Productos naturales de origen vegetal contra el COVID-19

Covid-19 has become a global public health problem. The use of natural products and in particular of medicinal plants, turns out to be a therapeutic tool for the treatment of the disease and its corresponding symptoms. The review that is presented below, after a search in databases of scientific rigor, has aimed to identify natural products of plant origin that can be used, for preventive purposes or as complementary therapies, against said viral infection. The evidence shows that, although there are still not enough clinical trials to define the use of certain plant resources, most authors are inclined to suggest those plants that have shown, by previous studies, potentialities including: antiviral, mucolytic, anti-inflammatory, immunomodulatory, immunostimulants, mucoprotective, antitussive, expectorant, bronchodilator and hepatoprotective activities. It should be noted that the largest number of scientific publications related to the subject refer to the traditional natural medicine of China and India. Although scientists worldwide have dedicated efforts to find preventive drugs or treatments for this condition, more reliable scientific evidence is still needed (standardized clinical trials) that can verify the real efficacy and safety of some medicinal plants or secondary metabolites derived from them.El COVID-19 se ha convertido en un problema de salud pública a nivel mundial. El uso de los productos naturales y en particular de las plantas medicinales, resulta ser una herramienta terapéutica para el tratamiento de la enfermedad y su correspondiente sintomatología. La revisión que a continuación se presenta, luego de una búsqueda en bases de datos de rigor científico, ha tenido como objetivo identificar los productos naturales de origen vegetal que pueden ser empleados, con fines preventivos o como terapias complementarias, contra dicha infección viral. Las evidencias muestran que, aunque aún no existen suficientes ensayos clínicos para definir el uso de determinados recursos vegetales, la mayoría de los autores se inclinan a sugerir aquellas plantas que han mostrado, por estudios previos, actividad antiviral, efecto mucolítico, antiinflamatorio, inmunomodulador, inmunoestimulante, mucoprotector, antitusivo, expectorante, broncodilatador, hepatoprotector, entre otros. Cabe destacar que el mayor número de publicaciones científicas relacionadas con la temática, hacen alusión a la medicina natural tradicional de China y la India. Aunque los científicos a escala mundial han dedicado esfuerzos para encontrar medicamentos preventivos o tratamientos para tal afección, aún se necesitan evidencias científicas más fehacientes (ensayos clínicos estandarizados) que puedan constatar la real eficacia y seguridad de algunas plantas medicinales o metabolitos secundarios derivados de estas

Pharmacognostic evaluation of Coriandrum Sativum L. leaves and extracts from different sources

The main objective of this work was to evaluate, from the pharmacognostic point of view, leaves of C. sativum L. obtained from different origins and culture conditions, as well as the aqueous and hydroalcoholic extracts. The study was developed with four samples of different origins and culture scenarios. In this work just the leaves were used. Following the standardized procedures, morphometric analyzes as well as quality control studies were performed on the crude drug and the aqueous and hydroalcoholic extracts. The qualitative chemical study was carried out through phytochemical screening and thin layer chromatography. In all the studies carried out, differences were observed between the samples studied. In most cases the drugs and extracts met the established quality control standards. The results obtained in the phytochemical screening suggested the presence of alkaloids, phenolic compounds, triterpenes, flavonoids, amino acids, saponins, mucilages, bitter principles and reducing substances in aqueous and hydroalcoholic extracts. The results obtained from the thin layer chromatography corroborated the presence of phenols and amino acids and suggest the existence of antioxidant activity for hydroalcoholic extracts.El objetivo principal de este trabajo fue evaluar, desde el punto de vista farmacognóstico, hojas de C. sativum L. obtenidas a partir de diferentes orígenes y condiciones de cultivo, así como los extractos acuosos e hidroalcohólicos de las mismas. El estudio se desarrolló con cuatro muestras, cuyos orígenes y escenarios de cultivo fueron diferentes. Se realizaron análisis morfométricos y se practicaron estudios de control de calidad a la droga cruda y a los extractos acuosos e hidroalcohólicos de las mismas, según los procedimientos normados. El estudio químico cualitativo se desarrolló a través de tamizaje fitoquímico y cromatografía en capa delgada. En todos los estudios realizados se constataron diferencias entre las muestras estudiadas. En la mayoría de los casos las drogas y los extractos cumplieron con las normas de control de la calidad establecidas. Los resultados obtenidos en el tamizaje fitoquímico sugirieron la presencia de alcaloides, compuestos fenólicos, triterpenos, flavonoides, aminoácidos, saponinas, mucílagos, principios amargos y azúcares reductores en los extractos acuosos e hidroalcohólicos. Los resultados obtenidos a partir de cromatografía en capa delgada corroboraron la presencia de fenoles y aminoácidos y sugieren la existencia de actividad antioxidante en los extractos hidroalcohólicos

