TLR-Mediated Host Immune Response to Parasitic Infectious Diseases

Toll-like receptors (TLRs) are important for the host immune response to a variety of pathogens, including bacteria, viruses, fungi, and parasites. These receptors become activated upon recognizing pathogen-associated molecular patterns (PAMPs) and thus initiate the innate immune response to the corresponding pathogen. A key aspect of TLRs is their activation of signaling that leads to cytokine production and an inflammatory response. Additionally, TLRs act as the bridge between innate and acquired immunity, enhancing phagocytosis and the process of killing parasites. We herein focus on how parasites (protozoans and helminths) and their derived products have the capability of stimulating or evading the host response by triggering or inhibiting TLR activation. Parasites often develop successful survival strategies that imply interference with the host immune response. Accordingly, many of these organisms have molecules that modulate inflammation and other aspects of host immunity. Taking advantage of such mechanisms, there are some anti-inflammatory therapies based on human infection with helminths. Helminths and protozoans influence the activity of various TLRs, especially TLR2, TLR4, and TLR9. A better understanding of the role of TLRs and their parasite-derived ligands should certainly provide new therapeutic tools for combatting various parasitic and inflammatory diseases

Super-poissonian photon statistics and correlations between pump and probe fields in Electromagnetically Induced Transparency

We have measured the photon statistics of pump and probe beams after interaction with Rb atoms in a situation of Electromagnetically Induced Transparency. Both fields present super-poissonian statistics and their intensities become correlated, in good qualitative agreement with theoretical predictions in which both fields are treated quantum-mechanically. The intensity correlations measured are a first step towards the observation of entanglement between the fields.Comment: 4 pages, two-column, 4 figures, first submitted to PRL on Aug. 6, 200

Point‑of‑care ultrasound in cardiorespiratory arrest (POCUS‑CA): narrative review article.

The POCUS-CA (Point-of-care ultrasound in cardiac arrest) is a diagnostic tool in the Intensive Care Unit and Emergency Department setting. The literature indicates that in the patient in a cardiorespiratory arrest it can provide information of the etiology of the arrest in patients with non-defibrillable rhythms, assess the quality of compressions during cardiopulmonary resuscitation (CPR), and define prognosis of survival according to specific findings and, thus, assist the clinician in decision-making during resuscitation. This narrative review of the literature aims to expose the usefulness of ultrasound in the setting of cardiorespiratory arrest as a tool that allows making a rapid diagnosis and making decisions about reversible causes of this entity. More studies are needed to support the evidence to make ultrasound part of the resuscitation algorithms. Teamwork during cardiopulmonary resuscitation and the inclusion of ultrasound in a multidisciplinary approach is important to achieve a favorable clinical outcomepost-print2391 K

Harina de centeno integral malteado. Almacenamiento, secado y propiedades

El centeno es un cereal que contiene una alta proporción de fibra soluble e insoluble, y que se usa en la elaboración de panificados en el este de Europa. El malteado modifica la calidad de las fibras, aumentando la fracción de fibras solubles mejorando sus características como prebióticas. Se propone el uso de harina centeno integral malteadoen la producción de panificados

Result of a pulmonary rehabilitation program on adherence and inhalation technique in patients with chronic respiratory disease

Introducción: Los programas de rehabilitación pulmonar deben incluir actividades educativas encaminadas a que el paciente conozca la enfermedad y reciba el adiestramiento que le permita abordar adecuadamente su tratamiento. Objetivo: Analizar la adherencia y la técnica inhalatoria en pacientes remitidos al programa de rehabilitación pulmonar de la Fundación Neumológica Colombiana y evaluar los cambios que se presentaron en éstas al finalizar el programa ambulatorio. Metodología: Estudio no experimental preprueba postprueba en pacientes mayores de 18 años. Se calificó la técnica inhalatoria utilizando la escala EDEN y la adherencia utilizando preguntas adaptadas de la escala de adherencia a la medicación de Morisky. Resultados: Se analizaron 320 pacientes; el porcentaje de pacientes que utilizaba correctamente los dispositivos inhalados al iniciar el programa de rehabilitación osciló entre 9% y19%; el error más común en todos los dispositivos fue no expulsar el aire antes de iniciar la inhalación. Después del programa de rehabilitación el porcentaje de pacientes que empleaban una técnica inhalatoria correcta fue en promedio 61% para inhaladores de dosis medida y 83% para dispositivos de polvo seco. La adherencia a los inhaladores antes del programa fue 58%, siendo descuido y olvido las principales razones que explican la no adherencia. Al finalizar el programa 86% de los pacientes eran adherentes. Conclusiones: Un porcentaje bajo de pacientes remitidos al programa de rehabilitación pulmonar aplicaba correctamente la técnica inhalatoria, la instrucción educativa dentro de un programa de rehabilitación pulmonar mejoró la técnica y la adherencia a los inhaladores en un porcentaje importante de pacientes.Introduction: Pulmonary rehabilitation programs must include educational activities focused on the acquisition of necessary knowledge and skills to control the disease and approach treatment appropriately. Objective: To analyze treatment adherence and inhalation technique in patients referred to pulmonary rehabilitation program of Fundación Neumológica Colombiana and evaluate changes in them at the end of the outpatient program. Methodology: Pretest - posttest design in patients older than 18 years. The inhalation technique was assessed using the EDEN scale, and adherence was scored with modified questions from the Morisky medication adherence scale. Results: We analyzed 320 patients. The percentage of patients who used inhalers correctly before starting the rehabilitation program ranged between 9% and 19%; the most common mistake was not exhale the air before starting inhalation. Upon completion of the program the percentage of patients performing a correct inhalation technique ranged between 61% for metered dose inhalers to 83% for dry powder inhalers. Adherence to inhalers before the program was 58%, with neglect and forget being the main reasons encountered. It improved in 86% of evaluated patients. Conclusion: A small percentage of patients referred to pulmonary rehabilitation program applied the inhalation technique correctly; educational instruction in a pulmonary rehabilitation program improved the technique and adherence to inhalers in a significant percentage of patients

