Core items to be included in a definition of moderate psoriatic arthritis: literature review and expert opinion.

Evidence-based treatment recommendations for psoriatic arthritis (PsA) suggest that treatment should be individualised but acknowledge the difficulty of correctly defining levels of activity (mild, moderate and severe). The aim of this study was to define the parameters or disease characteristics that should be included in a future definition of moderate PsA. Mixed. methods: (1) literature review to identify previous assessment tools used to classify patients into mild, moderate and severe forms, and (2) survey of rheumatologists, and experts in PsA, to obtain their opinion on the degree of validation and applicability of published definitions and tools, and on the parameters that should be included in a future definition of moderate PsA. We propose eight domains/items to be included in a definition of moderate PsA: number of active joints and inflamed entheses, physician global assessment (by visual analogue scale), dactylitis, body surface area (BSA) affected by psoriasis, psoriasis in special locations, and absence of hip involvement. The Disease Activity Index for Psoriatic Arthritis (DAPSA) score would be supported as part of this definition, as would the Psoriatic Arthritis Impact of Disease (PsAID) index. This study proposes a set of items/domains to be included in a definition of moderate PsA based on literature and expert opinion, which can be the starting point for further development and validation studies of the proposed items.

Oral infectivity through carnivorism in murine model of Trypanosoma cruzi infection.

Introduction: Oral transmission of T. cruzi is probably the most frequent transmission mechanism in wild animals. This observation led to the hypothesis that consuming raw or undercooked meat from animals infected with T. cruzi may be responsible for transmitting the infection. Therefore, the general objective of this study was to investigate host-pathogen interactions between the parasite and gastric mucosa and the role of meat consumption from infected animals in the oral transmission of T. cruzi. Methods: Cell infectivity assays were performed on AGS cells in the presence or absence of mucin, and the roles of pepsin and acidic pH were determined. Moreover, groups of five female Balb/c mice were fed with muscle tissue obtained from mice in the acute phase of infection by the clone H510 C8C3hvir of T. cruzi, and the infection of the fed mice was monitored by a parasitemia curve. Similarly, we assessed the infective capacity of T. cruzi trypomastigotes and amastigotes by infecting groups of five mice Balb/c females, which were infected orally using a nasogastric probe, and the infection was monitored by a parasitemia curve. Finally, different trypomastigote and amastigote inoculums were used to determine their infective capacities. Adhesion assays of T. cruzi proteins to AGS stomach cells were performed, and the adhered proteins were detected by western blotting using monoclonal or polyclonal antibodies and by LC-MS/MS and bioinformatics analysis. Results: Trypomastigote migration in the presence of mucin was reduced by approximately 30%, whereas in the presence of mucin and pepsin at pH 3.5, only a small proportion of parasites were able to migrate (∼6%). Similarly, the ability of TCTs to infect AGS cells in the presence of mucin is reduced by approximately 20%. In all cases, 60-100% of the animals were fed meat from mice infected in the acute phase or infected with trypomastigotes or amastigotes developed high parasitemia, and 80% died around day 40 post-infection. The adhesion assay showed that cruzipain is a molecule of trypomastigotes and amastigotes that binds to AGS cells. LC-MS/MS and bioinformatics analysis, also confirmed that transialidase, cysteine proteinases, and gp63 may be involved in TCTs attachment or invasion of human stomach cells because they can potentially interact with different proteins in the human stomach mucosa. In addition, several human gastric mucins have cysteine protease cleavage sites. Discussion: Then, under our experimental conditions, consuming meat from infected animals in the acute phase allows the T. cruzi infection. Similarly, trypomastigotes and amastigotes could infect mice when administered orally, whereas cysteinyl proteinases and trans-sialidase appear to be relevant molecules in this infective process.

Real-world apremilast use in biologic-naïve psoriatic arthritis patients. Data from Spanish clinical practice.

