Chagas disease: Historic perspective

This review is a perspective on the history of Chagas disease, and it adopts a novel approach from literary studies, historical documents and the science and epidemiology of the nature of the disease. From this analysis, comes the review's working definition of the Contact Zone (CZ): “the space in which geographically and historically separated people come into contact with each other and establish long-lasting relationships, which usually involve coercive conditions, radical inequality and intolerable conflict.” In the Patient-Physician CZ, we verified the triple transition phenomena: the American trypanosomiasis shifted from a rural, acute, and vectorial transmitted disease to an urban, chronic and non-vectorial disease. In the Academic CZ, we describe the original disagreements which denied the existence of the disease and the current controversies about pathogenic mechanisms and etiological treatment. From the News from Latin America, and in the Original CZ, we will review the evolution of different forms of transmission. As in any good story, research across broad disciplines is necessary to reveal historical perspectives, scientific approaches, and the epidemiology of the disease, which has a prequel of 9000 years and an open ending: thus, we explore across the Global CZ, with its multiple and unexpected actors.Fil: Chao, Chen. Fundación Favaloro; ArgentinaFil: Leone, José L.. No especifíca;Fil: Vigliano, Carlos. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Medicina Traslacional, Trasplante y Bioingeniería. Fundación Favaloro. Instituto de Medicina Traslacional, Trasplante y Bioingeniería; Argentin

Klebsiella pneumoniae is able to trigger epithelial-mesenchymal transition process in cultured airway epithelial cells

The ability of some bacterial pathogens to activate Epithelial-Mesenchymal Transition normally is a consequence of the persistence of a local chronic inflammatory response or depends on a direct interaction of the pathogens with the host epithelial cells. In this study we monitored the abilities of the K. pneumoniae to activate the expression of genes related to EMT-like processes and the occurrence of phenotypic changes in airway epithelial cells during the early steps of cell infection. We describe changes in the production of intracellular reactive oxygen species and increased HIF-1α mRNA expression in cells exposed to K. pneumoniae infection. We also describe the upregulation of a set of transcription factors implicated in the EMT processes, such as Twist, Snail and ZEB, indicating that the morphological changes of epithelial cells already appreciable after few hours from the K. pneumoniae infection are tightly regulated by the activation of transcriptional pathways, driving epithelial cells to EMT. These effects appear to be effectively counteracted by resveratrol, an antioxidant that is able to exert a sustained scavenging of the intracellular ROS. This is the first report indicating that strains of K. pneumoniae may promote EMT-like programs through direct interaction with epithelial cells without the involvement of inflammatory cells

Relationship of an hRAD54 gene polymorphism (2290 C/T) in an Ecuadorian population with chronic myelogenous leukemia

The hRAD54 gene is a key member of the RAD52 epistasis group involved in repair of double-strand breaks (DSB) by homologous recombination (HR). Thus, alterations of the normal function of these genes could generate genetic instability, shifting the normal process of the cell cycle, leading the cells to develop into cancer. In this work we analyzed exon 18 of the hRAD54 gene, which has been previously reported by our group to carry a silent polymorphism, 2290 C/T (Ala730Ala), associated to meningiomas. We performed a PCR-SSCP method to detect the polymorphism in 239 samples including leukemia and normal control population. The results revealed that the 2290 C/T polymorphism has frequencies of 0.1 for the leukemia and 0.1 for the control group. These frequencies show no statistical differences. Additionally, we dissected the leukemia group in chronic myelogenous leukemia (CML) and acute lymphoblastic leukemia (ALL) to evaluate the polymorphism. The frequencies found in these subgroups were 0.14 for CML and 0.05 for ALL. We found statistically significant differences between CML patients and the control group (p < 0.05) but we did not find significant differences between ALL and the control group (p > 0.05). These results suggest a possible link between the 2290 C/T polymorphism of the hRAD54 gene and CML

Pleiotropic Benefit of Monomeric and Oligomeric Flavanols on Vascular Health - A Randomized Controlled Clinical Pilot Study

