Possible role of metformin as an antidepressant in diabetes.

OBJECTIVE: Metformin (MET) is a drug used in the treatment of type 2 diabetes due to its insulin receptor sensitizing properties and anti-hepatic gluconeogenesis effect. One of the comorbidities in diabetes is the depression. This review aimed at summarizing the results of the available MET, depression and diabetes studies to clarify the possible role of MET in the depression during diabetes. METHODS: A bibliographic search on PubMed, Embase, PsycINFO, Web of Science, Cochrane Central for studies referring to MET, depression and diabetes. RESULTS: Several studies have associated depression to the chronic inflammation that characterizes diabetes. Additionally MET is an anti-inflammatory molecule that generally acts by activating AMPK and inhibiting the NF-kB factor. In the context of diabetes, MET can act directly as an anti-inflammatory drug as well as inhibiting other pro-inflammatory molecules. In this regard, MET may inhibit the pro-inflammatory effects of angiotensin II. By facilitating the action of insulin and reducing hepatic gluconeogenesis, MET reduces circulating glucose levels, decreasing the formation of advanced glycation end products and therefore inflammation. During diabetes, the gut microbiota and the permeability of the intestinal barrier are altered, causing high levels of circulating lipopolysaccharides (LPS), which induce inflammation. MET can normalize the microbiota and the intestinal barrier permeability reducing the levels of LPS and inflammation. Clinical and experimental studies show the anti-depressant effect of MET mediated by different mechanisms both at the peripheral level and in the central nervous system. CONCLUSION: Therefore, MET as an anti-inflammatory drug can decrease symptoms of depression and represents a therapeutic approach to improve the psychological state of patients with diabetes. Additionally, insulin also has an anti-inflammatory effect that could act together with MET.

Angiotensin II and post-streptococcal glomerulonephritis.

BACKGROUND: Post-streptococcal glomerulonephritis (PSGN) is a consequence of the infection by group A beta-hemolytic streptococcus. During this infection, various immunological processes generated by streptococcal antigens are triggered, such as the induction of antibodies and immune complexes. This activation of the immune system involves both innate and acquired immunity. The immunological events that occur at the renal level lead to kidney damage with chronic renal failure as well as resolution of the pathological process (in most cases). Angiotensin II (Ang II) is a molecule with vasopressor and pro-inflammatory capacities, being an important factor in various inflammatory processes. During PSGN some events are defined that make Ang II conceivable as a molecule involved in the inflammatory processes during the disease. CONCLUSION: This review is focused on defining which reported events would be related to the presence of this hormone in PSGN.

A comprehensive study of Ecuadorian adult patients with a mild and moderate presentation of COViD-19.

AIM: To characterize non-hospitalized patients with mild and moderate clinical presentation. METHODS: We performed an epidemiological, observational, descriptive, and cross-sectional study carried out in Ecuador, with 1,447 participants between 18 and 66 years, non-hospitalized, with a molecular RT-PCR test for SARS-CoV2. We analyzed demographic characteristics according to sex, age group, clinical findings, behavior after diagnosis, family and social behavior, sequelae, clinical evolution, type of exposure, and personal history. RESULTS: The sample analyzed had a mean age of 37 years (95% CI 18-66), women 713 individuals (49.27%), men 733 individuals (50.66%). Age group distribution was 18-30 years, 524 individuals (36.29%), 31-45, 538 individuals (37.26), and more of 45 years, 382 individuals (26.46%). 1416 individuals were mestizos (97.99%). According to the province of residence from Pichincha were 1019 patients (70.52%), followed by Imbabura, 93 patients (6.44%), and the others 335 (23.15%) patients come from all over the country. In women, the most common findings were fever >38°C (54.40%), sputum (27.43%) and hypoxia (16.32%); HTN (5.75%) and hypercholesterolemia (3.69%). Men were more prevalent in all other findings. Comorbidities were more prevalent in all those over 45 years of age. COVID-19 antibodies test was positive in 416 patients (28.85%). Neuropsychiatric symptoms such as sleep disorders, generalized anxiety disorder, depressed mood, and chronic fatigue were more prevalent in men than women. Still, generalized anxiety disorder and chronic fatigue were more common in individuals of 31 to 45 years. 868 patients (60.07%) were in contact with a known infected person, 318 patients (22.02%) were health workers, and 782 patients (57.63%) were informed about work exposure. 545 patients (37.72%) were overweight, primarily women 310 (42.29%). 609 patients (42.65%) showed symptoms after the acute period, and 331 individuals (23.49%) reported some sequelae. CONCLUSION: The epidemiological and clinical behavior of hospitalized and critical patients differs greatly from ambulatory or mild or moderate symptoms. It is essential to highlight those non-hospitalized patients constitute the predominant population of patients, hence the importance of adequate management that would directly affect the development of complicated forms and, consequently, the collapse of healthcare centers. It is vitally important to open more investigations that compare hospitalized and outpatient patients to have a clearer picture of the epidemic.