INTRODUCTION: Apremilast is approved for treatment of psoriasis and psoriatic arthritis (PsA). Real-world evidence on apremilast effectiveness in clinical practice is limited. METHODS: Observational study enrolling adult patients, across 21 Spanish centres, who had initiated apremilast in the prior 6 (±1) months and were biologic naive. Data were collected at routine follow-up visits 6 and 12 months after apremilast initiation. Primary outcome was 6 and 12-month persistence to apremilast. Secondary outcomes included Disease Activity for PsA (DAPSA), joint erosions, enthesitis, dactylitis, and patient-reported quality of life (QoL, measured using the PsA impact of disease [PsAID] questionnaire). RESULTS: We included 59 patients. Most had oligoarticular PsA, moderate disease activity, and high comorbidity burden. Three-quarters were continuing apremilast at 6 months and two-thirds at 12 months; mean (SD) apremilast treatment duration was 9.43 (1.75) months. DAPSA scores showed improved disease activity: one-third of patients in remission or low activity at apremilast initiation versus 62% and 78% at 6 and 12 months, respectively. Eleven of 46 patients with radiographic assessments had joint erosions at apremilast initiation and none at month 12. Median (Q1, Q3) number of swollen joints was 4.0 (2.0, 6.0) at apremilast initiation versus 0.0 (0.0, 2.0) at 12 months. Incidence of dactylitis and enthesitis decreased between apremilast initiation (35.6% and 28.8%, respectively) and month 12 (11.6% and 2.4%, respectively). Over two-thirds of patients had a PSAID-9 score <4 (cut-off for patient-acceptable symptom state) at month 12. CONCLUSIONS: In Spanish clinical practice, two-thirds of PsA patients continued apremilast at 12 months, with clinical benefits at the joint level, no radiographic progression of erosions, and a positive impact on patient-reported QoL. Trial registration number Clinicaltrials.gov: NCT03828045.

New PEPTIR-2.0 Peptide Designed for Use as Recognition Element in Electrochemical Biosensors with Improved Specificity towards E. coli O157:H7.

The detection of pathogens through alternative methodologies based on electrochemical biosensors is being studied. These devices exhibit remarkable properties, such as simplicity, specificity, and high sensitivity in monitoring pathogens. However, it is necessary to continue conducting studies that adequately improve these characteristics, especially the recognition molecule. This work aims to design and evaluate a new peptide, named PEPTIR-2.0, as a recognition molecule in electrochemical biosensors to detect E. coli O157:H7 in water. PEPTIR-2.0 was obtained from modifications of the PEPTIR-1.0 peptide sequence, which was previously reported and exhibited excellent properties for detecting and quantifying this pathogenic microorganism. PEPTIR-1.0 is a peptide analogous to the TIR (Translocated Intimin Receptor) protein capable of interacting with the Intimin outer membrane. The basis of this study was to obtain, by using bioinformatics tools, a molecule analogous to PEPTIR-1.0 that maintains its three-dimensional structure but increases the hydrophobic interactions between it and Intimin, since these intermolecular forces are the predominant ones. The designed PEPTIR-2.0 peptide was immobilized on screen-printed electrodes modified with gold nanoparticles. The detection capacity of E. coli O157:H7 in water was evaluated using electrochemical impedance spectroscopy in the presence of other microorganisms, such as P. aeruginosa, S. aureus, and non-pathogenic E. coli. The results showed that PEPTIR-2.0 confers remarkable specificity to the biosensor towards detecting E. coli, even higher than PEPTIR-1.0.

A Bioinspired Peptide in TIR Protein as Recognition Molecule on Electrochemical Biosensors for the Detection of E. coli O157:H7 in an Aqueous Matrix.

Currently, the detection of pathogens such as Escherichia coli through instrumental alternatives with fast response and excellent sensitivity and selectivity are being studied. Biosensors are systems consisting of nanomaterials and biomolecules that exhibit remarkable properties such as simplicity, portable, affordable, user­friendly, and deliverable to end­users. For this, in this work we report for the first time, to our knowledge, the bioinformatic design of a new peptide based on TIR protein, a receptor of Intimin membrane protein which is characteristic of E. coli. This peptide (named PEPTIR­1.0) was used as recognition element in a biosensor based on AuNPs­modified screen­printed electrodes for the detection of E. coli. The morphological and electrochemical characteristics of the biosensor obtained were studied. Results show that the biosensor can detect the bacteria with limits of detection and quantification of 2 and 6 CFU/mL, respectively. Moreover, the selectivity of the system is statistically significant towards the detection of the pathogen in the presence of other microorganisms such as P. aeruginosa and S. aureus. This makes this new PEPTIR­1.0 based biosensor can be used in the rapid, sensitive, and selective detection of E. coli in aqueous matrices.

