In Silico Analysis of Glutamate Receptors in Capsicum chinense: Structure, Evolution, and Molecular Interactions.

Plant glutamate receptors (GLRs) are integral membrane proteins that function as non-selective cation channels, involved in the regulation of developmental events crucial in plants. Knowledge of these proteins is restricted to a few species and their true agonists are still unknown in plants. Using tomato SlGLRs, a search was performed in the pepper database to identify GLR sequences in habanero pepper (Capsicum chinense Jacq.). Structural, phylogenetic, and orthology analysis of the CcGLRs, as well as molecular docking and protein interaction networks, were conducted. Seventeen CcGLRs were identified, which contained the characteristic domains of GLR. The variation of conserved residues in the M2 transmembrane domain between members suggests a difference in ion selectivity and/or conduction. Also, new conserved motifs in the ligand-binding regions are reported. Duplication events seem to drive the expansion of the species, and these were located in the evolution by using orthologs. Molecular docking analysis allowed us to identify differences in the agonist binding pocket between CcGLRs, which suggest the existence of different affinities for amino acids. The possible interaction of some CcGLRs with proteins leads to suggesting specific functions for them within the plant. These results offer important functional clues for CcGLR, probably extrapolated to other Solanaceae.

High morbidity and mortality associated with primary bloodstream infections among pediatric patients with cancer at a Guatemalan tertiary referral hospital.

Infectious complications remain major contributors to adverse outcomes in patients treated for non-communicable disease, particularly in resource limited settings. We performed a 5-year retrospective study of primary bloodstream infections at a dedicated pediatric oncology center in Guatemala. Two hundred and twelve episodes occurring in 194 unique patients qualified for inclusion. Patients required intensive care unit admission in 55% of episodes and death occurred in 24% of episodes. Despite subspecialty support in infectious diseases, poor outcomes, including prolonged hospitalization and mortality, were frequent. Our findings suggest that investments in laboratory and clinical data collection are critical to understanding the contributors to poor outcomes and therefore to improving the quality of bloodstream infection management in resource limited settings.

Alkaloid Biosynthesis in the Early Stages of the Germination of Argemone mexicana L. (Papaveraceae).

The synthesis of the benzylisoquinoline alkaloids, sanguinarine and berberine, was monitored in Argemone mexicana L. (Papaveracea) throughout the early stages of its hypocotyl and seedling development. Sanguinarine was detected in the cotyledons right after hypocotyl emergence, and it increased continuously until the apical hook unbent, prior to the cotyledonary leaves unfolding, when it abruptly fell. In the cotyledonary leaves, it also remained at low levels. Throughout development, berberine accumulation required the formation of cotyledonary leaves, whereas it was quickly detected in the hypocotyl from the time it emerged. Interestingly, the alkaloids detected in the cotyledons could have been imported from hypocotyls, because no transcriptional activity was detected in there. However, after turning into cotyledonary leaves, important levels of gene expression were noted. Taken together, these results suggest that the patterns of alkaloid tissue distribution are established from very early development, and might require transport systems.

Survey of practices for the clinical management of febrile neutropenia in children in hematology-oncology units in Latin America.

The management of febrile neutropenia (FN) in pediatrics is evolving. Our objective was to describe current practices for the care of patients with FN in pediatric oncology centers in Latin America and identify areas for practice improvement. We used an online survey to enroll eligible healthcare providers who treat children with cancer in Latin America. The survey addressed respondents' characteristics, the environment of care, and FN care practices, including risk assessment, criteria for hospitalization, initial management of FN, evaluation, antibiotic administration, and discharge. From 220 surveys sent, we received 109 responses and selected 108 from 19 countries for analysis. Most (94%) respondents were working in specialized oncology centers, oncology units within a pediatric or general care hospital. The cohort included oncologists (42%) and infectious diseases physicians (30%). Most (67%) respondents had available guidelines; they used a risk-stratification scoring system (73%) for severe infection; and their guidelines had locally adapted risk stratification (34%) or published risk stratification (51%). The respondents used diverse FN definitions and concepts, including fever definitions, temperature-obtaining methods, neutropenia values for assigning risk, empiric antimicrobials administration, and length of hospitalization. Overall, we detected common practices aligning with standard published recommendations, as well as care variability. These findings can guide further evaluations of care resources and practices to prioritize interventions, and professional networks can be used for FN discussions and consensus in Latin America.