Capacidad pro-apoptótica in vitro de Valeriana rígida y Valeriana decusata sobre una línea celular de cáncer de mama / In vitro pro-apoptotic capacity of Valerian rigid and Valerian decussata in cancer cells

Resumen El cáncer representa un problema de salud pública a nivel mundial, con altas tasas de incidencia y mortalidad en países desarrollados y no desarrollados. En la actualidad se están evaluando alternativas terapéuticas de origen natural, con el propósito de establecer tratamientos más eficientes y menos invasivos. Dado que la apoptosis es el tipo de muerte programada que experimentan las células cancerosas por los tratamientos con los fármacos antineoplásicos,el objetivo de esta investigación, fue evaluar in vitro la capacidad pro-apoptótica y citotóxica de los extractos de valeriana, sobre una línea celular de cáncer de mama (MCF-7). En este estudio las células MCF7 se cultivaron y trataron con diferentes concentraciones de los extractos de la raíz, hojas y tallos de Valeriana rígida y Valeriana decussata. La viabilidad celular se evaluó mediante el ensayo MTT. Para la determinación de la expresión génica de las proteínas anti y pro-apoptóticas (Bax, Bcl-2 y p53), se usó el ensayo de la PCR cuantitativa de transcripción inversa. Las diferentes concentraciones de los extractos (10-8 a 10-1 mg/mL) disminuyeron la viabilidad (proliferación) celular en concentraciones dependientes. Estos extractos indujeron la expresión génica de las proteínas Bax y Bcl-2, pero no de p53. La expresión de Bax fue mayor que la de Bcl-2 e indujo un elevado índice Bax/Bcl-2 (condición proapoptotica). En conclusión, se determinó que los extractos de Valeriana decussata y Valeriana rígida poseen efecto reductor de la viabilidad (proliferación) de la línea celular de cáncer de mama MCF-7, probablemente mediado por la alteración de la relación de las proteínas Bax y Bcl-2 vinculadas a la apoptosis.

Abstract Cancer represents a worldwide public health problem, with high incidence and mortality rates in developed and undeveloped countries. Currently, therapeutic alternatives of natural origin are being evaluated with the purpose of establishing more efficient and less invasive treatments. Apoptosis is the type of programmed death cancer cells undergo during treatment with anti-neoplastic drugs. Therefore, the aim of this research was to evaluate in vitro the pro-apoptotic and cytotoxic capacity of valerian extracts on a breast cancer cell line (MCF-7). In this study, MCF7 cells were cultured and treated with different concentrations of the extracts of the root, leaves and stems of Valeriana rígida and Valeriana decussata. Cell viability was assessed by the MTT assay. Quantitative reverse transcription PCR assays were used for the determination of gene expression of anti- and proapoptotic proteins (Bax, Bcl-2, p53). Different concentrations of the extracts (10-8 to 10-1 mg/mL) decreased cell viability (proliferation) in a concentration-dependent manner. These extracts induced gene expression of Bax and Bcl-2 proteins but not of p53. The expression of Bax was higher than that of Bcl-2, causing an elevated Bax/Bcl-2 ratio (proapoptotic condition). In conclusion, it was determined that Valeriana decussata and Valeriana rígida extracts have a viability (proliferation) reducing effect on the MCF-7 breast cancer cell line, probably mediated by altering the ratio of Bax and Bcl-2 proteins linked to apoptosis.

