Inhibition of Aspergillus carbonarius growth and Ochratoxin A production using lactic acid bacteria cultivated in an optimized medium.

The Gram-positive bacteria lactic acid bacteria (LAB) are used in the food industry but are also known for inhibiting certain food spoilage microorganisms, especially fungi. Sources of nitrogen (N) for culture media are generally organic and expensive. Many attempts have been made to formulate economical culture media with alternative N sources obtained from agricultural and industrial byproducts. This study describes the design and optimization of an inexpensive culture medium for Lactiplantibacillus plantarum (formerly Lactobacillus plantarum) MZ809351 strain B31. The culture medium was optimized using statistical experimental designs to identify the factors with the most significant effects on biomass concentration to reduce the overall cost, aiming to obtain a biomass concentration similar to that obtained with the reference LAB culture medium (de Man, Rogosa and Sharpe; MRS). Sodium acetate and magnesium sulfate were the most significant factors (p < 0.005), and their contents were reduced by 22 % and 40 %, respectively, without affecting biomass concentration. Malt germ extract (MGE) was used as an alternative nitrogen source to replace meat extract (ME) and proteose peptone (PP). Through these experiments, the composition of a culture medium that is less expensive than MRS broth was defined, which produced a biomass concentration (3.8 g/L) similar to that obtained with MRS medium. The inhibitory effects of two LAB strains isolated from the Ivory Coast and Mexico on the growth and production of ochratoxin A (OTA) in an ochratoxigenic fungus was tested. The minimum cellular concentration of the LAB to prevent the development of Aspergillus carbonarius Ac 089 and the production of OTA was determined in a model assay in Petri dishes. The conditions to inhibit the germination of A. carbonarius Ac 089 and the production of OTA were found. Using the optimized medium and a ratio of 2 × 104 LAB/spore (1 × 108 CFU/mL) strain B7 (L. plantarum MZ809351) and 2 × 103 LAB/spore (1 × 107 CFU/mL) strain B31 (L. plantarum MN922335) completely inhibited the growth of the fungus. A ratio of 2 × 105 LAB/spore (1 × 109 CFU/mL) was required to inhibit OTA production with strains B7 and B31. This study indicates the potential of cultivating LAB in an optimized and inexpensive culture medium for use as a biological control agent against ochratoxigenic fungi in food.

Anti-Inflammatory Local Effect of Hydroxytyrosol Combined with Pectin-Alginate and Olive Oil on Trinitrobenzene Sulfonic Acid-Induced Colitis in Wistar Rats.

Purpose: Evaluate the efficacy of hydroxytyrosol in the local treatment of inflammatory colitis. Currently, the existing treatments for inflammatory bowel diseases does not cure the disease and it is associated with high rates of side effects and complications. Hydroxytyrosol is a phenyl-ethyl-alcohol derived from the hydrolysis of oleuropein and present in olive oil, previous studies have demonstrated the anti-inflammatory effect of dietary hydroxytyrosol supplement, with no toxicity. Materials & Methods: Colitis has been induced by using Trinitrobenzene Sulfonic Acid at 40 rats. They were divided into four groups randomly: 10 rats without treatment; 10 rats with pectin/alginate mixture; 10 rats treated with pectin/alginate + olive oil; 10 rats treated with pectin/alginate + olive oil + hydroxytyrosol. Animals were sacrificed 10 days after induction of trinitrobenzene sulfonic acid, receiving 5 days of continuous treatment. Samples of the rectal area were studied and observed under a microscope to determine the damage by Hunter scoring modified, assessing inflammatory infiltration, number of intestinal walls involved, damage to the mucosal architecture, and edema. Results: When the rectum was analyzed in a global way, nonsignificant differences were observed; however, when performing an individualized analysis, statistically significant differences in the inflammatory infiltrate are present in the samples, which were evaluated using the ANOVA and Student-T statistics. Conclusions: Local treatment with the natural antioxidant hydroxytyrosol combined with pectin/alginate and olive oil of inflammatory bowel disease has been shown to be effective against inflammatory infiltration of TNBS-induced colitis.

Performance of crossbred lactating cows at grazing in response to nitrogen supplementation and different levels of concentrate feed / Desempenho de vacas mestiças leiteiras a pasto em resposta à suplementação nitrogenada e a diferentes níveis de concentrado

The performance of crossbred (1/2 Holstein x Zebu) cows supplemented on Brachiaria decumbens pasture during the wet-dry transition period was evaluated. Eight cows with 497±50kg, during third and fourth lactations and after the lactation peak were distributed in two 4 x 4 Latin squares. The treatments consisted of a factorial with two types of mineral supplements (nitrogenous and mineral salt) and two levels of concentrate (0.3 and 0.6% body weight (BW)/cow/day), based on corn and soybean meal (60:40), and supplied during the morning and afternoon milking. The experiment lasted 56 days, divided into four periods of 14 days, with seven days for adaptation and seven for data collection. No interaction (P> 0.05) was observed between the supplements and the concentrate levels. The nitrogenous salt and the highest concentrate level increased (P< 0.05) the intake of crude protein, and the highest concentrate level increased (P< 0.05) the intake of non-fibrous carbohydrates and the digestibility of crude protein. No effect (P> 0.05) of supplement and concentrate level was observed on the milk constituents and feed efficiency. Grazing crossbred after the lactation peak during the wet-dry transition period achieve the productive potential with 0.3% BW of concentrate per day and mineral salt.(AU)

Foi avaliado o desempenho de vacas mestiças (1/2 Holandês x Zebu) suplementadas em pastagens de Brachiaria decumbens durante o período de transição águas-seca. Oito vacas com 497±50kg, durante a terceira e a quarta lactação e após o pico de produção, foram distribuídas em dois quadrados latinos 4 x 4. Os tratamentos consistiram de um fatorial com dois tipos de suplementos (sal nitrogenado e sal mineral) e dois níveis de concentrado (0,3 e 0,6% do peso corporal (PC)/vaca/dia), baseado em milho e farelo de soja (60:40) e suprido durante as ordenhas da manhã e da tarde. O experimento durou 56 dias, divididos em quatro períodos de 14 dias, sendo sete dias para adaptação e sete para coletas. Não foi encontrada interação (P>0,05) entre os suplementos e os níveis de concentrado. O sal nitrogenado e o maior nível de concentrado aumentaram (P<0,05) o consumo de proteína bruta, e o maior nível de concentrado aumentou (P<0,05) o consumo de carboidratos não fibrosos e a digestibilidade da proteína bruta. Não foi observado efeito (P>0,05) de suplemento e de nível de concentrado sobre os componentes do leite e a eficiência alimentar. Vacas mestiças após o pico de lactação durante o período de transição águas-seca alcançam seu potencial produtivo com 0,3% do PC/dia de concentrado e sal mineral.(AU)

Antimycobacterial and hypolipemiant activities of Bidens odorata (Cavanilles).

ETHNOPHARMACOLOGICAL RELEVANCE: Bidens odorata Cavanilles is a medicinal and edible plant known as "mozote blanco, aceitilla, acahual, mozoquelite" which is traditionally used in Mexico as a diuretic, hypoglycaemic, anti-inflammatory, antipyretic, antitussive, to treat gastrointestinal disorders, kidney pain, and lung or respiratory diseases. AIM OF THE STUDY: This research study was aimed at phytochemical analysis of aerial extracts of B. odorata for antimycobacterial and lipid-lowering activities. MATERIALS AND METHODS: Compounds 1 (((2R, 3R, 4S, 5S, 6R)-3,4,5-Tryhidroxy-6-(((E)-3-(4-hydroxyphenyl) acryloyl) oxy) tetrahydro-2H-pyran-2-yl) methyl-4-hydroxybenzoate) and 2 (3,5-Dihydroxybenzoic acid) were isolated from B. odorata aerial shoots and their structural elucidation was carried out using 1 and 2D NMR, infrared spectroscopy (IR) and mass spectrometry (ESI-MS). The antimycobacterial activity of various extracts and compounds 1 and 2 was determined using the Microplate Alamar Blue Assay (MABA). The evaluation of the hypolipidemic effect of the ethanolic extract and the glycosylated compound 1 was tested in a murine model of hypercholesterolemia induced by diet and by Triton WR-1339. On the other hand, the LD50 of the ethanolic extract was evaluated in ICR mice by the OECD protocol TG 423. RESULTS: Antimycobacterial assay of hexane, CH2Cl2, EtOAc, ethanolic and aqueous extracts, as well as the new glycosidic compound 1 and benzoic acid derivative 2 isolated from B. odorata showed minimal inhibitory concentrations (MIC) of 100, 12.5, 12.5, 12.5, ≥200, 3.125 and 50 µg/mL, respectively, against Mycobacterium tuberculosis H37Rv. Only hexane and CH2Cl2 extracts were observed to be active against Mycobacterium smegmatis mc2155 at a concentration of 50 and 100 µg/mL, respectively. The ethanolic extract showed lipid-lowering activity at doses of 100 and 1000 mg/kg, while glycosidic compound 1 was active at doses of 50 and 100 mg/kg. In addition, the LD50 of the ethanolic extract was >2000 mg/kg, meaning that this extract does not cause lethality or adverse effects, and no signs of organs alterations or tissue damage were observed. CONCLUSION: The hexane, CH2Cl2, EtOAc, and ethanolic extracts of B. odorata, as well as their components 1 and 2, displayed antimycobacterial activity against M. tuberculosis. Moreover, the ethanolic extract and glycosidic compound 1 showed an important lipid-lowering effect, without lethality or secondary effect. The results of this study support the documented traditional use for B. odorata.

Urinary Tract Conditions Affect Fosfomycin Activity against Escherichia coli Strains Harboring Chromosomal Mutations Involved in Fosfomycin Uptake.

The steps by which Escherichia coli strains harboring mutations related to fosfomycin (FOS) resistance arise and spread during urinary tract infections (UTIs) are far from being understood. The aim of this study was to evaluate the effects of urine, pH, and anaerobiosis on FOS activity against a set of isogenic strains carrying the most prevalent chromosomal mutations conferring FOS resistance (ΔuhpT, ΔglpT, ΔcyaA, and ΔptsI), either singly or in combination. We also studied fosfomycin-resistant E. coli clinical isolates from patients with UTI. Our results demonstrate that urinary tract physiological conditions might have a profound impact on FOS activity against strains with chromosomal FOS resistance mutations. Specifically, acidic pH values and anaerobiosis convert most of the strains categorized as resistant to fosfomycin according to the international guidelines to a susceptible status. Therefore, urinary pH values may have practical interest in the management of UTIs. Finally, our results, together with the high fitness cost associated with FOS resistance mutations, might explain the low prevalence of fosfomycin-resistant E. coli variants in UTIs.

Efecto del entrenamiento de músculos abdominales sobre la función respiratoria en adolescentes sanos: Estudio piloto / Effect of abdominal muscle training on respiratory function in healthy adolescents: A preliminar study

The respiratory muscle training has been used to improve muscle strength and optimize the mechanism of cough. The aim of this study is to evaluate the effect of abdominal muscle training on respiratory muscle strength (MIP, MEP), peak expiratory flow (PEF) and peak cough flow (PCF) in healthy adolescents. The study design was quasi-experimental, variables of respiratory function were assessed before and after the muscle training protocol in a sample of sedentary healthy adolescents without gender restriction. The sample size calculated was 15 subjects. The training protocol consisted in 8 weeks of training divided into two stages (basic and advanced training plan) twice a week. Descriptive statistics were performed, tests for normality (Shapiro Wilk), U Mann Whitney test, Pearson coefficient and t-student test were used. Results are expressed as mean and its standard deviation. It was considered significant a p value < 0,05. Seventeen subjects (8 males and 9 females) entered to the study, all subjects performed the protocol and completed it without incidents. After completing the training protocol the sit-up test performance increased 21.7% (p = 0.0001), the MIP increase 16,5 cm H2O (17.1%) (p = 0.006), MEP increased 34.9 cm H2O (50,2 %) (p = 0.0001). Moreover, PEF increased 35.3 L/min (8.3%) (p = 0.003) and PCF increased 36.6 L/min (9,1%). There was no correlation between sit-up test performance and lung function variables. PEF showed only a moderate correlation with PCF (r = 0.6; p = 0.007) and MEP (r = 0.59; p = 0.01). We conclude that, in this sample, increases in respiratory muscle strength, PEF and PCF were observed after abdominal muscle training. No association between abdominal muscle strength and respiratory function variables was found before initiating the training protocol.

