar to that of the eexD mutant. Primer extension analysis located two promoters for the eexDEF operon, one of them was RpoS-dependent. Thus, during encysting conditions, RpoS coordinates the expression of both the AlgE1-7 epimerases and the EexDEF protein complex responsible for their transport.

Th1/Th17/Th22 immune response and their association with joint pain, imagenological bone loss, RANKL expression and osteoclast activity in temporomandibular joint osteoarthritis: A preliminary report.

It is well accepted that the presence of cytokines belonging to the Th1/Th17/Th22 axis of immuno-inflammatory response in the joint environment, such as IL-1ß, IL-17 and IL-22, respectively, are associated with pathogenesis of several synovial joint degenerative disorders. During temporomandibular joint osteoarthritis (TMJ-OA), IL-1ß and IL-17 have been implicated in the inflammation and resorption of sub-chondral bone; however, the role of Th22 response in the TMJ-OA pathophysiology has not been established. This study aimed to compare the expression of Th1/Th17/Th22-type cytokines, chemokines and chemokine receptors in synovial fluid samples obtained from TMJ-OA or disk displacement with reduction (DDWR) patients. In addition, it aimed to associate these levels with joint pain, imagenological signs of bone degeneration, RANKL production, osteoclastogenesis and osteoclast-induced bone resorption. Higher levels of IL-1ß, IL-17 and IL-22 were expressed in TMJ-OA compared with DDWR subjects, and these increased levels significantly correlated with RANKL expression, joint pain and articular bone degeneration. Higher levels of CCR5, CCR6 and CCR7, as well as their respective ligands CCL5 and CCL20, responsible for recruitment of IL-1ß, IL-17 and IL-22-producing cells, were over-expressed in TMJ-OA compared with DDWR subjects. Osteoclastogenesis and osteoclast-induced bone resorption were significantly greater in presence of synovial fluid from TMJ-OA compared with DDWR subjects. These data demonstrate that cytokines, CCLs and CCRs associated with the Th1/Th17/Th22 axis of immuno-inflammatory response are involved in TMJ-OA pathogenesis. These findings suggest that IL-22 is involved in the RANKL expression in TMJ-OA, which in turn induces differentiation of osteoclasts and subsequent resorption of sub-chondral bone.

Tratamiento quirúrgico o conservador para fracturas de cóndilo mandibular / Surgical or conservative treatment for mandibular condyle fractures

INTRODUCCIÓN: Las fracturas maxilofaciales se asocian a importante morbilidad, pérdida de función y secuelas estéticas, entre otros. Dentro de las fracturas mandibulares, las fracturas de cóndilo mandibular son las más frecuentes. Estas pueden ser tratadas mediante un tratamiento quirúrgico (reducción abierta más estabilización con miniplacas de titanio) o un tratamiento conservador (ortopédico). MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos ocho revisiones sistemáticas que en conjunto incluyen 66 estudios primarios, de los cuales, seis corresponden a ensayos aleatorizados. Concluimos que, en comparación con el tratamiento conservador, el tratamiento quirúrgico en fracturas de cóndilo mandibular probablemente se asocia a menor dolor articular, menor maloclusión y menor desviación lateral en apertura bucal.

INTRODUCTION: Maxillofacial fractures are associated with significant morbidity, loss of function and aesthetic sequelae, among others. Within mandibular fractures, mandibular condylar fractures are the most frequent. These can be treated by surgical treatment or conservative treatment (orthopedic). METHODS: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified eight systematic reviews including 66 primary studies overall, of which six were randomized trials. We concluded surgical treatment of mandibular condyle fractures, compared to conservative treatment, is probably associated with less joint pain, less malocclusion and less lateral deviation in buccal opening.

An anti-infective synthetic peptide with dual antimicrobial and immunomodulatory activities.

Antibiotic-resistant infections are predicted to kill 10 million people per year by 2050, costing the global economy $100 trillion. Therefore, there is an urgent need to develop alternative technologies. We have engineered a synthetic peptide called clavanin-MO, derived from a marine tunicate antimicrobial peptide, which exhibits potent antimicrobial and immunomodulatory properties both in vitro and in vivo. The peptide effectively killed a panel of representative bacterial strains, including multidrug-resistant hospital isolates. Antimicrobial activity of the peptide was demonstrated in animal models, reducing bacterial counts by six orders of magnitude, and contributing to infection clearance. In addition, clavanin-MO was capable of modulating innate immunity by stimulating leukocyte recruitment to the site of infection, and production of immune mediators GM-CSF, IFN-γ and MCP-1, while suppressing an excessive and potentially harmful inflammatory response by increasing synthesis of anti-inflammatory cytokines such as IL-10 and repressing the levels of pro-inflammatory cytokines IL-12 and TNF-α. Finally, treatment with the peptide protected mice against otherwise lethal infections caused by both Gram-negative and -positive drug-resistant strains. The peptide presented here directly kills bacteria and further helps resolve infections through its immune modulatory properties. Peptide anti-infective therapeutics with combined antimicrobial and immunomodulatory properties represent a new approach to treat antibiotic-resistant infections.