Arracacia xanthorrhiza Bancr compounds decrease β-actin, hypoxia-inducible factor-1 and nitric oxide production in HeLa cells / Los componentes de la Arracacia xanthorrhiza Bancr disminuyen las producciones de la actina β, del factor-1 inducible por la hipoxia y del óxido nítrico en células Hela

Abstract The treatment of cancer patients with anti-cancer drugs is often accompanied by the presence of undesirable side effects. The use of natural plant derivatives alone, or in conjunction with existing anti-neoplastic drugs, has been suggested to obtain better results and decrease these side effects. Nitric oxide (NO•), the hypoxia-inducible factor-1 (HIF-1), and decreased concentration of actin play important roles in cancer progression. The beneficial effects of polyphenols in various organ disorders including cancer has been reported. The aim of this study was to determine the effect of Arracacia xanthorrhiza Bancr extracts, white (WAXB) and red (RAXB) variants (compounds rich in polyphenols) on the concentrations of β-actin, NO• and HIF-1 in Hela cells cultures, to uncover possible anti-neoplastic effects. Extracts from the plant leaves were added to Hela cell cultures at a concentration of 10-3 mg/mL, and after 24 hours of culture, the concentrations of β-actin, NO• and HIF-1 were determined by immunohistochemical, biochemical and western blot assays. Both extracts reduced the concentrations of β-actin, NO• and HIF-1 (p<0.001), similar to the methotrexate effect. These results suggest an antineoplastic effect of the studied plant extracts and highlight the possibility of their use in the treatment of neoplasms.

Resumen El tratamiento de pacientes con cáncer utilizando drogas-antineoplásicas presenta problemas relacionados con efectos colaterales indeseables. Se ha sugerido el uso de derivados de plantas naturales solas, o en combinación con drogas antineoplásicas existentes para obtener mejores resultados y disminuir los efectos colaterales. Así mismo, se ha reportado que el óxido nítrico (NO•), el factor-1 inducible por hipoxia (HIF-1) y la disminución de la expresión de la actina tienen un papel en la progresión del cáncer. También se ha reportado los efectos beneficiosos de lo polifenoles en varios desordenes orgánicos, incluyendo el cáncer. El objetivo de este estudio fue determinar los efectos de los extractos procedentes de la Arracacia xanthorrhiza Bancr blanca (AXBB) y la variedad roja (AXBR) (compuestos ricos en polifenoles) en las concentraciones de la actina-beta, el NO• y el HIF-1 en cultivo de células Hela, para destacar sus posibles efectos antineoplásicos. A los cultivos de células Hela se les agregaron los extractos de las hojas de AXBB o AXBR (10-3 mg/mL, concentración final) y después de 24 horas de cultivo se determinaron las concentraciones de la actina-beta, el NO• y el HIF-1 por métodos inmunohistoquímicos, bioquímicos y western blot. Ambos extractos disminuyeron las concentraciones de la actina-beta, el NO• y el HIF-1 (p<0,001) de una manera similar al efecto del metotrexato. Estos resultados sugieren un efecto antineoplásico de estos extractos y destacan la posibilidad de ser usados para el tratamiento de las neoplasias.

C-reactive protein as an effector molecule in Covid-19 pathogenesis.

The current pandemic caused by SARS-CoV-2 virus infection is known as Covid-19 (coronavirus disease 2019). This disease can be asymptomatic or can affect multiple organ systems. Damage induced by the virus is related to dysfunctional activity of the immune system, but the activity of molecules such as C-reactive protein (CRP) as a factor capable of inducing an inflammatory status that may be involved in the severe evolution of the disease, has not been extensively evaluated. A systematic review was performed using the NCBI-PubMed database to find articles related to Covid-19 immunity, inflammatory response, and CRP published from December 2019 to December 2020. High levels of CRP were found in patients with severe evolution of Covid-19 in which several organ systems were affected and in patients who died. CRP activates complement, induces the production of pro-inflammatory cytokines and induces apoptosis which, together with the inflammatory status during the disease, can lead to a severe outcome. Several drugs can decrease the level or block the effect of CRP and might be useful in the treatment of Covid-19. From this review it is reasonable to conclude that CRP is a factor that can contribute to severe evolution of Covid-19 and that the use of drugs able to lower CRP levels or block its activity should be evaluated in randomized controlled clinical trials.

In situ immunopathological events in human cervical intraepithelial neoplasia and cervical cancer: Review.

Neoplasia of the cervix represents one of the most common cancers in women. Clinical and molecular research has identified immunological impairment in squamous intraepithelial cervical lesions and cervical cancer patients. The in-situ expression of several cytokines by uterine epithelial cells and by infiltrating leukocytes occurs during the cervical intraepithelial neoplasia and cervical cancer. Some of these cytokines can prevent and others can induce the progression of the neoplasm. The infiltrating leukocytes also produce cytokines and growth factors relate to angiogenesis, chemotaxis, and apoptosis capable of modulating the dysplasia progression. In this review we analyzed several interleukins with an inductive effect or blocking effect on the neoplastic progression. We also analyze the genetic polymorphism of some cytokines and their relationship with the risk of developing cervical neoplasia. In addition, we describe the leukocyte cells that infiltrate the cervical uterine tissue during the neoplasia and their effects on neoplasia progression.

