La Revista de Medicina y Cine como facilitador de publicaciones científicas de los estudiantes / The Journal of Medicine and Movies as a facilitator of students' scientific publications

La Revista de Medicina y Cine siempre estuvo abierta a publicar artículos de alumnos tanto de ciencias de la salud como de otras titulaciones. Una de las pretensiones de la revista fue el estimular la participación de los estudiantes como autores de sus publicaciones. El objetivo del presente artículo consiste en describir la participación de estudiantes en la revista informando del número de artículos publicados, del número de autores, del tipo de trabajo realizado, de las universidades de procedencia, de las películas comentadas y de los temas tratados. Se revisaron todos los artículos publicados desde el año 2005, inicio de la revista, hasta el año 2019. Se registraron 42 artículos con participación de estudiantes (16,9 % del total) con 60 autores procedentes de 12 universidades distintas y de 10 titulaciones diferentes, seis de ellas de ciencias de la salud. Se concluye que la Revista de Medicina y Cine, además de ser un medio para fomentar el aprendizaje en estudios de ciencias de la salud, puede facilitar a los estudiantes el desarrollo de la competencia genérica de elaborar artículos científicos

The Journal of Medicine and Movies was always open to publish articles by students of health sciences and other degrees. Encouraging the participation of students was always one of the pretensions of the journal. The objective of this article is to describe the participation of students in the journal informing of the number of articles published, the number of authors, the type of work carried out, the universities of origin, the commented films and the topics discussed. All articles published since 2005, at the beginning of the magazine, until 2019 were reviewed.42 articles were registered with the participation of students (16,9 % of total) with 60 authors from 12 different universities and 10 different degrees, six of them from health sciences. It is concluded that the Journal of Medicine and Movies, in addition to being a means to promote learning in health science studies, can facilitate to the students the development of the generic competence to produce scientific articles

La microbiología médica y las enfermedades infecciosas en el cómic / Medical microbiology and infectious diseases and comics

No disponible

Cardiotrophin-1 attenuates experimental colitis in mice.

Cardiotrophin-1 (CT-1) holds potent anti-inflammatory, cytoprotective, and anti-apoptotic effects in the liver, kidneys, and heart. In the present study, the role of endogenous CT-1 and the effect of exogenous CT-1 were evaluated in experimental ulcerative colitis. Colitis was induced in CT-1 knockout and wild-type (WT) mice by administration of dextran sulphate sodium (DSS) in the drinking water during 7 days. CT-1 knockout mice showed higher colon damage and disease severity than WT mice. In addition, CT-1 (200 µg/kg/day, iv) or vehicle (as control) was administered during 3 days to WT, colitic mice, starting on day 4 after initiation of DSS. Disease activity index (DAI), inflammatory markers (tumor necrosis factor α (TNF-α), INFγ, IL-17, IL-10, inducible nitric oxide synthase (iNOS)), colon damage, apoptosis (cleaved caspase 3), nuclear factor κB (NFκB) and STAT-3 activation, and bacterial translocation were measured. Compared with mice treated with DSS, mice also treated with exogenous CT-1 showed lower colon damage, DAI, plasma levels of TNFα, colon expression of TNF-α, INFγ, IL-17, iNOS and cleaved caspase 3, higher NFκB and signal transducer and activator of transcription 3 (STAT3) pathways activation, and absence of bacterial translocation. We conclude that endogenous CT-1 plays a role in the defense and repair response of the colon against ulcerative lesions through an anti-inflammatory and anti-apoptotic effect. Supplementation with exogenous CT-1 ameliorates disease symptoms, which opens a potentially new therapeutic strategy for ulcerative colitis.

Simulación de la propagación de un brote por Acinetobacter baumannii en entornos hospitalarios / Simulation of an outbreak of Acinetobacter baumannii in hospitals

Introducción. Las infecciones por Acinetobacter baumannii se han convertido en un hecho habitual y preocupante en los ambientes hospitalarios. Consecuentemente son de especial importancia aquellas aplicaciones que permitan no sólo simular la aparición y propagación de un brote, sino también evaluar las posibles medidas de control. El desarrollo de modelos matemáticos juega un papel decisivo en esta tarea. Material y métodos. Se desarrolló un modelo matemático determinista basado en ecuaciones diferenciales ordinarias, cuyas variables y parámetros fueron identificados a partir del conocimiento de la epidemiología y de las características de A. baumannii. Dicho modelo fue analizado cualitativamente e implementado computacionalmente. Resultados. La implementación computacional del modelo teórico posibilitó obtener múltiples simulaciones a partir de diferentes condiciones iniciales. El análisis cualitativo de las mismas permitió definir de manera explícita las medidas de control más efectivas a la hora de controlar esta infección nosocomial. Conclusiones. La herramienta desarrollada es de gran utilidad en la gestión (predicción del comportamiento y evaluación de contramedidas profilácticas) de brotes por A. baumannii. Se demuestra de manera teórica la eficacia de medidas higiénicas y de cribado (AU)

