A Mycobacterium tuberculosis fingerprint in human breath allows tuberculosis detection.

An estimated one-third of tuberculosis (TB) cases go undiagnosed or unreported. Sputum samples, widely used for TB diagnosis, are inefficient at detecting infection in children and paucibacillary patients. Indeed, developing point-of-care biomarker-based diagnostics that are not sputum-based is a major priority for the WHO. Here, in a proof-of-concept study, we tested whether pulmonary TB can be detected by analyzing patient exhaled breath condensate (EBC) samples. We find that the presence of Mycobacterium tuberculosis (Mtb)-specific lipids, lipoarabinomannan lipoglycan, and proteins in EBCs can efficiently differentiate baseline TB patients from controls. We used EBCs to track the longitudinal effects of antibiotic treatment in pediatric TB patients. In addition, Mtb lipoarabinomannan and lipids were structurally distinct in EBCs compared to ex vivo cultured bacteria, revealing specific metabolic and biochemical states of Mtb in the human lung. This provides essential information for the rational development or improvement of diagnostic antibodies, vaccines and therapeutic drugs. Our data collectively indicate that EBC analysis can potentially facilitate clinical diagnosis of TB across patient populations and monitor treatment efficacy. This affordable, rapid and non-invasive approach seems superior to sputum assays and has the potential to be implemented at point-of-care.

Correlation between cognitive performance and structural neuroanatomy in patients with type I bipolar affective disorder treated with and without lithium.

INTRODUCTION: Lithium treatment of bipolar disorder (BD) has been associated with less cognitive impairment and fewer changes in structural brain anatomy compared to other treatments. However, the studies are heterogeneous and few assess whether these effects are related. The objective of this study was to evaluate and relate cognitive performance and structural neuroanatomy in patients treated with and without lithium. METHODS: Cross-sectional study that included 48 subjects with BD-I, of which 22 were treated with lithium and 26 without lithium. Performance was assessed on Wechsler III (WAIS III), TMT A and B (Trial Making Test) neuropsychological tests, California verbal learning test (CVLT), Rey complex figure test and Wisconsin card sorting test. Brain structures obtained by magnetic resonance imaging (MRI) were evaluated. The standardised mean difference (SMD) between both groups was calculated, adjusted for confounding variables using a propensity score, and the Spearman correlation coefficient (ρ) was used to assess the relationship between cognitive performance and neuroanatomical regions. RESULTS: Compared to the group without lithium, the group with lithium had fewer perseverative errors in the Wisconsin test (SMD = -0.69) and greater left and right cortical areas (SMD = 0.85; SMD = 0.92); greater surface area in the left anterior cingulate (SMD = 1.32), right medial orbitofrontal cortex (SMD = 1.17), right superior frontal gyrus (SMD = 0.82), and right and left precentral gyrus (SMD = 1.33; SMD = 0.98); greater volume of the right amygdala (SMD = 0.57), right hippocampus (SMD = 0.66), right putamen (SMD = 0.87) and right thalamus (SMD = .67). In the lithium group, a correlation was found with these errors and the thickness of the left precentral gyrus (ρ = -0.78), the volume of the right thalamus (ρ = -0.44), and the right amygdala (ρ = 0.6). CONCLUSIONS: The lithium group had better cognitive flexibility and greater dimension in some frontal and subcortical cortical regions. Furthermore, there was a moderate to high correlation between performance in this executive function and the thickness of the right precentral gyrus, and the volumes of the thalamus and the right amygdala. These findings could suggest a neuroprotective effect of lithium.

Correlación entre el desempeño cognitivo y la neuroanatomía estructural en pacientes con trastorno afectivo bipolar tipo I tratados con y sin litio / Correlation Between Cognitive Performance and Structural Neuroanatomy in Patients with Type I Bipolar Affective Disorder Treated with and Without Lithium

