Proteomic Analysis of Sporothrix schenckii Exposed to Oxidative Stress Induced by Hydrogen Peroxide.

Sporothrix schenckii modulates the expression of its cell wall proteins (CWPs) in response to reactive oxygen species (ROS) generated by the phagocytic cells of the human host, which allows it to evade and escape the immune system. In this study, we performed a comparative proteomic analysis of the CW of S. schenckii after exposure and nonexposure to H2O2. Several CWPs involved in CW remodeling and fungal pathogenesis that modulated their expression in response to this oxidizing agent were identified, as were a number of antioxidant enzymes and atypical CWPs, called moonlighting proteins, such as the Hsp70-5, lipase 1 (Lip1), enolase (Eno), and pyruvate kinase (Pk). Moreover, RT-qPCR assays demonstrated that the transcription of genes HSP70-5, LIP1, ENO, and PK is regulated in response to the oxidant. The results indicated that S. schenckii differentially expressed CWPs to confer protection against ROS upon this fungus. Furthermore, among these proteins, antioxidant enzymes and interestingly, moonlighting-like CWPs play a role in protecting the fungus from oxidative stress (OS), allowing it to infect human host cells.

Re: Presencia de familiares durante la reanimación cardiopulmonar: perspectivas de pacientes, familiares y profesionales de la salud en el País Vasco / Re- Presence of relatives during cardiopulmonary resuscitation: Perspectives of health professionals, patients and family in the Basque Country

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Recent advances in the understanding and management of polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a multifaceted condition characterized by chronic anovulation and excess ovarian activity, in contrast to other causes of anovulation that involve ovarian dormancy or primary insufficiency. Recent studies indicated that PCOS is associated with low-grade chronic inflammation and that women with PCOS are at increased risk of non-alcoholic fatty liver disease. The inflammatory and metabolic derangements associated with PCOS are explained in part by the coexistence of insulin resistance and obesity but are further fueled by the androgen excess. New insights into the regulation of hormones and cytokines in muscle and fat tissue support the concept that PCOS is a systemic syndrome. The therapeutic plan should be tailored to the patient phenotype, complaints, and reproductive desire. Of note, the aromatase inhibitor letrozole seems to be more effective than the reference drug clomiphene citrate to treat infertility due to PCOS. Integral management by a multidisciplinary team may help the patients to adhere to lifestyle interventions and thereby reduce body adiposity and recover their metabolic and reproductive health.

2015 life tables of population user of Jalisco's Instituto Mexicano del Seguro Social services / Tablas de vida 2015 de la población usuaria del Instituto Mexicano del Seguro Social de Jalisco

Background: The life table is a useful instrument to measure the impact of health care in a population. In this case we report the situation of the population that use the medical services of the Instituto Mexicano del Seguro Social in the state of Jalisco. Methods: We used the abridged Reed-Merrell method, which shows the life expectancy in five-year age groups. Results: In 2015 life expectancy for people with hospital insurance was 80.51 for women and 77.93 for men. For the total of insured women and men, life expectancy was 77.65 and 73.73 years, respectively. Conclusion: Compared with previous calculations, we observed a deceleration of the gain of life expectancy in both sexes, even though women keep more life expectancy than men.

Introducción: La tabla de vida es un valioso instrumento para medir el impacto de la atención médica en una población. En este caso reportamos la situación de la población usuaria de los servicios de salud del Instituto Mexicano del Seguro Social en el estado de Jalisco, México. Métodos: Se utilizó el método abreviado de Reed-Merrell, que muestra la esperanza de vida en grupos quinquenales de edad. Resultados: En 2015 la esperanza de vida en asegurados hospitalizados hombres fue de 77.93 años y en mujeres, de 80.51 años. Para el total de asegurados mujeres y hombres fue de 77.65 y 73.73, respectivamente. Conclusiones: Si se compara con cálculos previos, se observa una desaceleración en la ganancia de expectativa de vida en pacientes hospitalizados de ambos sexos, aunque se conserva una mayor esperanza para las mujeres.

Patología crónica, fragilidad y funcionalidad en adultos mayores de Guadalajara. México / Chronic pathology, frailty, and functionality in older adults from Guadalajara. Mexico

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Plasma urocortin-1 as a preoperative marker of endometriosis in symptomatic women.

