Selection of allergen extract for immunotherapy in polysensitized allergic rhinitis patients.

Aim: To evaluate the criteria used by allergists in selecting an immunotherapy extract (allergen immunotherapy [AIT]-extract) in rhinitis patients with polysensitization. Methods: First, a cross-sectional study was carried out by evaluating different factors that influence the medical choice of AIT-extract. Second, a literature review was performed by evaluating the diagnostic performance of atopy tests. Results: A total of 419 patients were included (84 children, 149 adolescents and 186 adults). Anamnesis, atopy tests and exposure to pets were the main factors for choosing the AIT extract. The sensitivity and specificity of atopy tests were high for Dermatophagoides spp., (>80%), moderate for pets (60%) and indeterminate for Blomia tropicalis. Conclusion: NCTs could be necessary for AIT-extract selection in polysensitized allergic rhinitis patients.

Allergen immunotherapy is an effective treatment for patients with allergic rhinitis. Atopy tests are used to identify possible substances in the environment that cause symptoms. A patient may sometimes have multiple substances which could be causing their allergic reactions, which makes it difficult to choose the appropriate immunotherapy for the patient. In this study, we identified some factors that might help to guide the criteria used by allergists when selecting the extract for immunotherapy.

Biofouling inhibition by Staphylococcus aureus extracts and their potential use for paints.

For the control of biofouling, some paints based on compounds that are toxic to marine organisms have been used. There is an intensive search for biodegradable solutions that are friendly to non-target organisms. Bacteria have been shown to be a source of compounds with antifouling potential. In this work, the antifouling activity of a strain of Staphylococcus aureus was evaluated. Extracts activity against biofilm-forming bacteria and the toxicity against Artemia franciscana were evaluated. The extracts were incorporated in a hard gel and a paint matrix, and they were exposed to the sea. In both the laboratory and field, we found that the compounds produced by S. aureus have antifouling activity. The non-toxicity of the tested extracts against Artemia franciscana nauplii suggests that the extracts obtained from S. aureus could have a low ecological impact over non-target organisms. Significant differences were found in the percentage of organisms cover in hard gels with extracts and control. After 90 days, important differences were also observed between the percentage of organisms cover of the paints that contained extracts and the control. Dichloromethane extract is the most effective for the inhibition or delay of the settlement of organisms For this reason, they could be used in matrices with different applications, such as in the shipping industry, aquaculture, or any other in which biofouling is a cause of inconvenience.

Depth effect on the prokaryotic community assemblage associated with sponges from different rocky reefs.

Background: Sponge microbiomes are essential for the function and survival of their host and produce biologically active metabolites, therefore, they are ideal candidates for ecological, pharmacologic and clinical research. Next-generation sequencing (NGS) has revealed that many factors, including the environment and host, determine the composition and structure of these symbiotic communities but the controls of this variation are not well described. This study assessed the microbial communities associated with two marine sponges of the genera Aplysina (Nardo, 1834) and Ircinia (Nardo, 1833) in rocky reefs from Punta Arena de la Ventana (Gulf of California) and Pichilingue (La Paz Bay) in the coast of Baja California Sur, México to determine the relative importance of environment and host in structuring the microbiome of sponges. Methods: Specimens of Aplysina sp were collected by scuba diving at 10 m and 2 m; Ircinia sp samples were collected at 2 m. DNA of sponge-associated prokaryotes was extracted from 1 cm3 of tissue, purified and sent for 16S amplicon sequencing. Primer trimmed pair-ended microbial 16S rDNA gene sequences were merged using Ribosomal Database Project (RDP) Paired-end Reads Assembler. Chao1, Shannon and Simpson (alpha) biodiversity indices were estimated, as well permutational analysis of variance (PERMANOVA), and Bray-Curtis distances. Results: The most abundant phyla differed between hosts. Those phyla were: Proteobacteria, Acidobacteria, Cyanobacteria, Chloroflexi, Actinobacteria, Bacteroidetes, and Planctomycetes. In Ircinia sp the dominant phylum was Acidobacteria. Depth was the main factor influencing the microbial community, as analysis of similarities (ANOSIM) showed a significant difference between the microbial communities from different depths. Conclusion: Microbial diversity analysis showed that depth was more important than host in structuring the Aplysina sp and Ircinia sp microbiome. This observation contrast with previous reports that the sponge microbiome is highly host specific.

El Mantenimiento en las Relaciones de Pareja: Una Forma de Medirlo / Maintenance in Couple Relationships: An Assessment

Resumen El presente estudio tuvo como objetivo conocer la estructura factorial de la escala de mantenimiento en las relaciones de pareja en hombres y mujeres. Participaron de manera voluntaria y confidencial 731 personas (49.8% hombres y 50.2% mujeres). Se elaboró una escala con 178 reactivos, para evaluar el mantenimiento de las relaciones de pareja con base en un estudio exploratorio, con un formato de respuesta tipo Likert de 5 puntos. Esta consta de cuatro subescalas: Significado (46 reactivos y 6 factores), Motivos (30 reactivos y cuatro factores), Estrategias (46 reactivos y 6 factores) y Consecuencias (56 reactivos y 4 factores). Para cada subescala se obtuvo el análisis psicométrico. Los resultados indican una escala valida y confiable en sus cuatro subescalas, a través de análisis factoriales exploratorios y análisis de consistencia interna. Los hallazgos permiten contar con un instrumento robusto que permite evaluar en sus diferentes subescalas las áreas que componen el mantenimiento en la pareja, esto con la finalidad de realizar evaluaciones en las relaciones diádicas que fomenten parejas saludables, así como intervenciones, basadas en esta primera aproximación.

