La resistencia de un centro de investigación frente al escándalo de la vacuna de COVID-19

Sr. Editor, Con relación a la editorial publicada en el número 2 del volumen 82 de la revista Anales de la Facultad de Medicina, como investigadores de la Unidad de Ensayos Clínicos de la Universidad Nacional Mayor de San Marcos (UNMSM) alcanzamos la siguiente información: Iniciada la pandemia, disponíamos de una reglamentación nacional sobre ensayos clínicos que no respondía a un escenario impredecible de pandemia, por lo que el Instituto Nacional de Salud (INS) realizó modificaciones de emergencia (1) y conformó un comité nacional de ética específico para ensayos clínicos sobre COVID-19 (CNTEI) (2)

Microscopic Observation Drug Susceptibility Assay for Rapid Diagnosis of Lymph Node Tuberculosis and Detection of Drug Resistance.

In this study, 132 patients with lymphadenopathy were investigated. Fifty-two (39.4%) were diagnosed with tuberculosis (TB). The microscopic observation drug susceptibility (MODS) assay provided rapid (13 days), accurate diagnosis (sensitivity, 65.4%) and reliable drug susceptibility testing (DST). Despite its lower sensitivity than that of other methods, its faster results and simultaneous DST are advantageous in resource-poor settings, supporting the incorporation of MODS into diagnostic algorithms for extrapulmonary TB

Anti-inflammatory, pro-proliferative and antimicrobial potential of the compounds isolated from Daemonorops draco (Willd.) Blume

Ethno-pharmacological relevance: Daemonorops draco (D. draco) commonly known as “Dragon's blood” is one of the most used plants by Momok, Anak Dalam and Talang Mamak tribes from Indonesia as a remedy for wound healing. Aim of the study: This study aimed to identify the extract, fractions and compounds responsible for the anti-inflammatory and pro-proliferative activities of the D. draco resin. Additionally, the antimicrobial activity against two bacteria and one yeast species was analysed. Materials and methods: Bio-guided isolation of compounds with anti-inflammatory, pro-proliferative and antimicrobial activities from the D. draco resin was carried out by measuring: the inhibition of NF-κB and activation of Nrf2 in THP-1, HaCaT, NIH-3T3 cells; cell proliferation in NIH-3T3 and HaCaT cells; and the antimicrobial effect on E. coli, S. aureus and C. albicans. Results: Guided isolation by bioassay gave rise to the isolation and characterisation by nuclear magnetic resonance and mass spectrometry of three compounds: 1 (Bexarotene), 2 (Taspine) and 3 (2-hydroxy-1-naphthaldehyde isonicotinoyl hydrazone). All compounds showed NF-κB inhibitory activity with IC50 values of 0.10–0.13, 0.22–0.24 and 3.75–4.78 μM, respectively, while the positive control, Celastrol, had an IC50 of 7.96 μM. Likewise, all compounds showed an activating effect of Nrf2 with EC50 values of 5.34–5.43, 163.20–169.20 and 300.82–315.56 nM, respectively, while the positive control, CDDO-Me, had an EC50 of 0.11 nM. In addition, concerning the pro-proliferative activity, compound 1 (IC50 = 8.62–8.71 nM) showed a capacity of 100%, compound 2 (IC50 = 166–171 nM) showed a capacity of 75%, and compound 3 (IC50 = 469–486 nM) showed a capacity of 65%, while FSB 10% (positive control) had a pro-proliferative activity of 100% in the NIH3T3 cell lines (fibroblasts) and HaCaT (keratinocytes). Finally, all the compounds showed antimicrobial activity with MIC values of 0.12–0.16, 0.31–0.39 and 3.96–3.99 μM, respectively, in S. aureus, E. coli and C. albicans strains, while the positive control, Ofloxacin, had a MIC of 27.65 μM. Conclusion: This study managed to isolate, for the first time, three compounds (Bexarotene, Taspine and 2-hydroxy-1-naphthaldehyde isonicotinoyl hydrazone) from the resin of D. draco, with anti-inflammatory, and pro-proliferative as well as antimicrobial activitie

Protocol for studying cough frequency in people with pulmonary tuberculosis.

INTRODUCTION: Cough is a key symptom of tuberculosis (TB) as well as the main cause of transmission. However, a recent literature review found that cough frequency (number of coughs per hour) in patients with TB has only been studied once, in 1969. The main aim of this study is to describe cough frequency patterns before and after the start of TB treatment and to determine baseline factors that affect cough frequency in these patients. Secondarily, we will evaluate the correlation between cough frequency and TB microbiological resolution. METHODS: This study will select participants with culture confirmed TB from 2 tertiary hospitals in Lima, Peru. We estimated that a sample size of 107 patients was sufficient to detect clinically significant changes in cough frequency. Participants will initially be evaluated through questionnaires, radiology, microscopic observation drug susceptibility broth TB-culture, auramine smear microscopy and cough recordings. This cohort will be followed for the initial 60 days of anti-TB treatment, and throughout the study several microbiological samples as well as 24 h recordings will be collected. We will describe the variability of cough episodes and determine its association with baseline laboratory parameters of pulmonary TB. In addition, we will analyse the reduction of cough frequency in predicting TB cure, adjusted for potential confounders. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the ethics committees at each participating hospital in Lima, Peru, Asociación Benéfica PRISMA in Lima, Peru, the Universidad Peruana Cayetano Heredia in Lima, Peru and Johns Hopkins University in Baltimore, USA. We aim to publish and disseminate our findings in peer-reviewed journals. We also expect to create and maintain an online repository for TB cough sounds as well as the statistical analysis employed

