A general procedure for small-scale purification of fimbriae expressed by porcine enterotoxigenic escherichia coli strains

Fimbriae expression by enterotoxigenic Escherichia coli strains is a complex process which is controlled by global and local transcriptional regulators and post-transcriptional control. It is influenced by factors such as bacterial growth rate, culture medium composition, pH and temperature. Fimbrial expression could thus frequently become lost. Bacterial culture procedures favouring fimbrial expression are thus needed. The fimbriated bacterial population was therefore enriched by static culture in Mueller–Hinton broth. Fimbrial expression was then maintained by making it grow consecutively in agar CFA and Minca or minimal broth according to the fimbrial serotype. Maximum fimbrial expression was reached after 4h or 5h in culture. The fimbriae were extracted by heat -shock treatment and precipitated with 40% ammonium sulphate. Further purification was carried out by molecular exclusion and sodium deoxycholate treatment. This methodology integrates known procedures in a simple and reproducible process for obtaining F4, F5, F6 and F41 fimbriae in sufficient quantities for their subsequent use in producing antibodies, immunoassays and other studies (at laboratory level) requiring high-purity preparations (80%) to maintain their native structure. Key words: Enterotoxigenic Escherichia coli; fimbriae; Minca; minimal medium; CFA.La fimbriación en cepas de Escherichia coli enterotoxigénicas es un proceso complejo controlado por varios mecanismos: reguladores globales y locales de la transcripción y el control postranscripcional, e influenciado por factores como velocidad de crecimiento bacteriano, composición del medio de cultivo, temperatura y pH, entre otros. Estas características propician que la expresión fimbrial se pierda con alta frecuencia. De allí que se requieran procedimientos de cultivo que favorezcan el mantenimiento de dicha expresión. Con ese objetivo, en el trabajo la población bacteriana fimbriada se enriqueció mediante cultivo estático en caldo Mueller-Hinton. Luego, la expresión fimbrial se mantuvo mediante el crecimiento en forma consecutiva en agar CFA, y el caldo Minca o Mínimo, según el tipo fimbrial, en los que se alcanzó la máxima expresión a las 4-5h de cultivo. Las fimbrias se extrajeron mediante tratamiento térmico y se precipitaron con sulfato de amonio al 40%. La purificación se realizó mediante exclusión molecular y el tratamiento con deoxicolato de sodio. La metodología propuesta integra procedimientos conocidos en un proceso simple y reproducible para la obtención de las fimbrias F4, F5, F6 y F41 en cantidades suficientes para su posterior uso en la generación de anticuerpos, el desarrollo de inmunoensayos y otros estudios a escala de laboratorio, que necesiten de preparaciones con una pureza superior al 80%, que mantengan su estructura nativa. Palabras clave: Escherichia coli enterotoxigénica; fimbria; Minca; medio mínimo; CFA

The immunogenetic diversity of the HLA system in Mexico correlates with underlying population genetic structure

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) allele groups and alleles by PCR-SSP based typing in a total of 15,318 mixed ancestry Mexicans from all the states of the country divided into 78 sample sets, providing information regarding allelic and haplotypic frequencies and their linkage disequilibrium, as well as admixture estimates and genetic substructure. We identified the presence of 4268 unique HLA extended haplotypes across Mexico and find that the ten most frequent (HF > 1%) HLA haplotypes with significant linkage disequilibrium (Δ’≥0.1) in Mexico (accounting for 20% of the haplotypic diversity of the country) are of primarily Native American ancestry (A*02~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*08~DQB1*04, A*68~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*14~DQB1*03:01, A*24~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*04~DQB1*03:02, A*02~B*40:02~DRB1*04~DQB1*03:02, A*68~B*35~DRB1*04~DQB1*03:02, A*02~B*15:01~DRB1*04~DQB1*03:02). Admixture estimates obtained by a maximum likelihood method using HLA-A/-B/-DRB1 as genetic estimators revealed that the main genetic components in Mexico as a whole are Native American (ranging from 37.8% in the northern part of the country to 81.5% in the southeastern region) and European (ranging from 11.5% in the southeast to 62.6% in northern Mexico). African admixture ranged from 0.0 to 12.7% not following any specific pattern. We were able to detect three major immunogenetic clusters correlating with genetic diversity and differential admixture within Mexico: North, Central and Southeast, which is in accordance with previous reports using genome-wide data. Our findings provide insights into the population immunogenetic substructure of the whole country and add to the knowledge of mixed ancestry Latin American population genetics, important for disease association studies, detection of demographic signatures on population variation and improved allocation of public health resources.Fil: Barquera, Rodrigo. Max Planck Institute For The Science Of Human History; Alemania. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; MéxicoFil: Hernández Zaragoza, Diana Iraíz. Técnicas Genéticas Aplicadas A la Clínica (tgac); México. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; MéxicoFil: Bravo Acevedo, Alicia. Instituto Mexicano del Seguro Social; MéxicoFil: Arrieta Bolaños, Esteban. Universitat Essen; AlemaniaFil: Clayton, Stephen. Max Planck Institute For The Science Of Human History; AlemaniaFil: Acuña Alonzo, Víctor. Instituto Nacional de Antropología E Historia, Mexico; MéxicoFil: Martínez Álvarez, Julio César. Instituto Mexicano del Seguro Social; MéxicoFil: López Gil, Concepción. Instituto Mexicano del Seguro Social; MéxicoFil: Adalid Sáinz, Carmen. Instituto Mexicano del Seguro Social; MéxicoFil: Vega Martínez, María del Rosario. Hospital Central Sur de Alta Especialidad; MéxicoFil: Escobedo Ruíz, Araceli. Instituto Mexicano del Seguro Social; MéxicoFil: Juárez Cortés, Eva Dolores. Instituto Mexicano del Seguro Social; MéxicoFil: Immel, Alexander. Max Planck Institute For The Science Of Human History; Alemania. Christian Albrechts Universitat Zu Kiel; AlemaniaFil: Pacheco Ubaldo, Hanna. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; MéxicoFil: González Medina, Liliana. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; MéxicoFil: Lona Sánchez, Abraham. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; MéxicoFil: Lara Riegos, Julio. Universidad Autónoma de Yucatán; MéxicoFil: Sánchez Fernández, María Guadalupe de Jesús. Instituto Mexicano del Seguro Social; MéxicoFil: Díaz López, Rosario. Hospital Central Militar, Mexico City; MéxicoFil: Guizar López, Gregorio Ulises. Hospital Central Militar, Mexico City; MéxicoFil: Medina Escobedo, Carolina Elizabeth. Instituto Mexicano del Seguro Social; MéxicoFil: Arrazola García, María Araceli. Instituto Mexicano del Seguro Social; MéxicoFil: Montiel Hernández, Gustavo Daniel. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; MéxicoFil: Hernández Hernández, Ofelia. Técnicas Genéticas Aplicadas a la Clínica ; MéxicoFil: Ramos de la Cruz, Flor del Rocío. Instituto Mexicano del Seguro Social; MéxicoFil: Juárez Nicolás, Francisco. Instituto Nacional de Pediatría; MéxicoFil: Pantoja Torres, Jorge Arturo. Instituto Mexicano del Seguro Social; MéxicoFil: Rodríguez Munguía, Tirzo Jesús. Hospital General Norberto Treviño Zapata; MéxicoFil: Juárez Barreto, Vicencio. Hospital Infantil de Mexico Federico Gomez; MéxicoFil: Gonzalez-Jose, Rolando. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Ciencias Sociales y Humanas; Argentin