RESUMEN Introducción: El tratamiento del trastorno afectivo bipolar (TAB) con litio se ha relacionado con menos deterioro cognitivo y menores cambios en la anatomía estructural cerebral comparado con otros tratamientos. Sin embargo, los estudios son heterogéneos y son pocos los que evalúan si estos efectos están relacionados. El objetivo de este estudio es evaluar y relacionar el desempeno cognitivo y la neuroanatomía estructural en pacientes tratados con y sin litio. Métodos: Estudio de corte trasversal que incluyó a 48 sujetos con TAB I: 22 tratados con litio y 26 sin litio. Se evaluó el desempeno en las pruebas neuropsicológicas Wechsler III (WAIS III), TMTAyB (Trial Making Test), prueba de aprendizaje verbal de California (TAVEC), prueba de Figura compleja de Rey y prueba de clasificación de tarjetas de Wisconsin. Se evaluaron estructuras cerebrales obtenidas por resonancia magnétiva (RM) cerebral. Se calculó la diferencia de medias estandarizada (DME) entre ambos grupos, con ajuste por variables de confusión mediante puntuación de propensión, y se empleó el coeficiente de correlación de Spearman (p) para evaluar la relación existente entre el desempeno cognitivo y las regiones neuroanatómicas. Resultados: Respecto al grupo sin litio, el grupo con litio tuvo menos errores perseverativos en el Wisconsin (DME = -0,69) y mayores áreas corticales derecha e izquierda (DME = 0,85 y DME = 0,92); mayor superficie en el cíngulo anterior izquierdo (DME = 1,32), la corteza orbi-tofrontal medial derecha (DME = 1,17), el giro frontal superior derecho (DME = 0,82), los giros precentrales derecho e izquierdo (DME = 1,33 y DME = 0,98); mayor volumen de la amígdala derecha (DME = 0,57), el hipocampo derecho (DME = 0,66), el putamen derecho (DME = 0,87) y el tálamo derecho (DME = 0,67). En el grupo con litio, se encontró una correlación con dichos errores y el espesor del giro precentral izquierdo (p = -0,78), el volumen del tálamo derecho (p = -0,44) y la amígdala derecha (p = 0,6). Conclusiones: El grupo con litio tuvo mejor flexibilidad cognitiva y mayor dimensión en algunas regiones corticales frontales y subcorticales. Además, hubo correlación moderada a alta entre el desempeno en esta función ejecutiva y el espesor del giro precentral derecho, y los volúmenes del tálamo y la amígdala derecha. Estos hallazgos podrían indicar un efecto neuroprotector del litio

ABSTRACT Introduction: Lithium treatment of bipolar disorder (BD) has been associated with less impairment and fewer changes in structural brain anatomy compared to other treatments. However, the studies are heterogeneous and few assess whether these effects are related. The objective of this study was to evaluate and relate cognitive performance and structural neuroanatomy in patients treated with and without lithium. Methods: Cross-sectional study that included 48 subjects with BD-I, of which 22 were treated with lithium and 26 without lithium. Performance was assessed on Wechsler III (WAIS III), TMT A and B (Trial Making Test) neuropsychological tests, California verbal learning test (CVLT), Rey complex figure test and Wisconsin card sorting test. Brain structures obtained by magnetic resonance imaging (MRI) were evaluated. The standardised mean difference (SMD) between both groups was calculated, adjusted for confounding variables using a propen-sity score, and the Spearman correlation coefficient (p) was used to assess the relationship between cognitive performance and neuroanatomical regions. Results: Compared to the group without lithium, the group with lithium had fewer perse-verative errors in the Wisconsin test (SMD = -0.69) and greater left and right cortical areas (SMD = 0.85; SMD = 0.92); greater surface area in the left anterior cingulate (SMD = 1.32), right medial orbitofrontal cortex (SMD = 1.17), right superior frontal gyrus (SMD = 0.82), and right and left precentral gyrus (SMD = 1.33; SMD = 0.98); greater volume of the right amyg-dala (SMD = 0.57), right hippocampus (SMD = 0.66), right putamen (SMD = 0.87) and right thalamus (SMD=.67). In the lithium group, a correlation was found with these errors and the thickness of the left precentral gyrus (p = -0.78), the volume of the right thalamus (p =-0.44), and the right amygdala (p = 0.6). Conclusions: Thelithium group had better cognitive flexibility and greater dimension in some frontal and subcortical cortical regions. Furthermore, there was a moderate to high correlation between performance in this executive function and the thickness of the right precentral gyrus, and the volumes of the thalamus and the right amygdala. These findings could suggest a neuroprotective effect of lithium.

A Langmuir-Blodgett Study of the Interaction between Amphotericin B and Lipids of Histoplasma capsulatum.

Histoplasma capsulatum is a dimorphic, thermal, and nutritional fungus. In the environment and at an average temperature of 28 °C, it develops as a mold that is composed of infecting particles. Once in the host or in cultures at 37 °C, it undergoes a transition into the parasitic form. In the present work, we performed chemical extraction and characterization using chromatography techniques of the associated lipid composition of the external surface of the cell wall of the mycelial phase of two isolates of the H. capsulatum: one clinical and one environmental. Several differences were evidenced in the fatty acids in the phospholipid composition. Surface pressure-area isotherms and compression module curves of the Amphotericin B and lipid extract monolayers, as well as (AmB)-lipid extract mixed monolayers were recorded. Results show a high affinity of AmB towards lipid extracts. The most stable monolayers were formed by AmB + environmental with a mass ratio of 1:3 and AmB + clinical with a mass ratio of 1:2. Knowledge of the AmB aggregation processes at a molecular level and the characterization of the lipid extracts allows the possibility to understand the interaction between the AmB and the lipid fractions of H. capsulatum.

Lipid Secretion by Parasitic Cells of Coccidioides Contributes to Disseminated Disease.