The Golden Hour: Sustainability and Clinical Outcomes of Adequate Time to Antibiotic Administration in Children with Cancer and Febrile Neutropenia in Northwestern Mexico.

PURPOSE: Time to antibiotic administration (TTA) is a commonly used standard of care in pediatric cancer settings in high-income countries. Effective interventions to improve outcomes in cancer patients with febrile neutropenia (FN) often address timely and appropriate antibiotic administration. We assessed the effectiveness of a locally adapted multimodal strategy in decreasing TTA in a resource-constrained pediatric cancer center in Mexico. METHODS: We conducted a prospective observational study between January 2014 and April 2019. A three-phase (phase I: execution, phase II: consolidation, phase III: sustainability) multimodal improvement strategy that combined system change, FN guideline development, education, auditing and monitoring, mentoring, and dissemination was implemented to decrease TTA in inpatient and ambulatory areas. Sustainability factors were measured by using a validated tool during phases I and III. RESULTS: Our population included 105 children with cancer with 204 FN events. The baseline assessment revealed that only 50% of patients received antibiotics within 60 minutes of prescription (median time: inpatient, 75 minutes; ambulatory, 65 minutes). After implementing our improvement strategy, the percentage of patients receiving antibiotics within 60 minutes of prescription increased to 88%. We significantly decreased median TTA in both clinical areas during the three phases of the study. In phase III (sustainability), the median TTA was 40 minutes (P = .023) in the inpatient area and 30 minutes (P = .012) in the ambulatory area. The proportion of patients with sepsis decreased from 30% (baseline) to 5% (phase III) (P = .001). CONCLUSION: Our results demonstrate that locally adapted multimodal interventions can reduce TTA in resource-constrained settings. Mentoring and dissemination were novel components of the multimodal strategy to improve FN-associated clinical outcomes. Improving local infrastructure, ongoing monitoring systems, and leadership engagement have been key factors to achieving sustainability during the 5-year period.

VA-MENGOC-BC Vaccination Induces Serum and Mucosal Anti Neisseria gonorrhoeae Immune Responses and Reduces the Incidence of Gonorrhea.

BACKGROUND: Overall, there are over 30 different sexually transmitted infections with Neisseria gonorrhoeae being the third most frequent with a reported 78 million cases per year. Gonococcal infection causes genital inflammation, which can be a risk factor for others sexually transmitted infections, particularly human immunodeficiency virus. Gonorrhea is a treatable disease, but recently an increase in antibiotic resistance has been of concern. There are currently no vaccines available. However, parenteral vaccination with anti N. meningitidis serogroup B vaccine has been reported to decrease the incidence of gonococcal burden in New Zealand and in Cuba despite the fact that parenteral vaccination is not deemed to induce mucosal IgA. Here we explore possible mechanisms of protection against gonococcal infection through parenteral meningococcal B vaccination. METHODS: Ninety-two serum, saliva and oropharyngeal swabs samples of young adults (healthy and Neisseria carriers) of the internal higher school were obtained. They have been vaccinated with VA-MENGOC-BC (MBV) during their infancy and boosted with a third dose during this study. Serum and saliva samples were analyzed by ELISA and Western blot to measured IgG and IgA antibodies against N. meningitidis and N. gonorrhoeae antigens. N. meningitidis carriers were determined by standard microbiologic test. In addition, we reviewed epidemiologic data for N. meningitidis and N. gonorrhoeae infections in Cuba. RESULTS: Epidemiologic data show the influence of MBV over gonorrhea incidence suggesting to be dependent of sexual arrival age of vaccines but not over syphilis. Laboratorial data permit the detection of 70 and 22 noncarriers and carriers of N. meningitidis, respectively. Serum anti-MBV antigens (PL) responses were boosted by a third dose and were independent of carriage stages, but saliva anti-PL IgA responses were only present and were significant induced in carriers subjects. Carriers boosted with a third dose of MBV induced similar antigonococcal and -PL saliva IgA and serum IgG responses; meanwhile, serum antigonococcal IgG was significantly lower. In saliva, at least 2 gonococcal antigens were identified by Western blot. Finally, gonococcal-specific mucosal IgA antibody responses, in addition to the serum IgG antibodies, might contributed to the reduction of the incidence of N. gonorrhoeae. We hypothesize that this might have contributed to the observed reductions of the incidence of N. gonorrhoeae. CONCLUSION: These results suggest a mechanism for the influence of a Proteoliposome-based meningococcal BC vaccine on gonococcal incidence.

