El alivio natural: Sauzgatillo (Vitex agnus-castus) para el síndrome premenstrual y la dismenorrea / The natural relief: Chasteberry (Vitex agnus-castus) for premenstrual syndrome and dysmenorrhea

El síndrome premenstrual es un trastorno común en mujeres en edad reproductiva y se caracteriza por al menos un síntoma físico, emocional o conductual, que aparece en la fase lútea del ciclo menstrual y se resuelve poco después del inicio de la menstruación. Los tratamientos convencionales para el dolor perimenstrual cíclico tienen inconvenientes que incluyen efectos secundarios, interferencia con la función reproductiva de las mujeres o escasa efectividad en el alivio de los síntomas. Muchas mujeres recurren a terapias naturales para tratar una gran variedad de síntomas menstruales. Esta revisión se centra en una de esas opciones naturales, el Sauzgatillo (Vitex agnus-castus). Se realizó una búsqueda e identificación de artículos publicados hasta mayo de 2022 recopilados por medio de sistemas de búsqueda electrónicos como Google Scholar, Medline, PubMed y Scopus. Las palabras de búsqueda fueron: “Premenstrual syndrome”, “dysmenorrhea” AND “Vitex agnus-castus”. Los estudios preclínicos señalan un mecanismo de acción en su implicación sobre el sistema serotoninérgico, así como su unión a los receptores de dopamina. Los estudios clínicos demuestran la seguridad y el efecto positivo sobre el síndrome premenstrual y la dismenorrea.

Premenstrual syndrome is a common disorder in women of reproductive age and is characterized by at least one physical, emotional, or behavioral symptom, which appears in the luteal phase of the menstrual cycle and resolves shortly after the onset of menstruation. Conventional treatments for cyclical perimenstrual pain have drawbacks that include side effects, interference with womens reproductive function, or limited effectiveness in relieving symptoms. Many women turn to natural therapies to treat a wide variety of menstrual symptoms. This review focuses on one of those natural options, Chasteberry (Vitex agnus-castus). The information available until May 2022 was collected via the library and electronic search systems such as Google Scholar, Medline, PubMed, and Scopus. The search words were: “Premenstrual syndrome”, “dysmenorrhea” AND “Vitex agnus-castus”. Preclinical studies point to a mechanism of action in its involvement in the serotoninergic system, as well as its binding to dopamine receptors. Clinical studies prove safety and positive effect on premenstrual syndrome and dysmenorrhea.

Phytoremediation assisted by mycorrhizal fungi of a Mexican defunct lead-acid battery recycling site.

A field experiment was conducted during 15 months to study the effects of four arbuscular mycorrhizal fungi (AMF) on the growth of Ricinus communis accession SF7. Plants were established on amended soil (vermicompost:sawdust:soil 1:1:1) severely polluted by lead-acid batteries (LAB) located at Mexico State, Mexico. Plants inoculated with Acaulospora sp., Funneliformis mosseae and Gigaspora gigantea had 100% survival in comparison to non-inoculated plants (57%). These same AMF enhanced palmitic and linoleic acids content in seeds of R. communis. Acaulospora sp. modified rhizosphere soil pH and decreased 3.5 folds Pb foliar concentrations while F. mosseae BEG25 decreased three times Pb soil availability in comparison to non-inoculated plants. Spatial changes in Pb soil availability were observed at the end of this research. No fungal effect on P, Ca, Cu foliar concentrations, soluble sugars, proline, chlorophyll or on the activity of two oxidative stress enzymes was observed. Mycorrhizal colonization from the inoculated fungi was between 40% and 60%, while colonization by native fungi was between 16% and 22%. A similar percentage of foliar total phenolic compounds was observed in non-mycorrhizal plants and those inoculated with G. gigantea and Acaulospora sp. This is the first research reporting effects of AMF on R. communis (castor bean) shrubs when grown on a LAB recycling site suggesting the use of Acaulospora sp. and F. mosseae BEG25 in phytostabilization to ameliorate Pb pollution and decreasing its ecological risk.