BACKGROUND: Cardiovascular diseases are expanding to a major social-economic burden in the Western World and undermine man's deep desire for healthy ageing. Epidemiological studies suggest that flavanol-rich foods (e.g. grapes, wine, chocolate) sustain cardiovascular health. For an evidenced-based application, however, sound clinical data on their efficacy are strongly demanded. METHODS: In a double-blind, randomized, placebo-controlled intervention study we supplemented 28 male smokers with 200 mg per day of monomeric and oligomeric flavanols (MOF) from grape seeds. At baseline, after 4 and 8 weeks we measured macro- and microvascular function and a cluster of systemic biomarkers for major pathological processes occurring in the vasculature: disturbances in lipid metabolism and cellular redox balance, and activation of inflammatory cells and platelets. RESULTS: In the MOF group serum total cholesterol and LDL decreased significantly (P ≤ 0.05) by 5% (n = 11) and 7% (n = 9), respectively in volunteers with elevated baseline levels. Additionally, after 8 weeks the ratio of glutathione to glutathione disulphide in erythrocytes rose from baseline by 22% (n = 15, P<0.05) in MOF supplemented subjects. We also observed that MOF supplementation exerts anti-inflammatory effects in blood towards ex vivo added bacterial endotoxin and significantly reduces expression of inflammatory genes in leukocytes. Conversely, alterations in macro- and microvascular function, platelet aggregation, plasma levels of nitric oxide surrogates, endothelin-1, C-reactive protein, fibrinogen, prostaglandin F2alpha, plasma antioxidant capacity and gene expression levels of antioxidant defense enzymes did not reach statistical significance after 8 weeks MOF supplementation. However, integrating all measured effects into a global, so-called vascular health index revealed a significant improvement of overall vascular health by MOF compared to placebo (P ≤ 0.05). CONCLUSION: Our integrative multi-biomarker approach unveiled the pleiotropic vascular health benefit of an 8 weeks supplementation with 200 mg/d MOF in humans. TRIAL REGISTRATION: ClinicalTrials.gov NCT00742287

La educación médica innovada : cotidianeidad, debates y experiencias educacionales en la implementación de una nueva carrera

Se estudia el proceso de formación inicial de estudiantes de la carrera de Medicina de la Universidad Nacional de La Matanza desde los inicios de su organización y puesta en marcha. La intención es comprender en qué consisten los cambios sociales y culturales que se producen cuando se implementa un diseño curricular considerado innovadoror. La problemática planteada se enmarca en la reciente creación del Departamento de Ciencias de la Salud y de la carrera de Medicina, que propone trabajar a partir de la lógica de equipos de salud y organizar una oferta adecuada a las necesidades de formación de recursos humanos para el sistema sanitario. Considerando que salud y educación son pilares básicos para esta formación de médicos, este proyecto intenta instalarse en los puntos en que salud y educación se intersectan en torno a una concepción integral de la salud. De ahí la importancia que se le atribuye a la formación de los docentes y estudiantes como investigadores, así como al espacio socio demográfico como condicionante de primer orden para la formación de los profesionales y en consecuencia para este estudio. El propósito general es identificar y analizar problemas en los procesos de enseñanza y aprendizaje, definirlos en términos de conocimiento y explorar modos adecuados de evaluación de los aportes de los diferentes componentes del diseño curricular. El encuadre metodológico es de corte cualitativo-etnográfico para alcanzar una descripción detallada y analítica que permite interpretar las actividades, creencias compartidas, prácticas y discursos cotidianos desde las perspectivas de los miembros del grupo social en estudio y la reflexión sobre las propias prácticas. El proceso analítico incluye tareas de codificación, categorización, contrastación y diversas formas de triangulación y busca extender el campo explicativo en el plano teórico de la educación médica. Se elaboraron producciones escritas y audiovisuales y la difusión en eventos nacionales y en revistas académicas, así como contar con primeras experiencias de investigación con estudiantes.Fil: Milstein, Diana. Universidad Nacional de La Matanza; Argentina.Fil: Carneglia, Gabriela. Universidad Nacional de La Matanza; Argentina.Fil: Cattani, Alicia. Universidad Nacional de La Matanza; Argentina.Fil: Dakessian, María Andrea. Universidad Nacional de La Matanza; Argentina.Fil: Delgado, Lilia. Universidad Nacional de La Matanza; Argentina.Fil: Fernández, María Laura. Universidad Nacional de La Matanza; Argentina.Fil: Gené, Ricardo. Universidad Nacional de La Matanza; Argentina.Fil: José, Marta Susana. Universidad Nacional de La Matanza; Argentina.Fil: Klein, Karen. Universidad Nacional de La Matanza; Argentina.Fil: Lacarta, Gabriela. Universidad Nacional de La Matanza; Argentina.Fil: Lartigue, Fabiana. Universidad Nacional de La Matanza; Argentina.Fil: Leone, Francisco. Universidad Nacional de La Matanza; Argentina.Fil: Lourtau, Gabriela Marisa. Universidad Nacional de La Matanza; Argentina.Fil: Marcel, Ariel L. Universidad Nacional de La Matanza; Argentina.Fil: Mazur, Viviana. Universidad Nacional de La Matanza; Argentina.Fil: Olivetto, Adriana. Universidad Nacional de La Matanza; Argentina.Fil: Preide, Alicia. Universidad Nacional de La Matanza; Argentina.Fil: Rovere, Mario. Universidad Nacional de La Matanza; Argentina.Fil: Santos, María Graciela. Universidad Nacional de La Matanza; Argentina.Fil: Schwarcz, Tomás. Universidad Nacional de La Matanza; Argentina.Fil: Valdez, Pascual. Universidad Nacional de La Matanza; Argentina.Fil: Weisman, Clarisa. Universidad Nacional de La Matanza; Argentina

Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs