Phantom limb pain, traumatic neuroma, or nerve sheath tumor? Illustrative case.

BACKGROUND: Phantom limb pain and traumatic neuromas are not commonly seen in neurosurgical practice. These conditions can present with similar symptoms; however, management of traumatic neuroma is often surgical, whereas phantom limb pain is treated with conservative measures. OBSERVATIONS: A 77-year-old female patient with a long-standing history of an above-the-knee amputation experienced severe pain in her right posterior buttocks area for several years' duration, attributed to phantom limb pain, which radiated down the stump of her leg and was treated with a variety of conservative measures. A recent exacerbation of her pain led to a prolonged hospitalization with magnetic resonance imaging of her leg stump, revealing a mass in the sciatic notch, at a relative distance from the stump. The anatomical location of the mass on the sciatic nerve in the notch led to a presumed radiological diagnosis of nerve sheath tumor, for which she underwent excision. At surgery, a neuroma of the proximal portion of the transected sciatic nerve that had retracted from the amputated stump to the notch was diagnosed. LESSONS: Traumatic neuromas of transected major nerves after limb amputation should be considered in the differential diagnosis of phantom limb pain.

Digital Microscopy Augmented by Artificial Intelligence to Interpret Bone Marrow Samples for Hematological Diseases.

Analysis of bone marrow aspirates (BMAs) is an essential step in the diagnosis of hematological disorders. This analysis is usually performed based on a visual examination of samples under a conventional optical microscope, which involves a labor-intensive process, limited by clinical experience and subject to high observer variability. In this work, we present a comprehensive digital microscopy system that enables BMA analysis for cell type counting and differentiation in an efficient and objective manner. This system not only provides an accessible and simple method to digitize, store, and analyze BMA samples remotely but is also supported by an Artificial Intelligence (AI) pipeline that accelerates the differential cell counting process and reduces interobserver variability. It has been designed to integrate AI algorithms with the daily clinical routine and can be used in any regular hospital workflow.

Evaluation of the Performance of a 3D-Printed Smartphone-Based Retinal Imaging Device as a Screening Tool for Retinal Pathology in Mozambique.

Low-income countries carry approximately 90% of the global burden of visual impairment, and up to 80% of this could be prevented or cured. However, there are only a few studies on the prevalence of retinal disease in these countries. Easier access to retinal information would allow differential diagnosis and promote strategies to improve eye health, which are currently scarce. This pilot study aims to evaluate the functionality and usability of a tele-retinography system for the detection of retinal pathology, based on a low-cost portable retinal scanner, manufactured with 3D printing and controlled by a mobile phone with an application designed ad hoc. The study was conducted at the Manhiça Rural Hospital in Mozambique. General practitioners, with no specific knowledge of ophthalmology or previous use of retinography, performed digital retinographies on 104 hospitalized patients. The retinographies were acquired in video format, uploaded to a web platform, and reviewed centrally by two ophthalmologists, analyzing the image quality and the presence of retinal lesions. In our sample there was a high proportion of exudates and hemorrhages-8% and 4%, respectively. In addition, the presence of lesions was studied in patients with known underlying risk factors for retinal disease, such as HIV, diabetes, and/or hypertension. Our tele-retinography system based on a smartphone coupled with a simple and low-cost 3D printed device is easy to use by healthcare personnel without specialized ophthalmological knowledge and could be applied for the screening and initial diagnosis of retinal pathology.

Clinical trial links oncolytic immunoactivation to survival in glioblastoma.

Immunotherapy failures can result from the highly suppressive tumour microenvironment that characterizes aggressive forms of cancer such as recurrent glioblastoma (rGBM)1,2. Here we report the results of a first-in-human phase I trial in 41 patients with rGBM who were injected with CAN-3110-an oncolytic herpes virus (oHSV)3. In contrast to other clinical oHSVs, CAN-3110 retains the viral neurovirulence ICP34.5 gene transcribed by a nestin promoter; nestin is overexpressed in GBM and other invasive tumours, but not in the adult brain or healthy differentiated tissue4. These modifications confer CAN-3110 with preferential tumour replication. No dose-limiting toxicities were encountered. Positive HSV1 serology was significantly associated with both improved survival and clearance of CAN-3110 from injected tumours. Survival after treatment, particularly in individuals seropositive for HSV1, was significantly associated with (1) changes in tumour/PBMC T cell counts and clonal diversity, (2) peripheral expansion/contraction of specific T cell clonotypes; and (3) tumour transcriptomic signatures of immune activation. These results provide human validation that intralesional oHSV treatment enhances anticancer immune responses even in immunosuppressive tumour microenvironments, particularly in individuals with cognate serology to the injected virus. This provides a biological rationale for use of this oncolytic modality in cancers that are otherwise unresponsive to immunotherapy (ClinicalTrials.gov: NCT03152318 ).