Coccidioides is a soil-borne fungal pathogen and causative agent of a human respiratory disease (coccidioidomycosis) endemic to semi-desert regions of southwestern United States, Mexico, Central and South America. Aerosolized arthroconidia inhaled by the mammalian host first undergo conversion to large parasitic cells (spherules, 80-100 µm diameter) followed by endosporulation, a process by which the contents of spherules give rise to multiple endospores. The latter are released upon rupture of the maternal spherules and establish new foci of lung infection. A novel feature of spherule maturation prior to endosporulation is the secretion of a lipid-rich, membranous cell surface layer shed in vivo during growth of the parasitic cells and secretion into liquid culture medium during in vitro growth. Chemical analysis of the culture derived spherule outer wall (SOW) fraction showed that it is composed largely of phospholipids and is enriched with saturated fatty acids, including myristic, palmitic, elaidic, oleic, and stearic acid. NMR revealed the presence of monosaccharide- and disaccharide-linked acylglycerols and sphingolipids. The major sphingolipid components are sphingosine and ceramide. Primary neutrophils derived from healthy C57BL/6 and DBA/2 mice incubated with SOW lipids revealed a significant reduction in fungicidal activity against viable Coccidioides arthroconidia compared to incubation of neutrophils with arthroconidia alone. Host cell exposure to SOW lipids had no effect on neutrophil viability. Furthermore, C57BL/6 mice that were challenged subcutaneously with Coccidioides arthroconidia in the presence of the isolated SOW fraction developed disseminated disease, while control mice challenged with arthroconidia alone by the same route showed no dissemination of infection. We hypothesize that SOW lipids contribute to suppression of inflammatory response to Coccidioides infection. Studies are underway to characterize the immunosuppressive mechanism(s) of SOW lipids.

Correlation Between Cognitive Performance and Structural Neuroanatomy in Patients with Type I Bipolar Affective Disorder Treated with and Without Lithium. / Correlación entre el desempeño cognitivo y la neuroanatomía estructural en pacientes con trastorno afectivo bipolar tipo I tratados con y sin litio.

INTRODUCTION: Lithium treatment of bipolar disorder (BD) has been associated with less cognitive impairment and fewer changes in structural brain anatomy compared to other treatments. However, the studies are heterogeneous and few assess whether these effects are related. The objective of this study was to evaluate and relate cognitive performance and structural neuroanatomy in patients treated with and without lithium. METHODS: Cross-sectional study that included 48 subjects with BD-I, of which 22 were treated with lithium and 26 without lithium. Performance was assessed on Wechsler III (WAIS III), TMT A and B (Trial Making Test) neuropsychological tests, California verbal learning test (CVLT), Rey complex figure test and Wisconsin card sorting test. Brain structures obtained by magnetic resonance imaging (MRI) were evaluated. The standardised mean difference (SMD) between both groups was calculated, adjusted for confounding variables using a propensity score, and the Spearman correlation coefficient (ρ) was used to assess the relationship between cognitive performance and neuroanatomical regions. RESULTS: Compared to the group without lithium, the group with lithium had fewer perseverative errors in the Wisconsin test (SMD = -0.69) and greater left and right cortical areas (SMD = 0.85; SMD = 0.92); greater surface area in the left anterior cingulate (SMD = 1.32), right medial orbitofrontal cortex (SMD = 1.17), right superior frontal gyrus (SMD = 0.82), and right and left precentral gyrus (SMD = 1.33; SMD = 0.98); greater volume of the right amygdala (SMD = 0.57), right hippocampus (SMD = 0.66), right putamen (SMD = 0.87) and right thalamus (SMD=.67). In the lithium group, a correlation was found with these errors and the thickness of the left precentral gyrus (ρ = -0.78), the volume of the right thalamus (ρ =-0.44), and the right amygdala (ρ = 0.6). CONCLUSIONS: The lithium group had better cognitive flexibility and greater dimension in some frontal and subcortical cortical regions. Furthermore, there was a moderate to high correlation between performance in this executive function and the thickness of the right precentral gyrus, and the volumes of the thalamus and the right amygdala. These findings could suggest a neuroprotective effect of lithium.

Genotypic determination of resistance and heteroresistance to clarithromycin in Helicobacter pylori isolates from antrum and corpus of Colombian symptomatic patients.