Manifestaciones trombóticas en la neumonía viral por SARS-CoV-2 pacientes hospitalizados en el Hospital «Irma de Lourdes Tzanetatos¼, Panamá, Panamá. De marzo de 2020 a septiembre de 2020 / Thrombotic manifestations in viral neumonia by CoV-2-SARS hospitalized patients at «Irma Lourdes Tzanetatos¼ Hospital, Panama, Panama. March 2020 to September 2020

La respuesta a la infección viral produce un estado de trombosis o hipercoagulabilidad que, unido a la inflamación de las células endoteliales, puede generar disfunción plaquetaria y predisposición a la formación de trombos que, aunque con frecuencia son más venosos, también pueden aparecer en el sistema arterial y producir infartos a cualquier nivel así como tromboembolia e hipertensión pulmonar. Estas manifestaciones han sido captadas hospitalariamente y al egreso de los pacientes detectados por SARS-CoV-2 habiendo ya cumplido el tiempo establecido de virulencia. Los criterios diagnósticos de respuesta inmunológica trombótica asociada a COVID-19 (RITAC) ayudan a seleccionar al paciente que está predispuesto a esta condición; a esto se añade que el paciente ya tiene un diagnóstico de infección por SARS-CoV-2 (AU)

The response to viral infection produces a prothrombotic state of hypercoagulability , united with an inflammation of endothelial cells, It can generate platelet dysfunction and predisposition to the formation of thrombus, that, although, are more frequently venous, Also, it can appear in the arterial system and cause heart attacks at any level; thromboembolism and pulmonary hypertension, as well. These manifestations have been captured hospitably and with the egress of patients detected by SARS-CoV-2. The diagnostic criteria of RITAC (abbreviation in Spanish of Thrombotic Immune Response Associated to COVID-19), help to select the patient who is predisposed to this condition; adding that the patient already has a diagnosis of SARS-CoV-2 infection (AU)

Respuesta anticlases mayores de anticuerpos humanos séricos en antisueros hiperinmunes obtenidos en carneros / Characterization of hyperimmune anti-human serum produced in sheep

Introducción: La inmunoelectroforesis es una técnica de precipitación que permite la caracterización de muestras biológicas complejas. En el Departamento de Inmunología del Instituto de Ciencias Básicas y Preclínicas Victoria de Girón se cuenta con un antisuero hiperinmune obtenido por inmunizaciones de carneros contra proteínas totales séricas humanas y con otro antisuero anti IgA de calostro humano. Objetivo: Identificar IgG, IgM e IgA en suero humano y determinar respuesta anti IgM humana en el antisuero anti IgA de calostro humano obtenido en carnero. Material y Métodos: Se realizó un estudio observacional, descriptivo y transversal desde noviembre de 2017 hasta junio de 2018. Se desarrolló una inmunoelectroforesis de suero humano normal empleando el antisuero hiperinmune. Resultados: Se identificaron IgG, IgM e IgA además de albúmina y otras fracciones proteicas y se determinó respuesta anti IgM humana en el antisuero anti IgA de calostro humano obtenido en carnero. Conclusiones: Este trabajo permitió identificar y determinar la respuesta anticlases mayores de inmunoglobulinas en la muestra de estudio(AU)

Introduction: Immunoelectrophoresis is a precipitation technique that allows the characterization of complex biological samples. The Immunology Department of the Institute of Basic and Pre-Clinical Sciences Victoria de Girón has a hyperimmune antiserum obtained by immunization of sheep against human serum total proteins and it also has an anti-human IgA antiserum obtained from human colostrum. Objective: The aim of this study was to identify IgG, IgM and IgA in human serum and to determine response to anti-human IgM in human colostral IgA with antiserum obtained in sheep. Material and Methods: An observational descriptive cross-sectional study was conducted from November 2017 to June 2018. Immunoelectrophoresis of normal human serum was performed using hyperimmune antiserum. Results: These procedures allowed to identify IgG, IgM and IgA in addition to albumin and other protein fractions and to determine response to anti-human IgM in human colostral IgA with antiserum obtained in sheep. Conclusions: This work allowed us to identify and determine significant anti-class responses of immunoglobulins in the sample studied(AU)