El entrenamiento muscular respiratorio ha sido utilizado para mejorar la fuerza de los músculos y optimizar el mecanismo de la tos. El objetivo de este estudio es evaluar el efecto del entrenamiento de músculos abdominales sobre la fuerza de los músculos respiratorios (Pimax, Pemax), flujo espiratorio máximo (FEM) y flujo máximo de tos (FMT) en adolescentes sanos. Este estudio es cuasi experimental, donde se evaluaron las variables de función respiratoria antes y después del protocolo de entrenamiento. La muestra estuvo integrada por adolescentes sanos sedentarios sin restricción de sexo. La muestra mínima estimada fue de 15 sujetos. El protocolo de entrenamiento consistió en 8 semanas de entrenamiento dividido en 2 etapas (plan básico y avanzado de ejercicios) dos veces por semana. Se realizó estadística descriptiva, pruebas de normalidad (Shapiro Wilk); se utilizó test U de Mann Whitney, coeficiente de correlación de Pearson y test t-student para muestras pareadas. Los resultados se expresan en promedios y desviación estándar. Se consideró significativo un valor de p < 0,05. Ingresaron al estudio 17 sujetos (8 hombres y 9 mujeres), todos los sujetos realizaron el protocolo completo. Posterior al protocolo los sujetos incrementaron en 21,7% el rendimiento del sit-up test (p=0,0001); la Pimax aumentó 16,5 cm H2O (+17,1%) (p=0.006), la Pemax aumentó 34,9 cm H2O (+50,2%) (p=0,0001). Por otra parte, el FEM aumentó 35,3 L/min (+8,3%) (p=0,003) y el FMT aumentó 36,6 L/min (+9,1%). La fuerza de músculos abdominales no muestra correlación con las variables de función respiratoria. Sólo FEM muestra correlación moderada con el FMT (r = 0,6; p = 0,007) y Pemax (r = 0,59; p = 0,01). Se concluye que, en la muestra estudiada, se observan incrementos en la fuerza muscular respiratoria, FEM y FMT luego de un protocolo de entrenamiento de músculos abdominales. No se observó asociación entre la fuerza muscular abdominal y las variables de función respiratoria antes de iniciado el protocolo.

Effect of TEX-OE(®) treatment on the development of heat shock proteins in commercial broiler chicks and the impact on performance indicators in the grow-out period.

Heat shock proteins (HSPs) are highly conserved proteins, shown to protect organisms against physical and physiological stress. TEX-OE(®) is a patented total extract of the fruit of Opuntia ficus indica, which has been demonstrated to accelerate the development of HSPs in several animal species. One-day-old commercial broiler chicks were treated with TEX-OE(®); HSP was measured by enzyme-linked immunosorbent assay (ELISA), and a large commercial field trial investigated key performance indicators (KPIs) in treated versus untreated controls chicks. TEX-OE(®) significantly increased HSP concentrations in treated chicks versus controls. Final cumulative mortality, liveweight and percentage factory-rejects were better than in controls. The accelerated HSP response may enable chicks to cope with early stressors, which is reflected in improved KPIs.

Olive oil has a beneficial effect on impaired glucose regulation and other cardiometabolic risk factors. Di@bet.es study.