Accurate noninvasive diagnostic tests for endometriosis are still missing. This study evaluated the predictive value of the neuropeptide urocortin 1 (Ucn1) to detect pelvic endometriosis in symptomatic women. We enrolled prospectively 97 consecutive women submitted to gynecologic laparoscopy for chronic or acute pelvic pain, infertility or adnexal mass. Preoperative blood samples were assayed for Ucn1 using enzyme immunoassay. Patients with endometriosis had higher plasma Ucn1 levels compared to patients with no lesions (median 59 vs. 34 pg/ml, p < .01, Dunn's test). Elevated plasma Ucn1 levels were found among all endometriosis phenotypes (superficial peritoneal lesions, ovarian endometrioma, and deep infiltrating endometriosis, p < .05 vs. no lesions). Receiver operating characteristics curve analysis identified plasma Ucn1 > 46 pg/mL as the best cutoff point to detect endometriosis vs. no lesions, with 76% sensitivity and 88% specificity (area under the curve [AUC] 0.827, 95% confidence interval [CI] 0.695 - 0.959), but no cutoff could accurately distinguish endometriosis from other pathological conditions (AUC 0.593 [95% CI 0.474 - 0.711]). In women with chronic pelvic pain, infertility, or both symptoms, the probability of endometriosis (positive predictive value) increased consistently with the increase of plasma Ucn1 levels. The present findings suggest that high plasma Ucn1 levels increase the likelihood of endometriosis in symptomatic women.

Plasma brain-derived neurotrophic factor in women with pelvic pain: a potential biomarker for endometriosis?

AIM: To test whether plasma BDNF levels are useful to predict the presence of endometriosis in women with pelvic pain. PATIENTS & METHODS: Prospective cross-sectional study including 67 consecutive women aged 24-49 years, scheduled for laparoscopy due to chronic pelvic pain. Preoperative plasma samples were assayed for BDNF using a commercial enzyme immunoassay. RESULTS: Women with ovarian endometrioma had higher preoperative plasma BDNF (1063 ± 157 pg/ml) compared with women with other benign ovarian tumors (537 ± 131 pg/ml, F = 2.53; p = 0.02). However, plasma BDNF levels were not helpful to indicate the presence of peritoneal or deep infiltrating endometriosis. Plasma BDNF levels were positively correlated with the severity of pelvic pain (r = 0.489; p < 0.0001). CONCLUSION: Plasma BDNF might be a biomarker of ovarian endometrioma but not a useful diagnostic marker to detect other forms of endometriosis in women with painful symptoms.

[Cultural domain of the causes of diabetes in three generations of popular stratum in Guadalajara, Mexico]. / Dominio cultural sobre causas de diabetes en tres generaciones de estratos populares en Guadalajara, México.

BACKGROUND: The growing prevalence of diabetes must be confronted in several ways. Establishing the generational transmission of cultural knowledge offers some guidelines to prevent and control the disease. Once we identify and compare the semantic structures of shared knowledge we lay the foundations of a culturally comprehensive care. The objective was to characterize the main elements about cultural domain of the causes of diabetes in a population of grandparents, parents and children belonging to popular strata in Guadalajara, Jalisco, Mexico. METHODS: A cognitive anthropological study performed in 104 subjects selected randomly in Guadalajara. We applied the free listing technique in order to obtain the semantic model and the average of cultural knowledge on the causes of the disease through a consensus analysis.A cognitive anthropological study performed in 104 subjects selected randomly in Guadalajara. We applied the free listing technique in order to obtain the semantic model and the average of cultural knowledge on the causes of the disease through a consensus analysis. RESULTS: The studied groups were divided by generation: grandparents, parents and children. The data evidences intergenerational transmission, in form of a basic semantic structure, and a significant consensus around a single model. CONCLUSIONS: The semantic structure on the causes of the diabetes includes: a) the emotions, as traditional dimension; b) certain behaviours related with the lifestyle, as everyday dimension; c) some biomedical concepts, like an emergent dimension.