Abstract The purpose of this research was to obtain the factor structure of the Couple Relationship Maintenance Scale using a Mexican sample of men and women. A total of 731 voluntary people (49.8% men, 50.2% women) were part of this study and agreed to do so confidentially. Based on results from an exploratory study, the scale was initially developed considering 178 items in order to assess maintenance of couple relationships with a 5-point Likert response style. The scale was divided into four subscales: Meaning (46 items, 6 factors), Motives (30 items, 4 factors), Strategies (46 items, 6 factors), and Consequences (56 items, 4 factors). Each subscale required its own psychometric analysis. Exploratory factor analysis and internal consistency analysis show a valid and reliable scale in all four subscales. These findings allow for a robust scale that allows the evaluation of maintenance throughout several of its components. The development of instruments like the one presented becomes fundamental in the evaluation of dyadic relationships that in turn develop healthy couple relationships, as well as evidence-based interventions.

Matrix metalloproteinases 7, 8, 12, 13 gene haplotypes associated with colorectal cancer in a Mexican population.

BACKGROUND: Matrix metalloproteinases (MMPs) are involved in tumor invasion and progression in colorectal cancer (CRC). Variants rs11568818, rs11225395, rs2276109 and rs2252070 have been associated with this neoplasm. OBJECTIVE: To evaluate MMPs 7, 8, 12, and 13 haplotypes and their association with CRC. MATERIAL AND METHODS: One-hundred and four patients and 112 healthy individuals were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP). For the association analysis, odds ratio and confidence interval values were calculated. Haplotype and linkage disequilibrium (LD) analysis was performed with Arlequin software, v3.5. RESULTS: LD was present between rs2276109 and rs2252070. Haplotypes rs11568818(A)-rs11225395(T)-rs2276109(A)-rs2252070(A) and rs11568818(A)-rs11225395(C)-rs2276109(A)-rs2252070(G) were associated with CRC risk, and haplotypes rs11568818(G)-rs11225395(C)-rs2276109(A)-rs2252070(A) and rs11568818(A)-rs11225395(T)-rs2276109(A)-rs2252070(G), with protection. CONCLUSION: Variants rs2276109 and rs2252070 showed genetic linkage. Two haplotypes were associated with the development of CRC (ATAA and ACAG) and two were associated with protection (GCAA and ATAG). This study represents the first report on variants rs11225395 and rs2276109 frequency in a Mexican population.

ANTECEDENTES: Las metaloproteinasas (MMP) se involucran en invasión y progresión tumoral en cáncer colorrectal (CCR). Las variantes rs11568818, rs11225395, rs2276109 y rs2252070 se han asociado con esta neoplasia. OBJETIVO: Evaluar haplotipos de las MMP 7, 8, 12, y 13 y su asociación con CCR. MATERIAL Y MÉTODOS: Se genotipificaron 104 pacientes y 112 individuos sanos mediante reacción en cadena de la polimerasa con análisis del polimorfismo de los fragmentos de restricción (PCR-RFLP). Para el análisis de asociación fueron calculados valores de odds ratio e intervalo de confianza. El análisis de haplotipos y desequilibrio de ligamiento (LD) se realizó con el software Arlequin v3.5. RESULTADOS: Se presentó LD entre rs2276109 y rs2252070. Los haplotipos rs11568818(A)-rs11225395(T)-rs2276109(A)-rs2252070(A) y rs11568818(A)-rs11225395(C)-rs2276109(A)-rs2252070(G) se asociaron con riesgo de CCR y los haplotipos rs11568818(G)-rs11225395(C)-rs2276109(A)-rs2252070(A) y rs11568818(A)-rs11225395(T)-rs2276109(A)-rs2252070(G) con protección. CONCLUSIÓN: Las variantes rs2276109 y rs2252070 mostraron ligamiento génico. Dos haplotipos fueron asociados con el desarrollo de CCR (ATAA y ACAG) y dos fueron asociados con protección (GCAA y ATAG). Este estudio representa el primer reporte de frecuencias de las variantes rs11225395 y rs2276109 en población mexicana.

High frequency of MLH1 promoter methylation mediated by gender and age in colorectal tumors from Mexican patients.