Situación actual de la infección por Virus del Papiloma Humano (VPH) asociado a lesiones cervicales en mujeres del ecuador. Revisión Sistemática / Current situation of Human Papilloma Virus (HPV) associated with cervical injuries in women of Ecuador: Systematic Review

La infección causada por el Virus del Papiloma Humano (VPH) es la más común trasmitida por vía sexual y es uno de los principales factores relacionados con la génesis de lesiones preinvasivas y cáncer de cérvix. Los estudios epidemiológicos en Ecuador son escasos, por tanto, la casuística es limitada e inconclusa sobre genotipos y variantes del VPH. La metodología empleada para realizar el presente documento se basó en una búsqueda sistematizada de todas las investigaciones realizadas en los últimos 11 años en el Ecuador, a través de buscadores académicos empleando operadores booleanos para la recolección de datos y su análisis. Los resultados indicaron que los genotipos 16, 58 y 18 son los más prevalentes en el Ecuador, se evidencio que solo existen investigaciones generadas en el Sur y la región costera y que los datos no son homogéneos ni suficientes, de allí la importancia de conocer la distribución del VPH en el país y la necesidad de una caracterización epidemiológica y filogenética a gran escala

Infection caused by Human Papillomavirus (HPV) is the most common sexually transmitted infection and is one of the main factors related to the genesis of preinvasive lesions and cervical cancer. Epidemiological studies in Ecuador are scarce, therefore, the casuistry is limited and inconclusive on HPV genotypes and variants. The methodology used to carry out this document was based on a systematic search of all the investigations carried out in the last 11 years in Ecuador, through academic search engines using Boolean operators for data collection and analysis. The results indicated that genotypes 16, 58 and 18 are the most prevalent in Ecuador, it was evident that there are only investigations generated in the South and the coastal region and that the data is not homogeneous or sufficient, hence the importance of knowing the distribution of HPV in the country and the need for a large-scale epidemiological and phylogenetic characterization

The SARS-CoV-2 Pandemic in Latin America: the Need for Multidisciplinary Approaches.

Purpose of Review: Acute respiratory infections of viral etiology (ARIVE) constitute one of the most frequent infectious processes among humans. They cause significant morbidity and mortality every year in all age groups and regions of the world. Their etiology is diverse, and seasonal viruses began their journey, at some point, with an episode of expansion before their annual circulation as seasonal agents. The coronavirus disease 2019 (COVID-19) pandemic is a challenge for Latin America. Understanding dynamics is essential for decision making, to reduce the health, economic, and social impacts of the pandemic. Recent Findings: Currently, governments in Latin America have taken measures to mitigate the spread of COVID-19 primarily based on World Health Organization recommendations. However, the potential impact of the virus in Latin America is still unknown. Given the urgency, governments need more accurate estimates of what could happen in Latin America in order to make informed decisions, At the September 20, 2020, cumulative cases 2295 of COVID-19 per 1 million population has been registered in Latin America and the Caribbean. Brazil, Peru, and Chile are the most countries affected by this pandemic, registering a total of cumulative cases per million inhabitants of 21,148, 22,941, and 23,262 respectively. Peru has shown the highest death numbers with 949 per million inhabitants. Summary: The Latin American health authorities should make the most beneficial decisions based in scientific facts for the health and life of citizens, both understood in the broadest and most inclusive sense.Once the epidemic is over, Latin America should begin a profound health reform, at a single and universal health system, integrated and coordinated, where the leading role of the Ministry of Health is resumed, to have a national network of modern, integrated, and excellent quality laboratories for the benefit of the entire society.

Pandemia SARS Cov-2: Situación actual y perspectivas futuras / SARS Cov-2 pandemic: current situation and future perspectives

En enero de 2020, el agente etiológico responsable de un grupo de casos de neumonía grave en Wuhan, China, fue identificado como un nuevo Betacoronavirus (2019-nCoV), el cual mostraba marcadas diferencias del SARS-CoV y MERS-CoV, los cuales compartían homología con la secuencia descrita en murciélagos, los cuales se definieron como hospedadores o reservorios naturales, otros estudios señalaron como hospedador intermediario al pangolín, dejando eslabones inciertos en la historia evolutiva del virus. A la fecha diversos laboratorios ya han identificado la secuencia genómica completa de este nuevo agente encontrando deleciones en regiones codificantes y no codificantes, permitiendo el desarrollo de diferentes protocolos y modalidades diagnósticas, aunque algunas de ellas aún no se han validado por completo. Existen ciertas divergencias en cuanto a la biología y comportamiento del virus, rápida evolución, componentes genéticos, variabilidad en las características clínicas, inmunidad y patologías asociadas, las cuales han complicado el manejo de la pandemia, pues el virus pareciera comportarse de diversas formas según el área geográfica, grupo etario, protocolos terapéuticos y medidas de contención adoptadas

Dificultad en el diagnóstico de Paragonimiasis en centros de primer nivel. Reporte de un caso / Difficult Paragonimiasis diagnosis in first level centers. Case report

Paciente quien refiere ingesta de cangrejo sin cocción presentó cuadro caracterizado por ardor de garganta, dificultad respiratoria y deposiciones diarreicas. Seguidamente tos y hemoptisis; acudió a un centro de atención primaria donde le realizaron exámenes complementarios estableciéndose tratamiento sin mejoría, es referido a un hospital donde se diagnosticó Paragonimiasis Pulmonar

Patient who reports intake of crab without cooking presented a picture characterized by burning throat, respiratory distress and diarrheal depositions. Then cough and hemoptysis; went to a primary care center where they performed complementary exams establishing treatment without improvement, is referred to a hospital where Pulmonary Paragonimiasis was diagnosed

Propofol, fentanyl and remifentanil do not impair the phagocytic capacity to of human peripheral blood polimorphonuclear cells / Propofol, fentanil y remifentanil no alteran la capacidad de las células polimorfonucleares humanas de fagocitar a la Candida albicans

OBJECTIVES: The capacity of polymorphonuclear cells (PMN) to phagocyte microorganisms is an important function to be preserved during surgical interventions. Therefore, the aim of this study was to determine the effect of propofol, fentanyl and remifentanil combination on Candida albicans engulfment by human PMN. MATERIALS AND METHODS: Twenty patients scheduled to undergo surgical interventions (ASA I-II) received propofol, fentanyl and remifentanil as intravenous anesthesia. PMNs were obtained before and after the surgical procedure and phagocytosis assay was performed using opsonized C. albicans. RESULTS AND CONCLUSIONS: No differences between the values obtained before and after anesthesia treatment in the number of phagocytic PMN and the number of C. albicans engulfed were observed. These results suggest that the used anesthesic protocol does not alter one of the most important immune mechanisms.

OBJETIVOS: La capacidad de las células polimorfonucleares (CPN) de fagocitar a los microorganismos es una importante función que se debe de preservar durante las intervenciones quirúrgicas. Por lo tanto, el propósito de este estudio fue determinar el efecto de la combinación del propofol, el fentanil y el remifentanil en la ingestión de Candida albicans por parte de las CPN humanas. MATERIALES Y MÉTODOS: Veinte pacientes sujetos a intervenciones quirúrgicas (ASA I-II) recibieron propofol, fentanil y remifentanil como anestesia endovenosa. Los CPN se obtuvieron antes y después del procedimiento quirúrgico y el ensayo de fagocitosis fue realizando usando C. albicans opsonizada. RESULTADOS Y CONCLUSIONES: No se observaron diferencias significativas en los valores obtenidos antes y después del tratamiento anestésico tanto en el número de CPN fagocíticas como en el número de C. albicans dentro de las células. Estos hallazgos sugieren que el protocolo anestésico usado no altera uno de los mecanismos de defensa más importante del organismo.