Introduction. Acinetobacter baumannii infections have increased over time becoming a significant issue. Consequently, those applications that allow to predict the evolution of an outbreak and the relevance of the different control methods, are very important. The design of mathematical models plays a central role in this topic. Material and methods. Development of a deterministic mathematical model based on ordinary differential equations whose variables and parameters are defined upon the basis of knowledge of the epidemiology and characteristics of A. baumannii. This model is analyzed from a qualitative point of view and, also, its computational implementation is derived. Results. Several simulations were obtained developed from different initial conditions. The qualitative analysis of these simulations provides formal evidence of most effective control measures. Conclusions. The implementation of the computational model is an extremely useful tool in terms of managing A. baumannii outbreaks. There is mathematical proof of the fact that the observance of efficient hygiene and screening rules reduces the number of infected patients (AU)

Comparative study of bacterial translocation control with nitric oxide donors and COX2 inhibitor / Estudio comparativo del control de la translocación bacteriana con donadores de óxido nítrico e inhibidor de la COX2

OBJECTIVE AND DESIGN: To evaluate the beneficial effects of exogenous NO and an inhibitor of the COX2, and their action levels in a model of SIRS/bacterial translocation (BT) induced by Zymosan A®. MATERIAL AND METHODS: Ninety Wistar rats were submitted to different treatments, and after 12h and 24h they were anaesthetized in order to collect blood, mesenteric lymph nodes, and kidney for subsequent biochemical analyses and microbiological examinations. Treatments. A nitric oxide donor, Molsidomine®, was compared with a COX2 inhibitor, Celecoxib®. METHODS: Zymosan A® was administered to Wistar rats. The animals were divided into 6 groups: one group for survival study, Group (1) No manipulation (BASAL); Group (2) vehicle of Zymosan A® given intraperitoneally (SHAM); Group I (control), with Zymosan A® (0.6g/kg) intraperitoneally; Group II (Molsidomine), with Molsidomine® (4mg/kg) through the penis dorsal vein, 30min prior to administration of the Zy® (0.6g/kg); Group III (Celecoxib), with Celecoxib® (400mg/kg) orally through a stomach tube, 6h prior to administration of the Zy (0.6g/kg). Determinations. The parameters survival, bacterial translocation, renal function, neutrophil accumulation, oxygen free radicals (OFR), detoxifying enzymes, and cytokines were measured at different times after Zymosan administration. RESULTS: The model established induced a mortality rate of 100% and generated BT and systemic inflammatory response syndrome (SIRS) in all samples. It also significantly increased all variables, with p<.001 for MPO and all pro-inflammatory cytokines, and p<.01 for all OFR. Treatment with Molsidomine reduced mortality to 0%, decreased BT, MPO, pro-inflammatory cytokines and OFR (p<.001) significantly and increased IL-10 and IL-6 production. Moreover, the Celecoxib® showed a lower capacity for SIRS regulation. CONCLUSIONS: The exogenous administration of NO prevented BT and controlled SIRS. Therefore these results suggest that Molsidomine could be used as a therapeutic strategy to protect against BT