Leaf Epiphytic Bacteria of Plants Colonizing Mine Residues: Possible Exploitation for Remediation of Air Pollutants.

Plant surfaces are known as an important sink for various air pollutants, including particulate matter and its associated potentially toxic elements (PTE). Moreover, leaves surface or phylloplane is a habitat that harbors diverse bacterial communities (epiphytic). However, little is known about their possible functions during phytoremediation of air pollutants like PTE. The study of leaf epiphytic bacteria of plants colonizing mine residues (MR) containing PTE is thus a key to understand and exploit plant-epiphytic bacteria interactions for air phytoremediation purposes. In this research, we aimed (i) to characterize the functions of epiphytic bacteria isolated from the phylloplane of Brickellia veronicifolia, Flaveria trinervia, Gnaphalium sp., and Allionia choisyi growing spontaneously on multi-PTE contaminated MR and (ii) to compare these against the same plant species in a non-polluted control site (NC). Concentrations (mg kg-1) of PTE on MR leaf surfaces of A. choisyi reached up to 232 for Pb, 13 for Cd, 2,728 for As, 52 for Sb, 123 for Cu in F. trinervia, and 269 for Zn in Gnaphalium sp. In the four plant species, the amount of colony-forming units per cm2 was superior in MR leaves than in NC ones, being A. choisyi the plant species with the highest value. Moreover, the proportion of isolates tolerant to PTE (Zn, Cu, Cd, and Sb), UV light, and drought was higher in MR leaves than in those in NC. Strain BA15, isolated from MR B. veronicifolia, tolerated 150 mg Zn L-1, 30 mg Sb L-1, 25 mg Cu L-1; 80 mg Pb L-1, and was able to grow after 12 h of continuous exposition to UV light and 8 weeks of drought. Plant growth promotion related traits [N fixation, indole acetic acid (IAA) production, and phosphate solubilization] of bacterial isolates varied among plant species isolates and between MR and NC sampling condition. The studied epiphytic isolates possess functions interesting for phytoremediation of air pollutants. The results of this research may contribute to the development of novel and more efficient inoculants for microbe-assisted phytoremediation applied to improve air quality in areas exposed to the dispersion of metal mine tailings.

Lowering infant mortality in Cuba: Fernando Domínguez MD PhD. Neonatologist, Ramón González Coro University Maternity Hospital, Havana.

Neonatologist Dr Fernando Domínguez served two years in a remote municipality of Cuba's Guantánamo Province upon graduation from medical school in 1973. Continuing his commitment to vulnerable populations, he joined the Cuban team in the Democratic Republic of the Congo, serving as a family doctor attending neonates and children. After returning to Cuba, he completed his pediatric residency and later became head of the neurodevelopment department at Havana's Ramón González Coro University Maternity Hospital, where he has worked for over three decades. Dr Domínguez holds a doctorate in medical sciences, and since 1995 has served on the board of the Cuban Society of Pediatrics, where he was President from 2005-2011. He is also a member of the Ministry of Public Health's National Bioethics Commission; President of the Scientific Council of the Manuel Fajardo Medical School; on the Executive Board of the Latin American Association of Pediatrics; and a member of the Permanent Commission of the International Pediatric Association (IPA). Since 2010, he has served on IPA's Commission for Child Environmental Health and is the Editor-in-Chief of the pediatric section of Infomed, Cuba's national health portal.

Neurodevelopment of very low birth weight infants in the first two years of life in a Havana tertiary care hospital.