Commonalities between the Atacama Desert and Antarctica rhizosphere microbial communities.

Plant-microbiota interactions have significant effects on plant growth, health, and productivity. Rhizosphere microorganisms are involved in processes that promote physiological responses to biotic and abiotic stresses in plants. In recent years, the interest in microorganisms to improve plant productivity has increased, mainly aiming to find promising strains to overcome the impact of climate change on crops. In this work, we hypothesize that given the desertic environment of the Antarctic and the Atacama Desert, different plant species inhabiting these areas might share microbial taxa with functions associated with desiccation and drought stress tolerance. Therefore, in this study, we described and compared the composition of the rhizobacterial community associated with Deschampsia antarctica (Da), Colobanthus quitensis (Cq) from Antarctic territories, and Croton chilensis (Cc), Eulychnia iquiquensis (Ei) and Nicotiana solanifolia (Ns) from coastal Atacama Desert environments by using 16S rRNA amplicon sequencing. In addition, we evaluated the putative functions of that rhizobacterial community that are likely involved in nutrient acquisition and stress tolerance of these plants. Even though each plant microbial rhizosphere presents a unique taxonomic pattern of 3,019 different sequences, the distribution at the genus level showed a core microbiome with a higher abundance of Haliangium, Bryobacter, Bacillus, MND1 from the Nitrosomonadaceae family, and unclassified taxa from Gemmatiamonadaceae and Chitinophagaceae families in the rhizosphere of all samples analyzed (781 unique sequences). In addition, species Gemmatirosa kalamazoonesis and Solibacter usitatus were shared by the core microbiome of both Antarctic and Desert plants. All the taxa mentioned above had been previously associated with beneficial effects in plants. Also, this microbial core composition converged with the functional prediction related to survival under harsh conditions, including chemoheterotrophy, ureolysis, phototrophy, nitrogen fixation, and chitinolysis. Therefore, this study provides relevant information for the exploration of rhizospheric microorganisms from plants in extreme conditions of the Atacama Desert and Antarctic as promising plant growth-promoting rhizobacteria.

Remote analysis of sputum smears for mycobacterium tuberculosis quantification using digital crowdsourcing.

Worldwide, TB is one of the top 10 causes of death and the leading cause from a single infectious agent. Although the development and roll out of Xpert MTB/RIF has recently become a major breakthrough in the field of TB diagnosis, smear microscopy remains the most widely used method for TB diagnosis, especially in low- and middle-income countries. This research tests the feasibility of a crowdsourced approach to tuberculosis image analysis. In particular, we investigated whether anonymous volunteers with no prior experience would be able to count acid-fast bacilli in digitized images of sputum smears by playing an online game. Following this approach 1790 people identified the acid-fast bacilli present in 60 digitized images, the best overall performance was obtained with a specific number of combined analysis from different players and the performance was evaluated with the F1 score, sensitivity and positive predictive value, reaching values of 0.933, 0.968 and 0.91, respectively.

Overexpression of IGF-1 During Early Development Expands the Number of Mammary Stem Cells and Primes them for Transformation.

