Meningitis por Listeria: serie de casos en un hospital de tercer nivel y utilidad de las nuevas técnicas de diagnóstico microbiológico / Listeria meningitis: case series in a tertiary level hospital and the usefulness of new microbiological diagnostic techniques

Introducción: La meningitis por Listeria monocytogenes (MLM) es una entidad grave con complicaciones a corto plazo. La reacción de polimerasa en cadena (RPC) puede ayudar a mejorar su diagnóstico y pronóstico. Objetivos: Conocer las características de los pacientes diagnosticados de meningitis por L. monocytogenes en los últimos años, a través de diferentes métodos microbiológicos. Pacientes y Métodos: Serie de casos de pacientes adultos ingresados con MLM en el Hospital Clínico San Carlos, Madrid, España, durante doce años (2009-2021). Se describieron variables epidemiológicas, clínicas, microbiológicas, radiológicas y terapéuticas. Resultados: Se registraron doce pacientes con MLM (edad media 67,5 años, 75% varones). En ocho se obtuvo un cultivo positivo a L. monocytogenes. La RPC en líquido cefalorraquídeo (LCR) fue positiva en los dos casos en los que se realizó la prueba. El tratamiento dirigido en todos los casos fue ampicilina durante 21 días. Se registraron complicaciones en un cuarto de los casos. Del total de pacientes uno falleció. Conclusiones: La MLM es una enfermedad poco frecuente y de difícil diagnóstico. En nuestra serie de casos los dos pacientes diagnosticados por RPC tuvieron resultado de cultivo de LCR negativo, y presentaron buena evolución. La determinación de RPC podría permitir diagnosticar un mayor número de casos y con mayor precocidad.

Background: Listeria monocytogenes meningitis (LMM) is a serious entity with short-term complications. Polymerase chain reaction (PCR) can help to improve its diagnosis and prognosis. Aim: To know the characteristics of patients diagnosed with meningitis by L. monocytogenes in recent years, through different microbiological methods. Methods: Case series of adult patients admitted with LMM at the Hospital Clínico San Carlos of Madrid, Spain, during twelve years (2009-2021). Epidemiological, clinical, microbiological, radiological and therapeutic variables were described. Results: Twelve patients with LMM were recorded (mean age 67.5 years, 75% male). Eight had a positive culture for L. monocytogenes. cerebrospinal fluid (CSF) PCR was positive in the two cases in which the test was performed. Treatment in all cases was ampicillin for 21 days. Complications were recorded in a quarter of the cases. One patient died. Conclusions: LMM is a rare and difficult to diagnose disease. In our series of cases, the two patients diagnosed by PCR had negative CSF culture results, and presented good evolution. PCR determination could allow a greater number of cases to be diagnosed earlier.

Multi-institutional experience of genetic diagnosis in Ecuador: National registry of chromosome alterations and polymorphisms.

BACKGROUND: Detection of chromosomal abnormalities is crucial in various medical areas; to diagnose birth defects, genetic disorders, and infertility, among other complex phenotypes, in individuals across a wide range of ages. Hence, the present study wants to contribute to the knowledge of type and frequency of chromosomal alterations and polymorphisms in Ecuador. METHODS: Cytogenetic registers from different Ecuadorian provinces have been merged and analyzed to construct an open-access national registry of chromosome alterations and polymorphisms. RESULTS: Of 28,806 karyotypes analyzed, 6,008 (20.9%) exhibited alterations. Down syndrome was the most frequent autosome alteration (88.28%), followed by Turner syndrome (60.50%), a gonosome aneuploidy. A recurrent high percentage of Down syndrome mosaicism (7.45%) reported here, as well as by previous Ecuadorian preliminary registries, could be associated with geographic location and admixed ancestral composition. Translocations (2.46%) and polymorphisms (7.84%) were not as numerous as autosomopathies (64.33%) and gonosomopathies (25.37%). Complementary to conventional cytogenetics tests, molecular tools have allowed identification of submicroscopic alterations regions or candidate genes which can be possibly implicated in patients' symptoms and phenotypes. CONCLUSION: The Ecuadorian National Registry of Chromosome Alterations and Polymorphisms provides a baseline to better understand chromosomal abnormalities in Ecuador and therefore their clinical management and awareness. This data will guide public policy makers to promote and financially support cytogenetic and genetic testing.