INTRODUCTION: Several genes determine the development of colorectal cancer (CRC), such as MLH1, which encodes a protein that participates in DNA repair. MLH1 hypermethylation has been associated with gene silencing. OBJECTIVE: To analyze the methylation of five regions of MLH1 CpG island in colorectal tumors from Mexican patients. MATERIALS AND METHODS: One hundred and one tumor tissue samples were obtained from Mexican patients with CRC who provided informed consent. DNA was subjected to bisulfite conversion. Methylation of all five regions of the CpG island was evaluated using methylation-specific PCR. RESULTS: The frequency of methylation in Mexican patients with CRC was 25%. Regions A and B methylation was the main observed pattern (60%). Female patients showed a higher frequency of methylation (71%; OR 3.085; CI: 1.85-8.03; p = 0.02), and out of total methylated samples, 80% corresponded to individuals older than 45 years (p < 0.05). CONCLUSION: We calculated a methylation frequency for the MLH1 gene of 25% in Mexican patients with CRC, with this being the first report for this population. Female patients and patients older than 45 years showed a higher frequency of methylation.

INTRODUCCIÓN: Varios genes determinan el desarrollo de cáncer colorrectal (CCR), como MLH1, el cual codifica una proteína que participa en la reparación del ADN. La hipermetilación de MLH1 ha sido asociado con silenciamiento génico. OBJETIVO: Analizar la metilación de cinco regiones de la isla CpG de MLH1 en tumores colorrectales de pacientes mexicanos. MATERIALES Y MÉTODOS: Se obtuvieron 101 muestras de tejido tumoral de pacientes mexicanos con CCR, quienes proporcionaron su consentimiento informado. El ADN fue sometido a conversión por bisulfito. La metilación de las cinco regiones de la isla CpG fue evaluada utilizando PCR específica para metilación. RESULTADOS: La frecuencia de metilación en pacientes mexicanos con CCR fue del 25%. La metilación de las regiones A y B fue el principal patrón observado (60%). Las pacientes de sexo femenino mostraron una mayor frecuencia de metilación (71%) (odds ratio: 3.085; intervalo de confianza; 1.85-8.03; p = 0.02); y del total de muestras metiladas, el 80% fueron individuos mayores de 45 años (p < 0.05). CONCLUSIÓN: Calculamos una frecuencia de metilación para el gen MLH1 del 25% en pacientes mexicanos con CCR, siendo el primer reporte para esta población. Pacientes de sexo femenino y pacientes mayores de 45 años mostraron una mayor frecuencia de metilación.

Marine bacteria associated with shallow hydrothermal systems in the Gulf of California with the capacity to produce biofilm inhibiting compounds.

Shallow hydrothermal systems are extreme environments. The sediments and fluids emitted from the vents present unusual physical and chemical conditions compared to other marine areas, which promotes unique biodiversity that has been of great interest for biotechnology for some years. In this work, a bioprospective study was carried out to evaluate the capacity of bacteria associated with shallow hydrothermal vents to produce biofilm-inhibiting compounds. Degradation assays of N-acyl homoserine lactone (AHL) autoinducers (C6HSL) involved in the quorum sensing process were carried out on 161 strains of bacteria isolated from three shallow hydrothermal systems located in Baja California Sur (BCS), Mexico. The biosensor Chromobacterium violaceum CV026 was used. Twenty-three strains showed activity, and organic extracts were obtained with ethyl acetate. The potential of the extracts to inhibit the formation of biofilms was tested against two human pathogenic strains (Pseudomonas aeruginosa PAO1 and Aeromonas caviae ScH3), a shrimp pathogen (Vibrio parahaemolyticus M8), and two marine strains identified as producing biofilms on submerged surfaces (Virgibacillus sp C29 and Vibrio alginolyticus C96). The results showed that Vibrio alginolyticus and Brevibacillus thermoruber, as well as some thermotolerant strains (mostly Bacillus), produce compounds that inhibit bacterial biofilms (B. licheniformis, B. paralicheniformis, B. firmus, B. oceanizedimenis, B. aerius and B. sonorensis).

Marine bacteria from the Gulf of California with antimicrofouling activity against colonizing bacteria and microalgae / Bacterias marinas del Golfo de California con actividad antimicrobiana frente a bacterias colonizadoras y microalgas

Abstract One way of reducing the input of pollutants into the marine environment is to enforce the use of non-toxic antifouling paints in marine protected areas. Thus, the purpose of this study was to detect marine microorganisms that secrete inhibitory substances against bacteria and microalgae to avoid biofouling on manmade structures in La Paz bay, B.C.S., Mexico. The inhibitory potential of 125 bacteria was evaluated against biofilm-forming bacteria. Crude extracts were obtained with methanol and ethyl acetate from 16 bacterial strains that exhibited antagonistic and antibacterial activity in a preliminary screening. Antibacterial and antimicroalgal assays were performed using crude extracts, the minimum inhibitory concentration (MIC) was determined. The highest activity against bacteria and microalgae was found in two strains, Shewanella algae and Staphylococcus sp. The results of this study suggest that extracts of bacteria from the Gulf of California with antimicrobial properties against biofilm-forming bacteria can also prevent the adhesion of microalgae, which may control the development of biofilm formation and, as a consequence, biofouling.(AU)