BACKGROUND: The effectiveness of Helicobacter pylori first-line treatment has decreased drastically with the rise of strains resistant to clarithromycin. Therapy failure has also been described in patients with infections by strains with dissimilar antimicrobial susceptibilities. The present study aims to estimate the prevalence of resistance and heteroresistance to clarithromycin in H. pylori isolates from antrum and corpus of Colombian patients. METHODS: The study material included 126 isolates from antrum and corpus biopsies from 63 symptomatic patients over 18 years old who had a gastric endoscopy performed on them between June 2014 to August 2016. PCR amplification and sequencing of the H. pylori 23S rDNA gene was performed to determine the presence of mutations associated with clarithromycin resistance. Random amplified polymorphic DNA analysis was implemented in cases of resistance and heteroresistance. RESULTS: The overall frequency of resistance to clarithromycin was 38.1% (24/63 patients), of which 19 patients had resistant isolates in both stomach segments (14 with A2143G mutation and 5 with A2142G mutation), and 5 patients had a heteroresistant status. The remaining 61.9% (39/63 patients) presented only susceptible isolates. DNA fingerprinting analysis showed different patterns in 4/22 paired isolates. CONCLUSIONS: The high prevalence of H. pylori clarithromycin-resistance obtained (> 15%) constitutes an alert for gastroenterologists and suggests the need for reconsideration of the current eradication regimen for H. pylori in the studied population. The data show that heteroresistance status is an additional factor to be considered in the assessment of resistance. In consequence, it is advisable to examine at least two biopsies from different gastric segments.

Intramolecular energies of the cytotoxic protein CagA of Helicobacter pylori as a possible descriptor of strains' pathogenicity level.

The Helicobacter pylori cytotoxin-associated gene A (CagA) is known for causing gastroduodenal diseases, such as atrophic gastritis and peptic ulcerations. Furthermore Helicobacter pylori CagA positive strains has been reported as one of the main risk factors for gastric cancer (Parsonnet et al., 1997). Structural variations in the CagA structure can alter its affinity with the host proteins, inducing differences in the pathogenicity of H. pylori. CagA N-terminal region is characterized for be conserved among all H. pylori strains since the C-terminal region is characterized by an intrinsically disorder behavior. We generated complete structural models of CagA using different conformations of the C-terminal region for two H. pylori strains. These models contain the same EPIYA (ABC1C2) motifs but different level of pathogenicity: gastric cancer and duodenal ulcer. Using these structural models we evaluated the pathogenicity level of the H. pylori strain, based on the affinity of the interaction with SHP-2 and Grb2 receptors and on the number of interactions with the EPIYA motif. We found that the main differences in the interaction was due to the contributions of certain types of energies from each strain and not from the total energy of the molecule. Specifically, the electrostatic energy, helix dipole energy, Wander Waals clashes, torsional clash, backbone clash and cis bond energy allowed a separation between severe and mild pathology for the interaction of only CagA with SHP2.

Fatty acid derivative, chemokine, and cytokine profiles in exhaled breath condensates can differentiate adult and children paucibacillary tuberculosis patients.

The anti-mycobacterial immune response in adults and children with tuberculosis (TB), as well as the response in bacteriologically positive and negative patients, is different. However, knowledge of the immunological events occurring in the lungs in these clinical situations remains scarce. Exhaled breath condensate (EBC) samples may be useful for studying the inflammatory environment of the lower airways in TB patients. The fatty acid, cytokine, and chemokine profiles in EBC from healthy adults; smear-positive and smear-negative adult patients; and healthy, asthmatic, and TB children were determined using gas chromatography and LUMINEX, respectively. Unsaturated fatty acids, particularly oleate, were increased in TB adults and children compared with healthy individuals. Elevated levels of IL-17 were characteristic of paucibacillary patients (adults and children), whereas elevated MCP-1 (monocyte chemotactic protein-1) levels were characteristic of adult patients (smear-positive and smear-negative). The levels of all of the molecules were comparable to the controls after anti-TB treatment, suggesting that changes in the levels of the molecules detected in the EBC samples were the result of the active pulmonary TB. EBC samples may be an important tool for the detection of potential early biomarkers in the different clinical manifestations of pulmonary TB and a useful tool for the diagnosis of TB, particularly in children.

Mononuclear phagocyte accumulates a stearic acid derivative during differentiation into macrophages. Effects of stearic acid on macrophage differentiation and Mycobacterium tuberculosis control.

The fatty acid composition of monocytes changes substantially during differentiation into macrophages, increasing the proportion of saturated fatty acids. These changes prompted us to investigate whether fatty acid accumulation in the extracellular milieu could affect the differentiation of bystander mononuclear phagocytes. An esterified fatty acid derivative, stearate, was the only fatty acid that significantly increased in macrophage supernatants, and there were higher levels when cells differentiated in the presence of Mycobacterium tuberculosis H37Rv or purified protein derivative (PPD). Exogenous stearic acid enhanced the expression of HLA-DR and CD64; there was also accumulation of IL-12, TNF-α, IL-6, MIP-1 α and ß and a reduction in MCP-1 and the bacterial load. These results suggested that during differentiation, a derivative of stearic acid, which promotes the process as well as the effector mechanisms of phagocytes against the mycobacterium, accumulates in the cell supernatants.

Virus and Mycoplasma pneumoniae prevalence in a selected pediatric population with acute asthma exacerbation.