Síntesis intratecal de IgG anti-herpes virus como evidencia neuroinmunológica en pacientes pediátricos / Intrathecal synthesis of IgG against herpes virus as neuroimmunological evidence in pediatric patients

En los procesos neuroinflamatorios se produce a nivel de líquido cefalorraquídeo una activación policlonal y poliespecífica. Esta activación se produce desde los primeros días y puede permanecer por períodos prolongados. Luego por mecanismos de apoptosis los clones que no responden directamente contra los agentes biológicos involucrados no proliferan. El Reibergrama permite saber si las inmunoglobulinas presentes en el líquido cefalorraquídeo se sintetizaron o no en el sistema nervioso central (SNC) y el Índice de Anticuerpo (IA) determina la especificidad de las mismas en caso de que exista síntesis intratecal. Con estas herramientas nos propusimos identificar la respuesta neuroinmunológica frente a agentes de la familia herpesvirus en pacientes pediátricos con proceso inflamatorio del SNC a partir de sus respectivos IA. Para lograr esto se cuantificaron los niveles de IgG y albúmina en suero y líquido cefalorraquídeo (LCR) mediante inmunodifusión radial simple y por ensayo inmunoenzimático, con lo cual se construyó el Reibergrama que permitió la selección de 85 pacientes pediátricos con síntesis intratecal de inmunoglobulinas, que se diferenciaron en cuatro grupos según sus edades. Mediante ensayo inmunoenzimático se cuantificaron los niveles de IgG específica contra citomegalovirus, virus varicela zoster y virus herpes simple, tanto en suero como en LCR y se determinó el IA específico. La respuesta contra los virus estudiados fue similar para los distintos grupos de edades, lo cual nos permite afirmar la exposición temprana a los mismos(AU)

In a neuroinflammatory process a polyclonal and poly-specific activation is produced in cerebrospinal fluid. This activation starts from the first days and may persist for a long time. The clones not related directly against the biological agent do not proliferate by apoptosis. Reibergram determine if part of the immunoglobulins content in cerebrospinal fluid belongs from the blood or it is synthesized in the central nervous system. Antibody index determines if the specific antibodies was synthesized intrathecally. By these tools it can be possible to identify the humoral immune response against some herpes virus in pediatric patients suffering from a central nervous system inflammatory process. Quantification of specific IgG against citomegalovirus, varicella zoster and herpes simplex virus in serum and cerebrospinal fluid was done by ELISA. Specific Antibody index against these viruses were similar for the different age groups, which confirm the early exposure of the population(AU)

Vacuna antitetánica adyuvada en alúmina en inmunización simultánea por vías mucosa y parenteral / Alum adjuvant tetanus vaccine in simultaneous immunization by mucosal and parenteral routes

El tétanos es causado por Clostridium tetani, bacteria Gram+ esporulada que produce una potente neurotoxina. Las vacunas parenterales producen IgG antitoxina tetánica (anti TT) protectores en múltiples dosis inductoras y de reactivación; vax-TET® es una vacuna cubana parenteral adsorbida en alúmina. La IgAS (secretora), principal anticuerpo protector mucoso, sólo es inducida por la vía mucosa. La vía oral, la inducción de IgA y su papel protector no han sido exploradas. SinTimVaS se aplica por vía mucosa y parenteral simultánea que induce IgG sistémica similares a la vía parenteral y adiciona de respuesta de IgA mucosa. Evaluamos el efecto de vax-TET® aplicado en SinTimVaS en ratones Balb/c y exploramos la influencia del adyuvante sobre la inducción de IgA anti TT. SinTimVaS indujo similares respuestas de IgG anti TT séricas que dos dosis de vax-TET® intramusculares; pero superiores a una dosis. Tres dosis de vax-TET® orales no indujeron IgG anti TT sérica, mientras que la adyuvación con el adyuvante Finlay Cocleato 1 (AFCo1) sí la indujeron. No se logró determinar la inducción de IgA anti TT mucosa con ninguna de las formulaciones adjuvadas con alúmina; pero si con la formulación AFCo1+TT. Podemos concluir que vax-TET® en SinTimVaS funcionó de forma similar a la inmunización parenteral establecida, por lo que sería posible reducir los esquemas multidosis con formulaciones de adyuvantes más potentes y se confirma que se requieren potentes adyuvantes para inducir IgA mucosa(AU)

