Nuevos fitocompuestos activos naturales para el tratamiento y prevención de diarreas infecciosas

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Farmacia, Departamento de Microbiología II, leída el 24-07-2015Las infecciones entéricas siguen siendo uno de los problemas más importantes de salud pública. La diarrea infecciosa es a nivel mundial la segunda causa de morbilidad y mortalidad infantil, con 4,6 millones de muertes de los aproximadamente un billón de episodios de diarrea al año reportados en niños. Según informes recientes de la OMS, 1,9 millones de niños menores de cinco años siguen muriendo de estas enfermedades cada año. Los principales síntomas clínicos de las infecciones entéricas incluyen los síntomas gastrointestinales y las afecciones sistémicas, pudiendo darse sucesivamente. El principal síntoma de afectación gastrointestinal es la diarrea. Otros síntomas frecuentes son fiebre, nauseas, vómitos y dolor abdominal, en función de los patógenos microbianos. Los brotes de infecciones intestinales se producen a través de la ingestión de alimentos o agua contaminados, transmisión vía fecal oral, o por contacto directo, persona a persona. En los países en vías de desarrollo los agentes causantes de las infecciones entéricas más recurrentes son las bacterias. Escherichia coli es una bacteria anaerobia facultativa predominante en la microbiota intestinal del colon en los humanos que con el paso del tiempo se asoció a la aparición de diarreas. Las bacterias E. coli diarreicas se clasifican en seis categorías; entre ellas destaca E. coli enteropatógena, EPEC. EPEC es la causa más importante de morbilidad y mortalidad en niños menores de cinco años en los países en vías de desarrollo. EPEC se adhiere a las células intestinales y mediante un sistema de secreción denominado tipo tres, inyecta las proteínas efectoras bacterianas que se transfieren al citosol de la célula hospedadora afectando a múltiples funciones fisiológicas que en última instancia conducen a la enfermedad diarreica. EPEC se adhiere a las células intestinales formando una lesión histopatológica caracterizada por la degeneración local de las microvellosidades de absorción, la adherencia intima de la bacteria a la célula hospedadora y la formación de una estructura rica en filamentos de actina denominada pedestal. La terapia de rehidratación oral y el suplemento nutricional se deben realizar antes de administrar ningún otro agente terapéutico. Los antibioticos se requieren para el tratamiento de la gastroenteritis bacteriana en aquellos pacientes que sufren complicaciones graves, como por ejemplo pacientes donde la enfermedad se ha expandido por el organismo provocando sepsis. Generalmente, el tratamiento antimicrobiano consigue prevenir la progresión de la enfermedad. La aparición de resistencia bacteriana frente a los agentes antimicrobianos, particularmente de cepas de E. coli, se ha incrementado a nivel global. Un gran número de cepas bacterianas están mostrando ser resistentes a prácticamente todos los agentes terapéuticos disponibles. De este modo, el problema ha ido aumentando durante décadas, y hoy en día muchas infecciones comunes se están convirtiendo en infecciones difíciles o incluso imposibles de tratar, y así una infección común potencialmente mortal puede convertirse en una amenaza para la vida de la persona. Por lo tanto, hay una continua necesidad de buscar nuevos agentes antibacterianos para superar la resistencia a los antibioticos. El uso de plantas medicinales para el tratamiento de las enfermedades es una práctica arraigada en las distintas culturas desde la antigüedad. Cerca de 1.500 especies de plantas medicinales y aromáticas son ampliamente utilizadas en distintos países Europeos. En los últimos años, metabolitos secundarios como compuestos fenólicos, terpenoides, flavonoides y alcaloides han recibido una gran atención debido a sus diversas funciones biológicas. Por todo ello, en esta tesis hemos estudiado las propiedades antimicrobianas de una selección de extractos de plantas medicinales frente a diversas cepas de bacterias patógenas, 12 Gram positivas y Gram negativas en total, y 3 levaduras.Depto. de Microbiología y ParasitologíaFac. de FarmaciaTRUEunpu