Resumen Una alternativa para reducir la contaminación en el medio marino es el uso de pinturas anti-incrustantes no tóxicas en áreas marinas protegidas. En el presente estudio se propuso encontrar microorganismos marinos que secreten sustancias capaces de inhibir la adhesión de bacterias y microalgas, de esta manera evitar la bioincrustación en estructuras marinas en la bahía de La Paz, B.C.S., México. Un total de 125 bacterias fueron evaluadas por su capacidad para inhibir el desarrollo de bacterias formadoras de biopelículas. En una selección preliminar de actividad antagónica y antibacteriana, 16 cepas bacterianas mostraron potencial actividad inhibitoria, de las que se obtuvieron los extractos crudos con metanol y acetato de etilo. Se realizaron ensayos antibacterianos y anti-microalgales utilizando los extractos crudos, se determinó la concentración mínima inhibitoria (MIC). Dos cepas mostraron la mayor actividad contra bacterias y microalgas: Shewanella algae y Staphylococcus sp. Los resultados de este estudio sugieren que los extractos de bacterias aisladas en el Golfo de California que poseen propiedades antimicrobianas contra las bacterias formadoras de biofilm y también pueden prevenir la adhesión de microalgas, con lo que se podría controlar el desarrollo de la formación de biopelículas y como consecuencia, el biofouling.(AU)

Frecuencia de las reacciones alérgicas a la vacuna triple viral en pacientes con alergia al huevo / The frequency of allergic reactions to the triple viral vaccine in 94 patients with egg allergy

Introducción. La vacunación es la intervención en salud pública más efectiva de todos los tiempos, pues reduce la mortalidad y la morbilidad de múltiples enfermedades infecciosas. En muchas ocasiones, la aplicación de las vacunas se retrasa por el temor a las reacciones alérgicas, lo cual es frecuente entre los pacientes con alergia al huevo que requieren la vacuna triple viral (rubeola-sarampión-parotiditis). Objetivo. Evaluar la frecuencia de reacciones después de la aplicación de la vacuna triple viral en una población alérgica al huevo. Materiales y métodos. Se hizo un estudio retrospectivo multicéntrico (2014-2016) de pacientes con alergia al huevo que acudieron a centros de alergología de Medellín y requerían la aplicación de la vacuna triple viral. Resultados. Noventa y cuatro pacientes cumplían los criterios de selección; 68,2 % de ellos presentaba síntomas cutáneos al consumir huevo; 22,3 %, reacción anafiláctica; 5,3 %, síntomas gastrointestinales, y 4,2 %, síntomas respiratorios. Independientemente de la gravedad de su reacción al huevo, todos los pacientes recibieron la vacuna triple viral y la toleraron bien. Conclusión. Aunque la alergia al huevo es frecuente en la edad infantil, el riesgo de reacciones alérgicas después de aplicar la vacuna triple viral en esta población fue similar al de la población general, por lo que no se debe diferir su aplicación, incluso en pacientes con antecedentes de reacciones graves al huevo.

Introduction: Vaccination is the most effective public health intervention of all times, reducing the death and morbidity rates derived from multiple infectious diseases. In many cases, the administration and reception of vaccines is delayed due to the fear of allergic reactions; this is frequent among patients with allergy to egg who need the triple viral vaccine. Objective: To evaluate the frequency of reactions after the administration of triple viral vaccine (Measles, Mumps and Rubella, MMR) in an egg-allergic population. Materials and methods: We conducted a multi-center retrospective study (2014-2016) including patients with egg allergy who visited an allergology center and required the administration of the triple viral vaccine. Results: A total of 94 patients met the selection criteria. From these patients, 68.2% had cutaneous symptoms, 22.3% had an anaphylactic reaction, 5.3% had gastrointestinal symptoms, and 4.2% had respiratory egg-related symptoms. Regardless of the severity of their reaction to egg, all patients received the triple viral vaccine and in 100% of the cases, it was well tolerated. Conclusion: Although egg allergy is common in childhood, the risk of allergic reactions during the MMR vaccination in this population was similar to that in the general population, therefore, its use should not be deferred even in patients with a history of severe egg-related allergic reactions.

Biosorption of Cadmium by Non-Toxic Extracellular Polymeric Substances (EPS) Synthesized by Bacteria from Marine Intertidal Biofilms.

Cadmium is a major heavy metal found in polluted aquatic environments, mainly derived from industrial production processes. We evaluated the biosorption of solubilized Cd2+ using the extracellular polymeric substances (EPS) produced by Bacillus sp. MC3B-22 and Microbacterium sp. MC3B-10 (Microbactan); these bacteria were originally isolated from intertidal biofilms off the coast of Campeche, Mexico. EPS were incubated with different concentrations of cadmium in ultrapure water. Residual Cd2+ concentrations were determined by Inductive Coupled Plasma-Optic Emission Spectrometry and the maximum sorption capacity (Qmax) was calculated according to the Langmuir model. EPS were characterized by X-ray photoelectron spectroscopy (XPS) before and after sorption. The Qmax of Cd2+ was 97 mg g-1 for Microbactan and 141 mg g-1 for MC3B-22 EPS, these adsorption levels being significantly higher than previously reported for other microbial EPS. In addition, XPS analysis revealed changes in structure of EPS after biosorption and showed that amino functional groups contributed to the binding of Cd2+, unlike other studies that show the carbohydrate fraction is responsible for this activity. This work expands the current view of bacterial species capable of synthesizing EPS with biosorbent potential for cadmium and provides evidence that different chemical moieties, other than carbohydrates, participate in this process.