Experiencias sociocomunicativas en adultos mayores usuarios de audifonos / Socio-Communicative Experiences in Olders Adults Hearing-aid Headphones users

El presente artículo presenta un acercamiento real a las experiencias socio-comunicativas en los adultos mayores usuarios de audífonos, de la ciudad de Yopal. Gran parte del estudio se basa en la descripción de cuáles son las experiencias socio-comunicativas del adulto mayor que usa audífonos, incluyendo revisión teórica de varios autores que sustentan el beneficio de la ayuda auditiva en esta etapa de la vida. Teniendo en cuenta que la gran mayoría de los estudios relacionados con el uso de audífonos y su beneficio en el mejoramiento de la calidad de vida de los usuarios, no incluyen las experiencias socio-comunicativas de las personas adultas mayores, luego del proceso de adaptación, se pretendió indagar más profundamente sobre estas. Se aplicaron encuestas a un grupo de 20 adultos mayores entre 60 y 93 años, tanto hombres y mujeres, de la ciudad de Yopal ( Casanare- Colombia), quienes utilizan audífonos hace más de un año. Con los resultados obtenidos, se logró recolectar información, mediante un estudio cuantitativo, que permitió identificar, categorizar y analizar cada una de las experiencias de los adultos mayores, bajo los parámetros de actividades y participación, utilización de dispositivos y técnicas de comunicación, actividades recreativas y de ocio, actividades culturales (iglesia, grupos de apoyo), según lo planteado en la Clasificación Internacional del funcionamiento, la discapacidad y la salud (CIF).

This article presents a real approach to socio- communicative experiences in elderly hearing-aid users in the city of Yopal. Much of the study was based in the description of these experiences in the elderly that use hearing aids, including a theoretical review of several authors who support the benefits of these aids in this stage of life. Considering that, most research about hearing aids and their benefits in improving the users' quality of life does not include real socio-communicative experiences of the elderly after the adaptation process, this study pretended to investigate further into them. To achieve this, surveys were conducted to a group of 20 participants, both men and women, between 60 and 93 years old from Yopal ( Casanare- Colombia), who had been using hearing aid for a year. With the obtained results, this paper achieved to collect data through a quantitative study that allowed to identify, categorize, and analyze the experiences of the elderly, based on the activities' benchmarks and participation; devices' uses, communication techniques, leisure and cultural activities (churches and support groups), under the guidelines of ICF (International Classification of Functioning, Disability and Health).

Synthesis, In Silico, and In Vitro Evaluation of Long Chain Alkyl Amides from 2-Amino-4-Quinolone Derivatives as Biofilm Inhibitors.

Infection from multidrug resistant bacteria has become a growing health concern worldwide, increasing the need for developing new antibacterial agents. Among the strategies that have been studied, biofilm inhibitors have acquired relevance as a potential source of drugs that could act as a complement for current and new antibacterial therapies. Based on the structure of 2-alkyl-3-hydroxy-4-quinolone and N-acylhomoserine lactone, molecules that act as mediators of quorum sensing and biofilm formation in Pseudomonas aeruginosa, we designed, prepared, and evaluated the biofilm inhibition properties of long chain amide derivatives of 2-amino-4-quinolone in Staphylococcus aureus and P. aeruginosa. All compounds had higher biofilm inhibition activity in P. aeruginosa than in S. aureus. Particularly, compounds with an alkyl chain of 12 carbons exhibited the highest inhibition of biofilm formation. Docking scores and molecular dynamics simulations of the complexes of the tested compounds within the active sites of proteins related to quorum sensing had good correlation with the experimental results, suggesting the diminution of biofilm formation induced by these compounds could be related to the inhibition of these proteins.

[Pleural infiltration in a relapse of multiple myeloma.] / Infiltración pleural en la recaída de un mieloma múltiple.