Cambios en el perfil protéico de E. coli O157:H7 frente al tratamiento con Ib-M1 e IONP@Ib-M1 / Changes in the protein profile of E. coli O157: H7 against treatment with Ib-M1 and IONP@Ib-M1 / Identificação de alterações no perfil protetor de E. coli O157: H7 contra o tratamento com Ib-M1 e IONP@Ib-M1

Resumen Escherichia coli 0157:H7 es una bacteria patógena reconocida por su capacidad de resistencia a diversos antibióticos; razón por la cual, se generan complicaciones en el tratamiento de infecciones producidas por esta bacteria. El péptido Ib-M1 y el bioconjugado I0NP@Ib-M1 han surgido como una nueva alternativa antimicrobiana contra E. coli 0157:H7. El mecanismo de acción de Ib-Mi e I0NP@Ib-M1 contra esta bacteria aún es desconocido; por lo tanto, el objetivo de esta investigación fue identificar el cambio en el perfil de proteínas de E. coli 0157:H7 luego del tratamiento con Ib-M1 e I0NP@ Ib-M1 como primer paso para determinar su mecanismo de acción. Para esto, se llevó a cabo la obtención de proteínas, posteriormente se realizó una electroforesis bidimensional para finalmente realizar la determinación de la variabilidad de los perfiles proteicos. Una vez obtenidos estos perfiles, se llevó a cabo un análisis de varianza (AN0VA). Se identificaron 72 proteínas expresadas diferencialmente, las cuales pueden relacionarse con el efecto sobre el crecimiento de la bacteria en presencia de Ib-M1 e I0NP@Ib-M. Estas proteínas se encuentran involucradas en procesos de transferencia de grupos acilo (proteína Yhbs), translocación de lipoproteínas (proteína LolA) y transporte de aminoácidos (proteína GpmA), entre otros.

Abstract Escherichia coli 0157: H7 is a pathogenic bacterium which is recognized for the ability to resist multiple antibiotics; accordingly, complications occur in the treatment of infections caused by this bacterium. The Ib-M1 peptide and the I0NP @ Ib-M1 bioconjugate have emerged as a new antimicrobial alternatives against E. coli 0157: H7. The mechanism of action of Ib-M1 and I0NP @ Ib-M1 against this bacterium is still unknown; therefore, the goal of this research was to identify the change in the proteins profile of E. coli 0157: H7 after treatment with Ib-M1 and I0NP @ Ib-M1 as a first step to determine its mechanism of action. For this, the proteins were obtained first, and then a two-dimensional electrophoresis was performed to finally determine the variability of the protein profiles. 0nce the protein profiles were obtained, an analysis of variance (AN0VA) was carried out. 72 differentially expressed proteins were identified, which can be connected to the effect on the bacterium's growth in the presence of Ib-M1 and I0NP @ Ib-M. These proteins are involved in acyl groups transfer processes (Yhbs protein), lipoprotein translocation (LolA protein) and amino acid transport (GpmA protein), among others.

Resumo Escherichia coli O157: H7 é uma bactéria patogênica reconhecida por sua capacidade de resistir a vários antibióticos; razão pela qual, complicações são geradas no tratamento de infecções produzidas por essa bactéria. O peptídeo Ib-M1 livre e imobilizado em nanopartículas magnéticas de óxido de ferro (IONP @ Ib-M1) surgiu como uma nova alternativa antimicrobiana contra E. coli O157: H7 e isolados clínicos desta bactéria. O mecanismo de ação de Ib-M1 e IONP @ Ib-M1 contra E. coli O157: H7 ainda é desconhecido; Portanto, o objetivo desta pesquisa foi identificar a alteração no perfil proteico de E. coli O157: H7 após o tratamento com Ib-M1 e IONP @ Ib-M1 como um primeiro passo para determinar seu mecanismo de ação. Para isso, foi realizada a obtenção das proteínas, posteriormente foi realizada uma eletroforese bidimensional para finalmente determinar a variabilidade dos perfis protéicos. Uma vez obtidos os perfis de proteínas, foi realizada uma análise de variância (ANOVA). Os resultados mostram a identificação de proteínas expressas diferencialmente e que estão envolvidas em processos de transferência de grupos acila (proteína Yhbs), translocação de lipoproteínas (proteína LolA) e transporte de aminoácidos (proteína GpmA), entre outros.

Current status of multidisciplinary care in psoriatic arthritis in Spain: NEXUS 2.0 project. / Estado actual de la atención multidisciplinar para pacientes con artritis psoriásica en España: proyecto NEXUS 2.0.

OBJECTIVE: 1) To analyze the implementation of multidisciplinary care models in psoriatic arthritis (PsA) patients, 2) To define minimum and excellent standards of care. METHODS: A survey was sent to clinicians who already performed multidisciplinary care or were in the process of undertaking it, asking: 1) Type of multidisciplinary care model implemented; 2) Degree, priority and feasibility of the implementation of quality standards in the structure, process and result for care. In 6 regional meetings the results of the survey were presented and discussed, and the ultimate priority of quality standards for care was defined. At a nominal meeting group, 11 experts (rheumatologists and dermatologists) analyzed the results of the survey and the regional meetings. With this information, they defined which standards of care are currently considered as minimum and which are excellent. RESULTS: The simultaneous and parallel models of multidisciplinary care are those most widely implemented, but the implementation of quality standards is highly variable. In terms of structure it ranges from 22% to 74%, in those related to process from 17% to 54% and in the results from 2% to 28%. Of the 25 original quality standards for care, 9 were considered only minimum, 4 were excellent and 12 defined criteria for minimum level and others for excellence. CONCLUSIONS: The definition of minimum and excellent quality standards for care will help achieve the goal of multidisciplinary care for patients with PAs, which is the best healthcare possible.