Infusions of Moringa oleifera (moringa) combined with Cymbopogon citratus (lemon grass) and Lippia alba (mastranto)

Infusions of medicinal plants are not only consumed as drinks with a pleasant aroma and taste, but can also contribute to the proper functioning of the body. Moringa oleifera Lam (moringa) is a medicinal plant with recognized nutritional and pharmacological properties. Cymbopogon citratus (lemon grass) and Lippia alba Mill (mastranto) are aromatic species that are used mainly for medicinal purposes. The research proposed to design two formulations to prepare as infusions, using moringa leaves combined with mastranto leaves and lemon grass, indistinctly. The raw materials were evaluated through the determination of loss by drying, inorganic matter, protein (Bradford), total phenols (Folin-Ciocalteu) and antioxidant capacity (IC50 by DPPH). The quality standards determined for dry drugs are within the values referred to in the literature, highlighting the presence of high percentages of total phenols (GPE); total flavonoids above than 30 mg (QE) in the three drugs and IC50 values below 0.22 mg / mL. The percentage combinations with the highest sensory acceptance were: for the mixture M. oleifera / L. alba, 80:20 and 60:40 for M. oleifera / C. citratus. Quality control of the infusion, by means of physical-chemical tests, facilitated the standardisation of both, indicating that they have the necessary characteristics to be considered as possible functional drinks with an antioxidant effect and beneficial to human health.Las infusiones de plantas medicinales, no solo son consumidas como bebidas de agradable aroma y sabor, sino que también pueden contribuir al buen funcionamiento del organismo.  Moringa oleifera Lam (moringa) es una planta medicinal de reconocidas propiedades farmacológicas y nutritivas.  Cymbopogon citratus (hierba luisa) y Lippia alba Mill (mastranto) son especies aromática que se utilizan, fundamentalmente, con fines medicinales. En la investigación se propuso diseñar dos formulaciones para preparar como infusiones, usando hojas de moringa combinadas con hojas de mastranto y hierba luisa, indistintamente. Las materias primas fueron evaluadas a través de la determinación de pérdida por desecación, materia inorgánica, proteína (Bradford), fenoles totales (Folin-Ciocalteu) y capacidad antioxidante (CI50 mediante DPPH). Los estándares de calidad determinados a las drogas secas se encuentran dentro de los valores referidos en la literatura, destacando la presencia de elevados porcentajes de fenoles totales (EAG); flavonoides totales superiores a 30 mg (EQ) en las tres drogas y valores de CI50 por debajo de 0,22 mg/mL.  Las combinaciones porcentuales de mayor aceptación sensorial fueron: para la mezcla M. oleifera / L. alba, 80:20 y 60:40 para M. oleifera / C. citratus. El control de calidad de la infusión, mediante pruebas físico-químicas, facilitó la estandarización de ambas, indicando que poseen las características necesarias para ser consideradas como posibles bebidas funcionales con efecto antioxidante y beneficiosas para la salud humana

COMPOSICIÓN QUÍMICA Y ACTIVIDAD BIOLÓGICA DEL PSEUDOTALLO DE MUSA X PARADISIACA L (BANANO)