The frequency of allergic reactions to the triple viral vaccine in 94 patients with egg allergy / Frecuencia de las reacciones alérgicas a la vacuna triple viral en pacientes con alergia al huevo

Introduction: Vaccination is the most effective public health intervention of all times, reducing the death and morbidity rates derived from multiple infectious diseases. In many cases, the administration and reception of vaccines is delayed due to the fear of allergic reactions; this is frequent among patients with allergy to egg who need the triple viral vaccine. Objective: To evaluate the frequency of reactions after the administration of triple viral vaccine (Measles, Mumps and Rubella, MMR) in an egg-allergic population. Materials and methods: We conducted a multi-center retrospective study (2014-2016) including patients with egg allergy who visited an allergology center and required the administration of the triple viral vaccine. Results: A total of 94 patients met the selection criteria. From these patients, 68.2% had cutaneous symptoms, 22.3% had an anaphylactic reaction, 5.3% had gastrointestinal symptoms, and 4.2% had respiratory egg-related symptoms. Regardless of the severity of their reaction to egg, all patients received the triple viral vaccine and in 100% of the cases, it was well tolerated. Conclusion: Although egg allergy is common in childhood, the risk of allergic reactions during the MMR vaccination in this population was similar to that in the general population, therefore, its use should not be deferred even in patients with a history of severe egg-related allergic reactions.

Introducción. La vacunación es la intervención en salud pública más efectiva de todos los tiempos, pues reduce la mortalidad y la morbilidad de múltiples enfermedades infecciosas. En muchas ocasiones, la aplicación de las vacunas se retrasa por el temor a las reacciones alérgicas, lo cual es frecuente entre los pacientes con alergia al huevo que requieren la vacuna triple viral (rubeola-sarampión-parotiditis).Objetivo. Evaluar la frecuencia de reacciones después de la aplicación de la vacuna triple viral en una población alérgica al huevo.Materiales y métodos. Se hizo un estudio retrospectivo multicéntrico (2014-2016) de pacientes con alergia al huevo que acudieron a centros de alergología de Medellín y requerían la aplicación de la vacuna triple viral.Resultados. Noventa y cuatro pacientes cumplían los criterios de selección; 68,2 % de ellos presentaba síntomas cutáneos al consumir huevo; 22,3 %, reacción anafiláctica; 5,3 %, síntomas gastrointestinales, y 4,2 %, síntomas respiratorios. Independientemente de la gravedad de su reacción al huevo, todos los pacientes recibieron la vacuna triple viral y la toleraron bien.Conclusión. Aunque la alergia al huevo es frecuente en la edad infantil, el riesgo de reacciones alérgicas después de aplicar la vacuna triple viral en esta población fue similar al de la población general, por lo que no se debe diferir su aplicación, incluso en pacientes con antecedentes de reacciones graves al huevo.

Variantes en los genes TNFA , IL6 e IFNG asociadas con la gravedad del dengue en una muestra de población colombiana / Variants in the TNFA , IL6 and IFNG genes associated with dengue severity in a sample of Colombian population

Resumen Introducción. La composición genética del huésped determina, entre otros aspectos, el perfil clínico del dengue, lo cual se debería al efecto de variantes en los genes que codifican citocinas proinflamatorias. Objetivo. Evaluar la asociación entre las variantes de tres polimorfismos en los genes candidatos TNFA, IL6 e IFNG con la gravedad del dengue en una población colombiana. Materiales y métodos. Se evaluaron los polimorfismos rs1800750, rs2069843 y rs2069705 de los genes TNFA, IL6 e IFNG, respectivamente, en 226 pacientes con dengue. Los genotipos se tipificaron usando la reacción en cadena de la polimerasa (PCR) y los polimorfismos de la longitud de los fragmentos de restricción (Restriction Fragment Length Polymorphism, RFLP). Para determinar el riesgo de diferentes fenotipos del dengue, se compararon las frecuencias alélicas con la prueba de ji al cuadrado, y los genotipos y los haplotipos, con regresión logística. Por último, los análisis se ajustaron utilizando datos de autoidentificación o del componente genético ancestral. Resultados. El alelo A del rs2069843, ajustado por autoidentificación, se asoció con casos de dengue hemorrágico en afrocolombianos. En la muestra completa, dicho polimorfismo, ajustado por componente genético ancestral, fue reproducible. Además, hubo asociaciones significativas entre las combinaciones alélicas GGT y GAC de los rs1800750, rs2069843 y rs2069705 en pacientes con dengue hemorrágico, con ajuste por componente genético ancestral y sin él. Además, la combinación alélica AGC produjo 58,03 pg/ml más de interleucina 6 que la GGC, independientemente de los componentes genéticos europeo, amerindio y africano. Conclusión. Las variantes de los polimorfismos GGT y GAC de los rs1800750, rs2069843 y rs2069705 en los genes TNFA, IL6 e IFNG, respectivamente, se correlacionaron con la gravedad del dengue en esta muestra de población colombiana.

