Specific microbiome patterns and their association with breast cancer: the intestinal microbiota as a potential biomarker and therapeutic strategy.

Breast cancer (BC) is one of the most diagnosed cancers in women. Based on histological characteristics, they are classified as non-invasive, or in situ (tumors located within the milk ducts or milk lobules) and invasive. BC may develop from in situ carcinomas over time. Determining prognosis and predicting response to treatment are essential tools to manage this disease and reduce its incidence and mortality, as well as to promote personalized therapy for patients. However, over half of the cases are not associated with known risk factors. In addition, some patients develop resistance to treatment and relapse. Therefore, it is necessary to identify new biomarkers and treatment strategies that improve existing therapies. In this regard, the role of the microbiome is being researched as it could play a role in carcinogenesis and the efficacy of BC therapies. This review aims to describe specific microbiome patterns associated with BC. For this, a literature search was carried out in PubMed database using the MeSH terms "Breast Neoplasms" and "Gastrointestinal Microbiome", including 29 publications. Most of the studies have focused on characterizing the gut or breast tissue microbiome of the patients. Likewise, studies in animal models and in vitro that investigated the impact of gut microbiota (GM) on BC treatments and the effects of the microbiome on tumor cells were included. Based on the results of the included articles, BC could be associated with an imbalance in the GM. This imbalance varied depending on molecular type, stage and grade of cancer, menopause, menarche, body mass index, and physical activity. However, a specific microbial profile could not be identified as a biomarker. On the other hand, some studies suggest that the GM may influence the efficacy of BC therapies. In addition, some microorganisms and bacterial metabolites could improve the effects of therapies or influence tumor development.

Interference of AHL signal production in the phytophatogen Pantoea agglomerans as a sustainable biological strategy to reduce its virulence.

Pantoea agglomerans is considered one of the most ubiquitous and versatile organisms that include strains that induce diseases in various crops and occasionally cause opportunistic infections in humans. To develop effective strategies to mitigate its impact on plant health and agricultural productivity, a comprehensive investigation is crucial for better understanding its pathogenicity. One proposed eco-friendly approach involves the enzymatic degradation of quorum sensing (QS) signal molecules like N-acylhomoserine lactones (AHLs), known as quorum quenching (QQ), offering potential treatment for such bacterial diseases. In this study the production of C4 and 3-oxo-C6HSL was identified in the plant pathogenic P. agglomerans CFBP 11141 and correlated to enzymatic activities such as amylase and acid phosphatase. Moreover, the heterologous expression of a QQ enzyme in the pathogen resulted in lack of AHLs production and the attenuation of the virulence by mean of drastically reduction of soft rot disease in carrots and cherry tomatoes. Additionally, the interference with the QS systems of P. agglomerans CFBP 11141 by two the plant growth-promoting and AHL-degrading bacteria (PGP-QQ) Pseudomonas segetis P6 and Bacillus toyonensis AA1EC1 was evaluated as a potential biocontrol approach for the first time. P. segetis P6 and B. toyonensis AA1EC1 demonstrated effectiveness in diminishing soft rot symptoms induced by P. agglomerans CFBP 11141 in both carrots and cherry tomatoes. Furthermore, the virulence of pathogen notably decreased when co-cultured with strain AA1EC1 on tomato plants.

Spontaneous Variation of Ventriculo-Atrial Interval after Tachycardia Induction: Determinants and Usefulness in the Diagnosis of Supraventricular Tachycardias with Long Ventriculoatrial Interval.

Background: Determining the mechanism of supraventricular tachycardias with prolongedP ventriculoatrial (VA) intervals is sometimes a challenge. Our objective is to analyse the determinants, time course and diagnostic accuracy (atypical atrioventricular nodal reentrant tachycardias [AVNRT] versus orthodromic reentrant tachycardias through an accessory pathway [ORT]) of spontaneous VA intervals variation in patients with narrow QRS tachycardias and prolonged VA. Methods: A total of 156 induced tachycardias were studied (44 with atypical AVNRT and 112 with ORT). Two sets of 10 measurements were performed for each patient­after tachycardia induction and one minute later. VA and VV intervals were determined. Results: The difference between the longest and the shortest VA interval (Dif-VA) correlates significantly with the diagnosis of atypical AVNRT (C coefficient = 0.95 and 0.85 after induction and at one minute, respectively; p < 0.001). A Dif-VA ≥ 15 ms presents a sensitivity and specificity for atypical AVNRT of 50% and 99%, respectively after induction, and of 27% and 100% one minute later. We found a robust and significant correlation between the fluctuations of VV and VA intervals in atypical AVNRTs (Coefficient Rho: 0.56 and 0.76, after induction and at one minute, respectively; p < 0.001 for both) but not in ORTs. Conclusions: The analysis of VA interval variability after induction and one minute later correctly discriminates atypical AVNRT from ORT in almost all cases.

