Subcutaneous injection of an immunologically tolerated protein up to 5 days before skin injuries improves wound healing.

Oral tolerance blocks the development of specific immune responses to proteins ingested by the oral route. One of the first registries of oral tolerance showed that guinea pigs fed corn became refractory to hypersensitivity to corn proteins. Mice fed with chow containing corn are tolerant to zein, and parenteral injection of zein plus adjuvant blocks immunization to unrelated proteins injected concomitantly and reduces unspecific inflammation. Extensive and prolonged inflammatory infiltrate in the wound bed is one of the causes of pathological wound healing. Previous research shows that intraperitoneal injection of zein concomitant with skin injuries reduces the inflammatory infiltrate in the wound bed and improves wound healing. Herein, we tested if one subcutaneous injection of zein before skin injury improves wound healing. We also investigated how long the effects triggered by zein could improve skin wound healing. Mice fed zein received two excisional wounds on the interscapular skin under anesthesia. Zein plus Al(OH)3 was injected at the tail base at 10 min, or 3, 5, or 7 days before skin injuries. Wound healing was analyzed at days 7 and 40 after injury. Our results showed that a zein injection up to 5 days before skin injury reduced the inflammatory infiltrate, increased the number of T-cells in the wound bed, and improved the pattern of collagen deposition in the neodermis. These findings could promote the development of new strategies for the treatment and prevention of pathological healing using proteins normally found in the common diet.

Subcutaneous injection of an immunologically tolerated protein up to 5 days before skin injuries improves wound healing

Oral tolerance blocks the development of specific immune responses to proteins ingested by the oral route. One of the first registries of oral tolerance showed that guinea pigs fed corn became refractory to hypersensitivity to corn proteins. Mice fed with chow containing corn are tolerant to zein, and parenteral injection of zein plus adjuvant blocks immunization to unrelated proteins injected concomitantly and reduces unspecific inflammation. Extensive and prolonged inflammatory infiltrate in the wound bed is one of the causes of pathological wound healing. Previous research shows that intraperitoneal injection of zein concomitant with skin injuries reduces the inflammatory infiltrate in the wound bed and improves wound healing. Herein, we tested if one subcutaneous injection of zein before skin injury improves wound healing. We also investigated how long the effects triggered by zein could improve skin wound healing. Mice fed zein received two excisional wounds on the interscapular skin under anesthesia. Zein plus Al(OH)3 was injected at the tail base at 10 min, or 3, 5, or 7 days before skin injuries. Wound healing was analyzed at days 7 and 40 after injury. Our results showed that a zein injection up to 5 days before skin injury reduced the inflammatory infiltrate, increased the number of T-cells in the wound bed, and improved the pattern of collagen deposition in the neodermis. These findings could promote the development of new strategies for the treatment and prevention of pathological healing using proteins normally found in the common diet.

Protease-activated receptor 4 plays a role in lipopolysaccharide-induced inflammatory mechanisms in murine macrophages.

The role of protease-activated receptor (PAR)4 in thrombin-induced platelet aggregation has been studied, and PAR4 blockade is thought to be useful as a new and promising approach in antiplatelet therapy in humans. In recent years, studies have been conducted to clarify the role of PAR4 in the host defense against invading microorganisms and pathogen-induced inflammation; however, to date, the role of PAR4 in mediating the LPS-induced inflammatory repertoire in macrophages remains to be elucidated. Here, we investigated the effects of the synthetic PAR4 agonist peptide (PAR4-AP) AYPGKF-NH2 on the phagocytosis of zymosan-FITC particles; NO, ROS, and iNOS expression; and cytokine production in C57/BL6 macrophages cocultured with PAR4-AP/LPS. The PAR4-AP impaired LPS-induced and basal phagocytosis, which was restored by pharmacological PAR4 blockade. Coincubation with the PAR4-AP/LPS enhanced NO and ROS production and iNOS expression; decreased IL-10, but not TNF-α, in the culture supernatant; and increased translocation of the p65 subunit of the proinflammatory gene transcription factor NF-κ-B. Our results provide evidence for a complex mechanism and new approach by which PAR4 mediates the macrophage response triggered by LPS through counter-regulating the phagocytic activity of macrophages and innate response mechanisms implicated in the killing of invading pathogens.

Anti-inflammatory and immune properties of the peltatoside, isolated from the leaves of Annona crassiflora Mart., in a new experimental model zebrafish.

