Anticoncepción posevento obstétrico y embarazo subsecuente en adolescentes: perspectivas del personal de salud en México.

OBJETIVO: Identificar cómo se implementa la estrategia de anticoncepción posevento obstétrico (APEO) y analizar las barreras, acciones y recomendaciones para prevenir embara-zos subsecuentes en adolescentes. Material y métodos. Estudio cualitativo a través de análisis de contenido de 21 en-trevistas semiestructuradas a personal de salud de instituciones de atención a población sin seguridad social de la Ciudad de México y Morelos. RESULTADOS: La APEO se promueve du-rante el embarazo, parto, posaborto, puerperio y hasta 12 me-ses después del evento obstétrico. La consejería debe abordar, además de información técnica sobre métodos anticonceptivos, otras temáticas clave en relación con los derechos sexuales y reproductivos de los adolescentes. Se identifican barreras personales, institucionales y sociales para la implementación de la estrategia; el personal refiere acciones y recomendaciones específicas para su consolidación. Conclusión. La estrategia de APEO se debe fortalecer para garantizar la oferta de un servicio acorde con las necesidades de las mujeres menores de 20 años, así como diseñar intervenciones basadas en las buenas prácticas y recomendaciones de los prestadores de salud para superar las barreras y lograr periodos intergenésicos más allá de la adolescencia.

Anti-Helicobacter pylori Activity of Artemisia ludoviciana subsp. mexicana and Two of Its Bioactive Components, Estafiatin and Eupatilin.

Artemisia ludoviciana subsp. mexicana has been traditionally used for the treatment of digestive ailments such as gastritis, whose main etiological agent is Helicobacter pylori. In a previous screening study, the aqueous extract exhibited a good in vitro anti-H. pylori activity. With the aim of determining the efficacy of this species as a treatment for H. pylori related diseases and finding bioactive compounds, its aqueous extract was subjected to solvent partitioning and the fractions obtained were tested for their in vitro anti-H. pylori effect, as well as for their in vivo gastroprotective and anti-inflammatory activities. The aqueous extract showed a MIC = 250 µg/mL. No acute toxicity was induced in mice. A gastroprotection of 69.8 ± 3.8%, as well as anti-inflammatory effects of 47.6 ± 12.4% and 38.8 ± 10.2% (by oral and topical administration, respectively), were attained. Estafiatin and eupatilin were isolated and exhibited anti-H. pylori activity with MBCs of 15.6 and 31.2 µg/mL, respectively. The finding that A. ludoviciana aqueous extract has significant anti-H. pylori, gastroprotective and anti-inflammatory activities is a relevant contribution to the ethnopharmacological knowledge of this species. This work is the first report about the in vivo gastroprotective activity of A. ludoviciana and the anti-H. pylori activity of eupatilin and estafiatin.

Sexual and reproductive health among adolescents in vulnerable contexts in Mexico: Needs, knowledge, and rights.

Ensuring sexual and reproductive health, and rights for adolescents entails the prevention of early pregnancies, which are widely recognized as a public health problem. Based on the ecological model for early pregnancy, this article identifies the healthcare requirements for preventing unintended adolescent pregnancies in predominantly indigenous communities in Chiapas, Mexico. Using a convergent parallel mixed-methods study design, we surveyed adolescents (12-15 years old) and health personnel, organized focus groups with adolescents and their parents, and conducted in-depth interviews at the individual, family, school and community levels. Results showed that adolescents recognized their right to receive sexuality education (64.5%) as well as information on contraceptive methods (53.0%), with indigenous language speakers and individuals living in overcrowded households less likely to know about these rights. Parents of adolescents knew little about contraception and pregnancy. School teachers lacked necessary tools for offering comprehensive sexuality education. A traditional, patriarchal perspective predominated among participants, fostering gender inequalities. In conclusion, it is essential to implement multifocal strategies under a human-rights, intercultural, and health-equity approach. Special attention should be directed to the spheres in which adolescents interact, and efforts should focus on improving knowledge, empowering adolescents, and enhancing their access to sexual and reproductive health resources.

Gastroprotective Mechanism and Ulcer Resolution Effect of Cyrtocarpa procera Methanolic Extract on Ethanol-Induced Gastric Injury.

Gastric ulcers are a worldwide health problem and their poor healing is one of the most important causes for their recurrence. We have previously reported the remarkable gastroprotective and anti-Helicobacter pylori activities of the methanolic extract (CpMet) of Cyrtocarpa procera bark. This work investigates, in a murine model, the CpMet gastroprotective mechanism and establishes its preclinical efficacy in the resolution of ethanol-induced gastric ulcers. The results showed that the gastroprotective activity of CpMet is mainly associated with endogenous NO and prostaglandins, followed by sulfhydryl groups and KATP channels. Furthermore, CpMet (300 mg/kg, twice a day) orally administered during 20 consecutive days promoted an ulcer area reduction of 62.65% at the 20th day of the treatment. The effect was confirmed macroscopically by the alleviation of gastric mucosal erosions and microscopically by an increase in mucin content and a reduction in the inflammatory infiltration at the site of the ulcer. No clinical symptoms or signs of toxicity were observed in the treated animals. The results indicate the safety and efficacy of CpMet in promoting high quality of ulcer healing by different mechanisms, but mostly through cytoprotective and anti-inflammatory effects, making it a promising phytodrug for ulcer treatment.

Anti-Helicobacter pylori Potential of Three Edible Plants Known as Quelites in Mexico.

"Quelites" are edible plants that are part of the traditional agro-ecosystems in Mexico. These plants, despite their already known nutritional properties, are now considered neglected and underutilized species. With the objective of promoting their reinsertion in the markets and mainly, in daily diets, efforts have been made to study them from multidisciplinary approaches to demonstrate their beneficial properties. To generate evidence of an added health-promoting value that would encourage quelites consumption, in the present work, the anti-Helicobacter pylori activity of three representative quelite species, Anoda cristata (Alache), Cnidoscolus aconitifolius (Chaya), and Crotalaria pumila (Chepil), was tested. H. pylori is considered the etiological agent of gastritis, ulcer, and gastric cancer, and represents a public health problem in Mexico and worldwide. Aqueous (AQ) and dichloromethane-methanol (DM) extracts were obtained from the three species of quelites to investigate their effect on H. pylori growth and on two of its colonization factors (adherence and urease activity). DM extracts from Chaya, Chepil, and Alache exert the best inhibitory effect on bacterial growth, with minimum inhibitory concentrations of 62.5, 125, and 250 µg/mL, respectively. AQ and DM extracts inhibit bacterial adhesion by 30% to 50%. None of them has an effect on urease activity. The two flavonoids present in A. cristata, acacetin and diosmetin, inhibit H. pylori growth by ∼90% with 3.9 µg/mL. These results provide new information about the anti-H. pylori potential of three edible quelites, and give an added value, since their routine consumption may impact on the prevention and/or control of H. pylori-associated diseases.

Anti-Helicobacter pylori activity of anacardic acids from Amphipterygium adstringens.

Amphipterygium adstringens (Schltdl.) Standl. (Anacardiaceae) is widely used in traditional Mexican medicine for the treatment of gastritis and ulcers. In this work, we studied the anti-Helicobacter pylori activity of its bark, this Gram-negative bacterium is considered the major etiological agent of chronic active gastritis and peptic ulcer disease, and it is linked to gastric carcinoma. From a bio-guided assay of the fractions obtained form a continuous Soxhlet extraction of the bark, we identified that petroleum ether fraction had significant antimicrobial activity against Helicobacter pylori. From this fraction, we isolated an anacardic acids mixture and three known triterpenes: masticadienonic acid; 3alpha-hydroxymasticadienonic acid; 3-epi-oleanolic; as well as the sterol beta-sitosterol. Only the anacardic acids mixture exhibits a potent dose-dependent antibacterial activity (MIC=10 microg/ml in broth cultures). It is enriched in saturated alkyl phenolic acids (C15:0, C16:0, C17:0 C19:0) which represents a novel source of these compounds with potent anti-Helicobacter pylori activity. The promising use of anacardic acids and Amphipterygium adstringens bark in the development of an integral treatment of Helicobacter pylori diseases is discussed.

Inhibition of Helicobacter pylori growth and its colonization factors by Parthenium hysterophorus extracts.

ETHNOPHARMACOLOGICAL RELEVANCE: Parthenium hysterophorus (Asteraceae) is a traditional medicinal plant used to treat gastrointestinal disorders, such as gastritis. Helicobacter pylori have been described as the etiological agent of gastritis, peptic ulcer, as well as gastric adenocarcinoma. 50% of the world's population is infected with this bacterium and the current therapy fails due to the increment in antibiotic resistance; therefore, it is necessary to find new approaches to control H. pylori infection, either by its eradication or by preventing the bacterial colonization. AIM OF THE STUDY: To investigate the effect of P. hysterophorus extracts on H. pylori growth and upon its colonization-related factors. MATERIALS AND METHODS: Five different polarity extracts from roots and aerial parts of P. hysterophorus were evaluated in vitro against H. pylori growth by the broth dilution method. Anti-colonization activities were determined as follows: motility in soft agar plates, urease activity by ammonia colorimetrical quantification, and adherence of FITC labeled H. pylori to AGS cells by fluorometrical measurement. RESULTS: Organic extracts inhibited H. pylori growth. Particularly, the dichloromethane extract from roots showed a MIC of 15.6 µg/ml while the aqueous extracts showed low or null activity. There is a direct correlation between antibacterial activity and inhibition of motility. Urease activity was partially inhibited by organic extracts, at best 46%, except for the roots dichloromethane extract which reached 74% of inhibition with 500 µg/ml (IC50=136.4 µg/ml). Plant extracts inhibited adherence in different ranges but the dichloromethane-methanol ones possessed the highest effect, with a 70% maximal inhibition at 1mg/ml. CONCLUSION: The results indicate that some P. hysterophorus extracts have various biological activities that could act synergistically against H. pylori. This work contributes to the ethnomedical knowledge of this species and underlines the potential of some organic extracts as a good source for the isolation of bioactive compounds.

Exploring alternative treatments for Helicobacter pylori infection.

Helicobacter pylori (H. pylori) is a successful pathogen that can persist in the stomach of an infected person for their entire life. It provokes chronic gastric inflammation that leads to the development of serious gastric diseases such as peptic ulcers, gastric cancer and Mucosa associated lymphoid tissue lymphoma. It is known that these ailments can be avoided if the infection by the bacteria can be prevented or eradicated. Currently, numerous antibiotic-based therapies are available. However, these therapies have several inherent problems, including the appearance of resistance to the antibiotics used and associated adverse effects, the risk of re-infection and the high cost of antibiotic therapy. The delay in developing a vaccine to prevent or eradicate the infection has furthered research into new therapeutic approaches. This review summarises the most relevant recent studies on vaccine development and new treatments using natural resources such as plants, probiotics and nutraceuticals. In addition, novel alternatives based on microorganisms, peptides, polysaccharides, and intragastric violet light irradiation are presented. Alternative therapies have not been effective in eradicating the bacteria but have been shown to maintain low bacterial levels. Nevertheless, some of them are useful in preventing the adverse effects of antibiotics, modulating the immune response, gastroprotection, and the general promotion of health. Therefore, those agents can be used as adjuvants of allopathic anti-H. pylori eradication therapy.

Evidence of the anti-Helicobacter pylori, gastroprotective and anti-inflammatory activities of Cuphea aequipetala infusion.

ETHNOPHARMACOLOGICAL RELEVANCE: Cuphea aequipetala (Lythraceae) is a medicinal plant highly appreciated in Mexico to treat stomach ailments such as pain and burning sensation, stomach infections, ulcers, diarrhea, dysentery, and different types of tumors and bruises. In this work, the infusion of aerial parts of this plant (CAI) was investigated for its polypharmacological potential. MATERIALS AND METHODS: In vitro anti-Helicobacter pylori activity was assessed by broth dilution method. Pharmacological studies included acute toxicity in mice using Lorke´s model, anti-inflammatory activity by xylene and TPA induced ear edema assay, as well as gastroprotection with ethanol-induced gastric ulcer model. DPPH and ABTS assays were used to determine antioxidant capacity. Polyphenols and flavonoid contents were determined by Folin-Ciocalteu method and AlCl3 reaction, respectively. RESULTS: CAI showed good anti-Helicobacter pylori activity with a MIC of 125µg/mL. The infusion was not toxic according to Lorke's model with a LD50 greater than 5g/kg. CAI exhibited low anti-edematogenic action in the models assayed. Oral administration of 300mg/kg CAI significantly reduced gastric lesions by 87.9%. The effect was reversed only by indomethacin and N-ethylmaleimide demonstrating the role of endogenous prostaglandins and sulfhydryl compounds in gastroprotection. Total phenolic and flavonoid contents of CAI were 109.9mg GAE/g DW and 28.1mg QE/g DW, respectively, and the infusion exhibited a good antioxidant activity that is thought to play a role in its biological activity. The analysis of a preliminary fractionation of the infusion indicates that the complete extract conserves all its pharmacological activities in contrast to fractionated extracts. CONCLUSIONS: Cuphea aequipetala is a promising native herb in an integral therapy for the treatment of bacterial or non-bacterial gastric ulcer because it possesses some anti-inflammatory properties, as well as exhibits good gastroprotective and antibacterial effects. It represents an important source for the isolation of anti-Helicobacter pylori compounds. This work provides ethnopharmacological evidence that supports the traditional use of this species.

Contribution to the ethnopharmacological and anti-Helicobacter pylori knowledge of Cyrtocarpa procera Kunth (Anacardiaceae).

ETHNOPHARMACOLOGICAL RELEVANCE: Cyrtocarpa procera Kunth (Anacardiaceae) is a Mexican endemic tree; its bark has been traditionally employed in Mexico since prehispanic times to relieve digestive disorders. AIM OF THE STUDY: To perform an acute evaluation of the toxicity, gastroprotective, and anti-inflammatory properties, as well as the anti-Helicobacter pylori action of C. procera bark extracts, in order to determine polypharmalcological activities. MATERIALS AND METHODS: Five different polarity extracts (hexanic, CH(2)Cl(2), CH(2)Cl(2)-MeOH, methanolic, and aqueous) were prepared. Each of them was evaluated in the following acute mice models: toxicity Lorke test, ethanol-induced gastric ulcer, TPA-induced ear edema; and the in vitro anti-H. pylori activity with a broth dilution method. RESULTS: None of the extracts were toxic under acute administration. The methanolic, hexanic, and aqueous extracts possess remarkable gastroprotective activity. All the extracts inhibit H. pylori growth, being the hexanic the most active, and only this one showed significant anti-inflammatory effect. CONCLUSIONS: This work demonstrates that C. procera bark has polypharmacological activities; which makes it a promising asset to the development of an integral treatment for gastritis or peptic ulcer related or not to H. pylori. Our findings contribute to the ethnopharmacological knowledge about this species.

Isolation of the new anacardic acid 6-[16'Z-nonadecenyl]-salicylic acid and evaluation of its antimicrobial activity against Streptococcus mutans and Porphyromonas gingivalis.

A new anacardic acid, 6-[16'Z-nonadecenyl]-salicylic acid (1), along with seven known compounds, 6-[8'Z-pentadecenyl] salicylic acid (15:1 anacardic acid) (2), 6-nonadecenyl salicylic acid (anacardic acid 19:0) (3), 6-pentadecyl salicylic acid (anacardic acid 15:0) (4), masticadienonic acid (5), 3α-hydroxymasticadienonic acid (6), 3-epi-oleanolic acid (7) and ß-sitosterol, were isolated from the bark of Amphipterygium adstringens using a bioassay-guided fractionation method. The structure of the new compound (1) was elucidated by spectroscopic data interpretation. The known compounds (2-7) were identified by comparison of their spectroscopic data with reported values in the literature. Compounds 1-4 exhibited antibacterial activity against Streptococcus mutans and Porphyromonas gingivalis with minimum inhibitory concentrations ranging from 7 to 104 µg mL and from 12 to 126 µg mL, respectively.

Rapid paper disk test for identification of Helicobacter pylori in mixed cultures of gerbil gastric homogenates.

A method denominated rapid paper disk test (RPDT) was developed to identify H. pylori colonies in complex cultures obtained from gerbil gastric homogenates. Identification is based on a characteristic reaction pattern (RP) for H. pylori colonies given by the combination of the urease-oxidase activities on a paper disk. Compared to the RPs obtained from gerbil's intestinal tract isolated bacteria, H. pylori RP is completely distinguishable, even from those of bacteria that share one or both activities as are Aerococcus urinae, Bacillus sphaericus, Bacillus brevis, Corynebacterium pseudogenitalium, and Staphylococcus simulans, as well as from those produced by collection strains Proteus vulgaris and Pseudomonas aeruginosa. This method allows the practical quantification of H. pylori colonies in highly contaminated plates. RPDT has the following advantages over other methodologies that use indicators in the medium: it employs two of the three routinely used H. pylori biochemical identification tests, the reagents do not interfere with bacterial viability, there are no restrictions in relation to the medium used, and it is a simple, fast, and low-cost method.

Anti-Helicobacter pylori activity of plants used in Mexican traditional medicine for gastrointestinal disorders.

AIM OF THE STUDY: Helicobacter pylori is the major etiological agent of chronic active gastritis and peptic ulcer disease and is linked to gastric carcinoma. Treatment to eradicate the bacteria failed in many cases, mainly due to antibiotic resistance, hence the necessity of developing better therapeutic regimens. Mexico has an enormous unexplored potential of medicinal plants. This work evaluates the in vitro anti-H. pylori activity of 53 plants used in Mexican traditional medicine for gastrointestinal disorders. MATERIALS AND METHODS: To test the in vitro antibacterial activity, agar dilution and broth dilution methods were used for aqueous and methanolic extracts, respectively. RESULTS: Aqueous extracts of Artemisia ludoviciana subsp. mexicana, Cuphea aequipetala, Ludwigia repens,and Mentha x piperita (MIC 125 to <250 microg/ml) as well as methanolic extracts of Persea americana, Annona cherimola, Guaiacum coulteri, and Moussonia deppeana (MIC <7.5 to 15.6 microg/ml) showed the highest inhibitory effect. CONCLUSIONS: The results contribute to understanding the mode of action of the studied medicinal plants and for detecting plants with high anti-Helicobacter pylori activity.

Importance of Rhodospirillum rubrum H(+)-pyrophosphatase under low-energy conditions.

The physiological role of the membrane-bound pyrophosphatase of Rhodospirillum rubrum was investigated by the characterization of a mutant strain. Comparisons of growth levels between the wild type and the mutant under different low-potential conditions and during transitions between different metabolisms indicate that this enzyme provides R. rubrum with an alternative energy source that is important for growth in low-energy states.

Rhodobacter sphaeroides has a family II pyrophosphatase: comparison with other species of photosynthetic bacteria.

The cytoplasmic pyrophosphatase from Rhodobacter sphaeroides was purified and characterized. The enzyme is a homodimer of 64 kDa. The N-terminus was sequenced and used to obtain the complete pyrophosphatase sequence from the preliminary genome sequence of Rba. sphaeroides, showing extensive sequence similarity to family II or class C pyrophosphatases. The enzyme hydrolyzes only Mg-PP(i) and Mn-PP(i) with a K(m) of 0.35 mM for both substrates. It is not activated by free Mg (2+), in contrast to the cytoplasmic pyrophosphatase from Rhodospirillum rubrum, and it is not inhibited by NaF, methylendiphosphate, or imidodiphosphate. This work shows that Rba. sphaeroides and Rhodobacter capsulatus cytoplasmic pyrophosphatases belong to family II, in contrast to Rsp. rubrum, Rhodopseudomonas palustris, Rhodopseudomonas gelatinosa, and Rhodomicrobium vannielii cytoplasmic pyrophosphatases which should be classified as members of family I. This is the first report of family II cytoplasmic pyrophosphatases in photosynthetic bacteria and in a gram-negative organism.