El mieloma múltiple (MM) puede afectar al tórax en forma de lesiones óseas, plasmocitomas, infiltraciones pulmonares y derrame pleural. El derrame pleural por infiltración de células plasmáticas es poco frecuente, con una incidencia del 0,8% y menos de 100 casos descritos hasta la fecha.Presentamos el caso de un varón de 60 años que se le diagnosticó de mieloma múltiple. Tras recibir tratamiento y alcanzando remisión completa, se constata recaída precoz en forma de derrame pleural. Mostramos imágenes radiológicas, citológicas y de la traslocación t(14;16) por FISH. Se ha reportado que esta traslocación denota mal pronóstico, una clínica más agresiva y, a diferencia de otros subgrupos moleculares, su resultado no mejora con la introducción de bortezomib.

Male-directed infanticide in spider monkeys (Ateles spp.).

Infanticide is considered a conspicuous expression of sexual conflict amongst mammals, including at least 35 primate species. Here we describe two suspected and one attempted case of intragroup infanticide in spider monkeys that augment five prior cases of observed or suspected infanticide in this genus. Contrary to the typical pattern of infanticide seen in most primate societies, where infants are killed by conspecifics independent of their sex, all eight cases of observed or suspected infanticide in spider monkeys have been directed toward male infants within their first weeks of life. Moreover, although data are still scant, infanticides seem to be perpetrated exclusively by adult males against infants from their own social groups and are not associated with male takeovers or a sudden rise in male dominance rank. Although the slow reproductive cycles of spider monkeys might favor the presence of infanticide because of the potential to shorten females' interbirth intervals, infanticide is nonetheless uncommon among spider monkeys, and patterns of male-directed infanticide are not yet understood. We suggest that given the potentially close genetic relationships among adult males within spider monkey groups, and the need for males to cooperate with one another in territorial interactions with other groups of related males, infanticide may be expected to occur primarily where the level of intragroup competition among males outweighs that of competition between social groups. Finally, we suggest that infanticide in spider monkeys may be more prevalent than previously thought, given that it may be difficult for observers to witness cases of infanticide or suspected infanticide that occur soon after birth in taxa that are characterized by high levels of fission-fusion dynamics. Early, undetected, male-biased infanticide could influence the composition of spider monkey groups and contribute to the female-biased adult sex ratios often reported for this genus.

Therapeutic effectiveness of Galphimia glauca vs. lorazepam in generalized anxiety disorder. A controlled 15-week clinical trial.

UNLABELLED: Galphimia glauca Cav. has demonstrated anxiolytic activity attributable to nor-seco-triterpenes denominated galphimines, the most active of which is galphimine-B. Galphimine-B inhibits ventral tegmental area dopaminergic neurons and interacts with the serotoninergic system of the dorsal hippocampus. A previous clinical study that administered a G. glauca herbal medicinal product for 4 weeks evidenced high percentages of therapeutic effectiveness and safety in patients with generalized anxiety disorder. Based on the previous findings, the goal of the present study was to evaluate the effectiveness, safety, and tolerability of G. glauca herbal medicinal product administered during 15 weeks in patients with generalized anxiety disorder. STUDY DESIGN: double-blind, randomized, lorazepam-controlled clinical trial. STUDY SUBJECTS: adult males and females, ambulatory, diagnosed with generalized anxiety disorder, with 20 or more points on the Hamilton anxiety scale, without data of depression, and without anxiolytic treatment in the previous month. Interventions were as follows. Experimental treatment: G. glauca herbal medicinal product in capsules containing the dry extract of G. glauca standardized in 0.175 mg of galphimine-B, one or two capsules twice a day, during 12 weeks plus 3 withdrawal weeks, and control treatment: lorazepam 0.5 mg with the same presentation and posology. PRIMARY OUTCOME: anxiolytic effectiveness (≥ 50 % reduction of initial Hamilton anxiety scale score). SECONDARY OUTCOMES: tolerability and safety. One hundred ninety-one patients initiated the study with 94 in the experimental group. One hundred four patients concluded the study, 51 of these in the experimental group. Anxiolytic effectiveness, measured as 0 in a negative case and as 1 in a positive case, was assessed 593 times in the experimental group and 631 in the control; the mean effectiveness observed was 0.686 ± 0.019 vs. 0.588 ± 0.019 (repeated-measures ANOVA; p = 0.0003). In the same way, G. glauca-herbal medicinal product diminished the score in the Hamilton anxiety scale to 11.51 ± 8.27 points and lorazepam to 12.40 ± 8.07 points (repeated-measures ANOVA; p = 0.05). The tolerability analysis, which comprised patients who concluded the treatment plus 11 patients who withdrew due to adverse reactions did not show differences between treatments (p = 0.35), nor did therapeutic safety demonstrate differences between groups (p = 0.21). There were no cases of tolerance, intoxication, dependence, or suppression syndrome. We concluded that G. glauca herbal medicinal product, standardized in 0.175 mg of galphimine-B and administered for 15 weeks to patients with generalized anxiety disorder, showed greater anxiolytic effectiveness than that obtained with lorazepam, with high percentages of therapeutic tolerability and safety.