Establishing new animal models for the study of inflammation is very important in the process of discovering new drugs, since the inflammatory event is the basis of many pathological processes. Whereas rodent models have been the primary focus of inflammation research, we defend the zebrafish (Danio rerio) test as a feasible alternative for preclinical studies. Moreover, despite all the technological development already achieved by humanity, nature can still be considered a relevant source of new medicines. In this context, the aim of this work was to evaluate the anti-inflammatory effect of a substance isolated from the medicinal plant Annona crassilfora Mart, the peltatoside, in an inflammatory model of zebrafish. It was determined: (i) total leukocyte count in the coelomate exudate; (ii) N-acetyl-ß-d-glucuronidase (NAG); (iii) myeloperoxidase (MPO); (iv) and the histology of liver, intestine and mesentery. Peltotoside (25, 50 and 100 µg) and dexamethasone (25 µg) were administered intracelomatically (i.c.) 30 min before carrageenan (i.c.). Pretreatment with peltatoside at three doses significantly inhibited leukocyte recruitment in the coelomic cavity, and inhibited NAG and MPO activity against the action of Cg, in a similar manner as dexamethasone. However, some microlesions in the evaluated organs were detected. The dose of 25 µg showed an anti-inflammatory effect with lower undesirable effects in the tissues. Our results suggest that the zebrafish test was satisfactory in performing our analyzes and that the peltotoside has a modulatory action in reducing leukocyte migration.

Urinary incontinence and other pelvic floor dysfunctions in female athletes in Brazil: A cross-sectional study.

The pelvic floor (PF) provides support to all pelvic organs, as well as appropriately closure/opening mechanism of the urethra, vagina, and anus. Therefore, it is likely that female athletes involved in high-impact and in strong-effort activities are at risk for the occurrence of urinary incontinence (UI). This study aimed to investigate the occurrence of UI and other PF dysfunctions (PFD) [anal incontinence (AI), symptoms of constipation, dyspareunia, vaginal laxity, and pelvic organ prolapse] in 67 amateur athletes (AT) compared with a group 96 of nonathletes (NAT). An ad hoc survey based on questions from reliable and valid instruments was developed to investigate the occurrence of PFD symptoms. The risk of UI was higher in AT group (odds ratio: 2.90; 95% CI: 1.50-5.61), mostly among artistic gymnastics and trampoline, followed by swimming and judo athletes. Whereas, AT group reported less straining to evacuate (OR: 0.46; 95% CI: 0.22-0.96), manual assistance to defecate (OR: 0.24; 95% CI: 0.05-1.12), and a higher stool frequency (OR: 0.29; 95% CI: 0.13-0.64) than NAT group. The occurrence of loss of gas and sexual symptoms was high for both groups when compared with literature, although with no statistical difference between them. Pelvic organ prolapse was only reported by nonathletes. Athletes are at higher risk to develop UI, loss of gas, and sexual dysfunctions, either practicing high-impact or strong-effort activities. Thus, pelvic floor must be considered as an entity and addressed as well. Also, women involved in long-term high-impact and strengthening sports should be advised of the impact of such activities on pelvic floor function and offered preventive PFD strategies as well.

Tripanosomátidos aislados de mamíferos silvestres en tres departamentos de Bolivia (Cochabamba, Potosí y Santa Cruz de la Sierra) / Trypanosomatidae isolated from wild mammals in three departments of Bolivia (Cochabamba, Potosi and Santa Cruz de la Sierra)

Objetivos: el objetivo de la investigación fue aislar protozoarios kinetoplástidos a partir de mamíferos silvestres en tres departamentos de Bolivia, con la finalidad de identificar reservorios de tripanosomátidos que podrían causar infección en diferentes reservorios y enfermedades en el humano. Métodos: Los mamíferos silvestres fueron capturados en el Chaco, valles interandinos y la zona tropical de Bolivia, utilizando trampas Sherman, Havahard y Tomahawk. Los animales capturados fueron anestesiados para realizar el xenodiagnóstico y la extracción de sangre por punción cardiaca; el aislamiento de tripanosomátidos se realizó por hemocultivo utilizando medios de cultivo NNN y su respectiva identificación por las técnicas de PCR-RFLP en el laboratorio de Biología molecular IIBISMED. Resultados: fueron capturados 236 mamíferos silvestres pertenecientes a 30 especies, de las cuales 7 especies presentaron infección por hemoflagelados. Trypanosoma cruzi fue aislado de Didelphis marsupialis, D. albiventris, Galea musteloides, Graomys domorum y Andalgalomis pearsoni; T.c marinkellei y T. dionisii fueron aislados de Carolia perspicillata (murciélagos) y otros kinetoplástidos no identificados por herramientas moleculares disponibles fueron aislados de mamíferos del género Graomys y Andalgalomys, capturados en las provincias Campero de Cochabamba y Cordillera del departamento de Santa Cruz. Conclusiones: El T. cruzi, T.c. marinkellei, T. dionisii y otros tripanosomátidos se encuentran infectando a marsupiales (Didelphis), roedores (Graomys y Andalgalomys) y cobayos silvestres (Galea) los cuales se encuentran en su ciclo silvestre en las zonas estudiadas.