Insulin-like growth factor I (IGF-1) has been implicated in breast cancer due to its mitogenic and anti-apoptotic effects. Despite substantial research on the role of IGF-1 in tumor progression, the relationship of IGF-1 to tissue stem cells, particularly in mammary tissue, and the resulting tumor susceptibility has not been elucidated. Previous studies with the BK5.IGF-1 transgenic (Tg) mouse model reveals that IGF-1 does not act as a classical, post-carcinogen tumor promoter in the mammary gland. Pre-pubertal Tg mammary glands display increased numbers and enlarged sizes of terminal end buds, a niche for mammary stem cells (MaSCs). Here we show that MaSCs from both wild-type (WT) and Tg mice expressed IGF-1R and that overexpression of Tg IGF-1 increased numbers of MaSCs by undergoing symmetric division, resulting in an expansion of the MaSC and luminal progenitor (LP) compartments in pre-pubertal female mice. This expansion was maintained post-pubertally and validated by mammosphere assays in vitro and transplantation assays in vivo. The addition of recombinant IGF-1 promoted, and IGF-1R downstream inhibitors decreased mammosphere formation. Single-cell transcriptomic profiles generated from 2 related platforms reveal that IGF-1 stimulated quiescent MaSCs to enter the cell cycle and increased their expression of genes involved in proliferation, plasticity, tumorigenesis, invasion, and metastasis. This study identifies a novel, pro-tumorigenic mechanism, where IGF-1 increases the number of transformation-susceptible carcinogen targets during the early stages of mammary tissue development, and "primes" their gene expression profiles for transformation.

Tumor renal con extensión al atrio derecho a través de la vena cava inferior: reporte de caso / Renal tumor with extension to the right atrium through the inferior vena cava: case report

Resumen El presente articulo describe un caso clínico de una paciente con un ''trombo tumoral''. Estos son tumores que se extienden desde el órgano afectado hasta el atrio derecho, por la vena cava inferior. Hasta el 10 % de los tumores descritos pueden alcanzar la vena cava inferior y el 1 % de estos llegan a atrio derecho. El carcinoma de células renales es el más frecuente en producir este cuadro. El objetivo del articulo es mostrar que es fundamental realizar un adecuado diagnóstico diferencial, ya que existen diferentes procesos tumorales que pueden causar un ''trombo tumoral'' y diferentes causas de masas en el atrio derecho. La clínica de los pacientes con este cuadro será por obstrucción de la vena cava. El diagnóstico se realiza con estudios de imágenes, ultrasonido (US), ecocardiograma, tomografía axial computarizada (TAC) y resonancia magnética. El manejo debe de ser quirúrgico, sin embargo, presenta pronóstico desfavorable, en algunos casos se puede resecar el tumor primario y extraer la masa que ha invadido la vena cava inferior.

Abstract: This article describes a clinical case of a patient with a 'tumoral thrombus''. These are tumors that extend from the affected organ to the right atrium, through the inferior vena cava. Up to 10% of the tumors described can reach the inferior vena cava and 1% of these reach the right atrium. Renal cell carcinoma is the most common to produce this condition. The objective of the article is to show that it is essential to carry out an adequate differential diagnosis since there are different tumor processes that can cause a ''tumoral thrombus'' and different causes of masses in the right atrium. The symptoms of patients with this condition will be caused by the obstruction of the vena cava. The diagnosis is made with imaging studies, ultrasound (US), echocardiography, computerized axial tomography (CT) and magnetic resonance imaging. The management must be surgical, however it has an unfavorable prognosis, in some cases the primary tumor can be resected and the mass that has invaded the inferior vena cava removed.

Bacterial communities in fecal samples of myotis chiloensis from Southern, Chile / Comunidades bacterianas presentes en muestras fecales de myotis chiloensis en el sur de Chile

SUMMARY: The insectivorous bat Myotis chiloensis is endemic of South America. Even though potentially pathogenic bacterial species of Mycoplasma have been reported from this species, there are no further studies regarding the bacterial communities they harbor. This may provide important insights for the better understanding of its ecology, diet and implications in cross-species pathogens transmission. Here we report a first survey on bacterial communities of M. chiloensis based on metagenomic analysis of fecal samples. We found that taxonomic profile is dominated by Proteobacteria (23.7 to 57.7 %) and Firmicutes (11.8 to 61.6 %), which main families are represented by Burkholderiaceae- Enterobacteriaceae and Veillonellaceae-Bacillaceae, respectively. Phyla Bacteroidetes, Actinobacteria, Cyanobacteria, Planctomycetes and Acidobacteria were also present with abundance above 1 % of the total reads. Variations among individuals could be observed at genus level and no significant differences were found between sex groups regarding taxonomic profiles and diversity. Potentially pathogenic species were also detected in all the samples, including Staphylococcus aureus and Clostridium perfringens. Our results highlight the significance M. chiloensis as a reservoir of pathogenic bacteria and its microbiota as an interesting ecological model due to its wide distribution. Further metagenomic studies are necessary for a better understanding of M. chiloensis diet and its host-symbiont relationships.