OBJECTIVE: To determine the prevalence of viral and atypical bacteria Mycoplasma pneumoniae infection in children experiencing asthma exacerbation and compare positive and negative subjects with regard to exacerbation severity, need for hospitalization, and treatment. METHODS: One hundred sixty-nine asthmatic children aged 2-15 years old who were admitted to emergency rooms in Bogota, Colombia for acute asthma exacerbation were interviewed. Nasopharyngeal aspirates were taken for DNA and RNA extraction. M. pneumoniae and virus were detected by PCR using specific primers. RESULTS: The prevalence of M. pneumoniae and viral infection in the study population was 12.4% and 83.7%, respectively. All subjects positive for M. pneumoniae were also positive for viral infection. Rhinovirus was the most frequently detected viral agent. No significant differences in severity of asthma exacerbations or in need for hospitalization between the virus or M. pneumoniae positive and negative groups were observed. A significantly lower percentage of M. pneumoniae positive subjects had used inhaled steroids over the six months prior to asthma exacerbation compared to M. pneumoniae negative subjects (38.1% vs. 68.2%), suggesting that inhaled corticosteroids may have a protective effect against M. pneumoniae infections. CONCLUSIONS: The M. pneumoniae and virus prevalence found in this study were similar to those described in the literature. The 100% co-infection rate observed suggests that viral infection can predispose patients to M. pneumoniae infection, and that this interaction may trigger asthmatic exacerbation. Further studies should be done to confirm the protective effect of inhaled corticosteroids on M. pneumoniae infection in patients with asthma exacerbations.

Evaluación de la actividad biológica de extractos de semillas de Crotalaria pallida (cascabelito) sobre el modelo Drosophila melanogaster / Evaluation of the biological activity of extracts from Crotalaria pallida (streaked rattlepod) seeds using the Drosophila melanogaster model

Introducción: la búsqueda de metabolitos de origen natural, con actividad biológica promisoria, particularmente la actividad insecticida, es un blanco interesante en las investigaciones sobre productos naturales. Objetivos: evaluar la bioactividad de extractos de diferente polaridad de semillas de Crotalaria pallida Aiton sobre el modelo biológico Drosophila melanogaster. Métodos: la bioactividad de los extractos de diferente polaridad de semillas secas de C. pallida se evalúo por ingestión en el modelo biológico; permitiendo purificar y determinar la estructura química del principio activo usando RMN. Resultados: la bioactividad expresada resultó de dos tipos; uno causó la inhibición de los estados larvarios, evidenciada con la disminución del número de pupas de los tratamientos con respecto a los controles no tratados, la relación dosis-respuesta permitió calcular una CI 50 de 156,47 ppm; el otro efecto inhibió el paso pupa-adulto, disminuyendo el número de adultos de los tratamientos frente a los controles, estableciéndose una CI50 de 7,95 ppm. Con el uso de diferentes ensayos de RMN se determinó el alcaloide usaramina como responsable de esta actividad biológica. Conclusiones : la bioactividad de los extractos de polaridad media/baja permitió el aislamiento de un metabolito con actividad insecticida promisoria, manifestada con la inhibición del normal desarrollo del ciclo de vida de D. melanogaster, el extracto no exhibe actividad sobre la oviposición, en el intervalo de concentraciones evaluado; a bajas concentraciones inhibe la eclosión de pupas y a altas concentraciones afecta el desarrollo de las larvas; actividades que se mantienen al probar el metabolito purificado.

Introduction: the search for metabolites of natural origin with promising biological -particularly insecticidal- activity, is an interesting target for research about natural products. Objectives: evaluate the bioactivity of extracts of varying polarity from Crotalaria pallida Aiton seeds using the Drosophila melanogaster biological model. Methods: an evaluation was conducted of the bioactivity of extracts of varying polarity from dry C. pallida seeds by ingestion into the biological model, with the purpose of purifying and determining the chemical structure of the active principle through NMR spectroscopy. Results: two types of bioactivity were expressed. One caused inhibition of larval stages, evidenced in a smaller number of pupae in treatment controls with respect to non-treatment controls. The dose-response relationship allowed estimation of a CI50 of 156.47 ppm. The other effect inhibited progress from pupa to adult, reducing the number of adults in the treatment vs. control groups, with an CI50 of 7.95 ppm. With the use of various NMR assays, it was determined that the alkaloid usaramine was responsible for this biological activity. Conclusions: the bioactivity of extracts of medium / low polarity permitted the isolation of a metabolite with promising insecticidal activity, manifested in the inhibition of the normal development of the life cycle of D. melanogaster. The extract does not show any activity on oviposition in the concentration range studied. At low concentrations it inhibits the eclosion of pupae, whereas at high concentrations it affects larval development. Both activities remained when the purified metabolite was tested.

[Autonomy, Trust and Medical Ethics in Onora O'Neill's Work]. / Autonomía, confianza y ética médica en la obra de Onora O'Neill.