Tetanus is caused by Clostridium tetani, a sporulated Gram+ bacterium that produces a potent neurotoxin. Parenteral vaccines produce protective tetanus antitoxin (anti TT) IgG in multiple induction and reactivation doses; vax-TET® is a Cuban parenteral vaccine adsorbed onto alumina. IgAS (secretory), the main mucosal protective antibody, is only induced by the mucous membrane. The oral route, the induction of IgA and its protective role have not been explored. SinTimVaS is applied by simultaneous mucosal and parenteral route that induces systemic IgG similar to the parenteral route and adds an IgA mucosal response. We evaluated the effect of vax-TET® applied in SinTimVaS in Balb/c mice and we explored the influence of adjuvant on the induction of anti-TT IgA. SinTimVaS induced similar serum anti TT IgG responses to two intramuscular doses of vax-TET®; but higher than one dose. Three doses of oral vax-TET® did not induce serum anti-TT IgG, whereas adjuvanted with adjuvant Finlay Cocleate 1 (AFCo1) did induce it. It was not possible to determine the IgA anti-TT mucous induction with any of the formulations adjuvanted with alumina; but with the formulation AFCo1 + TT it was induced. We can conclude that vax-TET® in SinTimVaS worked in a similar way to the established parenteral immunization, so it would be possible to reduce the multi-dose vaccination schemes with more potent adjuvant formulations and it is confirmed that powerful adjuvants are required to induce mucosal IgA(AU)

Contribuciones de Moisés y Alejandro Chediak a la Inmunología, la Hematología y el Laboratorio Clínico en Cuba / Contributions of Moises and Alejandro Chediak to Immunology, Hematology and Clinical Laboratory in Cuba

Los doctores Moisés y Alejandro Chediak Ahuayda, cubanos de ascendencia libanesa, realizaron importantes contribuciones a la Inmunología y otras ciencias médicas. El doctor Moisés Chediak fue director del Laboratorio Clínico Central del Hospital General Calixto García desde 1940, año en que fundó el primer banco de sangre de Cuba. Llegó a ser Profesor Auxiliar de Microscopía y Química Clínica de la Universidad de la Habana. Entre sus artículos se destacan el primer caso de anemia de Cooley en un niño en Cuba, así como el reporte de una nueva forma de inmunodeficiencia primaria conocida como síndrome de Béguez-Chediak-Higashi. Participó en numerosos eventos en América, Europa y Asia, y fue un miembro reconocido de las Sociedades Cubanas de Patología Clínica, Microbiología y de Pediatría, así como de organizaciones internacionales. Alejandro Chediak llamó la atención de la comunidad científica al desarrollar un método que solo requería de una gota de sangre en papel para el diagnóstico serológico de la sífilis. La microrreacción de Chediak fue ampliamente evaluada, adoptada y modificada en Estados Unidos, Argentina, Alemania, Polonia, México, Chile, Brasil y Francia. Diseñó un dispositivo útil para diversas técnicas de laboratorio, como la aglutinación de grupos sanguíneos, el cual fue patentado en Cuba y Estados Unidos. Fue profesor de Física Biológica de la Facultad de Medicina de la Universidad de La Habana. Los hermanos Chediak Ahuayda, quienes se formaron y alcanzaron sus más importantes resultados profesionales en nuestro país, ocupan un lugar destacado en la historia de la medicina cubana del siglo XX(AU)

Doctors Moises and Alejandro Chediak Ahuayda, whose were born in Cuba and had Lebanese ascendants, made important contributions to Immunology and other medical sciences. Doctor Moises Chediak was director of the Central Clinical Laboratory of the General Calixto Garcia Hospital from 1940, the same year when he founded the first blood bank in Cuba. He was Associate Professor of Microscopy and Clinical Chemistry at the University of Havana. The first report in Cuba of a case of Cooley's anemia in a child, and a new form of a primary immunodeficiency, known as Beguez-Chediak-Higashi syndrome, were among his most relevant papers. He participated in many congressesin America, Europe and Asia; he was an outstanding member of the Cuban Societies of Clinical Pathology, Microbiology and Pediatrics, as well as various international organizations. Alejandro Chediak got the attention of the scientific community when he developed a method that required only a drop of blood in a paper for the serological diagnostics of syphilis. Chediak's microrreaction was widely evaluated, adopted and modified in the United States, Argentina, Germany, Poland, Mexico, Chile, Brazil and France. He designed a device useful for many laboratory assays, including blood group agglutination, patented in Cuba and the United States. He was professor of Biological Physics at the Faculty of Medicineof theUniversity of Havana. The brothers Chediak Ahuayda, who were trained and obtained their most important professional achievements in our country, have a relevant place in the history of Cuban medicine during XX century(AU)