Ascorbate Attenuates Oxidative Stress and Increased Blood Pressure Induced by 2-(4-Hydroxyphenyl) Amino-1,4-naphthoquinone in Rats.

Quinone derivatives like 2-(4-hydroxyphenyl) amino-1,4-naphthoquinone (Q7) are used as antitumor agents usually associated with adverse effects on the cardiovascular system. The objective of this study was to evaluate the cardioprotective effect of ascorbate on Q7-induced cardiovascular response in Wistar rats. In this study, blood pressure, vascular reactivity, and intracellular calcium fluxes were evaluated in cardiomyocytes and the rat aorta. We also measured oxidative stress through lipid peroxidation (TBARS), superoxide dismutase- (SOD-) like activity, and H2O2 generation. Oral treatment of rats with ascorbate (500 mg/kg) for 20 days significantly (p < 0.05) reduced the Q7-induced increase (10 mg/kg) in blood pressure and heart rate. The preincubation with ascorbate (2 mM) significantly (p < 0.05) attenuated the irregular beating of the atrium induced by Q7 (10-5 M). In addition, ascorbate induced endothelial vasodilation in the presence of Q7 in the intact aortic rings of a rat and reduced the cytosolic calcium levels in vascular smooth muscle cells. Ascorbate also reduced the Q7-induced oxidative stress in vivo. Ascorbate also attenuated Q7-induced SOD-like activity and increased TBARS levels. These results suggest a cardioprotective effect in vivo of ascorbate in animals treated orally with a naphthoquinone derivative by a mechanism involving oxidative stress.

Standards of care and quality indicators for multidisciplinary care models for psoriatic arthritis in Spain.

To define and give priority to standards of care and quality indicators of multidisciplinary care for patients with psoriatic arthritis (PsA). A systematic literature review on PsA standards of care and quality indicators was performed. An expert panel of rheumatologists and dermatologists who provide multidisciplinary care was established. In a consensus meeting group, the experts discussed and developed the standards of care and quality indicators and graded their priority, agreement and also the feasibility (only for quality indicators) following qualitative methodology and a Delphi process. Afterwards, these results were discussed with 2 focus groups, 1 with patients, another with health managers. A descriptive analysis is presented. We obtained 25 standards of care (9 of structure, 9 of process, 7 of results) and 24 quality indicators (2 of structure, 5 of process, 17 of results). Standards of care include relevant aspects in the multidisciplinary care of PsA patients like an appropriate physical infrastructure and technical equipment, the access to nursing care, labs and imaging techniques, other health professionals and treatments, or the development of care plans. Regarding quality indicators, the definition of multidisciplinary care model objectives and referral criteria, the establishment of responsibilities and coordination among professionals and the active evaluation of patients and data collection were given a high priority. Patients considered all of them as important. This set of standards of care and quality indicators for the multidisciplinary care of patients with PsA should help improve quality of care in these patients.

Decreased cruzipain and gp85/trans-sialidase family protein expression contributes to loss of Trypanosoma cruzi trypomastigote virulence.

Two cell lines derived from a single Trypanosoma cruzi clone by long-term passaging generated a highly virulent (C8C3hvir) and a low virulent (C8C3lvir) cell line. The C8C3hvir cell line was highly infective and lethal to Balb/c mice, and the C8C3lvir cell line was three- to five-fold less infective to mouse cardiomyocytes than C8C3hvir. The highly virulent T. cruzi cell line abundantly expressed the major cysteine proteinase cruzipain (Czp), complement regulatory protein (CRP) and trans-sialidase (TS), all of which are known to act as virulence factors in this parasite. The in vitro invasion capacity and in vivo Balb/c mouse infectiveness of the highly virulent strain was strongly reduced by pre-treatment with antisense oligonucleotides targeting TS or CRP or with E64d. Based on these results, we conclude that decreased levels of TS, CRP and Czp expression could contribute to loss of T. cruzi trypomastigote virulence.

Multidisciplinary Care Models for Patients With Psoriatic Arthritis. / Modelos de atención multidisciplinar en pacientes con artritis psoriásica en España.

