Reducción 5-log De Listeria monocytogenes en alimentos ácidos.

Listeria monocytogenes es un patógeno que produce listeriosis cuando se consume en alimentos por personas vulnerables como estado de gravidez, adultos inmunocomprometidos, con trasplantes, enfermos con HIV y adultos mayores. Es una bacteria cosmopolita y oportunista que puede ser tolerante a la acidez, característica que algunos productos presentan y que les confiere estabilidad. La bacteria requiere un pH óptimo de 7 para su crecimiento; sin embargo, se ha reportado que puede sobrevivir a pH hasta de 3.3 en alimentos ácidos como salsas de escabeche, vegetales acidificados, etc., por lo que para verificar su inocuidad se realizó un reto microbiológico utilizando salsas de tipo guacamole, roja y verde de tres marcas inoculadas con L. monocytogenes (con pH 3.45 a 4.08) a temperatura ambiente (25 °C) con el fin de medir la sobrevivencia del patógeno hasta su reducción 5-log durante 7 días consecutivos (T1-T7). Se obtuvo que L. monocytogenes se redujo desde el tiempo 1 (T1) en los 3 tipos de salsas de la marca 1 y la marca 3 y en la salsa guacamole de la marca 2; sin embargo, se redujo a partir del T4 en la salsa roja y a partir del T2 de la salsa verde de la marca 2. Estos resultados pueden ser utilizados en relación a marcos regulatorios internacionales en las industrias que deseen exportar estos productos

Effect of Tibolone on Bone Mineral Density in Postmenopausal Women: Systematic Review and Meta-Analysis

Low bone mineral density (BMD) on postmenopausal women causes bone fragility and fracture risk. Tibolone seems to prevent bone loss. Therefore, this systematic review with meta-analysis synthesizes the tibolone effect on BMD percent change in lumbar spine (LS), femoral neck (FN), and total hip (TH) in postmenopausal women. Controlled trials that provided tibolone evidence on the efficacy of tibolone in preventing loss of BMD were included. Regarding the included studies, a pooled mean difference (MD) with 95% confidence intervals (95%CI) was estimated to determine the BMD percentage change. Eleven studies were identified and eight were included in the quantitative analysis. Tibolone at a dose of 2.5 mg increased BMD compared with non-active controls at 24 months in LS (MD 4.87%, 95%CI: 4.16–5.57, and MD 7.35%, 95%CI: 2.68–12.01); and FN (MD 4.85%, 95%CI: 1.55–8.15, and 4.21%, 95%CI: 2.99–5.42), with Hologic and Lunar scanners, respectively. No difference was observed when tibolone 2.5 mg dose was compared with estrogen therapy (ET) at 24 months, LS (MD −0.58%, 95%CI: −3.77–2.60), FN (MD −0.29%, 95%CI: −1.37–0.79), and TH (MD −0.12%, 95%CI: −2.28–2.53). Therefore, tibolone increases BMD in LS and FN compared to non-active controls, and there was no showed difference with ET

Aspectos bioéticos de los cuidados paliativos

El dolor es un motivo frecuente de consulta médica en cualquier área de la medicina; los pacientes con enfermedades en la fase terminal lo presen-tan en más del 50% de los casos, principalmente niños con cáncer avanzado e incurable.8-1

Drug resistance phenotypes and genotypes in Mexico in representative gram-negative species: Results from the infivar network.

AimThis report presents phenotypic and genetic data on the prevalence and characteristics of extended-spectrum β-lactamases (ESBLs) and representative carbapenemases-producing Gram-negative species in Mexico.Material and methodsA total of 52 centers participated, 43 hospital-based laboratories and 9 external laboratories. The distribution of antimicrobial resistance data for Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, Acinetobacter baumannii complex, and Pseudomonas aeruginosa in selected clinical specimens from January 1 to March 31, 2020 was analyzed using the WHONET 5.6 platform. The following clinical isolates recovered from selected specimens were included: carbapenem-resistant Enterobacteriaceae, ESBL or carbapenem-resistant E. coli, and K. pneumoniae, carbapenem-resistant A. baumannii complex, and P. aeruginosa. Strains were genotyped to detect ESBL and/or carbapenemase-encoding genes.ResultsAmong blood isolates, A. baumannii complex showed more than 68% resistance for all antibiotics tested, and among Enterobacteria, E. cloacae complex showed higher resistance to carbapenems. A. baumannii complex showed a higher resistance pattern for respiratory specimens, with only amikacin having a resistance lower than 70%. Among K. pneumoniae isolates, blaTEM, blaSHV, and blaCTX were detected in 68.79%, 72.3%, and 91.9% of isolates, respectively. Among E. coli isolates, blaTEM, blaSHV, and blaCTX were detected in 20.8%, 4.53%, and 85.7% isolates, respectively. For both species, the most frequent genotype was blaCTX-M-15. Among Enterobacteriaceae, the most frequently detected carbapenemase-encoding gene was blaNDM-1 (81.5%), followed by blaOXA-232 (14.8%) and blaoxa-181(7.4%), in A. baumannii was blaOXA-24 (76%) and in P. aeruginosa, was blaIMP (25.3%), followed by blaGES and blaVIM (13.1% each).ConclusionOur study reports that NDM-1 is the most frequent carbapenemase-encoding gene in Mexico in Enterobacteriaceae with the circulation of the oxacillinase genes 181 and 232. KPC, in contrast to other countries in Latin America and the USA, is a rare occurrence. Additionally, a high circulation of ESBL blaCTX-M-15 exists in both E. coli and K. pneumoniae