Highly Stabilized Nanoparticles on Poly-l-Lysine-Coated Oxidized Metals: A Versatile Platform with Enhanced Antimicrobial Activity.

The increasing incidence of infections in implantable devices has encouraged the search for biocompatible antimicrobial surfaces. To inhibit the bacterial adhesion and proliferation on biomaterials, several surface functionalization strategies have been developed. However, most of these strategies lead to bacteriostatic effect and only few of these are able to reach the bactericidal condition. In this work, bactericidal surfaces were designed through the functionalization of titanium surfaces with poly-l-lysine (PLL) as the mediator for the incorporation of antimicrobial silver nanoparticles (AgNPs). This functionalization influences the adsorption of the particles on the substrate impeding the agglomeration observed when bare titanium surfaces are used, leading to a homogeneous distribution of AgNPs on the surfaces. The antimicrobial activity of this surface has been tested against two different strains, namely, Staphylococcus aureus and Pseudomonas aeruginosa. For both strains and different AgNPs sizes, the surface modified with PLL and AgNPs shows a much enhanced antimicrobial activity in comparison with AgNPs deposited on bare titanium. This enhanced antibacterial activity is high enough to reach bactericidal effect, a condition hard to achieve in antimicrobial surfaces. Importantly, the designed surfaces are able to decrease the bacterial viability more than 5 orders with respect to the initial bacterial inoculum. That means that a relative low load of AgNPs on the PLL-modified titanium surfaces reaches 99.999% bacterial death after 24 h. The results of the present study are important to avoid infections in indwelling materials by reinforcing the preventive antibiotic therapy usually dosed throughout the surgical procedure and during the postoperative period.

Relationship between aluminum stress and caffeine biosynthesis in suspension cells of Coffea arabica L.

Toxicity by aluminum is a growth-limiting factor in plants cultivated in acidic soils. This metal also promotes signal transduction pathways leading to the biosynthesis of defense compounds, including secondary metabolites. In this study, we observed that Coffea arabica L. cells that were kept in the dark did not produce detectable levels of caffeine. However, irradiation with light and supplementation of the culture medium with theobromine were the best conditions for cell maintenance to investigate the role of aluminum in caffeine biosynthesis. The addition of theobromine to the cells did not cause any changes to cell growth and was useful for the bioconversion of theobromine to caffeine. During a short-term AlCl3-treatment (500µM) of C. arabica cells kept under light irradiation, increases in the caffeine levels in samples that were recovered from both the cells and culture media were evident. This augmentation coincided with increases in the enzyme activity of caffeine synthase (CS) and the transcript level of the gene encoding this enzyme (CS). Together, these results suggest that actions by Al and theobromine on the same pathway lead to the induction of caffeine biosynthesis.

Multiple Primary Acral Lentiginous Melanomas (MPALM).

We present a rare case of a patient with multiple primary acral lentiginous melanomas of the foot. We would like to highlight the importance of whole-skin examination in all patients, even by the general practitioners, aiming the maximal early detection of acral lentiginous melanomas, considering their rapid progression, early metastatic spread and extremely poor prognosis. It can be extrapolated from current literature; however, that appropriate management of these patients, including staging work and surgical intervention, is to be determined by the individual characteristics of the melanoma and the patient's concomitant risk factors, if any.

[Analysis of population characteristics of infants affected by necrotizing enterocolitis in a tertiary centre in the last 12 years]. / Análisis de las características poblacionales de neonatos afectos de enterocolitis necrosante en un centro terciario en los últimos 12 años.