Objectives: The aim of this research was isolate kinetoplastid protozoan from wild mammals in three departments of Bolivia, to identify Trypanosomatids reservoirs that could cause infection in different reservoirs and disease in humans. Methods: The wild mammals were caught in the Chaco, valleys and the tropical zone of Bolivia, using Sherman, Havahard and Tomahawk traps. Captured animals were anesthetized and xenodiagnosis and blood cardiac puncture was performed; trypanosomatides isolation using blood culture was done in NNN culture media and the respective identification was performed by PCR-RFLP techniques in the molecular biology laboratory of IIBISMED. Results: 236 wild mammals belonging to 30 species were captured, of which 7 species showed infection by hemoflagellates. Trypanosoma cruzi was isolated from Didelphis marsupialis, D. albiventris, Galea musteloides, Graomys domorum and Andalgalomis pearsoni; T.c. marinkellei and T. dionisii were isolated from Carolia perspicillata (bats) and other kinetoplastid not identified by available molecular tools were also isolated from Andalgalomys and Graomys mammals genus, from Campero and Cordillera provinces of Cochabamba and Santa Cruz. Conclusions: The T. cruzi, T.c. marinkellei, T. dionisii and other trypanosomatids are infecting marsupials (Didelphis), rodents (Graomys and Andalgalomys) and wild guinea pigs (Galea) which are found in a sylvatic cycle in the studied areas.

[Cross sectional geriatric assessment of free living older subjects from Antofagasta, Chile]. / Valoración multidimensional del envejecimiento en la ciudad de Antofagasta.

BACKGROUND: The effects of aging on people must be evaluated to adequate sanitary actions. AIM: To assess the characteristics of older subjects living in Antofagasta, Chile. MATERIAL AND METHODS: Cross sectional assessment of 602 subjects without dementia, aged more than 60 years (55% females). A socioeconomic and medical history was obtained and Barthel, Lawton, Yesavage depression, Tromp fall risk and Folstein Mini mental scales were applied. RESULTS: Sixty eight percent of subjects had more than six years of studies. Forty six percent had hypertension, 28% had osteoarticular problems, 20% had hypercholesterolemia and 17% diabetes mellitus. Four percent had depression and falls were reported by 35%. Seventy four percent were independent in basic and instrumental activities. Ninety four percent had normal cognitive functions. Age was an important determinant of functional capacity. CONCLUSIONS: The main problems detected in this sample were the risk of falls and the presence of chronic diseases.

Valoración multidimensional del envejecimiento en la ciudad de Antofagasta / Cross sectional geriatric assessment of free living older subjects from Antofagasta, Chile

Background: The effects of aging on people must be evaluated to adequate sanitary actions. Aim: To assess the characteristics of older subjects living in Antofagasta, Chile. Material and Methods: Cross sectional assessment of 602 subjects without dementia, aged more than 60 years (55 percent females). A socioeconomic and medical history was obtained and Barthel, Lawton, Yesavage depression, Tromp fall risk and Folstein Mini mental scales were applied. Results: Sixty eight percent of subjects had more than six years of studies. Forty six percent had hypertension, 28 percent had osteoarticular problems, 20 percent had hypercholesterolemia and 17 percent diabetes mellitus. Four percent had depression and falls were reported by 35 percent. Seventy four percent were independent in basic and instrumental activities. Ninety four percent had normal cognitive functions. Age was an important determinant of functional capacity. Conclusions: The main problems detected in this sample were the risk of falls and the presence of chronic diseases.