Infección por VPH y su correlación clínica en población indígena de la región altoandina del Ecuador / Infección por VPH y su correlación clínica en población indígena de la región altoandina del Ecuador VPH infection and its clinical correlation in indigenous population of the high andean region of Ecuador

El cáncer cervico-uterino (CaCu) constituye un problema de salud pública. Estudios epidemiológicos han identificado una estrecha relación entre el CaCu y la infección por el virus del papiloma humano (VPH). El objetivo del estudio fue realizar la detección molecular de VPH, identificación de infecciones mixtas y el tamizaje de CaCu a través de un estudio transversal a 189 mujeres entre 21 a 65 años pertenecientes a la comunidad de Pilahuin- Provincia del Tungurahua a las cuales se les realizó detección molecular de VPH y citología convencional. Los resultados fueron analizados con los programas EPI INFO y SPSS. Resultados: La edad promedio de las participantes fue de 35,2 años, en relación estable, multíparas, con un nivel medio, bajo de instrucción, sin trabajo remunerado. El 100% de las participantes presentó una actitud favorable frente a la citología cervico-uterina sin mostrar relación con la edad, nivel de instrucción o estado civil. El 10,5% de las participantes presentaron infección por VPH y un 70% de las pacientes presentaron inflamación severa con una asociación positiva a infección bacteriana mixta.

Cervical-uterine cancer (CaCu) is a public health problem. Epidemiological studies have identified a close relationship between CaCu and human papillomavirus (HPV) infection. The purpose of this study was to perform the molecular detection of HPV, identification of mixed infections and the screening of CaCu through conventional cytology in an indigenous population of the high Andean highlands of Ecuador in order to correlate the data obtained with the presence of lesions. Methodology: A cross-sectional study was carried out on 189 women between the ages of 21 and 65; who belonged to the community of Pilahuin in the province of Tungurahua, who assisted to gynecological check-ups. Data were analyzed with the EPI-INFO and SPSS statistical programs. Results: the average age of the participants was 35.2 years, most of the participants identified themselves as indigenous, in a stable relationship, multiparous, with a medium to low level of education and no paid work. The participants showed a favorable attitude towards the cervico-uterine cytology in 100% of the cases without showing a relation with age, level of education or civil status. HPV infection was positive in 10.5% of the participants, 70% of the patients had severe inflammation with a positive association with mixed bacterial infection.

In situ expressions of protein 16 (p16CDKN2A) and transforming growth factor beta-1 in patients with cervical intraepithelial neoplasia and cervical cancer.

OBJECTIVES: Protein 16 (p16CDKN2A) and transforming growth factor-beta 1 (TGF- ß1) are important tumor suppressor molecules. The aim of this study was to evaluate the frequency and simultaneous expression of p16CDKN2A and TGF- ß1 in cervical intraepithelial neoplasia (CIN) and cervical cancer and their relationship whit the neoplasia progression. STUDY DESIGN: To evaluate the expressions of p16CDKN2A and TGF- ß1 an immunohistochemical study of both proteins in 75 cervical tissues (24 CIN I, 17 CIN II, 15 CIN III and 19 squamous cell cancer) was performed. RESULTS: Increased expression of epithelial and stromal p16CDKN2A in all grades of CIN and cancer was observed. Healthy controls were negative. The frequency of p16CDKN2A expression in the patients was as follow: 75% in CIN I and 100% in CIN II, CIN III and cancer. TGF- ß1 expression was found increased in all patients with CIN I and CIN II and decreased in CIN III and cancer; 60% of patients with CIN III and 16% with cancer showed reactivity for TGF- ß1. High intensity of p16CDKN2A reactivity and low intensity of TGF- ß1 reactivity were observed. CONCLUSIONS: The linear frequency of p16CDKN2A expression accompanied by decreased frequency of TGF- ß1 in CIN III and cancer could be involved in the neoplasia progression.

Colitis pseudomembranosa por Clostridium difficile: Reporte de un caso en paciente pediátrico. [Reporte de Caso] / Pseudomembranous colitis by Clostridium difficile infection: a case report in pediatric patient. [Case Report]

Clostridium difficile es un bacilo Gram positivo esporulado, anaerobio estricto, resistente a condiciones adversas y transmitido por vía oral-fecal, se describió por primera vez en 1930; sin embargo, se asoció a enfermedad en humanos en la década de los setenta al identificarse como agente causal de colitis pseudomembranosa. Esta infección se ha relacionado con diversas manifestaciones clínicas que van desde diarrea sin complicaciones hasta sepsis e incluso la muerte. Se presenta un caso clínico de un paciente masculino de 1 año 8 meses, con antecedentes de hipertermia y deposiciones líquidas abundantes, tras varios días de tratamiento antibiótico los síntomas se incrementaron con eliminación de resto membranoso en heces, se refiere a un hospital; donde se realiza el estudio de toxinas de Clostridium difficile, resultando positivo, por lo cual, se establece el diagnostico de colitis pseudomembranosa. Se administra metronidazol y vancomicina por 7 días, con una evolución favorable. El uso de antibióticos es un factor predisponente de colitis pseudomembranosa por la afectación de la microbiota intestinal; además de la estancia hospitalaria y factores intrínsecos. En la literatura se describe un número reducido de estudios sobre esta infección en pacientes pediátricos de allí la importancia del reporte de caso.