BACKGROUND: Necrotizing enterocolitis is the most lethal gastrointestinal emergency in the neonatal period. Incidence and mortality have remained stable in recent years despite advances in neonatal intensive care. The aim of this study is to show the general characteristics of patients diagnosed with necrotizing enterocolitis at Teresa Herrera's Hospital (La Coruna, Spain) in the last 12years. MATERIAL AND METHODS: This study makes a retrospective and prospective descriptive analysis, evaluating the medical records and collecting radiological demographic variables, gestational data, perinatal history, clinical, analytical and perinatal therapeutic management and events in patients diagnosed with and treated for necrotizing enterocolitis between 2003 and 2015. RESULTS: A total of 124 patients met the criteria for inclusion in the study. The mean gestational age of our patients was 33 weeks and remained stable compared with other studies. The average weight of our patients was 1,873g. In our series of cases there was a progressive and significant increase in maternal age and the rate of artificial pregnancies and multiple births. In our series 38.7% of our patients required surgical treatment and the fatality rate was 11.4%. DISCUSSION: Despite advances in pre- and perinatal care necrotizing enterocolitis represents the leading cause of premature mortality. Incidence has remained unchanged in recent decades. More studies are required to identify both, risk and protective factors to reduce the morbidity and mortality of this entity.

Development of newly sanguinarine biosynthetic capacity in in vitro rootless shoots of Argemone mexicana L. Mexican prickly poppy.

OBJECTIVE: To analyze berberine and sanguinarine biosynthetic capacities of both in vitro shoot and root cultures of Argemone mexicana and tissues from entire plants at different developmental stages. RESULTS: Berberine and sanguinarine were equally distributed in roots and aerial tissues of developing plantlet whereas, in juvenile plants, sanguinarine was only detected in roots. This alkaloid distribution was consistent with that of biosynthetic transcripts in juvenile plants. However, lower transcript abundance in plantlets´ leaves suggests that alkaloids were mainly formed in roots and then mobilized to this tissue. In vitro root cultures maintained similar alkaloid profiles to those from intact seedlings and plantlets. However, in addition to berberine, rootless shoot cultures accumulated high levels of sanguinarine and biosynthetic transcripts. CONCLUSION: In vitro shoot cultures of A. mexicana can synthesize sanguinarine in addition to berberine. This represent a convenient system for the production of both alkaloids.

Posibilidad de aplicación de la simulación computacional de tejido óseo en niños con torsión tibial / Possibility of application of computational simulation of bone tissue in children with tibial torsion

Introducción: con el desarrollo de la informática surgen nuevos caminos a soluciones de problemas en la práctica clínica. La modelación de tejidos desempeña un papel importante en el desarrollo de la medicina; la experimentación en pacientes vivos dificulta la obtención de resultados, de ahí la necesidad de buscar alternativas para mejorar la calidad del servicio de salud.Objetivo: valorar la importancia de la modelación computacional de tejidos biológicos en niños con torsión tibial.Métodos: se entrevistaron 44 especialistas entre doctores, técnicos en imágenes médicas, ingenieros mecánicos e ingenieros cibernéticos. Fue empleada una encuesta no estructurada sin guion previo.Resultados: se aplicaron valores empíricos de cargas para corregir deformidades como la torsión tibial, el 81 por cientode los encuestados conocen acerca las ventajas de las simulaciones computacionales aplicadas a la salud, el 17 por ciento opina que faltan recursos informáticos en los hospitales para emplear estas técnicas, el 2 por ciento cree que se debe capacitar a los doctores en el empleo de estas herramientas para apoyar la toma de decisiones y el diagnóstico clínico.Conclusiones: la encuesta proporcionó datos conclusivos sobre la posibilidad e interés de la aplicación de los modelos computacionales en el diagnóstico, pronóstico y seguimiento de enfermedades ortopédicas(AU)

Introduction: the development of information brings new paths to solve problems in the clinical practice. Tissue modeling plays an important role in the development of medicine, experimentation on living patients makes it difficult to some extent the results, hence the need to seek alternatives to improve the quality of health service.Objective: assess the importance of computational modeling of biological tissues in pediatric orthopedics, specifically in children with tibial torsion.Methods: forty-four specialists were interviewed including physicians, technicians in medical imaging, mechanical engineers, and cyber engineers. It an unscripted survey unstructured was used.Results: empirical values of loads are applied to correct deformities such as tibial torsion; 81 percent of respondents know about the advantages of computer simulations for health, 17 percent think that missing computer resources in hospitals to employ these techniques, 2 percent believes that doctors should be trained in the use of these tools to support decision-making and clinical diagnosis.Conclusions: the survey provided conclusive data on the ability and interest of the application of computational models in the diagnosis, prognosis, and monitoring of orthopedic diseases(AU)