BACKGROUND: Despite the marked increase in cardiovascular risk factors in Spain in recent years, the prevalence and incidence of cardiovascular diseases have not risen as expected. Our objective is to examine the association between consumption of olive oil and the presence of cardiometabolic risk factors in the context of a large study representative of the Spanish population. SUBJECTS AND METHODS: A population-based, cross-sectional, cluster sampling study was conducted. The target population was the whole Spanish population. A total of 4572 individuals aged ≥ 18 years in 100 clusters (health centers) were randomly selected with a probability proportional to population size. The main outcome measures were clinical and demographic structured survey, lifestyle survey, physical examination (weight, height, body mass index, waist, hip and blood pressure) and oral glucose tolerance test (OGTT) (75 g). RESULTS: Around 90% of the Spanish population use olive oil, at least for dressing, and slightly fewer for cooking or frying. The preference for olive oil is related to age, educational level, alcohol intake, body mass index and serum glucose, insulin and lipids. People who consume olive oil (vs sunflower oil) had a lower risk of obesity (odds ratio (OR)=0.62 (95% confidence interval (CI)=0.41-0.93, P=0.02)), impaired glucose regulation (OR=0.49 (95% CI=0.28-0.86, P=0.04)), hypertriglyceridemia (OR=0.53 (95% CI=0.33-0.84, P=0.03)) and low HDL cholesterol levels (OR=0.40 (95% CI=0.26-0.59, P=0.0001)). CONCLUSIONS: The results show that consumption of olive oil has a beneficial effect on different cardiovascular risk factors, particularly in the presence of obesity, impaired glucose tolerance or a sedentary lifestyle.

PP134. l-Arginine supplementation induces the expression of genes related to antioxidant defense in cultures of human vascular endothelial cells: Protective role for preeclampsia.

INTRODUCTION: Recently, it has been proposed that supplementation with l-Arginine reduces the incidence of preeclampsia in high risk women, but the molecular mechanisms involved in the protective effect need to be determined. In addition, a critical role of l-Arginine in endothelial cell survival during oxidative stress, and the participation of neutrophils in the induction of oxidative stress during preeclampsia have been suggested. OBJECTIVES: To address if supplementation with l-arginine provides antioxidant defense in human vascular endothelial cells. METHODS: Human vascular endothelial cells (HUVECs) were isolated from umbilical cord veins obtained from healthy women underwent cesarean sections at term, with no evidence of hypertension disorders through the pregnancy. HUVECs were cultured in EndoGro media with LS supplement kit and 1% antibiotic with (n=10) or without 200uM l-Arginine (n=10). Confluent HUVECs were stimulated with neutrophils activated with 50umol/L arachidonic acid (1:16 ratio of neutrophil/cells). After incubation, cells were rinsed in PBS and harvested for RNA and protein extraction. Reverse transcription was performed using the RT(2) First Strand kit, and expression gene profiling was generated using the RT(2) Profiler PCR Array Human Oxidative Stress and Antioxidant Defense that includes the expression profile of 84 genes related to the oxidative pathway. Expression results were analyzed with the RT(2) Profiler PCR Array Data Analysis Template v3.0 and two different lists of fold change in gene expression were generated: (1) HUVEC+neutrophils vs HUVEC+l-Arginine + neutrophils and (2) HUVEC vs HUVEC+neutrophils. Validation of the expression assays was performed using western blots or ELISAS for proteins expressed by selected genes. RESULTS: Fold up- or down gene regulation are shown in Table 1. Forty six genes involved in oxidative stress defense were significantly up-regulated in HUVECs supplemented with l-arginine when were exposed to neutrophils. Interestingly, almost the same genes were down-regulated in non-supplemented HUVECs after neutrophil exposure. CONCLUSION: Supplementation with l-Arginine upregulates the expression of genes related to antioxidant defense in primary cultures of endothelial cells. This finding provides a novel insight about the molecular mechanisms involved in the protective role of l-Arginine during preeclampsia.