First Record Of Microsporidium Neonosemoides Sp. And Some Ciliates Infecting Chrysichthus Auratus (Bagridae) From The Damietta Branch Of River Nile, Egypt

Abstract: The present study was carried out as a general survey for the possible ectoparasites that can infect the Nile fish Chrysichthus auratus. A total of 52 fish specimens were collected from Damietta branch of River Nile. Examination of the investigated fish revealed that, fish were infected with four ectoparasitic species belonging to three genera. These species were: Neonosemoides sp., Scyphidia sp. 1, Scyphidia sp. 2 and Ichthyophthirius multifillis. The first three species were recorded for the first time in Egypt. The recovered parasites have pathological effects on the host fish with subsequent economic losses were discussed

Effectiveness of Nursing Intervention on Health Locus of Control and Self-Efficacy in Women with Gestational Diabetes

Contents: Gestational diabetes is associated with an increased risk of complications during delivery and problems for both the mother and the offspring in prenatal and postnatal periods and later life. Lack of self-care is the most important reason for mortality in diabetic patients. Self-efficacy has a significant role in enhancing successful adherence to healthy behaviors, lifestyle modifications, and diabetes control among gestational diabetes pregnant women. Aim: The current study aimed to evaluate the nursing intervention (NI) effectiveness on health locus of control (HELOC) and self-efficacy in women with gestational diabetes (GD).Methods: A quasi-experimental design (study and control group) was used. The researchers conducted this study at the Antenatal Outpatient Clinics of Shebin El-Kom Teaching Hospital, Menoufia Governorate, Egypt. A purposive sample of 120 women with GD was carefully chosen from the nominated setting and dispersed accidentally into two identical groups (study and control group). Three tools were used for collecting the study data: A structured self-administered questionnaire, the Multidimensional Health Locus of Control Scale-C Form, and the General Self-efficacy Scale. Results: There is a statistically significant difference between the intervention and control groups in their internal health locus of control (HELOC) scores after the intervention, with a mean difference of 4.70 at CI 95% for the intervention group p<0.001. A non-statistically significant difference was found between the intervention group and the control group in the external health locus of control (HELOC) mean scores before and after the intervention, although there was a significant difference between the change in both groups p=0.032. Also, there is a highly statistically significant difference between the intervention group and the control group in the self-efficacy scores after the intervention in the intervention group, where p<0.001 compared to a non-significant difference between them before the intervention group intervention (p=0.555). Conclusion: The study concluded that the women with GD who attended NI sessions obtained higher HELOC scores (internal and external) and higher self-efficacy scores than those who do not. Educational nursing intervention should become a fundamental part of the total management of gestational diabetes in antenatal outpatient clinics

Photokératoconjonctivite par coup d′arc

La photokératite est une kératite douloureuse causée par l'exposition non-protégée des yeux aux rayons ultraviolets (UV). On parle de «coup d'arc» quand la photokératite est induite par le rayonnement UV émis par l′arc électrique pendant le soudage à l′arc électrique. Nous rapportons le cas d′un patient de 35 ans, sans antécédents notables, cavalier de profession qui se dit avoir regardé pendant quelques minutes, un arc électrique durant le soudage des portes du stable suite à laquelle, il a présenté une douleur oculaire bilatérale à type de brûlure associé à des larmoiements photophobie et blépharospasme. Son examen clinique a montré une acuité visuelle avec correction à 8/10 et 9/10, une hyperhémie conjonctivale avec une kératite érosive ponctuée limité à la fente palpébrale après instillation de la fluorescéine. Vu le contexte, le diagnostic d'une kératoconjonctivite par coup d'arc a été retenu. Le patient a été mis sous antibiotique topique, agents mouillants et cicatrisants. L′évolution a été marquée, par la disparition totale des signes avec une acuité visuelle qui est remonté à 10/10 en bilatérale. A travers ce cas, on illustre l′intérêt d′une prévention par un port d′équipements de protection adaptés