Search for massive rare particles with the SLIM experiment

The search for magnetic monopoles in the cosmic radiation remains one of the main aims of non-accelerator particle astrophysics. Experiments at high altitude allow lower mass thresholds with respect to detectors at sea level or underground. The SLIM experiment is a large array of nuclear track detectors at the Chacaltaya High Altitude Laboratory (5290 m a.s.l.). The results from the analysis of 171 m$^2$ exposed for more than 3.5 y are here reported. The completion of the analysis of the whole detector will allow to set the lowest flux upper limit for Magnetic Monopoles in the mass range 10$^5$ - 10$^{12}$ GeV. The experiment is also sensitive to SQM nuggets and Q-balls, which are possible Dark Matter candidates.Comment: Presented at the 29-th ICRC, Pune, India (2005

Impact of infection control measures to control an outbreak of multidrug-resistant tuberculosis in a human immunodeficiency virus ward, Peru

Multidrug-resistant tuberculosis (MDRTB) rates in a human immunodeficiency virus (HIV) care facility increased by the year 2000-56% of TB cases, eight times the national MDRTB rate. We reported the effect of tuberculosis infection control measures that were introduced in 2001 and that consisted of 1) building a respiratory isolation ward with mechanical ventilation, 2) triage segregation of patients, 3) relocation of waiting room to outdoors, 4) rapid sputum smear microscopy, and 5) culture/drug-susceptibility testing with the microscopic-observation drug-susceptibility assay. Records pertaining to patients attending the study site between 1997 and 2004 were reviewed. Six hundred and fifty five HIV/TB-coinfected patients (mean age 33 years, 79% male) who attended the service during the study period were included. After the intervention, MDRTB rates declined to 20% of TB cases by the year 2004 (P = 0.01). Extremely limited access to antiretroviral therapy and specific MDRTB therapy did not change during this period, and concurrently, national MDRTB prevalence increased, implying that the infection control measures caused the fall in MDRTB rates. The infection control measures were estimated to have cost US$91,031 while preventing 97 MDRTB cases, potentially saving US$1,430,026. Thus, this intervention significantly reduced MDRTB within an HIV care facility in this resource-constrained setting and should be cost-effective

Search for Intermediate Mass Magnetic Monopoles and Nuclearites with the SLIM experiment

SLIM is a large area experiment (440 m2) installed at the Chacaltaya cosmic ray laboratory since 2001, and about 100 m2 at Koksil, Himalaya, since 2003. It is devoted to the search for intermediate mass magnetic monopoles (107-1013 GeV/c2) and nuclearites in the cosmic radiation using stacks of CR39 and Makrofol nuclear track detectors. In four years of operation it will reach a sensitivity to a flux of about 10-15 cm-2 s-1 sr-1. We present the results of the calibration of CR39 and Makrofol and the analysis of a first sample of the exposed detector.Comment: Presented at the 22nd ICNTS, Barcelona 200

Prevalence of Burnout syndrome among Medical Residency applicants

Introduction: Doctors who are preparing to take the medical residency exam are exposed to work stress, because they have to work to pay their studies. Objectives: To determine the prevalence of Burnout syndrome in general practitioners preparing for the residency exam. Methods: A descriptive and cross-sectional study was carried out, the Maslach Burnout Inventory (MBI) was applied in general practitioners who worked and were preparing to take the medical residency exam were included, who voluntarily agreed to participate in the study. Univariate and bivariate statistics were performed, the calculations were performed with a confidence level of 95%. Results: A total of 306 general practitioners were included. 56,9 % were female and the average age was 28,5 ± 4,3 years. 2,3 % (7) of the doctors had Burnout syndrome, the subscales of depersonalization (42,2 %) and emotional exhaustion (32 %) had higher percentages of high indexes. Conclusions: The prevalence of Burnout syndrome was low in general practitioners preparing for the medical residency examination. The subscales with the highest indices were depersonalization and emotional exhaustion

The detection of airborne transmission of tuberculosis from HIV-infected patients, using an in vivo air sampling model