Clostridium difficile is a bacillus Gram positive and spore form, anaerobic strictly, resistant to adverse conditions and transmitted by oral - fecal route, it was described by the first time in 1930, nevertheless it's has been associated to disease in human beings in the decade of the seventies it identified as causal agent of pseudomembranous colitis. Its infection has related to diverse clinical manifestations such as diarrhea without complications, which lead to sepsis and inclusive the death. In the following clinical case we have a male infant 1 year old and 18 months patient, with precedents of hyperthermia and liquid depositions, after several days of antibiotics treatment, the symptoms increased with elimination of membranous rest in the faeces; reason why he is transferred to a hospital, in which the Clostridium difficile toxins test is realized, yielding positive results, therefore the diagnosis of pseudomembranous colitis is established metronidazole and vancomycin is given for 7 days having a favorable development. The use of antibiotics is a predisposing factor of pseudomembranous colitis for the affectation of the intestinal microbiota, in addition hospital stays and intrinsic factors. The literature describes a limited number of studies about this infection in pediatric patients, hence the importance of the case report

In situ increased chemokine expression in human cervical intraepithelial neoplasia.

Chemokines play a role in tumor-inflammation and angiogenesis that could be involved in tumor progression. Monocyte chemoattractant protein-1 (MCP-1), Interleukin-8 (IL-8) and macrophage inflammatory proteins (MIP) have been identified in tumor tissues of patients with different neoplasms. Therefore, the aim of the current study was to investigate the expressions of MCP-1, IL-8 and MIP-1α, mononuclear leukocyte infiltration and leukocyte/chemokine expressions in cervical tissues from patients with cervical intraepithelial neoplasia (CIN) and controls. MCP-1, IL-8 and MIP-1α expressions and leukocyte infiltration were determined by indirect immunofluorescence in cervix biopsies from CIN patients (n=65) and 7 normal controls. Increased expressions of MCP-1 and IL-8 in CIN were observed. Increment of lymphocyte infiltration and coexpression of CD3/MCP-1 and CD3/IL-8 were found in CIN. CD3/MCP-1 cell percentage was found decreased and CD3/IL-8 percentage increased according to the CIN evolution. MIP-1α remained similar to control values. The increased expression of MCP-1 and IL-8 in cervical neoplasia may lead to tumor progression.

Increased vascular endothelial growth factor expression, CD3-positive cell infiltration, and oxidative stress in premalignant lesions of the cervix.

BACKGROUND: Vascular endothelial growth factor (VEGF) plays an important role in cervical intraepithelial neoplasia (CIN) progression. The occurrence of leukocytes has been documented in CIN; however, their role in VEGF production remains unknown. Oxidative stress has been involved in the progression of malignant neoplasias, but to the authors' knowledge tissue oxidative stress in CIN has not been documented. The objective of the current study was to investigate the expression of VEGF, leukocyte infiltration, leukocyte VEGF expression, and nitrogen/oxygen metabolism in cervical tissues from patients with CIN. METHODS: Indirect immunofluorescence was used to study the expression of VEGF and leukocyte infiltration in cervical samples from 55 patients with CIN and 7 normal controls. Superoxide anion (O(2) (-)) expression was determined by a cytochemical method, and tissue and serum nitric oxide by the Griess reaction. Human papillomavirus (HPV) DNA and HPV types were identified by the hybrid capture 2 HPV DNA test. RESULTS: Increased expression of VEGF was observed related to the progression of CIN. A significant increment of CD3 lymphocytes was found in CIN type 3 (CIN 3) and coexpression of CD3/VEGF and monocyte-macrophage/VEGF in CIN 2 and 3. Increased O(2) (-)-positive cells were found in CIN 2 and 3; however, tissue nitrate-nitrite content remained similar to controls. The incidence of HPV infection was 16% in patients with CIN. No significant differences were observed in the values of HPV-positive or HPV-negative patients. CONCLUSIONS: Different factors leading to cervical neoplasia progression may be involved in the evolution of CIN, and the presence of these factors is most likely not related to the HPV infection status.