Development of PLA films containing oregano essential oil (Origanum vulgare L. virens) intended for use in food packaging.

Consumers' concerns about the environment and health have led to the development of new food packaging materials avoiding petroleum-based matrices and synthetic additives. The present study has developed polylactic acid (PLA) films containing different concentrations of essential oil from Origanum vulgare L. virens (OEO). The effectiveness of this new active packaging was checked for use in ready-to-eat salads. A plasticising effect was observed when OEO was incorporated in PLA films. The rest of the mechanical and physical properties of developed films did not show much change when OEO was included in the film. An antioxidant effect was recorded only for films containing the highest percentages of the active agent (5% and 10%). In addition, films exhibited in vitro antibacterial activity against Staphylococcus aureus, Yersinia enterocolitica, Listeria monocytogenes, Enterococcus faecalis and Staphylococcus carnosus. Moreover, in ready-to-eat salads, antimicrobial activity was only observed against yeast and moulds, where 5% and 10% of OEO was the most effective.

Melanoma maligno mucoso de cavidad nasal / Mucosal malignant melanoma of the nasal cavity

El melanoma maligno de cavidad nasal y senos paranasales es una patología rara, representa alrededor del 1% de todos los melanomas. Su sintomatología es inespecífica lo que dificulta el diagnóstico, tiene muy mal pronóstico con bajas tasas de supervivencia. Presentamos el caso de un varón de 66 años de edad, fumador de 30-40 cigarrillos por día, trabajador de la huerta expuesto a productos fitosanitarios que consultó por epistaxis recurrentes por fosa nasal derecha y ligera obstrucción respiratoria, a la exploración se observó una masa de color negruzco que ocupaba la fosa nasal derecha dependiente del cornete inferior derecho, el diagnóstico histopatológico fue de melanoma maligno; recibió tratamiento quirúrgico y radioterápico con evolución favorable. Revisamos la literatura de este raro tumor nasosinusal.

Malignant melanoma of the nasal cavity and paranasal sinuses is a rare disease, represents less than 1% of all melanomas. The symptoms are nonspecificand therefore diagnosis difficult. Has very poor prognosis, with low survival rates. We report a 66 year old smoking 30-40 cigarettes per day, orchard worker exposed to pesticides consulted for recurrent epistaxis by right nostril and light airway obstruction, exploration was observed a mass blackish located in the lower right turbinate, histopathological diagnosis was malignant melanoma; He received surgical and radiotherapy with favorable outcome. We review the literature on this rare sinonasal tumor. inferior turbinate.

Hiponatremia dilucional y trasplante hepático: Revisión / A Review of Dilutional Hyponatremia and Liver Transplantation

Los pacientes con hepatopatías avanzadas pueden presentar estados de hipervolemia que los puede llevar a desarrollar hiponatremia dilucional, la cual se origina principalmente a niveles persistentemente aumentados de hormona antidiurética. El trasplante hepático es la terapia de elección en pacientes con hepatopatías terminales con excelentes sobrevidas en el tiempo. La hiponatremia dilucional ha demostrado ser un factor pronóstico en pacientes con cirrosis e incluso de mortalidad en pacientes en lista de espera para trasplante de hígado. Por tal razón, actualmente hace parte de los puntajes de clasificación de lista de espera de trasplante hepático en pacientes con hepatopatías avanzadas. El papel de la hiponatremia pretrasplante en el pronóstico de pacientes que serán llevados a trasplante hepático es tema de renovado interés, con datos en la literatura bastante contradictorios. Hasta hace poco, solo la restricción hídrica era el tratamiento contra la hiponatremia dilucional; sin embargo, actualmente se dispone de tratamientos dirigidos contra la hiponatremia dilucional en pacientes con cirrosis con resultados algo alentadores, aunque poco se sabe sobre su efecto en pacientes con cirrosis que serán llevados a trasplante hepático.

Patients with advanced liver disease may present volume overloads that can lead to the development of dilutional hyponatremia primarily as the result of persistently high levels of antidiuretic hormone. Liver transplantation is the therapy of choice for patients with terminal liver disease. Patient survival time following transplantation is excellent. Dilutional hyponatremia has proven to be a prognostic factor for patients with cirrhosis, and it can even lead to mortality in patients on the waiting list for liver transplantation. Consequently, it is currently part of the scoring system for classifying patients with advanced liver disease who are on the waiting list for liver transplantation. The role of pretransplant hyponatremia in the prognoses of patients scheduled for liver transplantation is the subject of renewed interest, but the data in the literature is rather contradictory. Until recently, the only treatment for dilutional hyponatremia was the restriction of water intake, but now new and encouraging treatments are available that are directed against dilutional hyponatremia in patients with cirrhosis. Nevertheless, little is known about their effects in patients with cirrhosis who are about to undergo liver transplantation.

