Seguimiento de las guías españolas para el manejo del asma por el médico de atención primaria: un estudio observacional ambispectivo

Objetivo Evaluar el grado de seguimiento de las recomendaciones de las versiones de la Guía española para el manejo del asma (GEMA 2009 y 2015) y su repercusión en el control de la enfermedad. Material y métodos Estudio observacional y ambispectivo realizado entre septiembre del 2015 y abril del 2016, en el que participaron 314 médicos de atención primaria y 2.864 pacientes. Resultados Utilizando datos retrospectivos, 81 de los 314 médicos (25, 8% [IC del 95%, 21, 3 a 30, 9]) comunicaron seguir las recomendaciones de la GEMA 2009. Al inicio del estudio, 88 de los 314 médicos (28, 0% [IC del 95%, 23, 4 a 33, 2]) seguían las recomendaciones de la GEMA 2015. El tener un asma mal controlada (OR 0, 19, IC del 95%, 0, 13 a 0, 28) y presentar un asma persistente grave al inicio del estudio (OR 0, 20, IC del 95%, 0, 12 a 0, 34) se asociaron negativamente con tener un asma bien controlada al final del seguimiento. Por el contrario, el seguimiento de las recomendaciones de la GEMA 2015 se asoció de manera positiva con una mayor posibilidad de que el paciente tuviera un asma bien controlada al final del periodo de seguimiento (OR 1, 70, IC del 95%, 1, 40 a 2, 06). Conclusiones El escaso seguimiento de las guías clínicas para el manejo del asma constituye un problema común entre los médicos de atención primaria. Un seguimiento de estas guías se asocia con un control mejor del asma. Existe la necesidad de actuaciones que puedan mejorar el seguimiento por parte de los médicos de atención primaria de las guías para el manejo del asma. Objective: To assess the degree of compliance with the recommendations of the 2009 and 2015 versions of the Spanish guidelines for managing asthma (Guía Española para el Manejo del Asma [GEMA]) and the effect of this compliance on controlling the disease. Material and methods: We conducted an observational ambispective study between September 2015 and April 2016 in which 314 primary care physicians and 2864 patients participated. Results: Using retrospective data, we found that 81 of the 314 physicians (25.8%; 95% CI 21.3–30.9) stated that they complied with the GEMA2009 recommendations. At the start of the study, 88 of the 314 physicians (28.0%; 95% CI 23.4–33.2) complied with the GEMA2015 recommendations. Poorly controlled asthma (OR, 0.19; 95% CI 0.13–0.28) and persistent severe asthma at the start of the study (OR, 0.20; 95% CI 0.12–0.34) were negatively associated with having well-controlled asthma by the end of the follow-up. In contrast, compliance with the GEMA2015 recommendations was positively associated with a greater likelihood that the patient would have well-controlled asthma by the end of the follow-up (OR, 1.70; 95% CI 1.40–2.06). Conclusions: Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines

Microcosm evaluation and metagenomic analysis of the bioremediation of soils contaminated with PAHs by microbial consortia

Tesis (Doctorado en Ciencias en Biotecnología), Instituto Politécnico Nacional, CIBA, 2014, 1 archivo PDF, (153 páginas). tesis.ipn.m