Complications associated with peripherally inserted central catheters and Hickman™ in patients with advanced pulmonary hypertension treated with intravenous prostanoids.

BACKGROUND: Epoprostenol requires continuous infusion and may lead to catheter-related complications. Evidence regarding the comparison between peripherally inserted central catheters (PICC) or tunneled central catheters in Pulmonary Hypertension (PH) is scarce. We sought to study the incidence of mechanical and infectious complications associated with PICC and Hickman catheters in patients with PH under epoprostenol treatment. METHODS: This is a single-center retrospective study of patients with PH who received continuous treatment with intravenous epoprostenol for at least 24 h between January 2010 and July 2020. Mechanical and infectious complications were analyzed according to the catheter type: PICC and Hickman. The incidence of catheter-related complications was calculated per 1000 exposure-days of risk. RESULTS: 175 catheters were implanted in 109 patients, of which 100 (57.1%) were Hickman and 75 (42.9%) were PICC. After a median follow-up of 334 [130-798] days, there were no differences in the rates of local (0.22 vs 0.21; p = 0.904) or blood-stream infections (0.13 vs 0.21; p = 0.405). Mechanical complications were more frequent in the PICC group (0.98 vs 0.23 p=<0.001), including venous thrombosis (0.16 vs 0.00 p = 0.003) and catheter occlusion (0.66 vs 0.04 p=<0.001). These complications were associated with a greater need for hospitalization (1.48 vs 0.50; p=<0.001), without differences in mortality during follow-up (0.33 vs 0.21; p = 0.288). CONCLUSION: In patients with PH treated with intravenous epoprostenol, both Hickman and PICC catheters were associated with high rate of complications. Although there were no differences in the frequency of infectious-related complications, PICC was associated with a higher frequency of catheter occlusion and deep venous thrombosis.

Costo de la atención médica de pacientes con síndrome de fragilidad vs. pacientes con pre-fragilidad / Cost of patients care with fragility syndrome vs. pre-frailty patients

Introducción: el síndrome clínico de fragilidad se ha relacionado con eventos adversos como caídas, discapacidad, el estado cognitivo, hospitalizaciones e incluso la muerte, implicando con ello un mayor uso de los servicios de salud y de recursos. Objetivo: determinar el costo de la atención médica de pacientes con síndrome de fragilidad vs. pre-fragilidad. Métodos: estudio de costos en pacientes adultos mayores adscritos a tres unidades de medicina familiar que recibieron atención de enero 2011 a mayo de 2013. Se incluyeron expedientes de pacientes adultos mayores. Se integraron dos grupos: frágiles y pre-frágiles. El tamaño de la muestra (n=64) se calculó con la fórmula de promedios para dos poblaciones. La técnica muestral fue aleatoria estratificada, empleando como marco de muestra el listado de pacientes adultos mayores. Se estudiaron características sociodemográficas, de salud, perfil de uso de los servicios de medicina familiar, rayos x y laboratorio, y costos (costo unitario, costo promedio y costo promedio total). El análisis estadístico incluyó promedios y porcentajes. Resultados: la prevalencia de la hipertensión arterial en el grupo de pre-frágiles es 80,7 % y en el grupo frágil 95,5 %. La enfermedad con mayor tiempo de evolución en el grupo de pacientes con pre-fragilidad es la hipertensión arterial con 12,13 años y en el grupo de fragilidad la diabetes con promedio de 15,50. En pacientes frágiles el promedio de glucosa es de 156,67 mg/dl. El costo promedio total en el paciente con fragilidad es de $1 911,02 y en el paciente pre-frágil de $1 802,48. Conclusiones: el costo promedio total en ambos grupos presenta mínima diferencia, y su costo se relaciona con la inclusión del tratamiento de las enfermedades crónicas.