OBJETIVO Y DISEÑO. Evaluar los efectos beneficiosos del ON exógeno y de un inhibidor de la COX2 y sus niveles de acción en un modelo de síndrome de respuesta inflamatoria sistémica (SIRS)/traslocación bacteriana (TB) inducida por Zymosan A®. MATERIALES Y MÉTODOS: Noventa ratas Wistar fueron sometidas a diferentes tratamientos, y después de 12 y 24 horas fueron anestesiadas para recoger sangre, nódulos linfáticos mesentéricos y tejido renal, para analizarlos bioquímica y microbiológicamente. Tratamientos. Un donador de óxido nítrico, Molsidomina®, fue comparado con Celecoxib®, inhibidor de la COX2. MÉTODOS: Se administró Zymosan A® a las ratas Wistar. Estas fueron divididas en CINCO grupos: grupo 1 (basal), sin manipulaciones; grupo 2 (sham), vehículo de Zymosan A® administrado intraperitonealmente; grupo I (control), con Zymosan A® (0,6 g/kg) intraperitoneal; grupo II (Molsidomina) con Molsidomina® (4 mg/kg) administrada a través de la vena dorsal del pene, 30 minutos antes de la administración de Zymosan® (0,6 g/kg); y grupo III (Celecoxib) con Celecoxib® (400 mg/kg) administrado oralmente por tubo esomacal, 6 horas antes de la administración de Zymosan A® (0,6 g/kg). Determinaciones. Se midieron los parámetros supervivencia, traslocación bacteriana, función renal, acumulación de neutrófilos, radicales libres de oxígeno, enzimas detoxificantes y citoquinas, a diferentes tiempos después de la administración de Zymosan®. RESULTADOS: El modelo establecido inducía una tasa de mortalidad del 100%, y se generaba traslocación bacteriana y síndrome de respuesta inflamatoria sistémica en todas las muestras. También se incrementaban significativamente todas las variables, con p < 0,001 para mieloperoxidasa y todas las citokinas proinflamatorias, y p < 0,01 para todos los radicales libres de oxígeno. El tratamiento con Molsidomina reducía la mortalidad al 0%, disminuía la traslocación bacteriana, mieloperoxidasas, citokinas proinflamatorias y radicales libres de oxígeno (p < 0,001), e incrementaba la producción de IL-10 e IL-6. Además, Celecoxib® mostró una menor capacidad para la regulación del síndrome de respuesta inflamatoria sistémica. CONCLUSIONES: La administración exógena de óxido nítrico evita la traslocación bacteriana y controla el síndrome de respuesta inflamatoria sistémica. Estos resultados sugieren que Molsidomina podría usarse como estrategia terapéutica frente a la traslocación bacteriana

El microbiólogo clínico ante los cambios taxonómicos en el género Clostridium / The clinical microbiologist before the taxonomic changes in the genus Clostridium

Las especies incluidas en el género Clostridium son muy heterogéneas, tanto que desde un punto de vista fenotípico como filogenético. Los avances en la taxonomía polifásica y en particular en la filogenia están permitiendo resolver esta disfunción reclasificando a numerosas especies en otros géneros, aunque aún resta trabajo por hacer. Los cambios en las denominaciones genéricas son algo normal en taxonomía pero puede convertirse en un problema cuando afectan a especies con gran impacto clínico conocidas desde hace muchos años como es el caso de algunas especies tradicionales del género Clostridium. Tras conocerlos los microbiólogos clínicos, en cuyo quehacer la taxonomía es fundamental, deben valorar que está antes, la comunicación con los profesionales de la salud o la filogenia y valorar que quizás haya posibilidades de combinar ambos hechos. Este artículo revisa alguno de los cambios taxonómicos acaecidos en especies conocidas del género Clostridium, que genéticamente no pertenecen a este género, que pueden tener interés en clínica y evalúa, en lo posible, su trascendencia en la comunicación científica y sanitaria (AU)

The various species included in the genus Clostridium are very heterogeneous, both from a phenotypic and a phylogenetic point of view. The advances in polyphasic taxonomy, particularly in phylogeny, are allowing to resolve this dysfunction reclassifying several species in other genres, although there is still work to be done. Changes in generic denominations are quite normal in taxonomy, but can turn into a problem when they affect species with strong clinical impact and that have been recognised for a long time, as in the case of some traditional Clostridium species. After knowing these changes clinical microbiologists, in whose work taxonomy is an essential tool, should evaluate what matters most, if the communication with other health professionals or the phylogeny, and think about the possibility of combining both things. This paper reviews some of the taxonomic changes that have took place in well-known Clostridium species that can be clinically interesting and evaluates, as far as possible, their significance in the scientific and medical communication (AU)

Cambios en la epidemiología de la infección por Clostridium difficile durante 2005-2014 en Salamanca, España / Changes in the epidemiology of Clostridium difficile infection during 2005-2014 in Salamanca, Spain

Introducción. Conocer los rasgos epidemiológicos más relevantes de la infección por Clostridium difficile (ICD) ocurrida en la provincia de Salamanca (España) entre 2005-2014. Métodos. Estudio descriptivo transversal realizado a partir del archivo informático del Servicio de Microbiología del Complejo Asistencial Universitario de Salamanca. La detección se realizó según la metodología habitual. Resultados. El 2,6% de las muestras de heces analizadas para detección de toxinas de C. difficile (9.103) fueron positivas. La prevalencia media global fue de 6,8 casos por 100.000 habitantes y año. La media de edad fue de 65 ± 21,4 años y la mediana 70 años. El 59% de los casos se produjo en mayores de 64 años, con una prevalencia media anual de 16,5 (4 veces superior a la del grupo de 15-64). La mayoría de casos (86.4%) se produjeron en pacientes hospitalizados, siendo el grupo de mayores de 64 años el de mayor porcentaje de ICD hospitalaria, con un 55%. Conclusiones. Se observa un incremento significativo del número de peticiones y de la prevalencia de ICD a lo largo de la década estudiada y unas tasas de prevalencia bastante inferiores a las de otros estudios. El porcentaje de ICD aumentó de manera significativa tanto en pacientes hospitalizados como en los comunitarios. La edad y la hospitalización fueron factores de riesgo para desarrollar ICD. Tras la introducción de una técnica molecular de detección en 2014, la prevalencia aumentó, siendo 2.5 veces superior a la del 2013 (AU)