DIVERSIDADE MICROBIANA ASSOCIADA A ESPELETIA SPP. EM ECOSSISTEMAS DE ALTA MONTANHA

High mountain ecosystems have unique environmental characteristics, provide essential natural resources for the maintenance of life and represent hotspots of biological diversity and endemism of some animal and vegetal species. Within the great biological diversity that characterizes these environments, microbial diversity stands out due to its main role in the stability and balance of the ecosystem. The microorganisms establish important biological interactions with the native plants of the region, including the different species of Espeletia, allowing to improve their characteristics and optimizing the role of this type of ecosystems in the regulation of water sources. Therefore, this review aims to consolidate the current knowledge about the microbial diversity present in high mountain soils, highlighting the microbiota associated with Espeletia spp. and the plant-microorganism interactions that may occur.Los ecosistemas de alta montaña cuentan con características ambientales únicas, proveen recursos naturales indispensables para el mantenimiento de la vida y representan puntos de alta diversidad biológica y endemismo de algunas especies vegetales y animales. Dentro de la gran diversidad biológica que caracteriza estos ambientes, se resalta la diversidad microbiana por el papel principal que ésta tiene en la estabilidad y equilibrio del ecosistema. Los microorganismos establecen interacciones biológicas importantes con las plantas nativas de la región, incluyendo a las diferentes especies de Espeletia, permitiendo mejorar las características de las mismas y optimizando el rol de este tipo de ecosistemas en la regulación de las fuentes hídricas. Por tanto, esta revisión tiene como objetivo consolidar el conocimiento actual acerca de la diversidad microbiana presente en suelos de alta montaña, destacar la microbiota asociada con Espeletia spp. y las interacciones planta-microorganismo que se pueden presentar.Ecossistemas de alta montanha possuem características ambientais únicas, fornecem recursos naturais essenciais para a manutenção da vida e representam pontos de alta diversidade biológica e endemismo de algumas espécies animais e vegetais. Dentro da grande diversidade biológica que caracteriza esses ambientes, a diversidade microbiana se destaca pelo seu papel principal na estabilidade e equilíbrio do ecossistema. Os microrganismos estabelecem importantes interações biológicas com as plantas nativas da região, incluindo as diferentes espécies de Espeletia, permitindo melhorar suas características e otimizar o papel deste tipo de ecossistema na regulação dos mananciais. Portanto, esta revisão visa consolidar o conhecimento atual sobre a biodiversidade microbiana presente em solos de alta montanha, destacando a microbiota associada a Espeletia spp. e as interações planta-microorganismo que podem ocorrer

Polymorphisms of toll-like receptor 2 and 4 genes in Chagas disease

The aim of this study was to test the possible implication of toll-like receptor 2 (TLR2) and TLR4 gene polymorphisms in determining the susceptibility to Chagas' disease. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism in 475 individuals from Colombia, 143 seropositive with chagasic cardiomyopathy, 132 seropositive asymptomatic and 200 seronegative. The TLR2 arginine to glutamine substitution at residue 753(Arg753Gln) polymorphism was absent in the groups analyzed. The TLR4 Asp299Gly and Thr399Ile polymorphisms are in linkage disequilibrium and we observed a very low frequency of these polymorphisms in our study population (2.6% and 1.8% respectively). The overall TLR2 and TLR4 alleles and genotype distribution in seronegative and seropositive were not significantly different. We compared the frequencies between asymptomatic patients and those with chagasic cardiomyopathy and we did not observe any significant differences in the distribution of alleles or genotypes. In summary, this study corroborates the low frequency of TLR2 and TLR4 polymorphisms observed in other populations and suggest that these do not play an important role in Chagas' disease. The validation of these findings in independent cohorts is needed to firmly establish a role for TLR2 and TLR4 variants in Chagas' disease

Effect of Essential Oils on Growth Inhibition, Biofilm Formation and Membrane Integrity of Escherichia coli and Staphylococcus aureus

Biofilm as a cellular conformation confers survival properties to microbial populations and favors microbial resistance. Here, we investigated the antimicrobial, antibiofilm, antimotility, antihemolytic activity, and the interaction with synthetic membranes of 15 essential oils (EOs) on E. coli ATCC 25922 and S. aureus ATCC 29213. Antimicrobial activity of EOs was determined through microdilution method; development of the biofilm was assessed using the crystal violet assay and SEM microscopy. Results indicate that Lippia origanoides thymol–carvacrol II chemotype (LTC II) and Thymus vulgaris (TV) exhibited a significant antibacterial activity, with MIC values of 0.45 and 0.75 mg/mL, respectively. The percentage of biofilm formation inhibition was greater than 70% at subinhibitory concentrations (MIC50) for LTC II EO. The results demonstrate that these two oils had significantly reduced the hemolytic effect of S. aureus by 54% and 32%, respectively, and the mobility capacity by swimming in E. coli with percentages of decrease of 55% and 47%, respectively. The results show that LTC II and TV EOs can interact with the hydrophobic core of lipid bilayers and alter the physicochemical properties of membranes. The findings suggest that LTC II and TV oils may potentially be used to aid in the treatment of S. aureus and E. coli infections