Background. Nosocomial transmission of tuberculosis remains an important public health problem. We created an in vivo air sampling model to study airborne transmission of tuberculosis from patients coinfected with human immunodeficiency virus (HIV) and to evaluate environmental control measures. Methods. An animal facility was built above a mechanically ventilated HIV‐tuberculosis ward in Lima, Peru. A mean of 92 guinea pigs were continuously exposed to all ward exhaust air for 16 months. Animals had tuberculin skin tests performed at monthly intervals, and those with positive reactions were removed for autopsy and culture for tuberculosis. Results. Over 505 consecutive days, there were 118 ward admissions by 97 patients with pulmonary tuberculosis, with a median duration of hospitalization of 11 days. All patients were infected with HIV and constituted a heterogeneous group with both new and existing diagnoses of tuberculosis. There was a wide variation in monthly rates of guinea pigs developing positive tuberculin test results (0%–53%). Of 292 animals exposed to ward air, 159 developed positive tuberculin skin test results, of which 129 had laboratory confirmation of tuberculosis. The HIV‐positive patients with pulmonary tuberculosis produced a mean of 8.2 infectious quanta per hour, compared with 1.25 for HIV‐negative patients with tuberculosis in similar studies from the 1950s. The mean monthly patient infectiousness varied greatly, from production of 0–44 infectious quanta per hour, as did the theoretical risk for a health care worker to acquire tuberculosis by breathing ward air. Conclusions. HIV‐positive patients with tuberculosis varied greatly in their infectiousness, and some were highly infectious. Use of environmental control strategies for nosocomial tuberculosis is therefore a priority, especially in areas with a high prevalence of both tuberculosis and HIV infection

Estudio coproparasitario y ectoparasitario en alpacas (Vicugna pacos Linnaeus, 1758) de Apolobamba, con nuevos registros de Phthiraptera (Insecta) e Ixodidae (Acari), La Paz – Bolivia

Although parasites in South American camelids (SAC) can cause severe economic losses in Bolivia, a country with largepopulations of SAC, knowledge of these parasites in this species is limited. To obtain data on the parasitic fauna in alpacasfrom the Integrated Management Natural Area Apolobamba (ANMI Apolobamba), in February 2006 we evaluated 82 alpacas to determine the presence of ecto and endoparasites and investigate some biological and ecological drivers for the presenceand distribution of parasites. In 54 (98.2%) fecal samples were positive to coccidia parasitic forms, nematodes, cestodes andtrematodes. Significant prevalence (P<0.05) of nematodes of the order Strongylida and Capillaria spp. was found in adults and young alpacas respectively. From 82 individuals reviewed, 51 (62.2%) had infestations caused by Bovicola breviceps, Microthoracius mazzai, M. praelongiceps, M. minor, Amblyomma parvitarsum and Sarcoptes scabiei var. aucheniae, andsignificant prevalence (P <0.05) of lice M. praelongiceps was observed in females alpacas. This is the first registry of Bovicola breviceps in Bolivia, and the ectoparasites of Microthoracius mazzai, M. praelongiceps, M. minor and Amblyommaparvitarsum are the first records found in alpacas from Bolivia.Program, Wildlife Conservation Society, Calle Gabino Villanueva # 340 Calacoto. Casilla 3-35181, La Paz, [email protected], [email protected] Laboratorio de Investigación y Diagnóstico Veterinario Cochabamba, ServicioNacional de Sanidad Agropecuaria e Ino- cuidad Alimentaria. Calle Cincinato Prados/n, Quillacollo, Bolivia. [email protected] Ciencias Veterinarias, Universidad deConcepción, Casilla 537, Chillán, [email protected] *Dirección de contacto: Laboratorio de Investigación y Diagnóstico Veterinario Cochabamba, Servicio Nacional de Sanidad Agropecuaria e Ino- cuidad Alimentaria. Calle Cincinato Prados/n, Quillacollo, Bolivia. L. Fabian Beltrán-Saavedra E-mail [email protected] las parasitosis en camélidos sudamericanos (CSA) pueden causar grandes pérdidas económicas en Bolivia, el conocimiento sobre los parásitos en estas especies es limitado. Con el objetivo de entregar antecedentes sobre la fauna parasitariaen alpacas del Área Natural de Manejo Integrado Apolobamba (ANMI Apolobamba), en febrero de 2006 fueron evaluadas82 alpacas para determinar la presencia de ecto y endoparásitos y establecer algunas determinantes biológicas y ecológicaspara la presencia y distribución de los parásitos. En 54 (98.2%) muestras fecales se observaron formas parasitarias correspondientes a coccidias, nematodos, cestodos y trematodos, observándose predominio (P<0.05) de nematodos del ordenStrongylida y Capillaria spp., en alpacas adultas y juveniles respectivamente. De los 82 individuos revisados, 51 (62.2%)presentaron infestaciones provocadas por Bovicola breviceps, Microthoracius mazzai, M. praelongiceps, M. minor, Amblyomma parvitarsum y Sarcoptes scabiei var. aucheniae, con predominio (P<0.05) de los piojos M. praelongiceps en alpacas hembras. El registro de Bovicola breviceps es nuevo para Bolivia, y los ectoparásitos Microthoracius mazzai, M.praelongiceps, M. minor y Amblyomma parvitarsum constituyen los primeros registros para alpacas en Bolivia