OBJETIVE: To describe (structure, processes) of the multidisciplinary care models in psoriatic arthritis (PsA) in Spain, as well as barriers and facilitators of their implementation. METHODS: A qualitative study was performed following structured interviews with 24 professionals (12 rheumatologists, 12 dermatologists who provide multidisciplinary care for patients with PsA). We collected data related to the hospital, department, population and multidisciplinary care model (type, physical and human resources, professional requirements, objectives, referral criteria, agendas, protocols, responsibilities, decision- making, research and education, clinical sessions, development and planning of the model, advantages and disadvantages of the model, barriers and facilitators in the implementation of the model. The models characteristics are described. RESULTS: We analyzed 12 multidisciplinary care models in PsA, with at least 1-2 years of experience, and 3 subtypes of models, face-to-face, parallel, and preferential circuit. All are adapted to the hospital and professionals characteristics. A proper implementation planning is essential. The involvement and empathy between professionals and an access and well-defined referral criteria are important facilitators in the implementation of a model. The management of agendas and data collection to measure the multidisciplinary care models health outcomes are the main barriers. CONCLUSIONS: There are different multidisciplinary care models in PsA that can improve patient outcomes, system efficiency and collaboration between specialists.

Caracterización de los genotipos de rotavirus encontrados en muestras de heces diarreicas en niños menores de 5 años captados por los establecimientos centinela de la Secretaria de Salud de Honduras durante 2014

Objetivo: Caracterizar los genotipos de Rotavirus, encontrados en muestras de hecesdiarreicas en niños menores de 5 años captados por los establecimientos centinela de laSecretaria de Salud en Honduras durante 2014.Metodología: Es un estudio Descriptivo de corte transversal, la muestra estuvoconformada por un total de 68 casos procedentes de los hospitales de la VigilanciaCentinela de Rotavirus, se revisó la base de datos y libro de registro de resultados de lavigilancia Centinela de Rotavirus, para el procesamiento de datos se utilizó el programaEpi Info 7 y Hoja de Cálculo Excel para realizar tablas, gráficos con porcentaje yfrecuencias.Resultados: El 45,6 % está en el rango de edad de 09-17 meses, el género másfrecuente, fue el hombre con 47%, se identificó la circulación de 6 genotipos de Rotavirusen 11 departamentos de Honduras donde el 35,1% proceden de Francisco Morazán, el44,1% de los casos no posee el dato del estado vacunal, el 51,5% de los menores de 5años inicio síntomas en el tercer trimestre (comprendidos entre los meses deJulio-Septiembre).Se identificó al genotipo G12P[8] en el 89,6% de los casos encontrándose en losdepartamentos de Atlántida, Choluteca, Comayagua, Copan, Cortes, Francisco Morazán,Intibucá, Ocotepeque, El Paraíso, Santa Bárbara y Yoro. En el 54,1% de los casos seidentificó el genotipo G12P[8] se detectó durante el tercer trimestre.Conclusiones: Se determinó que el genotipo del virus de Rotavirus que predominodurante el 2014 fue el genotipo G12P[8] el cual circulo durante todo el año, pero seobservó su alza a partir del segundo trimestre donde se presentó un incremento decasos coincidiendo con el de inicio de invierno.

Coincidence of tuberous sclerosis and systemic lupus erythematosus-a case report. / Asociación lupus eritematoso sistémico y esclerosis tuberosa, un caso.

Tuberous sclerosis, also called Bourneville Pringle disease, is a phakomatosis with potential dermal, nerve, kidney and lung damage. It is characterized by the development of benign proliferations in many organs, which result in different clinical manifestations. It is associated with the mutation of two genes: TSC1 (hamartin) and TSC2 (tuberin), with the change in the functionality of the complex target of rapamycin (mTOR). MTOR activation signal has been recently described in systemic lupus erythematosus (SLE) and its inhibition could be beneficial in patients with lupus nephritis. We report the case of a patient who began with clinical manifestations of tuberous sclerosis complex (TSC) 30 years after the onset of SLE with severe renal disease (tipe IV nephritis) who improved after treatment with iv pulses of cyclophosphamide. We found only two similar cases in the literature, and hence considered the coexistence of these two entities of great interest.

[Skin cancer incidence in Zacatecas]. / Incidencia de cáncer de piel en Zacatecas.