GADD45α MODULATES DNA METHYLATION INDUCED BY DNA DAMAGE DURING HOMOLOGOUS RECOMBINATION / GADD45α MODULA LA METILACIÓN DEL ADN INDUCIDO POR EL DAÑO DEL ADN DURANTE LA RECOMBINACIÓN HOMÓLOGA

Homologous recombination is one of the major pathways for repairing DNA double strand breaks, the most deleterious of DNA lesions. Recent studies suggest that DNA methylation events target homologous recombination segments; however, the underlying mechanism of DNA methylation during homologous recombination is not understood. In this work, we show that GADD45α, a protein involved in cell cycle control, growth arrest, and apoptosis, plays some role in the epigenetic of homologous recombination. Specifically, it is suggested that dimerization of GADD45α monomers is required. Several point mutants of GADD45α were constructed and analyzed to show defects in self-association. Among them, the GADD45α mutant, CE83AA, lacked the ability to dimerize or oligomerize, which suppressed DNA methylation at homologous recombination sites in vivo. Based on this, we propose a model in which the dimerization (or oligomerization) of GADD45α is involved in strand specific DNA methylation that attends homologous recombination.

La recombinación homóloga es una de las principales vías para la reparación de la ruptura de doble cadena del ADN, la más grave de las lesiones del ADN. Estudios recientes sugieren que la metilación del ADN apunta hacia segmentos de recombinación homóloga; sin embargo, el mecanismo de metilación del ADN durante la recombinación homóloga no es claro. En este estudio, mostramos que GADD45α, una proteína que se encuentra relacionada con el control del ciclo celular, el ceso del crecimiento y la apoptosis, juega un papel en la epigenética de la recombinación homóloga. Específicamente, se ha sugerido que es requerido un dímero de monómeros de GADD45α. Varios puntos mutantes de GADD45α fueron construidos y analizados para mostrar defectos en la libre asociación. Entre ellos, el mutante GADD45α, CE83AA, carecía de la habilidad de dimerización u oligomerización, lo cual suprimió in vivo la metilación del ADN en los sitios de recombinación homóloga. Con base en esto, proponemos un modelo en el cual la dimerización (u oligomerización) de GADD45α está involucrada en la cadena específica de metilación del ADN que lleva a la recombinación homóloga.

Exploratory study on the clinical and mycological effectiveness of a herbal medicinal product from Solanum chrysotrichum in patients with Candida yeast-associated vaginal infection.

Mexican traditional medicine uses Solanum chrysotrichum to treat fungi-associated dermal and mucosal illness; its methanolic extract is active against dermatophytes and yeasts. Different spirostanic saponins (SC-2-SC-6) were identified as the active molecules; SC-2 was the most active in demonstrating a fungicidal effect against Candida albicans and non-albicans strains. The aim of the present study was to compare the clinical (elimination of signs and symptoms) and mycological effectiveness (negative mycological studies) of an S. chrysotrichum herbal medicinal product (Sc-hmp), standardized in 1.89 mg of SC-2, against ketoconazole (400 mg) in the topical treatment of cervical and/or vaginal infection by Candida. Both treatments (vaginal suppositories) were administered daily during 7 continuous nights. The study included 101 women (49 in the experimental group) with a confirmed clinical condition and positive mycological studies (direct examination and/or culture) of Candida infection. Basal conditions did not show differences between the groups; a moderate clinical picture was present in 62% of the cases, direct examination was positive in 69%, and the culture was positive with C. albicans predominating (65%). At the end of the administration period, both treatments demonstrated 100% tolerability, and clinical cure in 57.14% of S. chrysotrichum-treated cases and in 72.5% of ketoconazole-treated cases (p = 0.16), as well as 62.8% and 97.5% of mycological effectiveness, respectively (p = 0.0 001). We conclude that, at the doses used, Sc-hmp exhibits the same clinical effectiveness as ketoconazole, but with lower percentages of mycological eradication. Additional clinical studies with Sc-hmp are necessary, with increasing doses of SC-2, for improving the clinical and mycological effectiveness.