Problemas de salud, estrés, afrontamiento, depresión y apoyo social en adolescentes / Health problems, stress, coping, depression and social support in adolescents

Este estudio examinó la relación existente en adolescentes entre el reporte de problemas de salud y diversos factores psicosociales. además de las diferencias de género en las diversas variables. Los participantes fueron 497 estudiantes de ambos sexos de Concepción (Chile) con edades entre 14 y 18 años. Los problemas de salud informados mostraron relaciones significativas con los eventos estresantes, con el estrés percibido y con el ánimo depresivo, una relación baja con el afrontamiento evitativo y una ausencia de relación con el apoyo social percibido. Las mujeres reportaron mayores niveles de problemas de salud, de eventos estresantes, de estrés percibido, de estrategias de afrontamiento y de ánimo depresivo. Se proponen diversos factores para explicar los resultados obtenidos.

Depresión: la importancia de los síntomas residuales / Depression: the importance of residual symptoms

La Depresión es una enfermedad que se ha ido transformando en un gran problema de salud pública. Para poder tratarla efectivamente se requiere de un acabado conocimiento de los factores etiológicos, de su evolución y de la efectividad de los diferentes tratamientos disponibles actualmente. Durante los últimos años se ha reconocido que la Depresión es una enfermedad crónica y que parte de dicha cronicidad se debe a una deficiente liberación de los síntomas con los tratamientos actuales. Esto último ha hecho que pongamos nuestra atención en los síntomas residuales de la depresión. El siguiente artículo tiene como objetivo mostrar la importancia de los síntomas residuales y su tratamiento .

Actividades docentes en la educación médica de pregrado: clases teóricas / Teaching activities in undergraduate medical education: theoretical classes

En Medicina existe una cantidad enorme de información que debe ser adquirida por los estudiantes, y que es obtenida durante su formación a través de distintas actividades docentes. En nuestro medio, donde no se cuenta con el material adecuado para favorecer y promover el autoaprendizaje, es importante mantener las sesiones teóricas. Se desarrolló una pauta de evaluación que fue aplicada a las sesiones teóricas del programa teórico del Curso de Pediatría 1998. Facultad de Medicina Occidente. Universidad de Chile. La herramienta desarrollada permite una evaluación sistemática y permanente de las actividades teóricas de pregrado. Las sesiones evaluadas fueron en su totalidad de tipo expositivas, con escasa promoción de la participación de los alumnos. En aproximadamente la mitad de las sesiones no se presentaron objetivos específicos de la actividad. Sólo en un 18 por ciento se utilizaron modelos para ejemplarizar conceptos en las clases. La entrega de contenidos fue considerada mayoritariamente clara y se utilizó material audiovisual, sólo de regular calidad. Sólo en un 1/3 de las sesiones se entregaron apuntes o bibliografía del tema tratado. En la mayor parte de las clases el expositor no realizó un resúmen final. De lo analizado se desprende la falencia de formación docente en cuanto a diseño y preparación de material audiovisual de sesiones teóricas, desperdiciando así una posibilidad de transmisión efectiva de los conocimientos y experiencia de los docentes

Evaluación de la aplicación del fórceps para abreviar el período expulsivo / Obstetrical forceps evaluation to absrreviate the expulsive period

La correcta aplicación de una toma de fórceps para abreviar el período expulsivo exige considerar una serie de variables que de no tenerse en cuenta puden convertir la maniobra en un fracaso y lejos de solucionar un problema, generar daño tanto a la madre como al recién nacido

Evaluación de la aplicación del fórceps para abreviar el período expulsivo / Obstetrical forceps evaluation to absrreviate the expulsive period

La correcta aplicación de una toma de fórceps para abreviar el período expulsivo exige considerar una serie de variables que de no tenerse en cuenta puden convertir la maniobra en un fracaso y lejos de solucionar un problema, generar daño tanto a la madre como al recién nacido

[Obstetrical and perinatal aspects in renal transplantation]. / Aspectos obstétricos y perinatales en trasplantadas renales.

This study evaluates the record of 14 pregnant women all of whom have received living donor renal transplants, and their control and delivery was done in our Service. Five women have had more than one pregnancy. The latency period between renal transplantation and pregnancy was 39.3 months. Blood pressure figures were acceptable in 73% of the patients before pregnancy and 28% evolved during their postpartum period with blood pressure over 140/90. In those cases where pregnancy was longer than first trimester the percentage of successful gestation was 93% with 41% premature births, 38% growth retardation at birth, and there was 10% spontaneous abortions. Eighty three percent of pregnancies delivered by cesarean section.