Chemotherapy-induced peripheral neuropathy: clinical features, diagnosis, prevention and treatment strategies

Chemotherapy-induced peripheral neuropathy (CIN) is a common toxicity of anticancer treatment and its incidence is growing. It significantly affects quality of life and is a dose-limiting factor that interferes with treatment. Its diagnosis can be established in clinical terms but some complementary tests can help when the diagnosis is difficult. There is still no proven method to prevent it that has become a standard of care in spite of the huge amount of investigation carried out in recent years. There are promising strategies that could help reduce the burden of this complication. This review will suggest an approach to the diagnosis of these disorders and provide an update on new therapies (AU)

The impact of a clinical training unit on integrated child health care in Mexico.

This study had two aims: to describe the activities of a clinical training unit set up for the integrated management of sick children, and to evaluate the impact of the unit after its first four years of operation. The training unit was set up in the outpatient ward of a government hospital and was staffed by a paediatrician, a family medicine physician, two nurses and a nutritionist. The staff kept a computerized database for all patients seen and they were supervised once a month. During the first three years, the demand for first-time medical consultation increased by 477% for acute respiratory infections (ARI) and 134% for acute diarrhoea (AD), with an average annual increase of demand for medical care of 125%. Eighty-nine per cent of mothers who took their child for consultation and 85% of mothers who lived in the catchment area and had a deceased child received training on how to recognize alarming signs in a sick child. Fifty-eight per cent of these mothers were evaluated as being properly trained. Eighty-five per cent of primary care physicians who worked for government institutions (n = 350) and 45% of private physicians (n = 90) were also trained in the recognition and proper management of AD and ARI. ARI mortality in children under 1 year of age in the catchment area (which included about 25,000 children under 5 years of age) decreased by 43.2% in three years, while mortality in children under 5 years of age decreased by 38.8%. The corresponding figures for AD mortality reduction were 36.3% and 33.6%. In this same period, 11 clinical research protocols were written. In summary, we learned that a clinical training unit for integrated child care management was an excellent way to offer in-service training for primary health care physicians.

[Child health care program in Mexico. Evaluation of the quality of the integrated health care given in training centers]. / Programa de atención a la salud del niño en México. Evaluación de la calidad de la atención integrada que se otorga en los centros de capacitación.

OBJECTIVE: To assess the quality of the integral care of children under five years old (AIMCA) at three first level care units, that without additional resources, were selected by the Child Health Care Program (PASN) to function as statewide training centers. MATERIAL AND METHODS: Using matching list, structure, validated by a consensus of experts and a pilot test, six components of the AIMCA were assessed. The study included children under five years old outpatient clinic, during a period of a week: on the average 30 at each unit. RESULTS: Although there were differences between each health unit, in a high number of cases, the score given to each component of the AIMCA was optimum or satisfactory. The most relevant deficiencies were those related to the mother's training. The assessment allowed for correcting deficiencies in the AIMCA and others related with the organization of Training Centers. CONCLUSIONS: It is possible to have an AIMCA of good quality, at first level units without additional resources. We propose that the mother's training be given mainly by a nurse, especially in children with factors of poor prognosis. The methodology used can be employed to evaluate the AIMCA periodically at training centers.

Phenylpropanoids from Umbilicus pendulinus.

Phytochemical investigation of the leaves of Umbilicus pendulinus afforded in addition to 2-O-caffeoyl malate, isoquercitrin and Z-venusol, the new isomer E-venusol. Special NMR experiments were carried out to elucidate the configuration of the two latter compounds.

Hybrid finite element-finite difference method for thermal analysis of blood vessels.