El objetivo de la investigación fue evaluar las propiedades químicas y biológicas de extractos acuosos e hidroalcohólicos del pseudotallo de Musa x paradisiaca L. La materia prima vegetal fue caracterizada mediante análisis físico-químicos. El estudio químico cualitativo de los extractos se realizó a través de un tamizaje fitoquímico, por cromatografía en capa delgada (CCD) y mediante cromatografía líquida de alta eficiencia acoplada a espectrometría de masas (CLAE/EM), sugiriendo la existencia de saponinas y compuestos fenólicos. Se cuantificaron las saponinas en los tres extractos, obteniéndose la mayor concentración en el acuoso e hidroalcohólico (1:1). En la cuantificación de compuestos fenólicos por el método de Folin-Ciocalteu, el extracto hidroalcohólico (1:1), presentó la mayor cantidad de tales metabolitos. La actividad expectorante del extracto hidroalcohólico (1:1), siguiendo el modelo de rojo fenol en secreciones de ratón, a la dosis ensayada (500 mg/kg de peso del animal) mostró un efecto mucolítico similar al control positivo (Bisolvon). El estudio del efecto del extracto en el gasterópodo Cerithidea valida no reveló efecto letal bajo las condiciones estudiadas. Se detectó la inmediata retracción del cuerpo del molusco dentro de la concha y la oclusión de la abertura con el opérculo, lo que provocó la inmovilidad de los moluscos, comportamiento atribuido a la probable acción irritante del extracto.The objective of the research was to evaluate the chemical and biological properties of aqueous and hydroalcoholic extracts of the pseudostem of Musa x paradisiaca L. The vegetable raw material was characterized by physic-chemical methods. The qualitative chemical study of the extracts was carried out through phytochemical screening, by thin layer chromatography (TLC) and by high performance liquid chromatography coupled to mass spectrometry (HPLC/MS), suggesting the presence of saponins, phenolic compounds and reducing sugars. The saponins were quantified in the three extracts, obtaining the highest concentration in the aqueous and hydroalcoholic (1:1). The quantification of phenolic compounds by the Folin-Ciocalteu method, perceiving that the hydroalcoholic extract (1:1) showed the highest amount of such metabolites. The expectorant activity of the hydroalcoholic extract (1:1), following the phenol red model in mouse secretions, at the dose tested (500 mg / kg of animal weight) showed a mucolytic effect similar to the positive control (Bisolvon). The study of the effect of the extract on the Cerithidea valida gastropod did not reveal a lethal effect under the conditions studied. The immediate retraction of the body of the mollusk inside the shell and the occlusion of the opening with the operculum was detected, which caused the immobility of the mollusks, a behavior attributed to the probable irritant action of the extract

The effect of smoking on clinical parameters and structural damage in patients with axial spondyloarthritis: a systematic literature review.

Objectives: To evaluate the association between smoking and clinical parameters and structural damage in axial spondyloarthritis (axSpA). Methods: We systematically searched MEDLINE, EMBASE and Cochrane Library up to November 2015. We selected articles that analysed the smoking impact on disease activity, functional status, structural damage, physical mobility and life quality. Independent extraction of articles by 2 authors using predefined data fields was performed. Studies quality was graded according to the Oxford Level of Evidence scale. Results: A total of 17 articles were selected for inclusion: 2 case-control, 11 cross sectional and 4 prospective cohort studies, which analysed 4,694 patients. Weak evidence suggested a smoking effect on pain, overall assessment of health, disease activity, physical mobility and life quality in ankylosing spondylitis (AS). Moderate-good evidence revealed higher HAQ-AS among smokers (0.025 units/yr, 95%CI: 0.0071-0.0429, p=0.007). Every additional unit of ASDAS resulted in an increase of 1.9 vs. 0.4 mSASSS units/2 yr in AS smokers vs. non-smokers. Good evidence revealed that cigarette smoking and smoking intensity was associated with spinal radiographic progression in axSpA [mSASSS ≥2 units/2 yr: OR=2.75, 95%CI: 1.25-6.05, p=0.012; mSASSS progression in heavy smokers (> 10 cigarettes/day): OR=3.57, 95%IC: 1.33-9.60, p=0.012]. Conclusions: Published data indicate that smoking has a dose-dependent impact on structural damage progression in axSpA. There is worse HAQ among AS smokers compared to non-smokers. Respect to pain, overall assessment of health, disease activity, physical mobility and life quality, although the evidence level is poor, all evidence points in the same direction: smoking AS patients are worse than non-smoking.pre-print260 K

Diseño de una bebida a base de Solanum betaceum Cav. (tomate de árbol) y cascarilla de Theobroma cacao L(cacao)

La búsqueda de fuentes de sustancias antioxidantes, que pudieran ayudar a prevenir el estrés oxidativo, es un reto para la comunidad científica. Solanum betaceum Cav y Theobroma cacao L, son materias primas endémicas de Ecuador, a las que se les atribuye propiedades antioxidantes asociadas, fundamentalmente, a su contenido en compuesto fenólicos. El estudio tuvo como objetivo, diseñar una bebida a base de tomate de árbol con cascarilla de cacao, para obtener un alimento sensorialmente aceptado y con propiedades antioxidantes. Las formulaciones a evaluar se plantearon mediante un diseño de bloques, considerando como variable respuesta, la aceptación sensorial y como variables independientes tres niveles de cascarilla y goma xantana. La formulación de mayor aceptación (I), logró incluir 1 % de polvo de cascarilla de cacao con 0,05 % de estabilizante. El análisis físico-químico de la mejor formulación evidenció un aporte de 5,64 mg de vitamina C y 72,6 mg de fenoles totales, equivalente a ácido gálico por cada 330 mL de jugo. Su capacidad secuestradora de radicales libres fue del 81% expresado como porcentaje de inhibición frente al radical libre DPPH. Los resultados sugieren que esta bebida es una opción beneficiosa para el consumidor debido a su capacidad antioxidante.The search for sources of antioxidant substances, that could help prevent oxidative stress, is a challenge for the scientific community. Solanum betaceum Cav and Theobroma cacao L, are endemic raw materials from Ecuador, to which antioxidant properties associated, fundamentally, to its content in phenolic compounds have been attributed. The objective of this study was to design a tree tomato-based drink with cocoa husk to obtain a sensorially accepted food with antioxidant. The formulations to be evaluated were proposed by means a block design, considering as a response variable, the sensory acceptance and as independent variables three levels of cocoa husk and xanthan gum. The most widely accepted formulation sensory (I), managed to include 1% of cocoa husk powder with 0.05% stabilizer. The physical-chemical analysis of the best formulation showed a contribution of 5.64 mg of vitamin C and 72.6 mg of total phenols, equivalent to gallic acid for every 330 mL of juice. Its free radical scavenging capacity was 81% expressed as percentage of inhibition against free radical DPPH. The results suggest that this drink is a beneficial option for the consumer due to its antioxidant capacity