Abstract Introduction: The genetic makeup of the host contributes to the clinical profile of dengue. This could be due to the effect of variants in the genes encoding pro-inflammatory cytokines. Objective: To evaluate the association between the variants of three polymorphisms in TNFA, IL6 and IFNG candidate genes with dengue severity in a sample of Colombian population. Materials and methods: We evaluated the rs1800750, rs2069843, and rs2069705 polymorphisms in TNFA, IL6 and IFNG candidate genes, respectively, in 226 patients with dengue infection. The genotypes were typed using both polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). To determine the risk of different dengue phenotypes, we compared allele frequencies with chisquare and genotypes and haplotypes using logistic regression. Finally, these analyzes were adjusted with data from self-identification or the ancestral genetic component. Results: The A allele in the rs2069843 polymorphism, adjusted by self-identification, was associated with dengue hemorrhagic fever cases in Afro-Colombians. In the entire sample, this polymorphism, adjusted by the ancestral genetic component, was reproducible. In addition, there were significant associations between GGT and GAC allelic combinations of rs1800750, rs2069843, and rs2069705 in dengue hemorrhagic fever patients, with and without adjustment by ancestral genetic component. Additionally, the AGC allelic combination produced 58.03 pg/ml of interleukin-6 more than the GGC combination, regardless of European, Amerindian and African genetic components. Conclusions: The variants of GGT and GAC polymorphisms of rs1800750, rs2069843, and rs2069705 in the TNFA, IL6 and IFNG genes, respectively, were correlated with the susceptibility to dengue severity in a sample of Colombian population.

Funcionalidad, calidad de vida y grado de dolor en 243 pacientes con lumbalgia crónica degenerativa / FUNCTIONALITY, QUALITY OF LIFE, AND PAIN INTENSITY IN 243 PATIENTS WITH DEGENERATIVE CHRONIC LUMBAR DISEASE

Introducción: La enfermedad degenerativa lumbar ocasiona lumbalgia, es la patología musculo esquelética más frecuente en mayores de 65 años, la segunda causa de las consultas médicas en primer nivel, quinta en admisión en hospitales y tercera de cirugía de columna lumbar que ocasiona incapacidad y limitación de actividades cotidianas. El objetivo es correlacionar la calidad de vida con limitación funcional en pacientes con lumbalgia crónica degenerativa. Metodología: estudio transversal, en 243 adultos mayores con lumbalgia degenerativa, de ambos géneros, mayores de 65 años, con lumbalgia crónica y limitación funcional de actividades cotidianas. Se utilizó Escala Visual Analógica (EVA), Cuestionario de Salud SF-36 y Escala de Incapacidad por Dolor Lumbar de OSWESTRY. La estadística fue descriptiva y correlación Spearman. Resultados: N=273, edad media 77 ± 6.9 años, 63.38% fueron mujeres, 48.97% pensionados, 20.17% analfabetas, 25.10% nivel secundaria, 65.85% casados. En el SF-36: calidad de vida promedio 39.2, con mayor afectación en el dominio de funcionamiento social: media 51.99; OSWESTRY: imitación funcional mínima y moderada en 23.9%, limitación severa a máxima en 76.1%; EVA: 59.3% dolor leve a moderado y 40.7% dolor intenso y con el peor dolor posible; hubo correlación negativa entre SF-36 y OSWESTRY: -.830, p=0.000; tambien correlación negativa entre calidad de vida y grado de dolor: -.798 p<0.0001 y correlación positiva entre limitación funcional y grado de dolor: 0.734 p=0.000. Conclusión: La calidad de vida tiene correlación negativa con limitación funcional y dolor; la correlación entre limitación funcional y dolor es positiva en adultos mayores con lumbalgia crónica

Introduction: Lumbar degenerative disease causes lumbago, is the most common muscleskeletal pathology in patients over 65 yearsold and the second leading cause of medical consultations at first medical level, the fifth in hospital admissions and third of lumbar spine surgery. It causes disability and limitation of daily activities. The objective is to correlate the quality of life with functional limitation in patients with Atraumatic Chronic Lumbago. Methods: Cross-sectional study in 243, older than 65 years old, male and female, with Atraumatic Chronic Lumbago and functional limitation of daily activities. Visual Analog Scale (VAS), SF-36 and Oswestry questionaries were applied. Descriptive and correlation statistics were used. Results: N=273, mean age 77 ± 6.9 years, 63.38% women, 48.97% pensioners, 20.17% illiterate, 25.10% High School level and 65.85% were married. SF-36: 39.2 quality of life average was 39.2, with greater involvement in the social functioning domain: 51.99 media. OSWESTRY: moderate and low functional limitation in 23.9%, severe to maximum limitation in 76.1%; VAS mild to moderate pain in 59.3% and 40.7% severe pain and worst pain possible; there were negative correlation between SF -36 and OSWESTRY -.830, p= 0.000 and between quality of life and degree of pain: -.798 p < 0.0001; correlation between and positive degree of functional limitation and degree of pain was positive: 0.734 p=0.000. Conclusion: Quality of life is negatively correlated with pain and functional limitation; and the correlation between pain and functional limitation is positive in older adults with chronic low back pain

[Variants in the TNFA, IL6 and IFNG genes are associated with the dengue severity in a sample from Colombian population].