INTRODUCTION: Autonomy has become a key concept in bioethics. Onora O'neill is perhaps the most representative author and researcher in the philosophical and bioethical fields regrding the concept of autonomy. OBJECT: To review the concept of autonomy in Onora O'Neill's work so as to understand its relevance in current bioethics. METHOD: The concept of bioethics is reviewed in relation to three fundamental quesions: 1) Which are the main limitations of the individualistic conception of autonomy? 2) How to understand the relations between trust and autonomy together with their implications? and 3) Which are the implications of principled autonomy for aspects such as doctor-patient relationship and informed consent. The main works by O'Neill are reviewed, specifically regarding medical bioethics. RESULTS: O'neill's approach is original and relates Kantian autonomy to her own conceptions about trust, and both the individual and social levels of bioethics. CONCLUSIONS: The author has developed a Kantian non indvidualistic view of autonomy. Her conceptulization of trust and the crises this concept is currently undergoing complement and strengthen the concept of principled autonomy. The implications of O'Neill's concepts go beyond theoretical discussions and in her work she uses examples and analyzes circumstances which demonstrate the applicability of her proposals. O'Neill's work contributes to dealing with the challenges posed by the socio-political context of cost-efficiency oriented health systems and of the so-called defensive medicine.

Polaridad predominante en pacientes bipolares tipo I. Estudio en una población aislada con alta prevalencia de trastornos de ánimo / Predominant polarity in type-I bipolar patients. Study in an isolated population with a high prevalence of mood disorders

Introducción: Estudios recientes han demostrado que la descripción de la polaridad predominante tiene efectos en la detección temprana y el inicio oportuno del tratamiento en los pacientes con trastorno afectivo bipolar (TAB). Metodología: Estudio descriptivo de corte transversal en 101 pacientes con TAB procedentes de una muestra poblacional genéticamente aislada de la región colombiana de Antioquia. Resultados: El estudio abarcó una población de 101 pacientes con diagnóstico de TAB tipo I, de los cuales 57,4% cumplieron criterios de polaridad maniaca (PM), 10,1% presentaron polaridad depresiva (PD) y 25,7% fueron clasificados con polaridad indefinida (PI). En comparación con los otros, los pacientes con PM tienen menor nivel educativo y menor edad de inicio y hay más solteros que en los otros grupos. La mayor prevalencia de suicidio se dio dentro del grupo de PM. El grupo de PM presentó un mayor consumo de cannabinoides y cocaína. Dentro del grupo de PD se registró una fuerte tendencia al consumo de cigarrillo y alcohol. Respecto a los fármacos consumidos a lo largo de la vida por los pacientes que conforman el estudio, los antipsicóti-cos fueron el grupo más usado, seguido por el litio y los anticonvulsivantes. Hay un elevado porcentaje de pacientes con PM que usaron antidepresivos a lo largo de su vida. Conclusiones: La polaridad del primer episodio de la enfermedad parece ser un parámetro de pronóstico válido en cuanto a la polaridad de los episodios subsiguientes; por lo tanto funciona de forma indirecta como predictor del curso de la enfermedad...

Introduction: Recent studies have shown that the predominant description of polarity has effects upon early detection and the timely beginning of treatment in patients with bipolar affective disorder (BAD). Methodology:Cross sectional cut and descriptive study in 101 BAD patients coming from a genetically isolated population from the Colombian Region of Antioquia. Results: The study covered a population of 101 patients with type-I BAD diagnosis, out of which 57,4% met the criteria for maniac polarity (MP), 10,1% exhibited depressive polarity (DP) and 25,7% were classified with Indefinite Polarity (IP). In comparison, MP patients have a lower education level and less starting age, including a greater number of single people. The MP group showed the greatest prevalence of suicide and greater use of cannabinoids and cocaine. Within the DP group there was a strong tendency to cigarette and alcohol consumption. With respect to pharmaceutical drugs consumed by the study patients during their lives, antipsychotics were the most widely used group, followed by lithium and anticonvulsivants. There is high percentage of MP patients who have used antidepressants during their lives. Conclusion: The polarity of the first episode of the disease seems to be a valid predictive parameter concerning the polarity of subsequent episodes; therefore, it works indirectly as a valid predictor of the disease’s course...

[Predominant polarity in type-I bipolar patients: Study in an isolated population with a high prevalence of mood disorders]. / Polaridad predominante en pacientes bipolares tipo I: Estudio en una población aislada con alta prevalencia de trastornos de ánimo.

INTRODUCTION: Recent studies have shown that the predominant description of polarity has effects upon early detection and the timely beginning of treatment in patients with bipolar affective disorder (BAD). METHODOLOGY: Cross sectional cut and descriptive study in 101 BAD patients coming from a genetically isolated population from the Colombian Region of Antioquia. RESULTS: The study covered a population of 101 patients with type-I BAD diagnosis, out of which 57,4% met the criteria for maniac polarity (MP), 10,1% exhibited depressive polarity (DP) and 25,7% were classified with Indefinite Polarity (IP). In comparison, MP patients have a lower education level and less starting age, including a greater number of single people. The MP group showed the greatest prevalence of suicide and greater use of cannabinoids and cocaine. Within the DP group there was a strong tendency to cigarette and alcohol consumption. With respect to pharmaceutical drugs consumed by the study patients during their lives, antipsychotics were the most widely used group, followed by lithium and anti-convulsivants. There is high percentage of MP patients who have used antidepressants during their lives. CONCLUSION: The polarity of the first episode of the disease seems to be a valid predictive parameter concerning the polarity of subsequent episodes; therefore, it works indirectly as a valid predictor of the disease's course.