INTRODUCTION: Improved survival rates of neonates with very low birth weight (<1500 g) have led to a higher incidence of neurodevelopmental sequelae. OBJECTIVE: Examine neurodevelopment outcomes over the first two years of life of infants who weighed <1500 g at birth, in relation to birth weight, gestational age and 1-minute and 5-minute Apgar scores, in a Havana tertiary care hospital. METHODS: A case-series study was conducted to assess neurodevelopment outcomes of very low birth weight infants over their first two years of life. The study population comprised 116 surviving neonates with very low birth weight (<1500 g), born in the Dr Ramón González Coro University Maternity Hospital in Havana, Cuba, 2006-2010. A longitudinal, multidisciplinary and interdisciplinary follow up of all infants' neurodevelopment was performed, from hospital discharge to age two years, corrected for gestational age at birth. Data on each infant's perinatal variables were collected: birth weight in grams, gestational age at birth, and 1-minute and 5-minute Apgar scores. Patients were classified as having normal neurodevelopment, mild abnormalities and moderate-to-severe abnormalities. Pearson's chi-square test was used to determine possible relationships between perinatal variables studied and neurodevelopment, with exact sampling distribution and 95% confidence level. RESULTS: Normal neurodevelopment was observed in 69% of very low birth weight infants, 25.9% had mild abnormalities, and 5.2% displayed moderate-to-severe abnormalities. The results demonstrate a statistically significant relationship between gestational age and neurodevelopmental outcomes; more neurodevelopmental abnormalities were found in infants born at earlier gestational age (<30 weeks). CONCLUSIONS: Surviving very low birth weight neonates with lower gestational age at birth face a higher risk of neurodevelopmental abnormalities.

Enfoque bioético y social de la infección por el Virus de Inmunodeficiencia Humana / Bioethics and social approach of the Acquired Immunodeficiency Syndrome

Las personas portadoras o enfermas del virus de inmunodeficiencia humana han experimentado consecuencias devastadoras en el plano personal, familiar y social desde la aparición de los primeros casos. El objetivo del presente trabajo es analizar el cumplimiento de los principios bioéticos, así como la repercusión derivada de las implicaciones éticas del actuar profesional con estos pacientes, lo cual demuestra la necesidad de vencer los tabúes y la discriminación que han sido objeto desde los inicios de la epidemia.

Persons who are carrier of the Acquired Immunodeficiency Syndrome or persons who are sick have experienced destructive consequences in the personal, familiar and social spheres since the appearance of the first cases. The objective of this work is to analyze the fulfilment of the bioethical principles, as well as the repercussion derived from the ethics dilemma of the professional behaviour with these patients, what demonstrate the necessity of overcoming taboos and the discrimination they have suffered from since the beginnings of the disease.

Abscesos pulmonares múltiples. Presentación de un caso / Multiple lung abscesses. Case presentation

Introducción: el absceso de pulmón es una infección pulmonar supurada y circunscrita que provoca la destrucción del parénquima pulmonar, habitualmente aparece uno solo e infrecuentemente, múltiples. Puede presentar variadas etiologías, siendo los microorganismos que se aíslan con más frecuencia: Staphylococcus aereus, Streptococcus pneumoniae y gérmenes anaerobios. Objetivo: presentar un caso de un paciente inmunocompetente, que a partir de una celulitis abscedada en rodilla izquierda presentó abscesos pulmonares múltiples. Presentación del caso: se presenta el caso de un paciente masculino de 21 años, criador de palomas, con antecedentes de ser asmático desde niño. A los 21 días de una celulitis abscedada en rodilla izquierda, comienza con fiebre elevada, dolor torácico y tos con expectoración blanquecina. Se determinó la presencia de abscesos pulmonares múltiples. Se aisló Staphylococcus aureus en el lavado bronquial. Conclusiones: se presenta un caso muy infrecuente en la práctica clínica. Un paciente inmunocompetente con abscesos pulmonares múltiples causado por Stafilococcus aureus, a partir de una celulitis abscedada en rodilla izquierda. El diagnóstico se realizó por estudio microbiológico del lavado bronquial. Evolucionó favorablemente con mejoría clínica e imagenológica.