BACKGROUND: Skin cancer is the most frequent cancer related to ultraviolet radiation. The aim was to estimate the incidence of skin cancer type, melanoma and non-melanoma in Zacatecas, Mexico. METHODS: An epidemiological study was carried out during the period from 2008 to 2012. The data were obtained from the Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Secretaría de Salud de Zacatecas (SSZ) and a private source, the Centro Médico Alameda. The incidence and the global prevalence were estimated. RESULTS: We studied 958 skin cancer cases, histopathologically confirmed. The cases were distributed as: 63.6 % basal cell carcinomas, 25.8 % squamous cell carcinomas, and 10.6 % melanoma. Significantly higher proportions were observed in women in the basal cell carcinomas (60.4 %) and squamous cell carcinomas (53.4 %). However, in the case of melanoma, the major proportion was observed in men (55.9 %). The more frequent skin cancer location was the face and for basal cell carcinoma was the nose (53 %); for squamous cell carcinomas were the lips (36 %), and for melanoma it was also the nose (40 %). The skin cancer incidence was estimated in 20 cases for each 100 000 inhabitants. Linear regression analysis showed that the skin cancer is increasing at an annual rate of 10.5 %. CONCLUSIONS: The anatomical location indicates that solar UV radiation is a risk factor, since the face is the zone with major exposure to solar radiation.

INTRODUCCIÓN: el cáncer de piel es una neoplasia relacionada con la radiación ultravioleta solar. El objetivo fue estimar la incidencia del cáncer de piel de tipo melanoma y no-melanoma. MÉTODOS: se llevó a cabo un estudio epidemiológico entre 2008 y 2012 en Zacatecas, México. La información se obtuvo de los registros confirmados de cáncer de piel en el Instituto Mexicano del Seguro Social, el Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, la Secretaría de Salud de Zacatecas y el laboratorio privado del Centro Médico Alameda. Se calculó la incidencia y la prevalencia global. RESULTADOS: se estudiaron 958 casos de cáncer de piel: 63.6 % de carcinoma basocelular, 25.8 % de espinocelular y 10.6 % de melanoma. Se observó una mayor prevalencia de mujeres: 60.4 % en carcinoma basocelular y 53.4 % en carcinoma espinocelular. En el melanoma prevalecieron los hombres (55.9 %). La región anatómica donde predominó el cáncer de piel fue la cara: la nariz (53 %) en carcinoma basocelular, los labios (36 %) en carcinoma espinocelular y la nariz (40 %) en melanoma. La incidencia estimada fue 20 casos por cada 100 000 habitantes. El análisis de regresión lineal mostró que el cáncer de piel se incrementa 10.5 % anualmente. Conclusiones: la ubicación de las lesiones sugiere que un factor de riesgo es la exposición a los rayos solares UV.

Psychiatric manifestations of neurocysticercosis in paediatric patients.

Neurocysticercosis is the most frequent parasitic disease of the central nervous system and is caused by the larval stage of the tapeworm Taenia solium, in which the human being becomes the parasite's intermediary host. The disease has a worldwide distribution, with a marked prevalence in underdeveloped or developing. However, this disease is rare in children, which is attributed to the long incubation period of the disease, ranging from several months up to 30 years. For this reason, very few cases are found in infants at the age of preschoolers, while most frequently cases are found in children between the ages of 6 and 16.

Efecto del butirato de sodio sobre algunos parámetros productivos de gallinas de postura en semilibertad / Effect of sodium butyrate on productive performance of laying hens in a semi-free range system

An experiment was conducted with 32 week-old 470 ISA-Babcock B380 laying hens, housed in floor pens with wheat-straw litter, to study the replacement of the antibiotic growth promoter (bacitracin zinc 30 ppm) with sodium butyrate (300 g/ton) in the diet. Results in 24 weeks of experimentation were similar between treatments (P > 0.05), in: egg production (92.6 and 91.9%), egg weight (63.0 and 62.9 g), egg mass / bird / day (58.4 and 57.7 g), feed consumption / bird / day (123.6 and 124.3 g), feed conversion (2.11 and 2.15), egg albumen quality (Haugh Units 82.9 and 83), yolk color DSM fan (10.3 and 9.9), shell thickness (0.392 and 0.394 mm) and weight of the shell (6.26 and 8.03 g). According to information obtained in 24 weeks with 32 week old hens, the addition of sodium butyrate to feed as a substitute for the growth promoter (bacitracin zinc), was similar in the productive performance and egg quality.

Se realizó un experimento con 470 gallinas de la estirpe ISA-Babcock B380 de 32 semanas de edad, alojadas en pisos con cama de paja de trigo, para estudiar la sustitución del antibiótico promotor de crecimiento (bacitracina cinc 30 ppm) por butirato de sodio (300 g/ton) en la dieta. Los resultados obtenidos en 24 semanas de experimentación fueron similares (P > 0.05) entre tratamientos, en: porcentaje de postura (92.6 y 91.9%), peso del huevo (63.0 y 62.9 g), masa del huevo/ ave/día (58.4 y 57.7 g), consumo/ave/día (123.6 y 124.3 g), conversión alimenticia (2.11 y 2.15), calidad de la albúmina del huevo (82.9 y 83 Unidades Haugh), color de la yema con el abanico DSM (10.3 y 9.9), grosor de cascarón (0.392 y 0.394 mm) y peso del cascarón (6.26 y 8.03 g). De acuerdo con la información obtenida en 24 semanas de experimentación, con gallinas de 32 semanas de edad, la adición de butirato de sodio en el alimento, como sustituto del promotor de crecimiento (bacitracina cinc), fue similar en el comportamiento productivo y la calidad del huevo.