Background. To know the most relevant epidemiological features of Clostridium difficile infection (CDI) between 2005-2014 in the province of Salamanca (Spain). Methods. Descriptive cross-sectional study carried out through review of the clinical microbiologic records at Complejo Asistencial Universitario de Salamanca. Detection was performed according to standard methodology. Results. 2.6% of stool samples analyzed for detection of C. difficile toxins (9.103) were positive. The average prevalence was 6.8 cases per 100,000 people per year. The mean age was 65 ± 21.4 years and the median 70 years. 59% of cases occurred in patients over 64 years, with an average prevalence of 16.5 (4 times higher than the 15-64 group). Most cases (86.4%) occurred in hospitalized patients, and the group of over 64 had the highest percentage of hospital CDI, with 55%. Conclusions. A significant increase in the number of requests and in the prevalence of CDI over the decade studied is observed, and prevalence rates were significantly lower than those of other studies. The percentage of CDI increased significantly in both inpatient and community. Age and hospitalization were risk factors for developing CDI. After the introduction of a molecular detection technique in 2014, the prevalence increased, being 2.5 times higher than 2013 (AU)

Cambios en la epidemiología de las gastroenteritis causadas por Salmonella durante 2005-2014 en Salamanca, España / Changes in the epidemiology of gastroenteritis caused by Salmonella during 2005-2014 in Salamanca, Spain

Introducción. En España no abundan estudios poblacionales actualizados sobre salmonelosis, a pesar de ser una de las etiologías de gastroenteritis agudas (GEAs) bacterianas más habituales en el mundo. El objetivo fue conocer los rasgos epidemiológicos más relevantes de las GEAs producidas por Salmonella spp. entre 2005-2014 en Salamanca (España). Métodos. Estudio descriptivo transversal realizado a partir del archivo informático del Servicio de Microbiología del Complejo Asistencial Universitario de Salamanca. El cultivo, aislamiento, identificación y serotipificación se realizaron según la metodología habitual. Resultados. Salmonella se aisló en 1.477 pacientes, representando el 47,7% del total de coprocultivos positivos y el 53,3% de todos los ingresos por GEA bacteriana. La prevalencia media fue de 42,1 casos/100.000 habitantes y año. La media de edad fue de 23 ± 28 años y la mediana 7 años. El 40,2% de todos los aislamientos se produjo en menores de 5 años, con una prevalencia media de 45,1 casos/10.000 habitantes y año. Globalmente, el serotipo aislado con más frecuencia fue S. Typhimurium con un 57%, seguido por S. Enteritidis con un 35,8%. Conclusiones. La prevalencia de Salmonella disminuyó a lo largo del tiempo. El grupo entre 0-4 años presentó la tasa más alta durante todo el periodo. Sin embargo, produjo el mayor porcentaje de hospitalizaciones por GEA bacteriana. El serotipo S. Typhimurium ha reemplazado en los últimos años al serotipo S. Enteritidis y predomina en pacientes de menor edad. Se aprecia una infranotificación de los casos de salmonelosis producidos en Salamanca a pesar de ser obligatoria su declaración desde 2007 (AU)

Background. In Spain there are not many updated population studies about salmonellosis, despite being one of the most common etiologies of acute gastroenteritis (AGEs) caused by bacteria in the world. The aim of the study was to know the most relevant epidemiological features of AGEs produced by Salmonella spp. between 2005 and 2014 in Salamanca (Spain). Methods. Descriptive cross-sectional study carried out through review of the clinical microbiologic records at Complejo Asistencial Universitario de Salamanca. Culture, isolation, identification and serotyping were performed according to standard methodology. Results. Salmonella was isolated in 1,477 patients, representing 47.7% of all positive stool cultures and 53.3% of all income bacterial AGE. The average prevalence was 42.1 cases/100,000 people per year. The mean age was 23 ± 28 years and the median 7 years. 40.2% of all isolates occurred in children under 5 years, with an average prevalence of 45.1 cases/ 10,000 people per year. Overall, the most frequently isolated serotype was S. Typhimurium with 57%, followed by S. Enteritidis with 35.8%. Conclusions. The prevalence of Salmonella decreased over time. The group aged 0-4 years had the highest rate throughout the period. However, Salmonella produced the highest percentage of hospitalizations for bacterial AGE. In recent years, S. Typhimurium serotype has replaced S. Enteritidis serotype and predominates in younger patients. It is observed under-reporting of cases of salmonellosis produced in Salamanca despite being mandatory notification of these since 2007 (AU)

[Changes in the epidemiology of gastroenteritis caused by Salmonella during 2005-2014 in Salamanca, Spain]. / Cambios en la epidemiología de las gastroenteritis causadas por Salmonella durante 2005-2014 en Salamanca, España.

OBJECTIVE: In Spain there are not many updated population studies about salmonellosis, despite being one of the most common etiologies of acute gastroenteritis (AGEs) caused by bacteria in the world. The aim of the study was to know the most relevant epidemiological features of AGEs produced by Salmonella spp. between 2005 and 2014 in Salamanca (Spain). METHODS: Descriptive cross-sectional study carried out through review of the clinical microbiologic records at Complejo Asistencial Universitario de Salamanca. Culture, isolation, identification and serotyping were performed according to standard methodology. RESULTS: Salmonella was isolated in 1,477 patients, representing 47.7% of all positive stool cultures and 53.3% of all income bacterial AGE. The average prevalence was 42.1 cases/100,000 people per year. The mean age was 23 ± 28 years and the median 7 years. 40.2% of all isolates occurred in children under 5 years, with an average prevalence of 45.1 cases/ 10,000 people per year. Overall, the most frequently isolated serotype was S. Typhimurium with 57%, followed by S. Enteritidis with 35.8%. CONCLUSIONS: The prevalence of Salmonella decreased over time. The group aged 0-4 years had the highest rate throughout the period. However, Salmonella produced the highest percentage of hospitalizations for bacterial AGE. In recent years, S. Typhimurium serotype has replaced S. Enteritidis serotype and predominates in younger patients. It is observed under-reporting of cases of salmonellosis produced in Salamanca despite being mandatory notification of these since 2007.

Comparative study of bacterial translocation control with nitric oxide donors and COX2 inhibitor.

OBJECTIVE AND DESIGN: To evaluate the beneficial effects of exogenous NO and an inhibitor of the COX2, and their action levels in a model of SIRS/bacterial translocation (BT) induced by Zymosan A(®). MATERIAL AND METHODS: Ninety Wistar rats were submitted to different treatments, and after 12h and 24h they were anaesthetized in order to collect blood, mesenteric lymph nodes, and kidney for subsequent biochemical analyses and microbiological examinations. TREATMENTS: A nitric oxide donor, Molsidomine(®), was compared with a COX2 inhibitor, Celecoxib(®). METHODS: Zymosan A(®) was administered to Wistar rats. The animals were divided into 6 groups: one group for survival study, Group (1) No manipulation (BASAL); Group (2) vehicle of Zymosan A(®) given intraperitoneally (SHAM); Group I (control), with Zymosan A(®) (0.6g/kg) intraperitoneally; Group II (Molsidomine), with Molsidomine(®) (4mg/kg) through the penis dorsal vein, 30min prior to administration of the Zy(®) (0.6g/kg); Group III (Celecoxib), with Celecoxib(®) (400mg/kg) orally through a stomach tube, 6h prior to administration of the Zy (0.6g/kg). DETERMINATIONS: The parameters survival, bacterial translocation, renal function, neutrophil accumulation, oxygen free radicals (OFR), detoxifying enzymes, and cytokines were measured at different times after Zymosan administration. RESULTS: The model established induced a mortality rate of 100% and generated BT and systemic inflammatory response syndrome (SIRS) in all samples. It also significantly increased all variables, with p<.001 for MPO and all pro-inflammatory cytokines, and p<.01 for all OFR. Treatment with Molsidomine reduced mortality to 0%, decreased BT, MPO, pro-inflammatory cytokines and OFR (p<.001) significantly and increased IL-10 and IL-6 production. Moreover, the Celecoxib(®) showed a lower capacity for SIRS regulation. CONCLUSIONS: The exogenous administration of NO prevented BT and controlled SIRS. Therefore these results suggest that Molsidomine could be used as a therapeutic strategy to protect against BT.