Introduction: the lung abscess is a suppurated and circumscribed pulmonary infection which causes the destruction of lung parenchyma. Often it appears as a unity and hardly ever multiple. It has several etiologies and the most frequently isolated microorganisms are: Staphylococcus aureus, Streptococcus pneumoniae and anaerobic germs. Objective: to present a patient immune-competent that presented multiple lung abscesses due to an abscessed cellulitis at the left knee. Case Presentation: it is presented the case of a male patient, 21 years old who suffered asthma. He was a dove breeder. He was admitted at the hospital complaining about high fever, thoracic pain and cough whit whitish expectoration. He had a preview diagnostic of abscessed cellulitis at the left knee, a month before. It was confirmed about the presence of multiple lung abscesses. The Staphylococcus aureus was isolated at the bronchial washing. Conclusion: iIt presented a case of a patient immune- competent with multiple lung abscesses due to Stafilococcus aureus, to leave abscessed cellulitis at the left knee. The diagnosis was performed by microbiological study of the bronchial washed. It was applied triple antimicrobial therapy for three weeks and concluded with vancomicina. The patient presented a clinical and radiological improvement.

[Flu symptoms and preventive measures practiced by the inhabitants of Mexico City during the AH1N1 influenza epidemic]. / Sintomas de influenza y medidas preventivas que practicaron los habitantes de la Ciudad de Mexico durante la epidemia de influenza AH1N1.

OBJECTIVE: To know the frequency of flu symptoms and describe preventive measures practiced by the inhabitants of Mexico City during the AH1N1 epidemic. MATERIAL AND METHODS: A cross-sectional design was used and a survey containing demographic and health information was conducted in August and September 2009 in a sample of 4003 randomly selected people living in Mexico City. RESULTS: Referred flu symptoms were: 29% running nose, 25% cough, 25% throat infection, 17% muscle and joint pain, 10% respiratory problems, and 7% fever. Also 16% said having hypertension, 10% diabetes, and 2% morbid obesity. Among the preventive measures, 74% washed hands, 32% covered the nose and mouth with the forearm when coughing or sneezing, 28% used sanitizer gel five times a day in average, and 47% did not greet with a kiss or handshake. CONCLUSIONS: Almost all the population followed preventive measures and did not show high percentages of influenza symptoms. Useful elements for prevention were identified, such as the frequency of seasonal influenza vaccination, self-medication, and living with a person diagnosed with AH1N1. It is important to continue with mass communication to strengthen adequate hygiene and health measures.

Adenocarcinoma renal injertado en riñón poliquístico. Presentación de un caso / Renal adenocarcinoma implanted in kidney polycystic. Case presentation

Introducción: el carcinoma de células renales representa entre 90-95 % de los tumores malignos que afectan el riñón, siendo infrecuente su observación asociado a la enfermedad renal poliquística autosómica del adulto. Objetivo: mostrar la asociación de adenocarcinoma renal en una paciente con nefropatía poliquística del adulto de diagnóstico en edad avanzada con escasas manifestaciones clínicas y humorales. Presentación del caso: se presenta el caso clínico de una paciente de 65 años con antecedentes de poliquistosis renal que consulta por aumento de volumen del abdomen constatándose nefromegalia gigante. Se presentan los datos clínicos, humorales, imagenológicos e histológicos que permitieron su diagnóstico. Conclusiones: aunque infrecuente, debe considerarse la posibilidad de adenocarcinoma renal de células claras asociado al riñón poliquístico.

Introduction: the renal cells carcinoma represents between 90-95 % of the malignant tumors that affect the kidney being infrequent its observation associated with the autosomal polycystic kidney disease of the adult. Objetive: to show the association of renal adenocarcinoma in a patient with polycystic nephropathy of the adult of late presentation and with scarce clinical and humoral manifestations. Case Presentation: there appears the clinical case of a 65-year-old feminine patient with precedents of kidney polycystic that it consults of increase of volume of the abdomen being stated nefromegalia giant. The clinical information appears, humoral, imagenoly and histological that allowed its diagnosis. Conclusions: although infrequently should be consider the diagnostic possibility of clear cell renal adenocarcinoma associated to polycystic kidney.