Introducción: la creciente prevalencia de diabetes se debe afrontar de diversas maneras. Determinar la transmisión generacional del conocimiento cultural ofrece pautas para la prevención y el control de la enfermedad. Al identificar y comparar las estructuras semánticas del conocimiento compartido, sentamos las bases de una atención culturalmente comprensiva. El objetivo es caracterizar los principales elementos relacionados con el dominio cultural sobre las causas de la diabetes en una población de abuelos, padres e hijos pertenecientes a estratos populares en Guadalajara, México. Métodos: estudio antropológico cognitivo en 104 personas seleccionadas al azar en el sector Libertad de Guadalajara, Jalisco, México. Se aplicaron técnicas de listas libres para obtener el modelo semántico y el promedio de conocimiento cultural sobre las causas del padecimiento por análisis de consenso. Resultados: los grupos estudiados se dividieron por generación de abuelos, padres e hijos. Se evidenció transmisión intergeneracional al presentar el conocimiento cultural una estructura semántica básica y un consenso significativo. Conclusiones: la estructura semántica sobre causas de la diabetes incluye como elementos: a) las emociones, como dimensión tradicional; b) conductas relacionadas al estilo de vida, como dimensión cotidiana; c) algunos conceptos biomédicos, como dimensión emergente.

Serum antimüllerian hormone measurements with second generation assay at two distinct menstrual cycle phases for prediction of cycle cancellation, pregnancy and live birth after in vitro fertilization.

PURPOSE: This study investigated the usefulness of serum antimüllerian hormone (AMH) measurements at two distinct menstrual cycle phases to predict in vitro fertilization (IVF) outcomes. METHODS: This was a prospective observational study enrolling 135 consecutive patients referred for conventional IVF or ICSI in a university hospital. Blood samples were obtained for serum AMH measurements on days 3 and 18-20, while transvaginal ultrasound was performed for antral follicle count (AFC) at day 3 of the menstrual cycle immediately before treatment. AMH was measured with the new Beckman Coulter Generation II (GenII) assay. The main outcome measures were cycle cancellation due to poor ovarian response, clinical pregnancy, and live birth. RESULTS: There was a strong correlation between AMH levels measured at day 3 and day 18-20 of the menstrual cycle (r = 0.837; P < 0.0001). Day 18-20 serum AMH was comparable to day 3 serum AMH and AFC for the prediction of cycle cancellation (areas under the ROC curve were 0.84 for day 3 AMH, 0.89 for day 18-20 AMH, and 0.80 for AFC). Day 18-20 AMH had a modest predictive value for pregnancy or live birth (area under ROC curve 0.71 for both), which was comparable to that of day 3 AMH; however, AFC had no predictive value for these outcomes. CONCLUSIONS: Day 18-20 AMH was comparable to day 3 AMH for the prediction of cycle cancellation, clinical pregnancy, and live birth after IVF. Both AMH measurements were accurate for the prediction of cancellation but were significantly less useful for the prediction of pregnancy or live birth.

Are differences between patient and provider explanatory models of diabetes associated with patient self-management and glycemic control?

In this study we test whether differences between patient and provider explanatory models of diabetes affect self-management and glucose control in type 2 diabetes patients. Diabetic patients (n=60) and family practice physicians (n=39) in Guadalajara, Mexico, responded to a structured explanatory model interview (130 questions on causes, symptoms, and treatments). A cultural consensus analysis indicated a widely shared model among physicians and provided a single shared set of answers to the questions. Patient-provider congruence in beliefs was assessed by comparing each patient's responses with the physician answer set. Congruence in beliefs predicted self-management behaviors (r=0.27, p=.03), more than educational level (r=0.16, p=.23), but was not predictive of A1C (r=0.12, p=.40). Differences between patient and physician explanatory models can adversely affect patient-directed activities and may indirectly affect glycemic control by affecting self-management. These differences may be due to low patient educational level and resulting problems in understanding biomedical approaches to diabetes.

Explanatory models of diabetes in the U.S. and Mexico: the patient-provider gap and cultural competence.