Introduction: the clinical syndrome of frailty has been linked to adverse events such as falls, disability, cognitive status, hospitalization and even death, implying greater use of health services and resources. Objective: determine the care cost of fragility syndrome patients vs. pre-frailty patients. Methods: acost study was conducted on elderly patients assigned to three family medicine units that received attention from January 2011 to May of 2013. Elderly patients' records were included. Two groups were formed: Pre-frail and fragile. The sample size (n = 64) was calculated with the average formula for two populations. The stratified random sampling technique was used as a framework for the list of elderly patients. Socio-demographic characteristics and other variables were studied: health, usage profile of family medicine services, x-rays and lab, and costs (unit cost, average cost and average total cost). Statistical analysis included averages and percentages. Results: the prevalence of hypertension is 80.7% in pre-frail group and 95.5% in the fragile group. Hypertension has the longest history in the pre- fragility group of patients with 12-13 years and diabetes has the longest history in the fragility group with average of 15, 50. In frail patients average glucose is 156.67 mg / dl. The total average cost in patients with fragility is $ 1 911.02 and $ 1 802.48 in pre-frail patients. Conclusions: the total average cost in both groups has minimal difference and its cost is related to the inclusion of treatment of chronic diseases.

Valoración del ibuprofeno como analgésico y antiinflamatorio suministrado prequirúrgicamente en terceros molares incluídos / Eficacy of ibuprofen as an analgesic an antiinflamatory used prechirurgically in the extraction of included third molars

Este estudio fué realizado para determinar y valorar la eficacia del Ibuprofeno como analgésico y antiinflamatorio usado prequirúrgicamente,en la extracción de terceros molares incluídos.Se tomaron 106 pacientes entre los 17 y 25 años.Estos pscientes se dividieron en dos grupos.Un grupo experiemental cuyos pacientes se le dio la droga una hora antes de la cirugía y seis horas después durante tres dias: otro grupo control al que se le admnistró drogas antes de la cirugía más si se le dió la dosis postquirúrgica de Ibuprofen cada seis horas durante los tres dias siguientes.La inflamación fue medida individualmente prequirúrgicamente a las 24 horas y a las 48 horas en forma lineal tomando una medida horizontal y otra vertical y resultando la sumatoria en una medida facial.el grado del dolor se determinó por una escala cualitativa clasificada en ausente,leve,moderada y severa.Para fines estadísticos se determinaron y compararon los porcentajes de inflamción y grado de entre los dos grupos,teniendo en cuenta variables de tiempo(24hrs-48hrs) y administración del Ibuprofeno por medio de un análisis de promedios para la inflamación y de frecuencias para el dolor.En este estudio se encontraron diferencias entre los grupos experimental y control para el efecto analgésico y anatiinflamatorio,mostrando una reducción estadísticamente significativa para la inflamación de las primeras 24hrs(p=0.00022),al igual que a las 48hrs(p=0.000005),enlos pacientes a los que le fue admnistrado el ibuprofen preoperatoriamente.En cuanto al dolor la intensidad que presentó mayor frecuencia fue la leve y la moderada.

Optimacion del proceso de production de la vacina pertussis / Optimization of pertussis vaccine production process

The production of Pertussis Vaccine was reevaluated at the Instituto Nacional de Higiene(r)Rafael Rangel(r) in order to optimise it in terms of vaccine yield, potency, specific toxicity and efficiency (cost per doses). Four different processes, using two culture media (Cohen-Wheeler and Fermentacion Glutamato Prolina-1) and two types of bioreactors (25 L Fermentador Caracas and a 450 L industrial fermentor) were compared. Runs were started from freeze-dried strains (134 or 509) andcontinued until the obtention of the maximal yield. It was found that the combination Fermentacion Glutamato Prolina-1/industrial fermentor, shortened the process to 40 hours while consistently yielding a vaccine of higher potency (7.91 +/- 2.56 IU/human dose) and lower specific toxicity in a mice bioassay. In addition, the physical aspect of the preparation was rather homogeneous and free of dark aggregates. Most importantly, the biomass yield more than doubled those of the Fermentador Caracas using the two different media and that in the industrial fermentor with the Cohen-Wheeler medium. Therefore, the cost per doses was substantially decreased

Desprendimiento de retina, factores predisponentes y etiología / Retinal detachment, predisposing factors and etiology

En el presente trabajo se estudiaron 67 casos de pacientes con desprendimiento de retina y se determinó los factores predisponentes y causas vitreorretinianas desencadenantes más importantes. Entre los factores predisponentes la más importante asociación fue la miopía la cual se estableció en el 37,31 por ciento de los casos, mientras que entre las causas vitreorretinianas la más frecuente fue la degeneración reticular con un 20,89 por ciento . La hipertensión arterial sistémica y/o arterioesclerosis fue encontrada en 61,90 por ciento de los casos en los pacientes mayores de 40 años, constituyendo un factor importante en este grupo etario