Parálisis diafragmática bilateral. Presentación de un caso / Bilateral diaphragmatic paralysis

La parálisis diafragmática bilateral es una entidad muy infrecuente en la clínica, debido a diferentes entidades con capacidad de lesionar el nervio frénico. El compromiso respiratorio que produce requiere cuidado especializado. Este es el primer caso reportado en nuestra literatura a consecuencia de hernias cervicales múltiples. Se presenta un caso de un paciente de 43 años, con antecedentes de salud, exatleta de alto rendimiento, que ingresó en nuestro servicio, con disnea de 5 meses de evolución, que aumentó progresivamente en intensidad hasta mantenerlo en ortopnea constante, fue estudiado exhaustivamente hasta llegar a diagnostico definido y derivarlo al servicio de Neurocirugía para su solución definitiva. La importancia del tema que se presenta es que se describe una presentación rara de parálisis diafragmática bilateral, a consecuencia de hernias discales cervicales múltiples.

Bilateral diaphragmatic paralysis is a rare condition in clinical practice due to different entities that can damage phrenic nerve. The resulting respiratory compromise requires medical special care. This is the first case reported in our medical literature caused by multiple cervical hernias. A 43 year-old patient having health history, high performance ex-athlete, admitted in the service with 5-month evolution of dyspnea which progressively increased in intensity up to maintain him in permanent orthopnea, thorough studies were conducted to the definite diagnosis and he was transferred to Neurosurgery Service to a definite solution. A rare presentation of a bilateral diaphragmatic paralysis resulting from multiple cervical hernias gives importance to the topic.

Segundo Consenso Clínico de la Sociedad Iberoamericana de Neonatología: manejo hemodinámico del recién nacido / Second Clinical Consensus of the Ibero-American Society of Neonatology: hemodynamic management of newborns

Este trabajo informa acerca del proceso y los resultados del Segundo Consenso Clínico de la SIBEN (Sociedad Iberoamericana de Neonatología), en el cual 80 neonatólogos de 23 países fueron invitados a participar y colaborar. Se desarrollaron varias preguntas de importancia clínico-fisiológica sobre el manejo hemodinámico del recién nacido. Los participantes fueron distribuidos en grupos, facilitando así la interacción y el trabajo conjunto, con la consigna de responder de tres a cinco preguntas mediante el análisis de bibliografía y factores locales. El Grupo de Consenso se reunió en Mar del Plata, Argentina, donde se llevaron a cabo diversas ponencias, debates y presentaciones. En total participaron 54 neonatólogos de 21 países, con el objetivo de desarrollar un consenso sobre aspectos que incluyeron conceptos y definiciones de inestabilidad hemodinámica, la fisiopatología del cuadro de compromiso hemodinámico, las estrategias terapéuticas recomendadas y el monitoreo hemodinámico. Se espera que esta experiencia internacional sirva como una iniciativa útil tanto para la búsqueda de futuros consensos como para reducir las disparidades existentes entre los tratamientos y resultados de los diferentes países de la Región.

This study reports on the process and results of the Second Clinical Consensus of the Ibero-American Society of Neonatology. Eighty neonatologists from 23 countries were invited to collaborate and participate in the event. Several questions of clinical-physiological importance in the hemodynamic management of newborns were addressed. Participants were divided into groups to facilitate interaction and teamwork, with instructions to respond to three to five questions by analyzing the literature and local factors. Meeting in Mar del Plata, Argentina, the Consensus Group served as a form for various presentations and discussions. In all, 54 neonatologists from 21 countries attended, with the objective of reaching a consensus on such matters as concepts and definitions of hemodynamic instability, the physiopathology of hemodynamic compromise, recommended therapy strategies, and hemodynamic monitoring. It is hoped that this international experience will serve as a useful initiative for future consensus building and reduction of the existing disparities among the countries of the Region in terms of treatment and outcomes.

Infectious diseases in Mexico. A survey from 1995-2000.