La polio, el largo camino hacia el final de la partida / Polio, the long walk to the endgame

A pesar de que para la OMS la polio debería haber sido erradicada en el año 2000 -gracias a la vacunación y a los recursos institucionales, públicos y privados, destinados a tal fin- en 2013 la enfermedad siguió siendo endémica en tres países, Afganistán, Pakistán y Nigeria y se describieron casos en otros cinco. La circulación de poliovirus tipo 1 salvaje en Israel, Gaza y Cisjordania y los casos de Siria fueron una llamada de atención, como en su momento lo fueron los virus derivados de la vacuna oral que siguen siendo un problema. Los viajes «desde» y «a» zonas endémicas son un factor a tener en cuenta en la exportación de los virus y su difusión cuando llegan a zonas con carencias vacunales. Los conflictos bélicos, las persecuciones, la intolerancia, la incultura y la proliferación de grupos y movimientos «antivacunación» son en gran parte la causa de la ausencia y del abandono de la vacunación. En 2014 la situación se ha complicado, tanto que el Comité de Emergencias de la OMS se reunió en mayo para abordar el problema. Es necesario conocer la enfermedad y su agente causal, en el primer caso porque habrá que pensar en ella a la hora de hacer un diagnóstico diferencial de la parálisis flácida y seguir vacunando y en el segundo porque será imprescindible seguir buscando en muestras ambientales el virus de la polio, del que se desconocen muchos aspectos, pues es un modelo para el estudio de otros muchos virus

Although the WHO original target date for the global eradication of poliomyelitis was the year 2000 –thanks to vaccination and institutional, public and private, resources for that purpose–, in 2013 the disease remained endemic in three countries, Afghanistan, Pakistan and Nigeria, and some cases were described in five others. The circulation of wild type 1 poliovirus in Israel, Gaza and the West Bank and the cases in Syria were a wakeup call, as at that time there were polioviruses derived from the oral vaccine that are still circulating among the human population and can cause the development of the disease. Travelling “from” and “to” endemic areas are factors to consider in poliovirus exportation and in its spread when it reaches areas with poor immunogenicity. Wars, terrorism, intolerance, lack of culture and proliferation of anti-vaccine groups and the rise of the anti-vaccination movement are important factors in the maintenance and expansion of the virus and in the “non-vaccination” against it. Based on the international situation to date, the Emergency Committee of WHO met in May 2014 to address the problem. It is still necessary to enhance the knowledge of the disease and its agent. In the first case to perform a differential diagnosis of flaccid paralysis and to continue vaccination programs, and in the second case to keep studying and looking for the poliovirus in environmental samples, which is a model for the study of many other viruses

[Noma/Cancrum oris: a neglected disease]. / La enfermedad de Noma/cancrum oris: una enfermedad olvidada.

Noma is an aggressive orofacial gangrenous pathology that damages hard and soft tissues of the mouth and the face. Throughout the centuries it has been present around the globe, but nowadays it has practically disappeared from developed countries and mainly affects children from the most disadvantaged places, especially in Africa. Noma disease is a multifactorial process; malnutrition, debilitating diseases (bacterial or viral systemic diseases, HIV-associated immunosuppression, etc.) and intraoral infections are some of the factors implied. The characteristic tissue necrosis is produced by a polymicrobial infection. Fusobacterium necrophorum, Prevotella intermedia, Prevotella melaninogenica, Fusobacterium nucleatum, Bacteroides fragilis, Bacillus cereus, Trueperella pyogenes, spyrochetes, etc, are some of the species that have been isolated from the affected areas. Without treatment, noma is lethal in a short period of time, and the patients that survive show severe sequelae that hinder their life and interpersonal relationships. The aim of this paper is to unify the existing information and to promote wider knowledge and awareness among the population.

La enfermedad de Noma/cancrum oris: una enfermedad olvidada / Noma/Cancrum oris: a neglected disease

La enfermedad de Noma es una patología gangrenosa agresiva orofacial que daña a tejidos duros y blandos de la boca y de la cara. A lo largo de los siglos ha estado presente en todo el planeta, aunque en la actualidad ha desaparecido prácticamente de los países desarrollados, afectando casi siempre a niños de los lugares más desfavorecidos, especialmente en el continente africano. Es un proceso multifactorial en el que intervienen factores como la malnutrición, las enfermedades debilitantes (infecciones sistémicas bacterianas o víricas, inmunodepresión asociada al VIH, etc.) y las infecciones intraorales. La necrosis tisular característica la origina una infección polimicrobiana. Algunas de las especies que se han aislado de las zonas afectadas son: Fusobacterium necrophorum, Prevotella intermedia, Prevotella melaninogenica, Fusobacterium nucleatum, Bacteroides fragilis, Bacillus cereus, Trueperella pyogenes, espiroquetas, etc. Sin tratamiento es letal en poco tiempo, y los pacientes que sobreviven presentan graves secuelas que dificultan su vida y sus relaciones interpersonales. El objetivo de esta revisión es unificar la información existente y promover un mayor conocimiento y concienciación de la población (AU)