Otitis and autism spectrum disorders.

The case of a 5-year-old child diagnosed as having pervasive developmental disorder (PDD), autistic type, from age 1 is reported. After surgery of vegetation in middle ear for repetitive otitis, the child presented an improvement in autistic behaviours, previously expressed as impaired social interactions, qualitative abnormalities in communication, a marked delay in language development, echolalia, stereotypies and self-aggressive behaviours. The aim of this paper is to bring attention to occurrences of misdiagnosis of PDD, which can occur when an adequate screening of the autistic syndrome is not realised. The result of the surgery was an improvement in autistic behaviours, despite the persistence of less severe autistic traits that may be more closely related to Asperger's syndrome.

Efecto del butirato de sodio en dietas para gallinas sobre el comportamiento productivo, calidad del huevo y vellosidades intestinales / Effect of sodium butyrate on diets for laying hens on the productive performance, egg quality and intestinal villi

In this study, productive performance, quality of eggs and histological analysis of intestinal villi of the duodenum (length and width) was evaluated in Bovans laying hens of 63 weeks of age, with the addition of butyrate in the diet ( 0, 300, 500 ppm). The results obtained in ten weeks of experimentation showed a response (P < 0.05) on egg production percentaje (86.4, 92.2 and 89.6), egg weight (63.4, 63.4 and 64.1 g), feed consumption/bird/day (111.4, 111.9 and 113.4 g), feed conversion (2.09, 1.95 and 2.03), micro-fractures percentaje (20.8, 14.9 and 12.9), broken eggs percentaje (2.6, 2.1 and 0.6), length of villi (1.15, 1.22 and 1.32 mm) and villi width (0.467, 0.500 and 0.532 mm) to the addition of butyrate. These results indicate the beneficial effect of butyrate in laying hens in the last third of its first production cycle. From information obtained in this study, it is concluded that sodium butyrate on diets at 500 ppm for Bovans laying hens of 63 weeks of age, improves the productive performance, shell quality and intestinal villi integrity.

En el presente estudio se evaluó el comportamiento productivo, calidad del huevo y análisis histológico de vellosidades intestinales de duodeno (largo y ancho) en gallinas de la estirpe Bovans, de 63 semanas de edad, con adición de butirato en la dieta (0, 300, 500 ppm). Los resultados obtenidos en diez semanas de experimentación mostraron respuesta (P < 0.05) en porcentaje de postura (86.4, 92.2 y 89.6), peso del huevo (63.4, 63.4 y 64.1 g) consumo/ave/día (111.4, 111.9 y 113.4 g), conversión alimentaria (2.09, 1.95 y 2.03), de microfracturas (20.8, 14.9 y 12.9), de huevos rotos (2.6, 2.1 y 0.6), longitud de vellosidades (1.15, 1.22 y 1.32 mm) y ancho de vellosidades (0.467, 0.500 y 0.532 mm) a la adición de butirato. Los resultados indican el efecto benéfico del butirato en gallinas ponedoras en el último tercio de su primer ciclo de producción. De la información obtenida en el presente estudio se concluye que el butirato de sodio en dietas a 500 ppm para gallinas Bovans, de 63 semanas de edad, mejora el comportamiento productivo, la calidad del cascarón y la integridad de las vellosidades intestinales.

Equilibrative nucleoside transporters in fetal endothelial dysfunction in diabetes mellitus and hyperglycaemia.