Successful management of type 2 diabetes requires support and collaboration between diabetic patients, their health care providers, family and community. Using data collected in 1994-2001, we describe illness beliefs of physicians, patients, and representative samples of community members in the US and Mexico. We test whether differences in conceptualizations of diabetes are greater across national and linguistic boundaries or between physicians and lay groups. Interviews were conducted in southern Texas on the Mexican border and in Guadalajara, Mexico. Culturally appropriate interview materials were developed with a mixed-methods approach. Qualitative interviews elicited beliefs about causes, risks, symptoms, and treatments for diabetes and salient themes were incorporated into structured interviews. A cultural consensus analysis was used to verify salient themes within each of the six samples. The consistency in responses in each of the six samples indicated a shared core of beliefs that transcended individual variations. The greatest differences occurred between physician and lay samples; patient and community models were more similar to one another than to the physician models. Differences between physicians and patients may affect optimal management of diabetes, but these differences do not appear to be simply a function of differences in national culture and language, as the largest differences occurred in Mexico. This suggests that rather than cultural competence per se, formal educational levels and class differences may also play an important role in patient understanding and the gap in patient-provider understanding.

Conocimiento y uso de las plantas medicinales en la zona metropolitana de Guadalajara / Knowledge and use of medicinal plants in the metropolitan area of Guadalajara

Se destaca el conocimiento popular de "herbolarios, hierberos, yerberos o yerbateros" sobre las plantas medicinales utilizadas en mercados de la Zona Metropolitana de Guadalajara (zmg), en comparación con estudios fitoquímicos. Se rescatan datos sobre la práctica médica herbolaria con técnicas de antropología cognitiva. Las especies más utilizadas son: árnica, cuachalalate, tila, gordolobo, salvia, cola de caballo y boldo. Los resultados demuestran que existe consenso sobre las plantas medicinales que se usan, su efectividad y la conveniencia económica en contraste con las medicinas de patente. Se enfatiza la importancia de la comprensión del uso y significado de la enfermedad, y de la adquisición del conocimiento a través de generaciones por parte de los hierberos como un patrón de conocimiento cultural.

Presión arterial en adolescentes mexicanos: clasificación, factores de riesgo e importancia / Classifying Mexican adolescents' high blood pressure, associated factors and importance

Objetivo Determinar características de riesgo y frecuencia de niveles de presión sanguínea de acuerdo a dos criterios clasificatorios: 7° Comité Nacional Conjunto (JNC-7) y 4° Reporte del grupo de trabajo para el diagnostico, evaluación y tratamiento de la hipertensión arterial en niños y adolescentes. En un grupo de escolares de 12 a 16 años de la ciudad de León, México. Métodos Estudio observacional, descriptivo, transversal de 458 adolescentes varones. Previo consentimiento informado de padres y estudiantes, se determino la presión arterial de acuerdo a normas internacionales y se aplico cuestionario para captación de datos clínico-epidemiológicos de los alumnos investigados. Posteriormente se clasifican niveles de presión arterial (normotensos, prehipertensos, e hipertensos) de acuerdo con los criterios JNC7 y del 4o Reporte del grupo de trabajo para el diagnostico, evaluación y tratamiento de la hipertensión arterial en niños y adolescentes. Resultados Se detectaron, según los criterios JNC-7 y 4° Reporte: 61,3 y 68,7 por ciento normotensos, 34,9 y 20,7 por ciento prehipertensos, y 3,7 y 10,4 por ciento hipertensos. 71 y 66 por ciento con antecedentes familiares de diabetes e hipertensión; 22 por ciento con sobrepeso y obesidad y 24 por ciento con antecedentes de ingesta de alcohol. Conclusiones Se sugiere utilizar el criterio del 4° Reporte para su aplicación en la clínica, mientras que el JNC 7 para estudios epidemiológicos. Destaca el concepto de prehipertensión y su tamizaje temprano para la prevención de la hipertensión arterial. Su aceptación, facilitará el desarrollo de acciones efectivas y eficaces de promoción de salud en cambios del estilo de vida.

Objective Determining characteristics regarding risk and high blood pressure (HBP) frequency in a group of 12 to 16 year-old students from the city of León, Mexico, according to two types of classification: the 7th Joint National Committee (JNC-7) and 4th report of the working group for diagnosis, evaluation and treatment of HBP in children and adolescents. Methods This was an observational, descriptive cross-sectional study of 458 male students. HBP was determined according to international standards after parents and students' informed consent had been obtained and they answered a questionnaire for recording clinical-epidemiological data. Blood pressure levels were classified as being normal, pre-HBP and hyper-HBP in accordance with the guidelines issued by the 7th National Joint Committee for detecting, evaluating and treating HBP (JNC-7) and the 4th report of the working group for diagnosis, evaluation and treatment of HBP in children and adolescents. Results 61.3 percent and 68.7 percent were found to have normal blood pressure, 34.9 percent and 20.7 percent were pre-HBP and 3.7 percent and 10.4 percent hyper-HBP according to JNC-7 and 4th report guidelines, respectively, whilst 71 percent and 66 percent had a family background of diabetes and HBP, 22 percent were overweight and obese and 24 percent had a background of alcohol consumption. Conclusions It is suggested that 4th report guidelines should be adopted in clinical practice whilst JNC-7 guidelines should be used for epidemiological studies. Accepting the pre-HBP concept and its early detection for preventing HBP will facilitate effective health promotion regarding changes in lifestyle.