Rhodospirillum rubrum has a family I pyrophosphatase: purification, cloning, and sequencing.

The cytoplasmic pyrophosphatase of the photosynthetic bacterium Rhodospirillum rubrum was purified to electrophoretic homogeneity. The enzyme is a homohexamer of 20-kDa monomers. The gene was cloned and sequenced. Alignment of the deduced 179-amino-acid protein with known bacterial pyrophosphatases revealed conservation of all residues in the active site. Attempts to obtain an insertion mutant of the cytoplasmic pyrophosphatase gene did not yield any cell completely devoid of cytoplasmic pyrophosphatase activity. The mutants obtained showed 50% of the enzymatic activity and grew in twice the generation time of wild-type cells. This suggests that the membrane-bound pyrophosphatase of Rsp. rubrum is not sufficient for a normal growth rate, whereas the cytoplasmic enzyme is essential for growth. The characteristics of the gene and the encoded protein fit those of prokaryotic family I pyrophosphatases.

Relapsing polychondritis: a pediatric case.

A pediatric case of relapsing polychondritis is reported. Diagnostic features were recurrent episodes of painful inflammation of ear cartilage, episcleritis, and atopic disease. A good therapeutic response was obtained with systemic corticosteroids, dapsone, and methotrexate.

Una manera eficaz de mejorar la termorregulación del recién nacido prematuro: el polietileno / An effective way to improve thermoregulation on premature new born: Polyethylene

Introducción: La hipotermia es un factor crítico en las primeras horas de vida del recién nacido pretérmino; y el polietileno pareciera reducir la pérdida de calor. Objetivo: Comparar la temperatura corporal del recién nacido pretérmino y el uso del polietileno vs maniobra habitual en la primera hora de vida. Metodología: Ensayo clínico controlado, se estudiaron 30 pacientes del grupo control y 30 del experimental. A los recién nacidos pretérmino del grupo de estudio se les cubrió de los hombros hacia abajo con plástico de polietileno, la cabeza se cubrió con un gorro de algodón; al grupo control se le envolvió en una manta precalentada y gorro de algodón a ambos se colocaron en una cuna de calor radiante. Al minuto de vida en ambos grupos, se tomó la temperatura axilar del prematuro y de la incubadora, así como cada 15 minutos hasta la hora. Se realizó estadística descriptiva y t de Student. Resultados: En cuanto a las características generales de ambos grupos sin diferencia estadística; el registro de la temperatura corporal en la primera hora de vida en ambos grupos se incrementó siendo mayor para el grupo de estudio con respecto al control; en el grupo B vs A el incremento de la temperatura desde los 15 minutos tuvo diferencia estadística (p=0.02) 30' (p=0.01), 45' (p=0.001) y 60' (p=0.0001). La comparación de la temperatura de la incubadora en ambos grupos no mostró diferencia estadística. Conclusiones: Se recomienda la aplicación del polietileno en la primera hora de vida del recién nacido pretérmino.

Introduction: Hypothermia is a critical factor during the first hours on the life of a pre-term new born; and it seems that the polyethylene would reduce heat lost. Objective: To compare the body temperature on the pre-term new born using the polyethylene vs. habitual maneuver within the first hour of life. Methodology: Controlled clinic trial; 30 patients from the controlled group y and 30 more from the experimental were studied. The pre-term new born on the study group were covered from shoulder down with a polyethylene plastic, their heads were covered with a cotton cap; meanwhile, the controlled group was wrapped around a preheated blanket and cotton cap; both groups were placed on in a radiant heat frame. At one minute of life on both groups, the axilar temperature from the premature and the incubator were taken every 15 minutes during one hour. Descriptive statistic and t-student were done. Results: Regarding general characteristics on both groups there was not statistical difference; the corporal temperature records during the first hour of life in both groups was increased being higher for the study group in relation to the control group; on group B vs A, the temperature increment, since the first 15 minutes, had a statistical difference (p=0.02), at 30' (p=0.01), at 45' (p=0.001) and at 60' (p=0.0001). Temperature comparison in both groups did not show up statistical difference. Conclusions: It is recommended application of polyethylene during the first hours of life on a pre-term new born.