Posibilidad de aplicación de la simulación computacional de tejido óseo en niños con torsión tibial / Possible application de la modélisation assistée par ordinateur des tissus osseux chez des enfants atteints de torsion tibiale / Possibility of application of computational simulation of bone tissue in children with tibial torsion

Introducción: con el desarrollo de la informática surgen nuevos caminos a soluciones de problemas en la práctica clínica. La modelación de tejidos desempeña un papel importante en el desarrollo de la medicina; la experimentación en pacientes vivos dificulta la obtención de resultados, de ahí la necesidad de buscar alternativas para mejorar la calidad del servicio de salud. Objetivo: valorar la importancia de la modelación computacional de tejidos biológicos en niños con torsión tibial. Métodos: se entrevistaron 44 especialistas entre doctores, técnicos en imágenes médicas, ingenieros mecánicos e ingenieros cibernéticos. Fue empleada una encuesta no estructurada sin guion previo. Resultados: se aplicaron valores empíricos de cargas para corregir deformidades como la torsión tibial, el 81 por ciento de los encuestados conocen acerca las ventajas de las simulaciones computacionales aplicadas a la salud, el 17 por ciento opina que faltan recursos informáticos en los hospitales para emplear estas técnicas, el 2 por ciento cree que se debe capacitar a los doctores en el empleo de estas herramientas para apoyar la toma de decisiones y el diagnóstico clínico. Conclusiones: la encuesta proporcionó datos conclusivos sobre la posibilidad e interés de la aplicación de los modelos computacionales en el diagnóstico, pronóstico y seguimiento de enfermedades ortopédicas(AU)

Introduction: the development of information brings new paths to solve problems in the clinical practice. Tissue modeling plays an important role in the development of medicine, experimentation on living patients makes it difficult to some extent the results, hence the need to seek alternatives to improve the quality of health service. Objective: assess the importance of computational modeling of biological tissues in pediatric orthopedics, specifically in children with tibial torsion. Methods: forty-four specialists were interviewed including physicians, technicians in medical imaging, mechanical engineers, and cyber engineers. It an unscripted survey unstructured was used. Results: empirical values of loads are applied to correct deformities such as tibial torsion; 81 percent of respondents know about the advantages of computer simulations for health, 17 percent think that missing computer resources in hospitals to employ these techniques, 2 percent believes that doctors should be trained in the use of these tools to support decision-making and clinical diagnosis. Conclusions: the survey provided conclusive data on the ability and interest of the application of computational models in the diagnosis, prognosis, and monitoring of orthopedic diseases(AU)

Introduction: à fur et à mesure que l'informatique se développe, de nouvelles solutions aux problèmes de la pratique clinique apparaissent. La modélisation de tissus joue un rôle essentiel dans le développement de la médecine; l'expérimentation sur des patients vivants empêche l'obtention de résultats, il est pourtant nécessaire de chercher d'autres alternatives afin d'améliorer la qualité du service sanitaire. Objectif: le but de cette étude est d'évaluer l'importance de la modélisation assistée par ordinateur des tissus biologiques chez des enfants atteints de torsion tibiale. Méthodes: Quarante et quatre spécialistes, tels que médecins, techniciens en imagerie médicale, ingénieurs mécaniques et ingénieurs cybernétiques, ont été enquêtés. L'enquête utilisée n'avait aucune structure, aucun plan à suivre. Résultats: Des valeurs empiriques de charge ont été utilisées pour corriger des déformations, telles que la torsion tibiale; la majorité des enquêtés (81 pourcent) connaissent bien les bénéfices de la modélisation assistée par ordinateur appliqués à la santé ; la moitié (17 pourcent) considère qu'il y a un déficit de ressources informatiques dans les hôpitaux pour employer cette technique, tandis que la minorité (2 pourcent) croie qu'il faut que les médecins acquissent les habiletés nécessaires pour utiliser cet outil dans la prise de décisions et le diagnostic clinique. Conclusions: L'enquête a fourni des données incontestables sur la possibilité et l'intérêt à mettre en application la modélisation assistée par ordinateur dans le diagnostic, le pronostic et le suivi d'affections orthopédiques (AU)