[The alternative medicine used as complementary in patients positive for HIV]. / Uso de terapia alternativa/complementaria en pacientes seropositivos a VIH.

OBJECTIVE: To evaluate the use of complementary alternative medicine (CAM) in patients infected with the human immunodeficiency virus (HIV), and to identify the type and factors associated to its use. METHODS: Cross-sectional study made in HIV clinics of three majors institutions from Morelos State, Mexico; the sample was 293 subjects; a specific questionnaire looking for demographic information and CAM use was applied. RESULTS: The use of CAM was 73.4%; 71% informed to the physician of their use. 51% of the patients reported using nutritional complements, 29.7% herbal products and 19% used physical agents like exercise, Chinese medicine, and therapy by contact. A total of 96.6 % of the users reported some perception of benefit with its use. The patients with low income, IMSS beneficiaries and on antirretroviral treatment were the greatest CAM users. CONCLUSIONS: CAM use is a common practice among HIV (+) patients. The multivitamins and herbal products were the most used. The majority was prescribed by health personnel and the users showed some benefit. Other longitudinal studies are required to establish the CAM impact on the disease evolution and the quality of life of HIV (+) patients.

Early population differentiation in extinct aborigines from Tierra del Fuego-Patagonia: ancient mtDNA sequences and Y-chromosome STR characterization.

Ancient mtDNA was successfully recovered from 24 skeletal samples of a total of 60 ancient individuals from Patagonia-Tierra del Fuego, dated to 100-400 years BP, for which consistent amplifications and two-strand sequences were obtained. Y-chromosome STRs (DYS434, DYS437, DYS439, DYS393, DYS391, DYS390, DYS19, DYS389I, DYS389II, and DYS388) and the biallelic system DYS199 were also amplified, Y-STR alleles could be characterized in nine cases, with an average of 4.1 loci per sample correctly typed. In two samples of the same ethnic group (Aonikenk), an identical and complete eight-loci haplotype was recovered. The DYS199 biallelic system was used as a control of contamination by modern DNA and, along with DYS19, as a marker of American origin. The analysis of both mtDNA and Y-STRs revealed DNA from Amerindian ancestry. The observed polymorphisms are consistent with the hypothesis that the ancient Fuegians are close to populations from south-central Chile and Argentina, but their high nucleotide diversity and the frequency of single lineages strongly support early genetic differentiation of the Fuegians through combined processes of population bottleneck, isolation, and/or migration, followed by strong genetic drift. This suggests an early genetic diversification of the Fuegians right after their arrival at the southernmost extreme of South America.

Alteraciones de la variabilida de la frecuencia cardiaca y muerte súbita detectada durante electrocardiografía ambulatoria / Heart rate variability and sudden death detected during ambulatory electrocardiography

Dos pacientes con cardiopatía isquémica tuvieron muerte súbita, detectada mediante electrocardiografía ambulatoria: un paciente tuvo taquicardia ventricular-asistolia y el otro bradicardia-asistolia sin mediar una taquiarritmia ventricular maligna. En ambos casos se determinó la función autonómica del corazón, mediante la variabilidad de la frecuencia cardiaca por análisis espectral y por análisis de dominio de tiempo. Se apreció una importante disminución de la variabilidad de la frecuencia cardiaca en el paciente con taquiarritmia, más acentuada la hora previa a su muerte. En cambio en el paciente con bradicardia-asistolia hubo tendencia al incremento en la variabilidad de la frecuencia cardiaca. Ello sugiere una diferente influencia neutral entre ambos pacientes para el desarrollo de muerte súbita. Existe una alteración en la función autonómica del corazón en el paciente que desarrolló taquiarritmia ventricular maligna, a expensas de una depresión del tono parasimpático. En cambio, en el enfermo que desarrolló bradicardia-asistolia, el tono parasimpático estuvo acentuado