Voluntary Local Review Framework to Monitor and Evaluate the Progress towards Achieving Sustainable Development Goals at a City Level: Buraidah City, KSA and SDG11 as A Case Study

Around the world, cities are on the front lines of sustainable development. They are responsible for more than 70% of global carbon emissions. Many of these cities are experiencing dangerous levels of pollution, underemployment, and health disparities. Since 2015, 193 countries have endorsed the 17 Sustainable Development Goals (SDGs), intended to help address a wide range of challenges affecting cities and ultimately secure the resources for their next generations. All states are expected to present the national progress towards the SDGs through a Voluntary National Review (VNR). Despite the importance of the cities within this framework, only a handful of them worldwide have actively begun to review and assess progress towards these SDGs on a city scale. This paper seeks to develop a Voluntary Local Review (VLR) framework to assess and evaluate the progress of cities towards contributing to the SDGs. This framework has been developed by localizing the international and national frameworks to measure the performance of cities as they advance towards achieving the SDGs. Such a framework can serve as a tool for benchmarking progress on different aspects of sustainable development and help urban planners and policymakers prioritize policies and actions to improve urban quality of life. This framework is applied to monitor and evaluate the progress of the city of Buraidah in Saudi Arabia, as it strives towards achieving the targets of SDG11 (“Make cities and human settlements inclusive, safe, resilient and sustainable”).</jats:p

Parenting Stress in CHARGE Syndrome and the Relationship with Child Characteristics

This study investigates the parental perception of stress related to the upbringing of children with CHARGE syndrome and its association with behavioral and physical child characteristics. Parents of 22 children completed the Nijmegen Parenting Stress Index-Short, Developmental Behavior Checklist, and Dutch Vineland Screener 0-12 and reported their child’s problems with hearing, vision and ability to speak. Parenting stress was high in 59% of the subjects. Behavioral problems on the depression, autism, self-absorbed and disruptive behavior scales correlated positively with parenting stress. A non-significant trend was found, namely higher stress among the parents of non-speaking children. No associations were found with other child characteristics, i.e. level of adaptive functioning and intellectual disability, auditory and visual problems, deafblindness, gender, and age. Raising a child with CHARGE syndrome is stressful; professional support is therefore essential for this population. More research into other possible influencing characteristics is needed to improve family-oriented interventions. Since CHARGE is a rare syndrome, closer international collaboration is needed, not only to expand the group of study subjects to increase statistical power, but also to harmonize research designs and measurement methods to improve the validity, the reliability, and the generalization of the findings

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Controlo químico de infestantes

Uma planta é considerada infestante quando nasce espontaneamente num local e momento indesejados, podendo interferir negativamente com a cultura instalada. As infestantes competem com as culturas para o espaço, a luz, água e nutrientes, podendo atrasar e prejudicar as operações de colheita, depreciar o produto final e assegurarem a reinfestação nas culturas seguintes. Dado o modo de propagação diferenciado das diversas espécies de infestantes, com as anuais a propagarem-se por semente e as perenes ou vivazes a assegurarem a sua propagação através de órgãos vegetativos (rizomas, bolbos, tubérculos, etc.), assim, também o seu controlo quer químico, quer mecânico terá que ser diferenciado, ou seja, para controlar infestantes anuais será suficiente destruir a sua parte aérea, enquanto para controlar infestantes perenes teremos que destruir os seus órgãos reprodutivos. O controlo de infestantes poderá ser químico, através da utilização de herbicidas, ou mecânico pela utilização de alfaias agrícolas, tais como a charrua de aivecas, a charrua de discos, a grade de discos, o escarificador e a fresa. Quando a técnica utilizada na instalação das culturas é a sementeira directa, o controlo das infestantes terá que ser obrigatoriamente químico, enquanto se o recurso à mobilização do solo for a técnica mais utilizada (sistema de mobilização tradicional ou sistema de mobilização reduzida), o controlo das infestantes tanto poderá ser químico como mecânico. Neste trabalho iremos abordar apenas, o controlo químico de infestantes