Data obtained at a central laboratory for emerging, re-emerging, and other infectious diseases in Mexico from 1995-2000 are presented. An outstanding increase of DEN-3 circulation was identified. Aedes aegypti, the dengue vector, is widely distributed. Leptospirosis has become the most important differential diagnosis for dengue. Identification of rabies virus variants allowed cataloging of new transmitters of rabies. Rotavirus showed a clear seasonal distribution, while different proportions of pathogenic classes of Escherichia coli under endemic and outbreak conditions were seen. Serotypes of several bacteria are reported as well as the sources of isolation and frequency of Shigella, Salmonella, and Vibrio cholerae. Rise and disappearance of cholera could be followed along the past decade. Influenza strains were identified, as were several pathogens causing sexually transmitted infections. Laboratory support was important for surveillance after Hurricane Mitch. Multidrug-resistant strains of Mycobacterium tuberculosis are emerging and primary resistance is very high. It is now mandatory to search for antibodies to Trypanosoma cruzi in blood banks. Triatoma barberi, a peridomestic bug, is the main vector of Chagas disease. Localized cutaneous leishmaniosis increased in regions having a guerrilla element in Chiapas. Modern immunodiagnostic techniques are used for control studies of cysticercosis and similar techniques were recently standardized for Trichinella spiralis detection. Low iodine values in children's urine were found in several Mexican states; therefore, use of iodized salt should be encouraged.

Doppler a color (dúplex) comparado con flebografía en el diagnóstico de trombosis venosa profunda después de cirugá ortopédica mayor de miembros inferiores / Colour Doppler (duplex) comparison to phlebography in diagnosis of deep venous thrombosis, after major orthopaedic surgery in lower limbs

La trombosis venosa profunda (TVP) es una complicación frecuente en cirugía ortopédica de miembros inferiores. Las modalidades diagnósticas con que se cuenta actualmente muestran limitaciones como baja sensibilidad y especificidad. El dúplex ha sido utilizado en años recientes con considerables ventajas. El presente trabajo estudió 110 pacientes sometidos a cirugía ortopédica de miembros inferiores en el periodo comprendido del 1o. de septiembre de 1997 al 30 de mayo de 1998, se utilizó como profiláctico para TVP enoxaparina subcutánea a dosis de 40 miligramos diarios por promedio de 10 días. Fue un estudio prospectivo, longitudinal y comparativo entre dúplex y flebografía como métodos diagnósticos. Los resultados obtenidos demostraron una incidencia de TVP de miembros inferiores de 9.09 por ciento. De 10 pacientes diagnósticados con TVP, solo cuatro (40 por ciento) presentaron datos clínicos. Hubo tres falsos negativos y tres falsos positivos con dúplex, lo que no representó diferencia estadística significativa con la flebografía (p=0.61). La sensibilidad del dúplex fue del 70 por ciento y expecificidad del 90.9 por ciento. El tiempo quirúrgico prolongado resultó tener relación directa con la aparición de TVP (p=0.001). El uso de torniquete neumático no demostró correlacionarse con la incidencia de TVP (p=0.42)

La prótesis total roscada de la cadera BCP de Pasquali-Lasagni / The BCP threaded total hip prosthesis of Pasquali-Lasagni

Podría considerarse que las prótesis totales de la cadera, tienen el reconocimiento histórico de devolver una mejor calidad de vida a un sinnúmero de pacientes inválidos que en otro tiempo estaban destinados por definición a vivir de una manera caracterizada por una dependencia cada vez mayor y por un deterioro progresivo de su subsistencia. Sin embargo, la mayoría de las prótesis disponibles en el mercado adolescen de deficiencias mecánicas que de alguna manera se han heredado por generaciones entre autores y fabricantes de las mismas, como es el caso de la fuerza de cizallamiento, que la mayor parte conservan tanto en la copa acetabular como el vástago femoral La prótesis roscada de Paquali elimina muchos de los incovenientes mecánicos comunes a las prótesis convencionales. Su diseño en forma de cono, aprovecha íntegramente el apoyo en la metáfisis del fémur, que precisamente es cónica y elimina los huecos anterior, lateral y posterior que dejan casi todos los vástagos. La mayor profundidad de las espiras proximales del vástago femoral, se apoyan solamente en la región metafisaria, de manera que el resto del cono queda libre, librando así a la diáfisis proximal de la rigidización que producen otros. Se elimina también el efecto de cizallamiento. El objetivo del acetábulo roscado es igualmente eliminar la fuerza de cizallamiento que produce verticalización tardía