INTRODUCTION: The genetic makeup of the host contributes to the clinical profile of dengue. This could be due to the effect of variants in the genes encoding pro-inflammatory cytokines. OBJECTIVE: To evaluate the association between the variants of three polymorphisms in TNFA, IL6 and IFNG candidate genes with dengue severity in a sample of Colombian population. MATERIALS AND METHODS: We evaluated the rs1800750, rs2069843, and rs2069705 polymorphisms in TNFA, IL6 and IFNG candidate genes, respectively, in 226 patients with dengue infection. The genotypes were typed using both polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). To determine the risk of different dengue phenotypes, we compared allele frequencies with chi-square and genotypes and haplotypes using logistic regression. Finally, these analyzes were adjusted with data from self-identification or the ancestral genetic component. RESULTS: The A allele in the rs2069843 polymorphism, adjusted by self-identification, was associated with dengue hemorrhagic fever cases in Afro-Colombians. In the entire sample, this polymorphism, adjusted by the ancestral genetic component, was reproducible. In addition, there were significant associations between GGT and GAC allelic combinations of rs1800750, rs2069843, and rs2069705 in dengue hemorrhagic fever patients, with and without adjustment by ancestral genetic component. Additionally, the AGC allelic combination produced 58.03 pg/ml of interleukin-6 more than the GGC combination, regardless of European, Amerindian and African genetic components. CONCLUSIONS: The variants of GGT and GAC polymorphisms of rs1800750, rs2069843, and rs2069705 in the TNFA, IL6 and IFNG genes, respectively, were correlated with the susceptibility to dengue severity in a sample of Colombian population.

[Allergen immunotherapy: Mechanisms of action, and therapeutic and socioeconomic impact Consensus of the Asociación Colombiana de Alergia, Asma e Imunología].

Allergies comprise a set of highly prevalent diseases. When allergic processes are not controlled, they can endanger patients' health and lives, and have an important economic and social impact. The aim of this paper is to present a practical consensus of the scientific evidence on the use of immunotherapy in allergic diseases. A collaborative review made by various institutes and universities in Colombia was carried out upon request of the Asociación Colombiana de Alergia, Asma e Imunología, led by general practitioners, allergists, immunologists, internists and paediatricians with experience in the field of allergies. As a result, based on current national and international scientific evidence, we describe in detail what immunotherapy is about, its indications, contraindications and its economic and health benefits. Conclusions show immunotherapy as a clinically effective and safe treatment, which can substantially reduce the cost of the overall treatment of allergic patients.

Inmunoterapia con alérgenos: mecanismos de acción, impacto terapéutico y socioeconómico Consenso de la Asociación Colombiana de Alergias, Asma e Inmunología / Allergen immunotherapy: Mechanisms of action, and therapeutic and socioeconomic impact Consensus of the Asociación Colombiana de Alergia, Asma e Imunología

Las alergias constituyen un conjunto de enfermedades de gran prevalencia. Cuando los procesos alérgicos no se controlan, pueden poner en peligro la salud e, incluso, la vida de los pacientes y, además, su efecto económico y social es considerable. El objetivo de esta revisión es presentar un consenso práctico de la información científica disponible sobre el empleo de la inmunoterapia en las enfermedades alérgicas con la colaboración de varios institutos y universidades de Colombia, por solicitud de la Asociación Colombiana de Alergia, Asma e Inmunología. La revisión incluyó aspectos prácticos presentados desde el punto de vista de médicos generales, alergólogos, inmunólogos, internistas y pediatras con experiencia en el campo de las alergias. Con base en la evidencia científica actual a nivel nacional e internacional, se describió de forma detallada en qué consiste la inmunoterapia, sus indicaciones, contraindicaciones y sus beneficios para la salud, así como en el ámbito socioeconómico. Se concluyó que la inmunoterapia es efectiva y segura, y que, además, puede reducir sustancialmente el costo del tratamiento global de los pacientes alérgicos.

Allergies comprise a set of highly prevalent diseases. When allergic processes are not controlled, they can endanger patients´ health and lives, and have an important economic and social impact. The aim of this paper is to present a practical consensus of the scientific evidence on the use of immunotherapy in allergic diseases. A collaborative review made by various institutes and universities in Colombia was carried out upon request of the Asociación Colombiana de Alergia, Asma e Imunología , led by general practitioners, allergists, immunologists, internists and paediatricians with experience in the field of allergies. As a result, based on current national and international scientific evidence, we describe in detail what immunotherapy is about, its indications, contraindications and its economic and health benefits. Conclusions show immunotherapy as a clinically effective and safe treatment, which can substantially reduce the cost of the overall treatment of allergic patients.

Evaluation of Commercially Available Assays for Diagnosis of Acute Dengue in Schoolchildren During an Epidemic Period in Medellin, Colombia.