Clostridioides difficile-associated diarrhea in surgical service patients in Mexico

Introduction: Clostridium difficile is the first cause of healthcare-associated diarrhea in developed countries. In recent years the incidence of C. difficile infection (CDI) has increased worldwide. There is not much information on the topic in Mexico, and little is known about the risk factors for the infection in patients that are hospitalized in surgical services. Materials and methods: A case-control study was conducted that compared the epidemiologic findings and risk factors between surgical patients with PCR-confirmed CDI, surgical patients with diarrhea and a negative PCR test, and surgical patients with no diarrhea. The statistical analysis was carried out using the SPSS version 22.0 program. Results: The majority of the surgical patients with CDI belonged to the areas of neurosurgery, cardiac surgery, orthopedics, and general surgery. A total of 53% of the CDI cases were associated with the hypervirulent CD NAP1/027 strain. The presence of mucus in stools (OR: 1.5, p = 0.001), fever (OR: 1.4, p = 0.011), leukocytes in stools (OR: 3.2, p < 0.001), hospitalization within the past twelve weeks (OR: 2.0, p < 0.001), antibiotic use (OR: 1.3, p = 0.023), and ceftriaxone use (OR: 1.4, p = 0.01) were independent risk factors for the development of CDI

Diarrea asociada a Clostridioides difficile en pacientes de servicios quirúrgicos en México

Introducción: Clostridioides difficile (CD) es la primera causa de diarrea asociada al cuidadode salud en los países desarrollados. En los últimos a˜nos, la incidencia de la infección asociadaa CD (ICD) ha aumentado en el ámbito mundial. En México, la información al respecto es escasay se conoce poco sobre los factores de riesgo para esta enfermedad en pacientes hospitalizadosen servicios quirúrgicosMaterial y métodos: Estudio de casos y controles. Se compararon hallazgos epidemiológicos yfactores de riesgo entre pacientes quirúrgicos con ICD confirmada por PCR contra pacientes qui-rúrgicos con diarrea PCR negativa y contra pacientes quirúrgicos sin diarrea. Se realizó análisisestadístico mediante el paquete estadístico SPSS versión 22.0.Resultados: La mayoría de los pacientes quirúrgicos con ICD correspondían a las áreas de neu-rocirugía, cardiocirugía, ortopedia y cirugía general. El 53% de los casos de ICD se asociaron a lacepa hipervirulenta de CD NAP1/027. La presencia de moco en heces (RM 1.5, p = 0.001), fiebre(RM 1.4, p = 0.011), leucocitos en heces (RM 3.2, p = < 0.001), hospitalización en las últimas12 semanas (RM 2.0, p = < 0.001), uso de antibióticos (RM 1.3, p = 0.023) y uso de ceftriaxona(RM 1.4, p = 0.01) constituyeron factores de riesgo independientes para el desarrollo de ICD. Conclusiones: La diarrea por CD en servicios quirúrgicos es frecuente en nuestra institución(Hospital Civil de Guadalajara Fray Antonio Alcalde)

Working memory training improves cognitive efficiency in multiple sclerosis patients

La Esclerosis Múltiple (EM) es una enfermedad en la que la memoria de trabajo (MT) se encuentra comúnmente afectada. Estudiar la eficacia de un programa de entrenamiento en MT en pacientes de EM. 29 pacientes de EM Remitente-Recurrente fueron seleccionados para el estudio: 15 realizaron el entrenamiento en MT y 14 fueron seleccionados como grupo control. Todos los participantes fueron valorados a nivel neuropsicológico y se adquirieron imágenes de Resonancia Magnética funcional (RMf) durante la realización de la tarea 2 y 3-back (basal y post tratamiento-7 días). Los pacientes entrenados mejoraron su ejecución en 2 y 3-back (p<.001), tanto en aciertos como en tiempo de reacción (TR). Durante la realización de la tarea 2-back, los pacientes sin entrenamiento mostraron una mayor activación en el giro angular derecho (FWEc=125, p<.001) que correlaciona con el TR (r=.459, p<.05). También se observó una disminución de la actividad cerebral en el grupo de pacientes entrenados en el giro precentral derecho (FWEc=273, p<.01). Los resultados encontrados apoyan la eficacia del entrenamiento cognitivo en MT. Los pacientes de EM entrenados muestran una clara mejoría a nivel conductual asociada a un incremento de la eficiencia cognitiva, es decir, un menor uso de recursos cerebrales obteniendo una mejor ejecución.Multiple Sclerosis (MS) is a disease usually associated with a working memory (WM) impairment. Study the efficacy of a WM cognitive training program in MS patients. 29 relapsing-remitting MS patients were enrolled in the study: 15 underwent WM training and 14 were assigned to a control group. All participants were neuropsychologically assessed and Functional Magnetic Resonance imaging (fMRI) images were acquired during 2 and 3-back execution (baseline and post-training +7days). Training improved MS patients’ performance in 2 and 3-back, hence showing shorter reaction times (RT) and higher percentages of correct responses (p<.001). During 2-back performance, non-trained MS-patients exhibited a greater activation in in right angular gyrus (FWEc=125, p<.001) that was correlated to RT (r=.459, p<.05). Further, lower activation in right precentral gyrus in the trained MS-patients (FWEc=273, p<.01) was also found. The results obtained demonstrates the effectiveness of a WM training program in MS-patients. Trained MS-patients showed a marked improvement of WM performance and increased cognitive efficiency, i.e, using less cerebral resources to achieve higher performance