A hybrid finite-difference/finite-element technique for the thermal analysis of blood vessels embedded in perfused tissue has been developed and evaluated. This method provides efficient and accurate solutions to the conjugated heat transfer problem of convection by blood coupled to conduction in the tissue. The technique uses a previously developed 3D automatic meshing method for creating a finite element mesh in the tissue surrounding the vessels, coupled iteratively with a 1-D marching finite difference method for the interior of the vessels. This hybrid technique retains the flexibility and ease of automated finite-element meshing techniques for modelling the complex geometry of blood vessels and irregularly shaped tissues, and speeds the solution time by using a simple finite-difference method to calculate the bulk mean temperatures within all blood vessels. The use of the 1D finite-difference technique in the blood vessels also eliminates the large computer memory requirements needed to accurately solve large vessel network problems when fine FE meshes are used in the interior of vessels. The accuracy of the hybrid technique has been verified against previously verified numerical solutions. In summary, the hybrid technique combines the accuracy and flexibility found in automated finite-element techniques, with the speed and reduction of computational memory requirements associated with the 1D finite-difference technique, something which has not been done before. This method, thus, has the potential to provide accurate, flexible and relatively fast solutions for the thermal analysis of coupled perfusion/blood vessel problems, and large vessel network problems.

[Mortality for diarrheic disease in Mexico: problem of accessibility or quality of care?]. / La mortalidad por enfermedad diarreica en México: problema de acceso o de calidad de atención?

OBJECTIVE: To evaluate the access to health services and the process of care provided to children under five years old who died from acute diarrhea (AD). MATERIAL AND METHODS: In four states of Mexico, a cross-sectional study was carried out. Deaths from AD that occurred in the lapse of one year were included. Information about clinical characteristics of the illness, process of care and access to the health facilities were obtained through verbal autopsy. Descriptive analysis and comparison of data between rural and urban communities were performed. RESULTS: Five-hundred and fifty three deaths were analysed. Most of the children were not enrolled in a public care health system. The main children's characteristics were the following: residence in rural communities; age less than one year; died at home or had short illness duration. Geographic and economic access barriers were identified in rural areas. Oral rehydration salts were provided as a part of household treatment in about 75% of children. 20% of them received non-medical care, specially from traditional healers. Primary medical care was provided to 60% of cases; the drawbacks of the process were related to a high rate of medication prescription, lack or referral to hospital, and lack of recommendation for a new visit in presence of alarm signs. Public physicians and those from rural communities prescribed oral rehydration therapy in a greater proportion. CONCLUSIONS: The problem of access to health services in rural communities was confirmed. However, low quality of care provided by primary level physicians was found in both rural and urban areas. We propose the creation of clinical teaching centers to improve the quality of the process of medical care as a strategy to decrease mortality due to AD.

An intercultural comparison of home case management of acute diarrhea in Mexico: implications for program planners.

BACKGROUND: The objective was to assess the extent to which similarities in cultural beliefs and practices related to home management of diarrhea would permit general recommendations to improve the content of health care messages. METHODS: We studied six communities in Mexico, covering rural and urban conditions, different ethnic groups, and different socioeconomic levels. Systematic data collection relied on open-ended, face-to-face interviews with mothers of children under 5 years of age who had had an episode of diarrhea. Similarities among communities were assessed by means of a quadratic assignment procedure applied to signs, symptoms, and treatment matrices. Significant similarity among most of the communities sustained use of a global composite matrix to represent all communities. RESULTS: We suggest specific recommendations to promote sound home management of diarrhea based on significant correlations among signs and symptoms with treatments. Signs and symptoms include those promoted by the National Program for the Control of Diarrheal Diseases (diarrhea, fever, vomiting) and others commonly mentioned by mothers (stomach ache, sadness, restlessness, refusal to eat). Similarly, recommendations to use home-based treatments based on beliefs related to their use may include the feeding of rice water, soups, and broth to a child who is sad, or rice-gruel and teas for a child with a fever. CONCLUSIONS: Our study supports that there are enough similarities among mothers' beliefs and practices for the care of acute diarrhea in childhood to support general recommendations at the program level.

Localization of neurons expressing substance P and neurokinin B gene transcripts in the human hypothalamus and basal forebrain.

