The ATENción Plena en Enfermedad de Alzheimer (ATENEA-Mindfulness in Alzheimer's Disease) Program for Caregivers: Study Protocol for a Randomized Controlled Trial.

A person affected by Alzheimer's disease (AD) gradually loses the ability to perform activities of daily living and becomes dependent on caregivers, thereby having a negative impact on the caregivers' quality of life. There is evidence that suggests that interventions aimed at caregivers, such as mindfulness, may be effective at reducing this burden and emotional issues, such as depression and anxiety, and improving their quality of life. However, there is a lack of consistency in the findings and conclusions remain tentative. In addition, as neuropsychiatric symptoms (NPSs) of AD are major determinants of the caregiver's burden, these interventions should examine the relationship between these symptoms and caregiver outcomes. Importantly, to improve the design of therapeutic interventions for caregivers and complement the treatment of AD, aspects related to occupational performance and the participation of people with AD and their caregivers should also be considered. Therefore, this study will aim to examine first, the effects of a mindfulness-based program designed for caregivers on NPSs of AD and caregivers' anxiety and depression; second, the effects of this program on patients' functional capacity, cognitive performance, executive functions, and quality of life, and on caregivers' burden, quality of life, occupational balance, executive functions, psychological wellbeing, and self-compassion. We believe that the findings of this study will have significant implications for future healthcare strategies focused on improving the quality of life and wellbeing of caregivers.

Importancia de la farmacovigilancia en medicina herbaria / Importance of pharmacovigilance in herbal medicine

Introducción: el uso de hierbas medicinales para la prevención y el tratamiento de diversas enfermedades es una práctica ancestral. A pesar del papel beneficioso y tradicional de las mismas en diferentes comunidades, hay que considerar que también pueden provocar reacciones adversas y toxicidad. Objetivo: analizar las notificaciones sobre reacciones adversas de productos medicinales a base de hierbas durante el período 2010-2016 en la provincia del Chaco, Argentina. Métodos: estudio retrospectivo, transversal y descriptivo. Se evaluaron las notificaciones de reacciones adversas a partir de los datos obtenidos de la ficha de Comunicación de Eventos Adversos por uso de Medicamentos Fitoterápicos, Productos Vegetales y/o Preparados de Drogas Vegetales, recibidas de farmacias y centros de salud de la provincia del Chaco, Argentina, como efectores periféricos del Sistema Nacional de Farmacovigilancia de la Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (ANMAT). Resultados: se recibieron un total de 129 notificaciones, se observó un predominio de reacciones adversas por el uso de productos medicinales a base de hierbas en el sexo femenino y un considerable porcentaje de las mismas que incluyó a lactantes y niños, siendo el paico ( Chenopodium ambrosioides L.) el más reportado en este grupo etario y sen (Cassia angustifolia Vahl.) en adultos. La mayoría de las reacciones adversas notificadas correspondieron a trastornos del sistema gastrointestinal. En cuanto a la intensidad e imputabilidad predominaron las leves y probables respectivamente. Conclusiones: es primordial la vigilancia continua de las medicinas a base de hierbas para promover su uso seguro sobre todo en poblaciones vulnerable(AU)

Introduction: Ever since ancient times medicinal herbs have been used to prevent and treat a variety of diseases. Despite the beneficial traditional role of medicinal herbs in various communities, their potential for causing adverse reactions and toxicity should also be borne in mind. Objective: Analyze the reports of adverse reactions by herbal medicinal products issued from 2010 to 2016 in the province of Chaco, Argentina. Methods: A descriptive cross-sectional retrospective study was conducted to evaluate the reports of adverse reactions received from pharmacies and healthcare institutions from the province of Chaco, Argentina, at the National System of Pharmacovigilance of the National Drug, Food and Medical Technology Administration (ANMAT). The study was based on official forms for the report adverse events caused by the use of phytotherapeutic drugs, plant products and/or plant drug preparations. Results: A total 129 reports were received. Adverse reactions caused by the use of herbal medicinal products prevailed in the female gender, whereas a large percentage affected infants and children. Paico (Chenopodium ambrosioides L.) was the species most commonly reported in this age group and sen (Cassia angustifolia Vahl.) among adults. Most of the adverse reactions reported were gastrointestinal disorders. As to intensity and imputability, there was a predominance of mild and probable reactions, respectively. Conclusions: Permanent vigilance of herbal medicines is crucial to promote their safe use, particularly in vulnerable populations(AU)

Importancia de la farmacovigilancia en medicina herbaria / Importance of pharmacovigilance in herbal medicine