Diabetes mellitus types 1 and 2, and gestational diabetes are characterized by abnormal D-glucose metabolism and hyperglycaemia, and induce foetal endothelial dysfunction with implications in adult life increasing the risk of vascular diseases. Synthesis of nitric oxide (NO) and uptake of L-arginine (i.e. the L-arginine/NO signalling pathway) and adenosine (a vasoactive endogenous nucleoside) by the umbilical vein endothelium is altered in pathological pregnancies, including pregnancies with pre-established diabetes mellitus or in gestational diabetes. The mechanisms underlying these alterations include differential expression of equilibrative nucleoside transporters (ENTs), amino acid transporters and NO synthases (NOS). Modulation of ENTs and NOS expression and activity in endothelium involves several signalling molecules, including protein kinase C, mitogen-activated protein kinases p42 and p44, calcium and phosphatidyl inositol 3 kinase. Elevated extracellular D-glucose and diabetes alters human endothelial function. However, information regarding modulation the transport capacity as well as expression of ENTs is limited. This review focuses on the effect of diabetes mellitus and gestational diabetes, and hyperglycaemia on the reported mechanisms described for transcriptional and post-transcriptional regulation of ENTs, and the potential consequences for foetal endothelial function in these pathologies. Recent available information regarding functional consequences of an abnormal environment on the functionality of the endothelium from microvasculature of the human placenta is mentioned. The available information is scarce, but it could contribute to a better understanding of the cell and molecular basis of the altered vascular endothelial function in this pathological conditions, emphasizing the key role of this type of epithelium in fetal-placental function and the normal foetal development and growth.

Estudio comparativo de los niveles séricos de magnesio iónico en mujeres no gestantes, gestantes normales y gestantes con preeclampsia / A comparative study of the ionic magnesium serum levcels in non-pregnant, normal pregnant and preeclamptic pregnant women

OBJETIVO: No hay datos respecto al nivel de magnesio iónico sérico en la población peruana y se sabe que durante la gestación disminuyen los niveles de magnesio. El propósito del estudio fue comparar los niveles séricos de magnesio iónico en mujeres de nuestro medio: no gestantes, gestantes normales y gestantes con preeclampsia. MATERIAL Y MÉTODOS: Se realizó un estudio transversal en el Servicio de Obstetricia del Hospital Nacional Arzobispo Loayza en tres grupos de mujeres: 19 no gestantes, 19 gestantesnormales y 16 gestantes con preeclampsia, en las que se midió magnesio iónico en sangre en el laboratorio de la Unidad de CuidadosIntensivos del Hospital Nacional Arzobispo Loayza y se analizaron sus características clínicas. RESULTADOS: La edad fue similar en los tres grupos 24,4 ± 3,6 años (rango: 19 a 33). La hemoglobina fue mayor en no gestantes 12,77 ± 0,84 g/dL que en gestantesnormales 11,9 ± 0,96 g/dL y en preeclámpticas 11,8 ± 0,71 g/dL (p < 0,05). Los niveles de magnesio fueron: 0,51 ± 0,03 mmol/L en no gestante, 0,49 ± 0,03 mmol/L en gestantes normales y 0,46 ± 0,03 mmol/L en preeclámpticas, con diferencia estadística entre los tres grupos (p < 0,05). El porcentaje de hipomagnesemia fue 0%, 5,3% y 37,5% en no gestante, gestantes normales y preeclámpticas, respectivamente. CONCLUSIONES: Las mujeres con preeclampsia tuvieron niveles más bajos de magnesio iónico sérico que las gestantes normales y no gestantes. El porcentaje de hipomagnesemia fue de 37,5% en las pacientes con preeclampsia.

There is no available data on the serum ionic magnesium levels in our population and it is well known that these levels decrease during pregnancy. The purpose of this study was to compare the serumionic magnesium levels in non-pregnant women, women during normal pregnancy and pregnant women with pre eclampsia. MATERIAL AND METHODS: The crossed study was conducted in the Obstetric Departmentof the Hospital Nacional Arzobispo Loayza, Lima, with three groups: 19 non-pregnant women, 19 with normal pregnancy and 16 with preeclamptic pregnancy. In each group, the ionic serum magnesium levels were measured in the Critical Care Unit Laboratory. Their clinical characteristics were analyzed. RESULTS: The age was similar in all three groups: 24,4 ± 3,6 years (range: 19 to 33). The highest hemoglobin level was found in the non-pregnant women group (12,77 ±0,84 g/dL) followed by the normal pregnancy group (11,9 ± 0,96 g/dL)and the preeclamptic pregnancy group (11,8 ± 0,71 g/dL).There was statistical difference (p < 0,05). In a similar manner, the magnesium highest levels were found in the non-pregnant women group (0,51 ± 0,03 mmol/L) followed by the normal pregnancy group (0,49 ± 0,03 mmol/L) and the preeclamptic pregnancy group (0,46 ± 0,03 mmol/L) (p < 0,05). Hypomagnesaemia was found to be 0%, 5,3% and 37,5%, respectively in the non-pregnant, normal pregnant and preeclamptic pregnant women. CONCLUSIONS: Preeclamptic women have lower serum ionic magnesium levels than normal pregnant and non-pregnant women. Hypomagnesemia was found to be 37,5% in preeclamptic pregnant women.