In situ hybridization histochemistry was used to map the distribution of neurons expressing the substance P (SP) or neurokinin B (NKB) genes in the human hypothalamus and basal forebrain. Hypothalami from five adult males were frozen in isopentane at -30 degrees C and serially sectioned at 20 jm thickness. Every 20th section was hybridized with [35S]-labeled, 48-base synthetic cDNA probes that were complementary to either SP or NKB mRNAs. Slides were dipped into nuclear emulsion for visualization of mRNAs at the single-cell level. The location of labeled neurons (greater than x 5 background) was mapped by using an image-combining computer microscope system. A distinct and complementary distribution pattern of SP and NKB neurons was observed in the human hypothalamus and basal forebrain. NKB was the predominant tachykinin in the rostral hypothalamus, whereas SP mRNA predominated in the posterior hypothalamus. Numerous NKB neurons were identified in the magnocellular basal forebrain, the bed nucleus of stria terminalis, and the anterior hypothalamic area. Scattered NKB neurons were present in the infundibular and paraventricular nuclei, paraolfactory gyrus, posterior hypothalamic area, lateral division of the medial mammillary nucleus, and amygdala. Numerous neurons expressing SP mRNAs were identified in the premammillary, supramammillary, and medial mammillary nuclei; the posterior hypothalamic area; and the corpus striatum. Scattered SP neurons were also observed in the preoptic area; the infundibular, intermediate, dorsomedial, and ventromedial nuclei; the infundibular stalk; the amygdala; the bed nucleus of stria terminalis; and the paraolfactory gyrus. These studies provide the first description of the location of neurons that express tachykinin gene transcripts in the human hypothalamus.

Human skeletal muscle nebulin sequence encodes a blueprint for thin filament architecture. Sequence motifs and affinity profiles of tandem repeats and terminal SH3.

Analysis of deduced protein sequence and structural motifs of approximately 5500 residues of human fetal skeletal muscle nebulin reveals the design principles of this giant multifunctional protein in the sarcomere. The bulk of the sequence is constructed of approximately 150 tandem copies of approximately 35-residue modules that can be classified into seven types. The majority of these modules form 20 super-repeats, with each super-repeat containing a 7-module set (one of each type in the same order). These super-repeats are further divided into eight segments: with six segments containing adjacent, highly homologous super-repeats, one single repeat segment consisting of 8 nebulin modules of the same type, and a non-repeat segment terminating with a SH3 domain at the C terminus. The interactions of actin, tropomyosin, troponin, and calmodulin with nebulin fragments consisting of either repeating modules or the SH3 domain support its role as a giant actin-binding cofilament of the composite thin filament. Such affinity profiles also suggest that nebulin may bind to tropomyosin and troponin to form a composite calcium-linked regulatory complex on the thin filament. The modular construction, super-repeat structure, and segmental organization of nebulin sequence appear to encode thin filament length, periodicity, insertion, and sarcomere proportion in the resting muscle.

Morphometric study of fetal brain transplants in the insular cortex and NGF effects on neuronal and glial development.

Homotopic grafts supplemented with nerve growth factor (NGF) speed the recovery from learning deficits observed following electrolytic lesions of the insular cortex in rats. NGF also reduces the time in which the activity of choline acetyltransferase (ChAT) is first detected inside the graft by histochemical techniques. It is not known whether this behavioral and biochemical recovery correlates with an advanced maturation of the cellular elements within the graft, presumably induced by NGF. To investigate the degree of maturation of neurons, glial cells and blood vessels in NGF-supplemented grafts, adult rats were lesioned electrolytically in the insular cortex, and homotopic embryonic grafts (E16) with or without NGF supplementation were transplanted into the lesion. Fifteen days post grafting, the rats were perfused and the brains stained using silver impregnation techniques. Our results showed that neuronal maturation, as evaluated through several morphometric parameters, was advanced in NGF-supplemented grafts when compared with other experimental groups. Furthermore, grafts supplemented with NGF also showed significant increases in the number of neurons, oligodendrocytes, astrocytes and blood vessels. These observations indicated that the addition of NGF to insular cortex grafts promoted the maturation of neuronal and glial elements within the graft. They also support the possibility that the advanced morphological maturation of insular cortex grafts supplemented with NGF underlies the accelerated functional and biochemical recovery of animals with lesions of the insular cortex.