Introducción: el uso de hierbas medicinales para la prevención y el tratamiento de diversas enfermedades es una práctica ancestral. A pesar del papel beneficioso y tradicional de las mismas en diferentes comunidades, hay que considerar que también pueden provocar reacciones adversas y toxicidad. Objetivo: analizar las notificaciones sobre reacciones adversas de productos medicinales a base de hierbas durante el período 2010-2016 en la provincia del Chaco, Argentina. Métodos: estudio retrospectivo, transversal y descriptivo. Se evaluaron las notificaciones de reacciones adversas a partir de los datos obtenidos de la ficha de Comunicación de Eventos Adversos por uso de Medicamentos Fitoterápicos, Productos Vegetales y/o Preparados de Drogas Vegetales, recibidas de farmacias y centros de salud de la provincia del Chaco, Argentina, como efectores periféricos del Sistema Nacional de Farmacovigilancia de la Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (ANMAT). Resultados: se recibieron un total de 129 notificaciones, se observó un predominio de reacciones adversas por el uso de productos medicinales a base de hierbas en el sexo femenino y un considerable porcentaje de las mismas que incluyó a lactantes y niños, siendo el paico ( Chenopodium ambrosioides L.) el más reportado en este grupo etario y sen (Cassia angustifolia Vahl.) en adultos. La mayoría de las reacciones adversas notificadas correspondieron a trastornos del sistema gastrointestinal. En cuanto a la intensidad e imputabilidad predominaron las leves y probables respectivamente. Conclusiones: es primordial la vigilancia continua de las medicinas a base de hierbas para promover su uso seguro sobre todo en poblaciones vulnerable(AU)

Introduction: Ever since ancient times medicinal herbs have been used to prevent and treat a variety of diseases. Despite the beneficial traditional role of medicinal herbs in various communities, their potential for causing adverse reactions and toxicity should also be borne in mind. Objective: Analyze the reports of adverse reactions by herbal medicinal products issued from 2010 to 2016 in the province of Chaco, Argentina. Methods: A descriptive cross-sectional retrospective study was conducted to evaluate the reports of adverse reactions received from pharmacies and healthcare institutions from the province of Chaco, Argentina, at the National System of Pharmacovigilance of the National Drug, Food and Medical Technology Administration (ANMAT). The study was based on official forms for the report adverse events caused by the use of phytotherapeutic drugs, plant products and/or plant drug preparations. Results: A total 129 reports were received. Adverse reactions caused by the use of herbal medicinal products prevailed in the female gender, whereas a large percentage affected infants and children. Paico (Chenopodium ambrosioides L.) was the species most commonly reported in this age group and sen (Cassia angustifolia Vahl.) among adults. Most of the adverse reactions reported were gastrointestinal disorders. As to intensity and imputability, there was a predominance of mild and probable reactions, respectively. Conclusions: Permanent vigilance of herbal medicines is crucial to promote their safe use, particularly in vulnerable populations(AU)

Novel Catalytically-Inactive PII Metalloproteinases from a Viperid Snake Venom with Substitutions in the Canonical Zinc-Binding Motif.

Snake venom metalloproteinases (SVMPs) play key biological roles in prey immobilization and digestion. The majority of these activities depend on the hydrolysis of relevant protein substrates in the tissues. Hereby, we describe several isoforms and a cDNA clone sequence, corresponding to PII SVMP homologues from the venom of the Central American pit viper Bothriechis lateralis, which have modifications in the residues of the canonical sequence of the zinc-binding motif HEXXHXXGXXH. As a consequence, the proteolytic activity of the isolated proteins was undetectable when tested on azocasein and gelatin. These PII isoforms comprise metalloproteinase and disintegrin domains in the mature protein, thus belonging to the subclass PIIb of SVMPs. PII SVMP homologues were devoid of hemorrhagic and in vitro coagulant activities, effects attributed to the enzymatic activity of SVMPs, but induced a mild edema. One of the isoforms presents the characteristic RGD sequence in the disintegrin domain and inhibits ADP- and collagen-induced platelet aggregation. Catalytically-inactive SVMP homologues may have been hitherto missed in the characterization of snake venoms. The presence of such enzymatically-inactive homologues in snake venoms and their possible toxic and adaptive roles deserve further investigation.

Factores que influyen en el consumo de ácidofólico preconcepcional en el País Vasco / Factors that influence the consumption of folic acid during the preconception period in the Basque Country