Diagnóstico de necesidades de formación para revitalizar el sector comercial

Producción CientíficaEstudio del comercio minorista en las ciudades de Valladolid (incluyendo análisis pormenorizado del centro y varios barrios) y Medina del Campo, basado en el impuesto de actividades económicas y la realización de encuestas a comerciantes y consumidores.Geografí

Incidence, associated factors and clinical impact of severe infections in a large, multicentric cohort of patients with systemic lupus erythematosus

OBJECTIVES: To estimate the incidence of severe infection and investigate the associated factors and clinical impact in a large systemic lupus erythematosus (SLE) retrospective cohort. METHODS: All patients in the Spanish Rheumatology Society Lupus Registry (RELESSER) who meet ?4 ACR-97 SLE criteria were retrospectively investigated for severe infections. Patients with and without infections were compared in terms of SLE severity, damage, comorbidities, and demographic characteristics. A multivariable Cox regression model was built to calculate hazard ratios (HRs) for the first infection. RESULTS: A total of 3658 SLE patients were included: 90% female, median age 32.9 years (DQ 9.7), and mean follow-up (months) 120.2 (±87.6). A total of 705 (19.3%) patients suffered ?1 severe infection. Total severe infections recorded in these patients numbered 1227. The incidence rate was 29.2 (95% CI: 27.6-30.9) infections per 1000 patient years. Time from first infection to second infection was significantly shorter than time from diagnosis to first infection (p < 0.000). Although respiratory infections were the most common (35.5%), bloodstream infections were the most frequent cause of mortality by infection (42.0%). In the Cox regression analysis, the following were all associated with infection: age at diagnosis (HR = 1.016, 95% CI: 1.009-1.023), Latin-American (Amerindian-Mestizo) ethnicity (HR = 2.151, 95% CI: 1.539-3.005), corticosteroids (?10mg/day) (HR = 1.271, 95% CI: 1.034-1.561), immunosuppressors (HR = 1.348, 95% CI: 1.079-1.684), hospitalization by SLE (HR = 2.567, 95% CI: 1.905-3.459), Katz severity index (HR = 1.160, 95% CI: 1.105-1.217), SLICC/ACR damage index (HR = 1.069, 95% CI: 1.031-1.108), and smoking (HR = 1.332, 95% CI: 1.121-1.583). Duration of antimalarial use (months) proved protective (HR = 0.998, 95% CI: 0.997-0.999). CONCLUSIONS: Severe infection constitutes a predictor of poor prognosis in SLE patients, is more common in Latin-Americans and is associated with age, previous infection, and smoking. Antimalarials exerted a protective effect.Spanish Foundation of Rheumatology. FIS/ISCIII (grant number PI11/02857). Dr. Pego-Reigosa is supported by Grant 316265 (BIOCAPS) from the European Union 7th Framework Programme (FP7/REGPOT-2012–2013.1)

Resultados clínicos iniciales y variables pronósticas en la implementación de un Código Sepsis en un Hospital Universitario de alta complejidad