Atividades biológicas de espécies amazônicas de Rubiaceae / Biological activities of Amazonian species of Rubiaceae

RESUMORubiaceae é uma família botânica com grande potencial químico e biológico Neste trabalho realizou-se a prospecção fitoquímica e avaliou-se as atividades citotóxica, antioxidante e antifúngica dos extratos diclorometânicos e metanólicos das folhas de Duroia saccifera, Ferdinandusa goudotiana, F. hirsuta, F. paraensis, Ferdinandusa sp., Palicourea corymbifera e P. guianensis. A avaliação da citotoxicidade foi realizada empregando-se o ensaio de toxicidade sobre Artemia salina. A atividade antifúngica foi determinada pelo método de difusão em ágar utilizando-se os fungos: Epidermophyton floccosum, Microsporum canis 32905, M. gipseum 29/00, Trichophyton mentagrophytes ATCC 9533/03, T. rubrum ATCC 28189, T. tonsurans 21/97, Cladosporium cladosporioides, C. sphaerospermum, FusariumU. 662/06, Scytalidium U. 661/06, Candida albicans ATCC 3632 e C. albicans U. 5/99. A atividade antioxidante foi determinada através dos ensaios de redução do radical livre 1,1-difenil-2-picrilhidrazila (DPPH) e de descoloração do cátion radical ácido-6-sulfônico-2,2-azinobis-3-etilbenzotiazolina (ABTS). Para o ensaio de toxicidade sobre A. salina observou-se maior toxicidade no extrato metanólico de F. goudotiana, que se mostrou tóxico até a concentração de 5 µg mL-1. A presença de princípios antifúngicos foi observada em F. hirsuta e F. paraensiscontra quatro dos fungos testados. Na avaliação da atividade antioxidante os extratos metanólicos mostraram maior atividade que os extratos diclorometânicos, sendo coincidente o resultado obtido através de ambos os métodos (redução do DPPH e descoloração do ABTS). Os resultados criam possibilidades para futuras investigações relacionadas à estrutura e atividade dos componentes de cada extrato ativo.

ABSTRACTRubiaceae is a plant family with great chemical and biological potential. In this work a phytochemical prospection was performed and it was assessed the cytotoxic, antioxidant and antifungal activities of dichloromethanic and methanolic extracts of the leaves of Duroia saccifera, Ferdinandusagoudotiana, F. hirsuta, F. paraensis, Ferdinandusa sp., Palicourea corymbifera and P. guianensis. The cytotoxicity evaluation was carried out using the test toxicity on Artemia salina. The antifungal activity was determined by agar diffusion method using fungi: Epidermophyton floccosum, Microsporum canis 32905, M. gipseum 29/00, Trichophyton mentagrophytes ATCC 9533/03, T.rubrum ATCC 28189, T. tonsurans 21/97 , Cladosporium cladosporioides, C. sphaerospermum, FusariumU. 662/06, Scytalidium U. 661/06, Candida albicans ATCC 3632 and C. albicans U. 5/99. The antioxidant activity was determined by testing the amount of free radical 1,1-diphenyl-2-picrylhydrazyl (DPPH) and the discoloration of the radical cation 6-sulfonic acid-2 ,2-azinobis-3-ethylbenzothiazoline (ABTS). For the toxicity test on A. salina greater toxicity in the methanol extract of F. goudotiana was observed, which proved to be toxic up to a concentration of 5 µg mL-1. The presence of antifungal principles was observed in the F. hirsuta and F. paraensis against four tested fungi. In the evaluation of the antioxidant activity, the methanol extracts showed greater activity than the dichloromethanic ones, being similar the obtained result through both methods (reduction of DDPH and ABTS decolorization) . The results create possibilities for future researches related to the structure and activity of the components of each active extract.

Role of TNFRSF1B polymorphisms in the response of Crohn's disease patients to infliximab.