Diferentes organizaciones y organismos, tanto nacionales como internacionales,recomiendan la suplementación con ácido fólico durante el periodo pregestacional a fin de prevenir los defectos del tubo neural en el feto. Objetivo: Conocer los principales factores que determinan el correcto consumo de ácido fólico en la etapa pregestacional entre las gestantes que controlan su embarazo en el Servicio Vasco de Salud. Personas y métodos: Estudio correlacional, descriptivo, multicéntrico,transversal, llevado a cabo en mujeres gestantes que acuden a laconsulta de la matrona de atención primaria durante el primer trimestredel embarazo. En 2009 se realiza una encuesta de elaboración propia,que comprende datos socio demográficos y datos relacionados con el consumo de ácido fólico previo a la gestación. La muestra del estudio está formada por 371 gestantes de las tres provincias vascas. Resultados: Un 84,1% de las mujeres de la muestra eran de nacionalidad española, y la edad media era de 32,10 años; el 50,4% eran primigestas y el 86,8% trabajaban fuera del hogar. El 48% de las mujeres de la muestra había tomado ácido fólico antes de la gestación; entrel as que no lo habían tomado, el 52,33% desconocía la recomendación de este aporte nutricional previo a la gestación. Conclusiones: La suplementación con ácido fólico pregestacional sigue siendo una asignatura pendiente para las administraciones sanitarias. Se necesitan campañas de sensibilización e información para los profesionales de la salud y para la población en general (AU)

From different organizations and national and international agencies, supplementation with folic acid during the preconception period is recommended, in order to prevent neural tube defects in the fetus. Objective: To identify the main factors that determines the proper consumption of folic acid during the pregestational stage among pregnant women who manage their pregnancies in the Basque Health Service. Subjects and methods: A multicenter cross-sectional descriptive correlational study with pregnant women attending Primary Care midwifeclinics during the 1st trimester. In 2009, we studied these women through the questionnaire created by the research team that includedsocio-demographic data and data related to the intake of folic acid beforepregnancy. 371 pregnant women in the 3 Basque provinces werepart of the sample. Results: The selected sample consists of 84.1% of Spanish women with a mean age of 32.10 years. 50.4% were nulliparous and 86.8% work outside the home. From the total sample, 48% had taken folic acid before pregnancy. Among women who did not take folic acid pregestational, the 52.33% had no knowledge of the nutritional recommendation before preganancy. Conclusions: Preconception folic acid supplementation remains as an important issue for healthcare providers. Awareness campaigns and information for health professionals and the general population are necessary (AU)

Crystal structure and statistical coupling analysis of highly glycosylated peroxidase from royal palm tree (Roystonea regia).

Royal palm tree peroxidase (RPTP) is a very stable enzyme in regards to acidity, temperature, H(2)O(2), and organic solvents. Thus, RPTP is a promising candidate for developing H(2)O(2)-sensitive biosensors for diverse applications in industry and analytical chemistry. RPTP belongs to the family of class III secretory plant peroxidases, which include horseradish peroxidase isozyme C, soybean and peanut peroxidases. Here we report the X-ray structure of native RPTP isolated from royal palm tree (Roystonea regia) refined to a resolution of 1.85A. RPTP has the same overall folding pattern of the plant peroxidase superfamily, and it contains one heme group and two calcium-binding sites in similar locations. The three-dimensional structure of RPTP was solved for a hydroperoxide complex state, and it revealed a bound 2-(N-morpholino) ethanesulfonic acid molecule (MES) positioned at a putative substrate-binding secondary site. Nine N-glycosylation sites are clearly defined in the RPTP electron-density maps, revealing for the first time conformations of the glycan chains of this highly glycosylated enzyme. Furthermore, statistical coupling analysis (SCA) of the plant peroxidase superfamily was performed. This sequence-based method identified a set of evolutionarily conserved sites that mapped to regions surrounding the heme prosthetic group. The SCA matrix also predicted a set of energetically coupled residues that are involved in the maintenance of the structural folding of plant peroxidases. The combination of crystallographic data and SCA analysis provides information about the key structural elements that could contribute to explaining the unique stability of RPTP.

Efecto del suplemento oral de cinc sobre el sistema inmunológico en pacientes con úlceras venosas / Effect of the oral zinc supplementation on the immune system of patients with venous ulcers

El cinc es un oligoelemento con funciones básicas como catalítica, estructural y de regulación que definen su papel biológico. Interviene en la síntesis de proteínas, ácidos nucleicos, división celular y en la expresión genética de varias proteínas. Diferentes estudios han indicado que las células del sistema inmunológico decrecen frente a deficiencias de cinc, por lo que juega un importante papel en el sistema inmunológico. Evaluar el tratamiento con sulfato de cinc sobre el sistema inmunológico en pacientes con úlceras venosas, con el fin de acelerar la cicatrización de las lesiones. Fueron estudiados pacientes con úlceras venosas sometidos a un tratamiento oral de sulfato de cinc de 220 mg durante 4 semanas y un grupo control. Además de determinar la concentración de cinc en suero, en leucocitos y en linfocitos, fue determinada la función inmunológica mediante las células T, y la actividad microbicida de leucocitos polimorfonucleares, antes y después del tratamiento. Se encontraron diferencias en los niveles de cinc en suero, tanto en los linfocitos como los leucocitos, al compararlos con el grupo control. Los suplementos de cinc parecen tener un efecto beneficioso sobre la curación de heridas venosas en pacientes con hipocinquemia y mejoran su estado inmune(AU)