Objective: To assess the impact of the first months of application of a Code Sepsis in a high complexity hospital, analyzing patient´s epidemiological and clinical characteristics and prognostic factors. Methods: A long-term observational study was carried out throughout a consecutive period of seven months (February 2015 - September 2015). The relationship with mortality of risk factors, and analytic values was analyzed using uni- and multivariate analyses. Results: A total of 237 patients were included. The in-hospital mortality was 24% at 30 days and 27% at 60 days. The mortality of patients admitted to Critical Care Units was 30%. Significant differences were found between the patients who died and those who survived in mean levels of creatinine (2.30 vs 1.46 mg/dL, p 65 years (OR 5.33, p 3 mmol/L (OR 5,85, p 1,2 mgr /dL (OR 4,54, p <0,05) and shock (OR 6,57, P <0,05). Conclusions: The epidemiological, clinical and mortality characteristics of the patients in our series are similar to the best published in the literature. The study has identified several markers that could be useful at a local level to estimate risk of death in septic patients. Studies like this one are necessary to make improvements in the Code Sepsis programsObjetivo. Evaluar el impacto de un programa educativo y organizativo llamado Código Sepsis, en los primeros siete meses de su aplicación en un hospital de alta complejidad. Material y métodos. Se realizó un estudio observacional durante un período consecutivo de siete meses (Febrero 2015-Septiembre 2015). Se analizó la relación con la mortalidad de los factores de riesgo y los valores analíticos usando análisis uni y multivariante. Resultados. Se incluyeron un total de 237 pacientes. La mortalidad intrahospitalaria a los 30 días fue del 24 % y del 27% a los 60 días. La mortalidad de los pacientes ingresados en Unidades de Cuidados Críticos fue del 30%. Se encontraron diferencias significativas entre los pacientes que murieron y los que sobrevivieron en sus valores medios de creatinina (2,30 vs 1,46 mg/dL, p <0,05), ácido láctico (6,10 vs 2,62 mmol/L, p <0,05) y procalcitonina (23,27 vs 12,73 mg/dL, p <0,05). Se encontró una tendencia lineal estadísticamente significativa entre los valores de la escala SOFA y la mortalidad (p <0,05). En el análisis multivariante se identificaron otros factores de riesgo independientes asociados con la muerte: edad > 65 años (OR 5,33, p 3 mmol/L (OR 5,85, p <0,05), creatinina > 1,2 mgr/dL (OR 4,54, p <0,05) y el shock (OR 6,57, P <0,05). Conclusiones. La mortalidad en este estudio se encuentra dentro de los límites de los ensayos clínicos más recientes de sepsis. El estudio ha identificado varios marcadores que podrían ser útiles a nivel local para estimar el riesgo en pacientes sépticos. Estudios como éste son necesarios para hacer mejoras en los programas de Código Sepsi

Effectiveness and safety of COVID-19 vaccines on maternal and perinatal outcomes:a systematic review and meta-analysis

Objective: To assess the effects of COVID-19 vaccines in women before or during pregnancy on SARS-CoV-2 infection-related, pregnancy, offspring and reactogenicity outcomes. Design: Systematic review and meta-analysis. Data sources: Major databases between December 2019 and January 2023. Study selection: Nine pairs of reviewers contributed to study selection. We included test-negative designs, comparative cohorts and randomised trials on effects of COVID-19 vaccines on infection-related and pregnancy outcomes. Non-comparative cohort studies reporting reactogenicity outcomes were also included. Quality assessment, data extraction and analysis: Two reviewers independently assessed study quality and extracted data. We undertook random-effects meta-analysis and reported findings as HRs, risk ratios (RRs), ORs or rates with 95% CIs. Results: Sixty-seven studies (1 813 947 women) were included. Overall, in test-negative design studies, pregnant women fully vaccinated with any COVID-19 vaccine had 61% reduced odds of SARS-CoV-2 infection during pregnancy (OR 0.39, 95% CI 0.21 to 0.75; 4 studies, 23 927 women; I2=87.2%) and 94% reduced odds of hospital admission (OR 0.06, 95% CI 0.01 to 0.71; 2 studies, 868 women; I2=92%). In adjusted cohort studies, the risk of hypertensive disorders in pregnancy was reduced by 12% (RR 0.88, 95% CI 0.82 to 0.92; 2 studies; 115 085 women), while caesarean section was reduced by 9% (OR 0.91, 95% CI 0.85 to 0.98; 6 studies; 30 192 women). We observed an 8% reduction in the risk of neonatal intensive care unit admission (RR 0.92, 95% CI 0.87 to 0.97; 2 studies; 54 569 women) in babies born to vaccinated versus not vaccinated women. In general, vaccination during pregnancy was not associated with increased risk of adverse pregnancy or perinatal outcomes. Pain at the injection site was the most common side effect reported (77%, 95% CI 52% to 94%; 11 studies; 27 195 women). Conclusion: COVID-19 vaccines are effective in preventing SARS-CoV-2 infection and related complications in pregnant women. PROSPERO registration number: CRD42020178076