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Epidemiologia molecular aplicada a la identificación del modelo de la infección nosocomial causada por entero bacterias productoras de beta lactamasas de espectro extendido en tres hospitales de Bogotá

IP 1101-04-12675ANEXOS: Caracterizacion de un brote por Klebsiella pneumoniaeproductora de CTX-M-12 en una unidad de cuidado intensivo neonatal en un hospital colombiano; Procedimiento para identificacion decefotaximasas CTX-M; Caracterizacion molecular de infeccion por Klebsiella pneumoniaeproductora de beta lactamasas de espectro extendido (BLEE) tipo SHV-5 en un hospital de tercer niveldeatencion enBogotá; Epidemiologia molecular de la infeccion intrahospitalaria causada por Klebsiella pneumoniaey Klebsiella oxytoca productoras de B lactasamas de espectro extendido en el Hospital UniversitarioClinica SanRafael de Bogotá; Evaluacion de tres sistemas de rep-PCR para la tipificacion de Klebsiella pneumoniae; Caracterizacion molecular y epidemiologica de aislamientos de enterobacter cloacae resistentes a cefalosporinas de tercera generacion provenientes de un Hospital de Bogotá; Tipificacion epidemiologica de aislamientosde enterobacter cloacae multirresistentes productores de B- lactamasas de espectro extendido provenientesdel Hospital Universitario Clinica San Rafael Bogotá

Educación social : revista de intervención socioeducativa

Resumen en catalán e inglésResumen basado en el de la publicaciónMonográfico con el título: Nuevos enfoques para viejas problemáticas en la educación socialSe presentan los resultados de una experiencia de evaluación y educación preventiva llevada a cabo con cincuenta familias con niños de dos años de edad. Las familias fueron evaluadas a través de una entrevista en visita domiciliaria, después recibieron pautas de crianza para poner en práctica en su vida diaria. Los resultados aportan datos empíricos que avalan la pertinencia de poner en marcha una estrategia de evaluación y educación preventiva familiar en los ámbitos educativo, sanitario y de servicios socialesES

Procedimiento general para purificar a pequeña escala las fimbrias expresadas por cepas porcinas de Escherichia coli enterotoxigénicas

La fimbriación en cepas de Escherichia coli enterotoxigénicas es un proceso complejo controlado por varios mecanismos: reguladores globales y locales de la transcripción y el control postranscripcional, e influenciado por factores como velocidad de crecimiento bacteriano, composición del medio de cultivo, temperatura y pH, entre otros. Estas características propician que la expresión fimbrial se pierda con alta frecuencia. De allí que se requieran procedimientos de cultivo que favorezcan el mantenimiento de dicha expresión. Con ese objetivo, en el trabajo la población bacteriana fimbriada se enriqueció mediante cultivo estático en caldo Mueller-Hinton. Luego, la expresión fimbrial se mantuvo mediante el crecimiento en forma consecutiva en agar CFA, y el caldo Minca o Mínimo, según el tipo fimbrial, en los que se alcanzó la máxima expresión a las 4-5h de cultivo. Las fimbrias se extrajeron mediante tratamiento térmico y se precipitaron con sulfato de amonio al 40%. La purificación se realizó mediante exclusión molecular y el tratamiento con deoxicolato de sodio. La metodología propuesta integra procedimientos conocidos en un proceso simple y reproducible para la obtención de las fimbrias F4, F5, F6 y F41 en cantidades suficientes para su posterior uso en la generación de anticuerpos, el desarrollo de inmunoensayos y otros estudios a escala de laboratorio, que necesiten de preparaciones con una pureza superior al 80%, que mantengan su estructura nativa. Palabras clave: Escherichia coli enterotoxigénica; fimbria; Minca; medio mínimo; CFA