Noma is an aggressive orofacial gangrenous pathology that damages hard and soft tissues of the mouth and the face. Throughout the centuries it has been present around the globe, but nowadays it has practically disappeared from developed countries and mainly affects children from the most disadvantaged places, especially in Africa. Noma disease is a multifactorial process; malnutrition, debilitating diseases (bacterial or viral systemic diseases, HIV-associated immunosuppression, etc.) and intraoral infections are some of the factors implied. The characteristic tissue necrosis is produced by a polymicrobial infection. Fusobacterium necrophorum, Prevotella intermedia, Prevotella melaninogenica, Fusobacterium nucleatum, Bacteroides fragilis, Bacillus cereus, Trueperella pyogenes, spyrochetes, etc, are some of the species that have been isolated from the affected areas. Without treatment, noma is lethal in a short period of time, and the patients that survive show severe sequelae that hinder their life and interpersonal relationships. The aim of this paper is to unify the existing information and to promote wider knowledge and awareness among the population (AU)

[Prevention of an outbreak of Acinetobacter baumannii in intensive care units: study of the efficacy of different mathematical methods]. / Prevención de un brote de Acinetobacter baumannii en una unidad de cuidados intensivos: eficacia de diversos métodos matemáticos.

INTRODUCTION: Although in past decades, Acinetobacter baumanni infections have been sporadically identified in hospitals, nowadays the nosocomial infections due to this pathogen have notably increased. Its importance is due to its multidrug- resistance, morbidity and mortatility in healthcare settings. Consequently, it is important to predict the evolution of these outbreaks in order to stablish the most efficient control measures. There are several experimental studies shown that the compliance with hand and environmental hygiene and the efficient management of the healthcare work help to control the evolution of these outbreaks. The goal of this work is to formally proof these experimental results by means of the analysis of the results provided by the model. METHODS: A stochastic mathematical model based on cellular automata was developed. The variables and parameters involved in it have been identified from the knowledge of the epidemiology and main characteristics of Acinetobacter infections. RESULTS: The model provides several simulations from different initial conditions. The analysis of these results proofs in a formal way that the compliance with hand and environmental hygiene and an efficient plannification of the work of healtcare workers yield a decrease in the colonized patients. Moreover, this is the unique model proposed studying the dynamics of an outbreak of A. baumanni. CONCLUSIONS: The computational implementation of the model provides us an efficient tool in the management of outbreaks due to A. baumanni. The analysis of the simulations obtained allows us to obtain a formal proof of the behaviour of the measures for control and prevention.

Las bacterias anaerobias 150 años después de su descubrimiento por Pasteur / Anaerobic bacteria 150 years after their discovery by Pasteur

El año 2011 marcó el 150 aniversario del descubrimiento de las bacterias anaerobias por Louis Pasteur. Tras este tiempo el interés biomédico por ellas se mantiene, y Clostridium difficile es probablemente la que más interés despierta en la actualidad. En estos últimos años se han producido importantes avances en taxonomía gracias al desarrollo tecnológico e informático, particularmente en el campo de la genética; así, se han caracterizado un número importante de nuevas especies implicadas en infecciones humanas y se han reclasificado algunas ya conocidas. A nivel patogénico, algunos anaerobios de la microflora que no se habían aislado de infecciones humanas se han aislado en algún cuadro clínico, ha habido emergencia o reemergencia de algunas especies y cuadros, ciertos anaerobios se han relacionado con síndromes infecciosos establecidos, ha aumentado la virulencia de algunas cepas y se han formulado hipótesis sobre su participación en ciertas enfermedades. En cuanto al diagnóstico, la generalización del MALDI-TOF ha supuesto una reducción de tiempo y un abaratamiento en la identificación que mejora día a día según se optimizan las bases de datos. La aplicación de la PCR en tiempo real ha sido otro gran avance, y la secuenciación del ARNr 16S y otros genes es ya una realidad para muchos laboratorios. Los anaerobios han ido aumentando su resistencia a los antimicrobianos, y la aparición de la resistencia a carbapenem y metronidazol y la mutirresistencia son ya una realidad. En esta última situación linezolid puede ser una buena alternativa en Bacteroides. Fidaxomicina es el único antianaerobio introducido en los últimos años, en concreto para la diarrea por C. difficile. Por último, se han desarrollado modelos matemáticos para el estudio de esta especie