During an active surveillance study in school children in Medellin, we assessed the performance of two diagnostic strategies for dengue virus. A total of 41 patients with suspected dengue acute infection were evaluated. Diagnostic strategies consisted of one combining Panbio(®) Dengue virus IgM and IgG Capture ELISAs (enzyme-linked immunosorbent assays) with reverse transcriptase polymerase chain reaction (RT-PCR) and another using a commercial rapid SD Bioline Dengue Duo (IgG/IgM + NS1 Ag) test. These two strategies were compared with the enzyme-linked immunospot microneutralization test (ELISPOT-MNT). The sensitivity and specificity were 53.9% and 80.0% for the combination of Panbio(®) ELISAs and RT-PCR tests, and 30.8% and 73.3% for the SD Bioline Duo test, respectively. ELISPOT-MNT detected 16.4% additional cases and revealed the presence of neutralizing antibodies in all the acute samples, evidencing that they were all secondary infections. In contrast, Panbio(®) and SD Dengue Duo rapid tests only classified 23.0% and 26.9% of the cases as secondary dengue infections, respectively. Cohen's kappa coefficient and McNemar's association tests demonstrated a significant disagreement between the two diagnostic strategies and ELISPOT-MNT. Overall, these results evidence the relatively poor performances of commercial assays for the diagnosis of acute and secondary dengue infections, compared with ELISPOT-MNT, and raise concern about the accuracy of these assays for the diagnostic of dengue in endemic areas.

[Dengue infection: A common cause of febrile syndrome in patients from Quibdó, Chocó, Colombia]. / Infección por dengue: una causa frecuente de síndrome febril en pacientes de Quibdó, Chocó, Colombia.

INTRODUCTION: Quibdó, a municipality in Chocó, has poor public services and weather and social conditions that favor dengue transmission. However, there are few studies about this problem in this district. OBJECTIVE: To determine the frequency of dengue infection in patients with acute febrile syndrome and to compare clinical features among dengue infected patients with other febrile diseases. MATERIALS AND METHODS: A cross-sectional study was conducted from January, 2008, to March, 2010. The study population comprised patients with febrile syndrome of seven or fewer days of evolution, recruited from hospitals in the town. Dengue diagnosis was made in serum samples by detection of IgM antibodies, NS1 antigen, reverse transcription polymerase chain reaction, and virus isolation. Clinical and laboratory information from the patients was obtained. RESULTS: During the study period, 469 patients with acute febrile syndrome were recruited, of whom 98.3% were Afro-descendant. Dengue fever was found in 28.4% of the cases. Four dengue serotypes were identified with DENV-1 predominance. The ages ranged from zero to 76 years. From all patients, 70.7% of cases were classified as dengue without warning signs. Nausea, vomiting, abdominal pain, cough, nasal congestion and sore throat were significantly more frequent in patients with another febrile disease. CONCLUSIONS: Active surveillance of the acute febrile syndrome allowed for the detection of undiagnosed cases of dengue; the observed frequency of this infection suggests that the study area has a high risk of dengue infection.

Frequency and clinical manifestations of dengue in urban medellin, Colombia.

A dengue fever surveillance study was conducted at three medical facilities located in the low-income district of San Javier in Medellin, Colombia. During March 2008 to 2009, 781 patients with fever regardless of chief complaint were recruited for acute dengue virus infection testing. Of the 781 tested, 73 (9.3%) were positive for dengue infection. Serotypes DENV-2 (77%) and -3 (23%) were detected by PCR. One patient met the diagnostic criteria for dengue hemorrhagic fever. Only 3 out of 73 (4.1%) febrile subjects testing positive for dengue infection were diagnosed with dengue fever by the treating physician. This study confirms dengue virus as an important cause of acute febrile illness in Medellin, Colombia, but it is difficult to diagnose without dengue diagnostic testing.

African genetic ancestry is associated with a protective effect on Dengue severity in colombian populations.

The wide variation in severity displayed during Dengue Virus (DENV) infection may be influenced by host susceptibility. In several epidemiological approaches, differences in disease outcomes have been found between some ethnic groups, suggesting that human genetic background has an important role in disease severity. In the Caribbean, It has been reported that populations of African descent present considerable less frequency of severe forms compared with Mestizo and White self-reported groups. Admixed populations offer advantages for genetic epidemiology studies due to variation and distribution of alleles, such as those involved in disease susceptibility, as well to provide explanations of individual variability in clinical outcomes. The current study analysed three Colombian populations, which like most of Latin American populations, are made up of the product of complex admixture processes between European, Native American and African ancestors; having as a main goal to assess the effect of genetic ancestry, estimated with 30 Ancestry Informative Markers (AIMs), on DENV infection severity. We found that African ancestry has a protective effect against severe outcomes under several systems of clinical classification: Severe Dengue (OR: 0.963 for every 1% increase in African ancestry, 95% confidence interval (0.934-0.993), p-value: 0.016), Dengue Haemorrhagic Fever (OR: 0.969, 95% CI (0.947-0.991), p-value: 0.006), and occurrence of haemorrhages (OR: 0.971, 95% CI (0.952-0.989), p-value: 0.002). Conversely, decrease from 100% to 0% African ancestry significantly increases the chance of severe outcomes: OR is 44-fold for Severe Dengue, 24-fold for Dengue Haemorrhagic Fever, and 20-fold for occurrence of haemorrhages. Furthermore, several warning signs also showed statistically significant association given more evidences in specific stages of DENV infection. These results provide consistent evidence in order to infer statistical models providing a framework for future genetic epidemiology and clinical studies.