Zinc is an oligoelement with catalytic, structural and regulating functions that define its biological role. It is involved in protein and nucleic acids synthesis, in cell division and in genetic expression of several proteins. A number of studies have revealed that the number of immune system cells decreases when zinc deficiency is present, so this compound plays an important role in the immune system. To evaluate the effect of the zinc sulphate-based treatment on the immune system of patients with venous ulcers, in order to accelerate lesion cicatrisation. A study was performed on patients with venous ulcers under 220 mg oral zinc sulphate treatment for 4 weeks and on a control group. The zinc concentrations in serum, leukocytes and lymphocytes, and T lymphocyte immune function as well as microbial action by polymorphonuclear leukocytes were determined before and after the treatment. Some differences were found in serum zinc concentrations, both in leukocytes and lymphocytes when compared with those of the control group. Zinc supplementation seems to have a beneficial effect on venous wound healing of patients with hypozincemia and improves their immune condition(AU)

cDNA cloning and functional expression of jerdostatin, a novel RTS-disintegrin from Trimeresurus jerdonii and a specific antagonist of the alpha1beta1 integrin.

Jerdostatin represents a novel RTS-containing short disintegrin cloned by reverse transcriptase-PCR from the venom gland mRNA of the Chinese Jerdons pit viper Trimeresurus jerdonii. The jerdostatins precursor cDNA contained a 333-bp open reading frame encoding a signal peptide, a pre-peptide, and a 43-amino acid disintegrin domain, whose amino acid sequence displayed 80% identity with that of the KTS-disintegrins obtustatin and viperistatin. The jerdostatin cDNA structure represents the first complete open reading frame of a short disintegrin and points to the emergence of jerdostatin from a short-coding gene. The different residues between jerdostatin and obtustatin/viperistatin are segregated within the integrin-recognition loop and the C-terminal tail. Native jerdostatin (r-jerdostatin-R21) and a R21K mutant (r-jerdostatin-K21) were produced in Escherichia coli. In each case, two conformers were isolated. One-dimensional (1)H NMR showed that conformers 1 and 2 of r-jerdostatin-R21 represent, respectively, well folded and unfolded proteins. The two conformers of the wild-type and the R21K mutant inhibited the adhesion of alpha(1)-K562 cells to collagen IV with IC(50) values of 180 and 703 nm, respectively. The IC(50) values of conformers 2 of r-jerdostatin-R21 and r-jerdostatin-K21 were, respectively, 5.95 and 12.5 microm. Neither r-jerdostatin-R21 nor r-jerdostatin-K21 showed inhibitory activity toward other integrins, including alpha(IIb)beta(3), alpha(v)beta(3), alpha(2)beta(1), alpha(5)beta(1), alpha(4)beta(1), alpha(6)beta(1), and alpha(9)beta(1) up to a concentration of 24 mum. Although the RTS motif appears to be more potent than KTS inhibiting the alpha(1)beta(1) integrin, r-jerdostatin-R21 is less active than the KTS-disintegrins, strongly suggesting that substitutions outside the integrin-binding motif and/or C-terminal proteolytic processing are responsible for the decreased inhibitory activity.

Ultrasonographic diagnosis and medical treatment of human cystic echinococcosis in asymptomatic school age carriers: 5 years of follow-up.

Hydatidosis or cystic echinococcosis (CE) caused by Echinococcus granulosus is endemic in the Province of Río Negro, Argentina. The objective of this investigation was to evaluate the results of a program carried out in endemic areas of the Province of Río Negro, Argentina, in the years 1997-2002. Abdominal ultrasonography was used, classifying the cases detected according to WHO guidelines. A treatment algorithm was defined which included observation, albendazol therapy, PAIR or surgery, according to cyst type and size. A total of 5745 schoolchildren were evaluated, detecting hydatid cyst carriers in 70 (1.2%). Of these; 40 (57.1%) were included in follow-up protocol, 25 (35.7%) in treatment protocol with albendazol, 2 (2.9%) with PAIR and 3 (4.3%) with conventional surgery. After a mean of 44 months, among 25 cases treated with albendazol, in 2 (8%) cysts underwent total involution, in 17 (68%) they presented positive changes, in one (4%) they remained unchanged and in 4 (16%) they progressed to type II, while 1 (4%) displayed negative evolutionary changes. Out of 39 cases under observation alone protocol, in 8 cases (21%) cysts underwent total involution, in 7 (18%) they presented positive changes, in 11 (28%) they remained unchanged, in 2 (5%) they progressed to Type II and in 11 (28%) they presented negative evolutionary changes and had to be included in the other protocol types. In this study, conventional surgery, was applied to 10% of detected cases. The combination of ultrasonographic screening and albendazol treatment showed promising results.