In 2011 we celebrated the 150 th anniversary of the discovery of anaerobic bacteria by Louis Pasteur. The interest of the biomedical community on such bacteria is still maintained, and is particularly focused on Clostridium difficile. In the past few years important advances in taxonomy have been made due to the genetic, technological and computing developments. Thus, a significant number of new species related to human infections have been characterised, and some already known have been reclassified. At pathogenic level some specimens of anaerobic microflora, that had not been isolated from human infections, have been now isolated in some clinical conditions. There was emergence (or re-emergence) of some species and clinical conditions. Certain anaerobic bacteria have been associated with established infectious syndromes. The virulence of certain strains has increased, and some hypotheses on their participation in certain diseases have been given. In terms of diagnosis, the routine use of MALDI-TOF has led to a shortening of time and a cost reduction in the identification, with an improvement directly related to the improvement of data bases. The application of real-time PCR has been another major progress, and the sequencing of 16s rRNA gene and others is currently a reality for several laboratories. Anaerobes have increased their resistance to antimicrobial agents, and the emergence of resistance to carbapenems and metronidazole, and multi-resistance is a current reality. In this situation, linezolid could be an effective alternative for Bacteroides. Fidaxomicin is the only anti-anaerobic agent introduced in the recent years, specifically for the diarrhoea caused by C. difficile. Moreover, some mathematical models have also been proposed in relation with this species

Prevención de un brote de Acinetobacter baumannii en una unidad de cuidados intensivos: eficacia de diversos métodos matemáticos / Prevention of an outbreak of Acinetobacter baumannii in intensive care units: study of the efficacy of different mathematical methods

Introducción. Las infecciones nosocomiales por Acinetobacter baumannii han pasado de ser un hecho poco representativo a habitual en muchos servicios de Medicina Intensiva por su frecuencia, mortalidad asociada y resistencia a los antimicrobianos. Cuando se produce un brote es importante poder predecir su evolución y el impacto global e individualizado de los diferentes métodos de control. Se ha demostrado experimentalmente que tomar determinadas medidas (lavado de manos, planificación del trabajo del personal sanitario, etc.) ayuda a controlar y prevenir tanto la aparición como la extensión de dichos brotes. El objetivo es demostrar de manera formal los resultados empíricos comentados anteriormente valiéndonos de un novedoso modelo matemático. Material y Métodos. Se desarrolló un modelo matemático estocástico basado en autómatas celulares. A partir del conocimiento de la epidemiología y de las características de A. baumanii se identificaron las variables y los parámetros del modelo. Resultados. El modelo proporciona múltiples simulaciones usando diferentes condiciones iniciales. Su análisis demuestra formalmente que el cumplimiento con las normas de higiene así como una correcta planificación del trabajo del personal sanitario reduce el número de pacientes colonizados. Asimismo, no existe en la literatura especializada otro modelo matemático que estudie la dinámica de un brote por A. baumannii. Conclusiones. La implementación computacional del modelo proporciona una herramienta de gran utilidad para la comunidad sanitaria en la gestión de brotes por A. baumanii en ambientes hospitalarios. Se prueba matemáticamente como unas eficientes medidas higiénicas y de planificación del trabajo del personal sanitario reducen el número de pacientes colonizados (AU)

Introduction. Although in past decades, Acinetobacter baumanni infections have been sporadically identified in hospitals, nowadays the nosocomial infections due to this pathogen have notably increased. Its importance is due to its multidrug-resistance, morbidity and mortatility in healthcare settings. Consequently, it is important to predict the evolution of these outbreaks in order to stablish the most efficient control measures. There are several experimental studies shown that the compliance with hand and environmental hygiene and the efficient management of the healthcare work help to control the evolution of these outbreaks. The goal of this work is to formally proof these experimental results by means of the analysis of the results provided by the model. Methods. A stochastic mathematical model based on cellular automata was developed. The variables and parameters involved in it have been identified from the knowledge of the epidemiology and main characteristics of Acinetobacter infections. Results. The model provides several simulations from different initial conditions. The analysis of these results proofs in a formal way that the compliance with hand and environmental hygiene and an efficient plannification of the work of healtcare workers yield a decrease in the colonized patients. Moreover, this is the unique model proposed studying the dynamics of an outbreak of A. baumanni. Conclusions. The computational implementation of the model provides us an efficient tool in the management of outbreaks due to A. baumanni. The analysis of the simulations obtained allows us to obtain a formal proof of the behaviour of the measures for control and prevention (AU)