[Classifying Mexican adolescents' high blood pressure, associated factors and importance]. / Presión arterial en adolescentes mexicanos: clasificación, factores de riesgo e importancia.

OBJECTIVE: Determining characteristics regarding risk and high blood pressure (HBP) frequency in a group of 12 to 16 year-old students from the city of León, Mexico, according to two types of classification: the 7th Joint National Committee (JNC-7) and 4th report of the working group for diagnosis, evaluation and treatment of HBP in children and adolescents. METHODS: This was an observational, descriptive cross-sectional study of 458 male students. HBP was determined according to international standards after parents and students' informed consent had been obtained and they answered a questionnaire for recording clinical-epidemiological data. Blood pressure levels were classified as being normal, pre-HBP and hyper-HBP in accordance with the guidelines issued by the 7th National Joint Committee for detecting, evaluating and treating HBP (JNC-7) and the 4th report of the working group for diagnosis, evaluation and treatment of HBP in children and adolescents. RESULTS: 61.3 % and 68.7 % were found to have normal blood pressure, 34.9 % and 20.7 % were pre-HBP and 3.7 % and 10.4 % hyper-HBP according to JNC-7 and 4th report guidelines, respectively, whilst 71 % and 66 % had a family background of diabetes and HBP, 22 % were overweight and obese and 24 % had a background of alcohol consumption. CONCLUSIONS: It is suggested that 4th report guidelines should be adopted in clinical practice whilst JNC-7 guidelines should be used for epidemiological studies. Accepting the pre-HBP concept and its early detection for preventing HBP will facilitate effective health promotion regarding changes in lifestyle.

Differential toxicity of antifungal protein AFP against mutants of Fusarium oxysporum.

Antifungal protein (AFP) from Aspergillus giganteus was assayed for toxicity against the Fusarium oxysporum wild-type strain and mutants in genes involved in cell signaling (DeltapacC, pacCc Deltafmk1) or cell-wall biogenesis (DeltachsV, Deltachs7, Deltagas1). The mutants were classified into two groups according to their sensitivity to AFP: DeltapacC, Deltagas1 and Deltachs7, which were significantly more resistant to AFP than the wild-type, and pacCC, Deltafmk1 and DeltachsV, which were more sensitive. Western blot analysis revealed increased binding of AFP to the three resistant mutants, DeltapacC, Deltagas1 and Deltachs7, but also to DeltachsV, indicating that differential binding may not be a key determinant for sensitivity. Addition of Ca2+ or K+ dramatically reduced antifungal activity and binding of AFP, suggesting that these cations compete for the same targets as AFP at the surface of the fungal cell.

Differential toxicity of antifungal protein AFP against mutants of Fusarium oxysporum

Antifungal protein (AFP) from Aspergillus giganteus was assayed for toxicity against the Fusarium oxysporum wild-type strain and mutants in genes involved in cell signaling (DeltapacC, pacCc Deltafmk1) or cell-wall biogenesis (DeltachsV, Deltachs7, Deltagas1). The mutants were classified into two groups according to their sensitivity to AFP: DeltapacC, Deltagas1 and Deltachs7, which were significantly more resistant to AFP than the wild-type, and pacCC, Deltafmk1 and DeltachsV, which were more sensitive. Western blot analysis revealed increased binding of AFP to the three resistant mutants, DeltapacC, Deltagas1 and Deltachs7, but also to DeltachsV, indicating that differential binding may not be a key determinant for sensitivity. Addition of Ca2+ or K+ dramatically reduced antifungal activity and binding of AFP, suggesting that these cations compete for the same targets as AFP at the surface of the fungal cell (AU)

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