RESUMEN: El murciélago insectívoro Myotis chiloensis es endémico de América del Sur. A pesar de que en esta especie se han reportado bacterias potencialmente patógenas tipo Mycoplasma, no existen estudios sobre sus comunidades bacterianas, lo cual podría proporcionar información importante para una mejor comprensión de su ecología, dieta e implicaciones en la transmisión de patógenos. En el presente trabajo se realiza una descripción de las comunidades bacterianas del murciélago M. chiloensis basada en análisis metagenómico de muestras fecales. El perfil taxonómico encontradofue dominado por Proteobacterias (23,7-57,7 %) y Firmicutes (11,8-61,6 %), cuyas principales familias fueron representadas por Burkholderiaceae-Enterobacteriaceae y Veillonellaceae-Bacillaceae, respectivamente. También se encontraron los filos Bacteroidetes, Actinobacteria, Cyanobacteria, Planctomycetes y Acidobacteria con una abundancia superior al 1 %. Se observaron variaciones entre los individuos a nivel de género, sin diferencias significativas de los perfiles taxonómicos y diversidad según sexo. Se detectaron especies potencialmente patógenas en todas las muestras, entre ellos Staphylococcus aureus y Clostridium perfringens. Nuestros resultados destacan la importancia de M. chiloensis como un reservorio de bacterias patógenas y el estudio de su microbiota como un modelo ecológico debido a su amplia distribución. Más estudios metagenómicos son necesarios para comprender la dieta de M. chiloensis y sus relaciones huésped-simbionte.

Kullback-Leibler Divergence of a Freely Cooling Granular Gas.

Finding the proper entropy-like Lyapunov functional associated with the inelastic Boltzmann equation for an isolated freely cooling granular gas is a still unsolved challenge. The original H-theorem hypotheses do not fit here and the H-functional presents some additional measure problems that are solved by the Kullback-Leibler divergence (KLD) of a reference velocity distribution function from the actual distribution. The right choice of the reference distribution in the KLD is crucial for the latter to qualify or not as a Lyapunov functional, the asymptotic "homogeneous cooling state" (HCS) distribution being a potential candidate. Due to the lack of a formal proof far from the quasielastic limit, the aim of this work is to support this conjecture aided by molecular dynamics simulations of inelastic hard disks and spheres in a wide range of values for the coefficient of restitution (α) and for different initial conditions. Our results reject the Maxwellian distribution as a possible reference, whereas they reinforce the HCS one. Moreover, the KLD is used to measure the amount of information lost on using the former rather than the latter, revealing a non-monotonic dependence with α.

Unraveling response to temozolomide in preclinical GL261 glioblastoma with MRI/MRSI using radiomics and signal source extraction.

Glioblastoma is the most frequent aggressive primary brain tumor amongst human adults. Its standard treatment involves chemotherapy, for which the drug temozolomide is a common choice. These are heterogeneous and variable tumors which might benefit from personalized, data-based therapy strategies, and for which there is room for improvement in therapy response follow-up, investigated with preclinical models. This study addresses a preclinical question that involves distinguishing between treated and control (untreated) mice bearing glioblastoma, using machine learning techniques, from magnetic resonance-based data in two modalities: MRI and MRSI. It aims to go beyond the comparison of methods for such discrimination to provide an analytical pipeline that could be used in subsequent human studies. This analytical pipeline is meant to be a usable and interpretable tool for the radiology expert in the hope that such interpretation helps revealing new insights about the problem itself. For that, we propose coupling source extraction-based and radiomics-based data transformations with feature selection. Special attention is paid to the generation of radiologist-friendly visual nosological representations of the analyzed tumors.

Escala de Ansiedad por Coronavirus: Un Nuevo Instrumento para Medir Síntomas de Ansiedad Asociados al COVID-19 / Coronavirus Anxiety Scale: A New Instrument to Measure Anxiety Symptoms Associated with COVID-19

RESUMEN Introducción : El propósito de este estudio fue adaptar y validar el Coronavirus Anxiety Scale en una muestra de hispanos residentes en Puerto Rico. Este instrumento es un breve cernimiento de salud mental para identificar síntomas de ansiedad asociados específicamente al COVID-19. Método : Se utilizó un muestreo por disponibilidad y una muestra de 327 participantes de habla hispana. Resultados : Los análisis psicométricos confirmaron que la escala posee una estructura unidimensional y una sólida confiabilidad (Ω = .93) y validez. Los 5 ítems cumplieron con valores adecuados de discriminación, demostrando que el instrumento puede distinguir entre personas que presentan síntomas de ansiedad asociados al COVID-19 y los que no presentan síntomas. El punto de corte, según los análisis realizados, para identificar síntomas significativos de ansiedad por coronavirus fue ≥ 10. La prevalencia de síntomas significativos de ansiedad por coronavirus fue de 15.29% (n = 50). Conclusión : Estos resultados respaldan la escala como una herramienta eficaz y válida para la investigación y práctica clínica.

ABSTRACT Background : The purpose of this study was to adapt and validate the Coronavirus Anxiety Scale in a sample of Hispanic residents in Puerto Rico. This instrument is a brief mental health screening to identify anxiety symptoms associated with COVID-19. Method : An availability sampling and a sample of 327 Spanish-speaking participants were used. Results : Psychometric analyses confirmed that the scale has a one-dimensional structure and solid reliability (Ω = .93) and validity. The five items met fair discrimination values, demonstrating that the instrument can distinguish between people with anxiety symptoms associated with COVID-19 and those without symptoms. According to the analyses performed, the cut-off points to identify significant symptoms of coronavirus anxiety was ≥ 10. The prevalence of significant symptoms of coronavirus anxiety was 15.29% (n = 50). Conclusions : These results support the scale as a useful and valid tool for clinical research and practice.

Erratum: Energy nonequipartition in gas mixtures of inelastic rough hard spheres: The tracer limit [Phys. Rev. E 96, 052901 (2017)].

This corrects the article DOI: 10.1103/PhysRevE.96.052901.

Large Mpemba-like effect in a gas of inelastic rough hard spheres.

We report the emergence of a giant Mpemba effect in the uniformly heated gas of inelastic rough hard spheres: The initially hotter sample may cool sooner than the colder one, even when the initial temperatures differ by more than one order of magnitude. In order to understand this behavior, it suffices to consider the simplest Maxwellian approximation for the velocity distribution in a kinetic approach. The largeness of the effect stems from the fact that the rotational and translational temperatures, which obey two coupled evolution equations, are comparable. Our theoretical predictions agree very well with molecular dynamics and direct simulation Monte Carlo data.

Dynamic role of the codon 72 p53 single-nucleotide polymorphism in mammary tumorigenesis in a humanized mouse model.

Female breast cancer (BrCa) is the most common noncutaneous cancer among women in the United States. Human epidemiological studies reveal that a p53 single-nucleotide polymorphism (SNP) at codon 72, encoding proline (P72) or arginine (R72), is associated with differential risk of several cancers, including BrCa. However, the molecular mechanisms by which these variants affect mammary tumorigenesis remain unresolved. To investigate the effects of this polymorphism on susceptibility to mammary cancer, we used a humanized p53 mouse model, homozygous for either P72 or R72. Our studies revealed that R72 mice had a significantly higher mammary tumor incidence and reduced latency in both DMBA-induced and MMTV-Erbb2/Neu mouse mammary tumor models compared to P72 mice. Analyses showed that susceptible mammary glands from E-R72 (R72 x MMTV-Erbb2/Neu) mice developed a senescence-associated secretory phenotype (SASP) with influx of proinflammatory macrophages, ultimately resulting in chronic, protumorigenic inflammation. Mammary tumors arising in E-R72 mice also had an increased influx of tumor-associated macrophages, contributing to angiogenesis and elevated tumor growth rates. These results demonstrate that the p53 R72 variant increased susceptibility to mammary tumorigenesis through chronic inflammation.

Pharmacological and toxicological study of a chemical-standardized ethanol extract of the branches and leaves from Eysenhardtia polystachya (Ortega) Sarg. (Fabaceae).

Eysenhardtia polystachya is used for the empirical treatment of cancer, infections, diarrhea, inflammation, and pain. This study identified, using GC-MS, the main chemical components in an ethanol extract of E. polystachya branches and leaves (EPE) and tested its cytotoxic, antimicrobial, anti-diarrheal, anti-inflammatory, and antinociceptive effects. The in vitro and in vivo toxicity of EPE was evaluated using the comet assay in human peripheral blood mononuclear cells (PBMC) and the acute toxicity test in mice, respectively. The cytotoxic and the antimicrobial effects were performed using the MTT assay and the minimum inhibitory concentration (MIC) test, respectively. The levels of pro-inflammatory mediators in LPS-stimulated macrophages were measured to evaluate the in vitro anti-inflammatory effects of EPE. The antidiarrheal (castor oil test, small intestine transit, and castor oil-induced enteropooling), and anti-inflammatory activities (TPA and carrageenan) of EPE were also performed. The antinociceptive actions of EPE were carried out with the following tests: acetic acid, formalin, and hot plate. The hypnotic and locomotor effects were analyzed using pentobarbital and a rotarod system, respectively. The main component in EPE was D-pinitol (26.93%). The antidiarrheal and antinociceptive effects of D-pinitol were also evaluated. EPE showed low in vitro toxicity (DNA damage in PBMC at concentrations higher than 200 µg/ml), and low in vivo toxicity (LD50 > 2000 mg/kg i.p. and p.o.). Furthermore, EPE lacked cytotoxic activity (IC50 > 300 µg/ml) on human cancer cells, but showed good antimicrobial effects in E. coli (MIC=1.56 µg/ml) and S. aureus (MIC = 0.78 µg/ml). In multi-drug resistant microorganisms, EPE showed MIC> 100 µg/ml. EPE exerted in vitro anti-inflammatory effects, mainly, by the decrease in the production of H2O2 (IC50 = 43.9 ±â€¯3.8 µg/ml), and IL-6 (73.3 ±â€¯6.9 µg/ml). EPE (ED50 =7.5 ±â€¯0.9 mg/kg) and D-pinitol (ED50 = 0.1 ±â€¯0.03 mg/kg) showed antidiarrheal activity, and antinociceptive effects in the acetic acid test with ED50 = 117 ±â€¯14.5 mg/kg for EPE and 33 ±â€¯3.2 mg/kg for D-pinitol. EPE showed also antinociceptive activity in the phase 2 of the formalin test (ED50 = 48.9 ±â€¯3.9 mg/kg), without inducing hypnotic effects or altering the locomotor activity in mice. The results here presented corroborate the folk medicinal use of Eysenhardtia polystachya in the treatment of infections, diarrhea, inflammation, and pain. D-pinitol, the main metabolite of EPE, showed antinociceptive and antidiarrheal effects with similar potency compared to standard drugs.

Impact of roughness on the instability of a free-cooling granular gas.

A linear stability analysis of the hydrodynamic equations with respect to the homogeneous cooling state is carried out to identify the conditions for stability of a granular gas of rough hard spheres. The description is based on the results for the transport coefficients derived from the Boltzmann equation for inelastic rough hard spheres [Phys. Rev. E 90, 022205 (2014)PLEEE81539-375510.1103/PhysRevE.90.022205], which take into account the complete nonlinear dependence of the transport coefficients and the cooling rate on the coefficients of normal and tangential restitution. As expected, linear stability analysis shows that a doubly degenerate transversal (shear) mode and a longitudinal ("heat") mode are unstable with respect to long enough wavelength excitations. The instability is driven by the shear mode above a certain inelasticity threshold; at larger inelasticity, however, the instability is driven by the heat mode for an inelasticity-dependent range of medium roughness. Comparison with the case of a granular gas of inelastic smooth spheres confirms previous simulation results about the dual role played by surface friction: while small and large levels of roughness make the system less unstable than the frictionless system, the opposite happens at medium roughness. On the other hand, such an intermediate window of roughness values shrinks as inelasticity increases and eventually disappears at a certain value, beyond which the rough-sphere gas is always less unstable than the smooth-sphere gas. A comparison with some preliminary simulation results shows a very good agreement for conditions of practical interest.

Implicancias estructurales y fisiológicas de la célula bacteriana en los mecanismos de resistencia antibiótica / Structural and physiological implications of bacterial cell in antibiotic resistance mechanisms