Infliximab (IFX) is a valid treatment for Crohn's disease (CD), but a relevant percentage of patients do not benefit from this therapy. In the Japanese population, the response to IFX was associated with markers in the TNF receptor superfamily 1A (TNFRSF1A) and 1B (TNFRSF1B) genes. We aimed to replicate the association previously described in the Japanese population and to ascertain the role of TNF receptors as modulators of the response to IFX. We studied 297 white Spanish CD patients with a known response to IFX: 238 responders and 59 primary nonresponders. Four single nucleotide polymorphisms (SNPs) were analyzed: rs767455 in TNFRSF1A and rs1061622, rs1061624, and rs3397 in TNFRSF1B. Comparisons between groups were performed with chi-square tests or the Fisher's exact test. Different features (sex, age, disease duration, smoking among others) were evaluated as possible confounding factors. No significant association was found between the studied TNFRSF1A polymorphisms and response to IFX. In the TNFRSF1B gene, the haplotype rs1061624_A-rs3397_T was significantly increased in nonresponders: p = 0.015, OR = 1.78, 95% CI 1.09-2.90; and an increased frequency of rs1061622_G carriers was observed in patients with remission: p = 0.033 vs nonresponders and p = 0.023 vs patients with a partial response. Our results support a role of TNFRSF1B gene variants in the response to IFX in CD patients.

Defective regulation of adipose tissue autophagy in obesity.

OBJECTIVES: Autophagy is a highly regulated process that has an important role in the control of a wide range of cellular functions, such as organelle recycling, nutrient availability and tissue differentiation. A recent study has shown an increased autophagic activity in the adipose tissue of obese subjects, and a role for autophagy in obesity-associated insulin resistance was proposed. Body mass reduction is the most efficient approach to tackle insulin resistance in over-weight subjects; however, the impact of weight loss in adipose tissue autophagy is unknown. SUBJECTS: Adipose tissue autophagy was evaluated in mice and humans. RESULTS: First, a mouse model of diet-induced obesity and diabetes was maintained on a 15-day, 40% caloric restriction. At baseline, markers of autophagy were increased in obese mice as compared with lean controls. Upon caloric restriction, autophagy increased in the lean mice, whereas it decreased in the obese mice. The reintroduction of ad libitum feeding was sufficient to rapidly reduce autophagy in the lean mice and increase autophagy in the obese mice. In the second part of the study, autophagy was evaluated in the subcutaneous adipose tissue of nine obese-non-diabetic and six obese-diabetic subjects undergoing bariatric surgery for body mass reduction. Specimens were collected during the surgery and approximately 1 year later. Markers of systemic inflammation, such as tumor necrosis factor-1α, interleukin (IL)-6 and IL-1ß were evaluated. As in the mouse model, human obesity was associated with increased autophagy, and body mass reduction led to an attenuation of autophagy in the adipose tissue. CONCLUSION: Obesity and caloric overfeeding are associated with the defective regulation of autophagy in the adipose tissue. The studies in obese-diabetic subjects undergoing improved metabolic control following calorie restriction suggest that autophagy and inflammation are regulated independently.

Neumonía grave del adulto adquirida en la comunidad manejada en sala de cuidados generales en un hospital público / Severe community-acquired pneumonia in adult patients managed in a general ward at a public hospital

Introducción: la neumonía grave del adulto adquirida en la comunidad (NAC grave) se caracteriza por requerir manejo en la unidad de cuidados intensivos (UCI), dado su mayor mortalidad y riesgo de complicaciones, por lo cual se han diseñado distintas escalas de predicción de gravedad. Objetivo: identificar apacientes adultos con NAC grave manejados en la sala de cuidados generales. Pacientes y Métodos: estudio clínico descriptivo retrospectivo, se revisaron las fichas clínicas de 131 pacientes adultos egresados del servicio de medicina del hospital de Quilpué con el diagnóstico de NAC entre el 1 de enero y 31 de diciembre del 2010. Se examinaron los criterios de NAC grave de la Sociedad de Tórax Americana (ATS) y se midió el CURB-65 de 89 pacientes que consignaban esta información. Resultados: en 16 pacientes (18 por ciento) se obtuvo una puntuación del CURB-65 > 3 y en 8 pacientes (9 por ciento) se identificaron > 3 criterios menores de la ATSy en 2 de ellos un criterio mayor. Conclusión: se identificaron pacientes con NAC grave manejados en la sala de cuidados generales de un hospital publico.

Introduction: severe community-acquired pneumonia (severe CAP) is characterized by intensive care unit (ICU) requirement, given its higher mortality and complications rate. Different prediction scales have been designed to assess severity. Objective: identify adult patients with severe CAP managed in the general ward of a public hospital. Patients and Methods: retrospective descriptive study, including all adult patients dischargedfrom hospital with CAP diagnosis, from january 1st to december 31st, 2010, with a total of 131 medical records reviewed. The American Thoracic Society criteria (ATS) of severe CAP and CURB-65 scores from 89 medical records were calculated. Results: 16 patients (18 percent) had CURB-65 score > 3, 8 patients (9 percent) had > 3 minor ATS criteria, and 2 of those patients had a major criterion. Conclusion: a significant number of patients with severe CAP were managed on the general ward of a public hospital.