Fungicidal activity of Eucalyptus tereticornis essential oil on the pathogenic fungus Fusarium oxysporum / Actividad antimicótica del aceite esencial a partir de Eucalyptus tereticornis sobre el hongo patógeno Fusarium oxysporum

The objective of present paper was to determine the antifungal activity of the Eucalyptus tereticornis (Myrtaceae) essential oil and two fractions on the Fusarium oxysporum mushroom, a pathogen with clinical and agricultural significance. The total citronelal (44.8 percent) and geraniol (9.78 percent) essential oil had a fungicidal effect at a 3 g/L concentration and a fungicidal activity at small concentrations. The A and B fractions composed most of p-mentane-3,8-diol (18.95 percent) and geraniol acetate (24.34 percent), respectively were more active than the total extract. The observations at microscopic level showed damages and changes in hyphae and chlamydospores, as well as a decrease in the number of conidia. The observed fungicidal activity and the morphologic damages were dependent on the concentration.

El objetivo de este trabajo fue determinar la actividad antifúngica del aceite esencial de Eucalyptus tereticornis (Myrtaceae) y 2 fracciones sobre el hongo Fusarium oxysporum, patógeno de importancia tanto clínica como agrícola. El aceite esencial total, compuesto principalmente por citronelal (44,8 por ciento), citronelol (9,78 por ciento) presentó un efecto fungicida a una concentración de 3 g/L y actividad fungistática a concentraciones menores. La fracciones A y B compuestas en su mayoría por p-mentano-3,8-diol (18,95 por ciento) y acetato de citronelol (24,34 por ciento) respectivamente fueron más activas que el extracto total. Las observaciones a nivel microscópico mostraron daños y cambios en hifas y clamidosporas, así como disminución en el número de conidias. La actividad fungistática observada y los daños morfológicos fueron dependientes de la concentración.

Características de los suicidios de áreas rurales y urbanas de Antioquia, Colombia / Characteristics of suicides in rural and urban areas in Antioquia, Colombia

Objetivo: Determinar si existen diferencias entre áreas rurales y urbanas de Antioquia en las características asociadas con el suicidio. Método: Se compararon 79 sujetos provenientes de áreas rurales y 75 de áreas urbanas de Antioquia. Se hizo autopsia psicológica y se calcularon razones de prevalencia (RP) (frecuencia de la característica en zona rural/frecuencia de la característica en zona urbana). Resultados: Las características asociadas de manera independiente con provenir de área rural y urbana fueron: “momento del suicidio durante la noche” (RP = 0,65; IC 95%: 0,48-0,89) y “vivir solo” (RP = 0,40; IC 95%: 0,17-0,98), que fueron más frecuentes en zona urbana, y “envenenamiento con pesticidas”, que ocurrió más en zona rural (RP = 1,80; IC 95%: 1,39-2,34). Conclusiones: Los individuos suicidas provenientes de zonas rurales y urbanas tenían características diferentes. Ello puede tener implicaciones para el diseño de las estrategias de prevención del suicidio en cada una de las zonas. Se requieren otros estudios para determinar los factores de riesgo propios de cada área...

Objective: To determine differences in characteristics associated with suicide between rural and urban populations from Antioquia. Method: 79 subjects from rural areas and 75 subjects from urban areas were compared. Psychological autopsy was done and prevalence ratios (PR) (frequency of characteristic in rural zone/frequency of characteristic in urban zone) were calculated. Results: The characteristics that associated independently with coming from rural or urban areas were: “suicide during the night” (PR = 0.65; 95% CI: 0.48-0.89) and “living alone” (PR = 0.40; 95% CI: 0.17-0.98), which were more frequent in urban areas, and “pesticide poisoning” which was more frequent in rural areas (PR = 1.80; 95% CI: 1.39-2.34). Conclusions: Individuals who committed suicide from rural and urban areas have different characteristics. This finding might have implications for the design of preventive strategies in each zone. Additional studies are required to determine specific risk factors in urban and rural areas...

Fatty acid profile during the differentiation and infection with Mycobacterium tuberculosis of mononuclear phagocytes of patients with TB and healthy individuals.