RESUMEN: La alta capacidad de adaptación de las bacterias a ambientes hostiles ha permitido el desarrollo de resistencia a antibacterianos, causando problemas de impacto mundial en la salud hospitalaria y de la comunidad, limitando las opciones terapéuticas lo que afecta el control de enfermedades, elevando las tasas de morbi-mortalidad. Esta capacidad de resistencia es mediada por factores estructurales y fisiológicos de las bacterias que actúan a diferentes niveles tanto extracelular como intracelular. A niveles extracelulares se destaca la capacidad de las poblaciones bacterianas en la formación de biopelículas y la regulación de señales celulares quorum sensing, permitiendo la evasión de la acción antibiótica. A nivel de envoltura celular se destaca el funcionamiento y comportamiento de la pared celular y de la membrana celular, principalmente por medio de la regulación de la expresión de canales de entrada o porinas y/ o bombas de expulsión que impiden el acceso o inducen la salida de antibióticos; otros mecanismos integran la modificación de la actividad de drogas por medio de la hidrólisis o modificación del sitio activo del fármaco. A nivel intracelular, las bacterias pueden cambiar los procesos de óxido/reducción, modificar los sitios objetivos del antibiótico e inactivar los grupos transfer, y modificar las subunidades ribosomales afectando la acción de los antibióticos que inhiben la síntesis de proteínas. A esto se añaden las modificaciones en la expresión génica y del código genético, que regula todos los anteriores, y es capaz de generar cambios adaptativos, resistencia a fármacos y desinfectantes, entre otros. La presente revisión tiene como objetivo describir las implicancias estructurales y fisiológicas de la célula bacteriana en los mecanismos de resistencia antibiótica considerando la organización estructural y fisiológica involucrada en los principales mecanismos de resistencia a antibióticos presentes en bacterias de importancia clínica que conllevan a fallas terapéuticas con alto costo en salud humana.

SUMMARY: The high adaptability of bacteria to hostile environments has favored antibacterial resistance development, impacting hospital and community healthcare worldwide. It has also affected disease control, limited therapeutic options and raised morbiditymortality rate. This resistance ability is mediated by structural and physiological factors of bacteria acting at both extracellular and cellular levels. The ability of bacterial populations in biofilm formation and regulation of cellular signal quorum sensing at the extracellular level, allows for the evasion of antibiotic action. At a cellular level, the performance and behavior of the cell wall and cell membrane is emphasized, mainly by regulating the expression of inlet channels or porins and/or expulsion pumps preventing access to, or inducing the outflow of antibiotics. Other mechanisms integrate modification of drug activity by hydrolysis or modification of the active site of the drug. Further into intracellular level, bacteria can change the oxidation/reduction processes; modify the target sites of the antibiotic and inactivate transfer groups. Bacteria can also modify the ribosomal subunits affecting the antibiotics which inhibit protein synthesis, and cause modifications of gene expression and genetic code that regulate the above mechanism. These may also generate adaptive changes and resistance to drugs and disinfectants. The aim of the present review is to describe the structural and physiological implications of bacterial cell in the mechanisms of antibiotic resistance. The study also considered the structural and physiological organization involved in the main mechanisms of antibiotic resistance in bacteria relevant to clinical healthcare.

Nanopartículas Sintetizadas por Bacterias Antárticas y sus Posibles Mecanismos de Síntesis / Nanoparticles Synthesized by Antarctic Bacteria and their Possible Mechanisms of Synthesis

En los últimos años microorganismos tales como hongos, levaduras y, en especial, las bacterias han sido utilizadas para realizar biosíntesis de nanopartículas. Existen varios tipos de bacterias descritas como productoras de nanopartículas, sin embargo, las bacterias psicrófilas y psicrotolerantes no han sido ampliamente estudiadas, aun cuando su utilización en la producción de nanopartículas podría entregar ventajas relacionadas con su estabilidad, el gasto energético de su producción, al mismo tiempo que son una alternativa amigable con el medio ambiente. Este artículo entrega una breve revisión de las bacterias antárticas psicrófilas y psicrotolerantes sintetizadoras de nanopartículas, los posibles mecanismos que se asocian a esta síntesis y perspectivas futuras relacionadas a la biosíntesis bacteriana de nanopartículas.

In recent years microorganisms as fungi, yeasts and especially bacteria have been used to produce nanoparticles biosynthesis. Several types of bacteria are described as nanoparticles producers, however, psychrophilic and psychrotolerant bacterias have not been studied widely, although its use in the production of nanoparticles could provide advantages related to the stability of nanoparticles, energy expenditure on its production, while being an environmentally friendly alternative. This article provides a brief overview of Antarctic bacterias, both psychrophilic and psychrotolerant that synthesis nanoparticles, possible mechanisms associated to this synthesis and future perspectives related to bacterial biosynthesis of nanoparticles.