The blockade of sPLA-2, as well as the removal of calcium during the infection with Mycobacterium tuberculosis, prevents necrosis in mononuclear phagocytes. In addition, previous evidence indicates that the necrosis is modulated by cytokines and may condition the inflammatory environment. The production of cytokines and chemokines in response to infection with M. tuberculosis, fatty acid profile and the lactate dehydrogenase activity in mononuclear phagocytes from tuberculosis patients and healthy controls were interrelated using a principal component analysis in order to establish whether there was an association between the induction and effector stages of necrosis with the production of cytokines and chemokines. Differentiation increased the ratio of saturated/unsaturated fatty acids. The oleate and palmitate correlated with differentiation, laureate, arachidonate and linolenate with infection and necrosis correlates with the production of IL-10. Monocytes from tuberculosis patients seem to be lees differentiated ex vivo.

Caracterización molecular y bioinformática de la proteína CagA de Helicobacter pylori a partir de biopsias gástricas de pacientes colombianos / Molecular and bioinformatic characterization of Helicobacter pylori CagA protein using gastric biopsies of Colombian patients

El gen cagA de Helicobacter pylori codifica para la proteína CagA considerada uno de los factores de virulencia cuya presencia se asocia a un mayor riesgo de padecer enfermedades gástricas severas. El presente estudio planteó como objetivo el diseño de una estrategia molecular y bioinformática útil en la determinación de la presencia de secuencias repetitivas que pueden contener uno o más motivos de fosforilación (EPIYA). Se amplificó y secuenció la región variable de cagA en muestras H. pylori CagA positivas. Se realizó una búsqueda y selección de herramientas bioinformáticas que permitieran establecer las características de los motivos EPIYA. La presencia de motivos tipo EPIYA-A y EPIYA-B, seguido por una a dos repeticiones de EPIYA-C, similares a los reportados para países de Occidente, fueron encontrados. De las aplicaciones bioinformáticas evaluadas, solo un conjunto de herramientas demostró ser útil en la caracterización de las unidades de repetición en la proteína CagA.

Helicobacter pylori CagA protein, the cagA gen product, has been considered as a virulence factor associated with a considerable increase risk for develops severe gastric illness. The purpose of this research was to design a molecular and bioinformatics strategy that allowed the establishment of phosphorylation status of the tyrosine residue of the CagA protein. The amplification and sequencing of the variable fragment region of cagA in the positive CagA samples were used to do the bioinformatics analysis in order to establish the characteristics of the EPIYA motifs. The presence of the EPIYA-A and EPIYA-B motifs, followed by one or two EPIYA-C repetitions, similar to those reported previously for occidental countries were set up. From the different bioinformatics applications that were employed only one group of tools proved to be useful to characterize the repeated units presents in the CagA protein.

Validación del “inventario de razones para vivir” (RFL) en sujetos con conducta suicida de Colombia / Validation of the Reasons for Living Inventory (Rfl) in subjects with suicidal behavior in Colombia

Objetivo: Evaluar la estructura factorial, la confiabilidad y la validez de contenido y constructo de una versión en español para Colombia del Inventario de Razones para Vivir (Rfl) en una muestra clínica de sujetos con intento de suicidio. Método: Se hicieron dos traducciones al español y dos traducciones en sentido inverso de cada uno de los ítems. Se examinó la validez del contenido y del constructo, la consistencia interna y la reproducibilidad prueba-reprueba. Resultados: La estructura factorial tiene seis dominios que explican el 63,5% de la varianza: “Creencia en la vida y capacidad de afrontamiento”, “Miedo a la muerte y a la desaprobación social”, “Responsabilidad con la familia”, “Preocupación por los hijos”, “Percepción de incapacidad para el suicidio” y “Objeciones morales”. La consistencia interna fue alta (Alfa de Cronbach=0,96), así como la reproducibilidad prueba-reprueba (CCI=0,89, IC95%: 0,78-0,94). Cuando se evaluó la validez del constructo encontramos diferencias significativas en las puntuaciones del Rflentre individuos con riesgo de suicidio alto y bajo, definido clínicamente. Conclusiones: La versión colombiana del Rflmuestra buenas propiedades psicométricas en una población clínica con comportamiento suicida.

Objective: To evaluate the factor structure, reliability, and construct and content validity of the Colombian Spanish version of the Reasons for Living Inventory (Rfl) in a clinical sample of subjects who attempted suicide. Method: Two translations into Spanish and two back-translations for each of the items were done. We assessed content and construct validity as well as internal consistency and test-retest reproducibility. Results: The factor structure has six domains which explain 63.5% of the variance: “survival and coping beliefs”, “fear of death and social disapproval”, “responsibility to family”, “child-related concerns”, “perception of incapacity for suicide” and “moral objections”. The internal consistency was high (Cronbach’s alpha=0.96), as was test-retest reproducibility (ICC=0.89, IC95%: 0.78-0.94). When assessing construct validity, we found significant differences between individuals with clinically defined high and low suicide risk in Rflscores. Conclusions: The Rflversion for Colombia shows good psychometric properties in clinical population with suicidal behavior.