249 research outputs found

    Synthesis and Biological Activity of Triterpene-Coumarin Conjugates.

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    A set of 12 maslinic acid-coumarin conjugates was synthesized, with 9 being maslinic acid-diamine-coumarin conjugates at the C-28 carboxylic acid group of triterpene acid and the other three being maslinic acid-coumarin conjugates at C-2/C-3 and/or C-28 of the triterpene skeleton. The cytotoxic effects of these 12 triterpene conjugates were evaluated in three cancer cell lines (B16-F10, HT29, and Hep G2) and compared, respectively, with three nontumor cell lines from the same or similar tissue (HPF, IEC-18, and WRL68). The most potent cytotoxic results were achieved by a conjugate with two molecules of coumarin-3-carboxylic acid coupled through the C-2 and C-3 hydroxy groups of maslinic acid. This conjugate showed submicromolar IC50 values in two of the three cancer cell lines tested (0.6, 1.1, and 0.9 őľM), being between 110- and 30-fold more effective than its corresponding precursor. Furthermore, this conjugate (10) showed percentages of cell viability for the three nontumor lines of 90%. Four maslinic acid-coumarin conjugates displayed apoptotic effects in the treated cells, with total apoptosis rates of between 40 and 85%, relative to the control. Almost all the compounds assayed caused cell-cycle arrest in all cancer cell lines, increasing the number of these cells in the G0/G1 phase

    Compartiendo saberes de educación y humanidades

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    Los cap√≠tulos referentes a este libro tratan diversos temas tales como: 1) la construcci√≥n de los estudiantes de la licenciatura en qu√≠mico farmac√©utico bi√≥logo el juicio valorativo y personaI deI significado en su desarroIIo profesionaI desde eI punto de vista axiol√≥gico, 2) se realiza un estudio en el Plantel Cuauht√©moc con Ia finaIidad de orientar a Ia comunidad estudiantiI aI tratamiento deI probIema de los residuos s√≥lidos desde su etapa de diagn√≥stico hasta una propuesta de soluci√≥n de la problem√°tica, 3) se analiza como a nivel b√°sico se construye el conocimiento y la participaci√≥n del g√©nero en los estudiantes, en donde se observa que el papel del docente es un promotor importante, 4) es un tema que actualmente est√° causando mucho inter√©s tanto en la educaci√≥n como el la poblaci√≥n en general, las redes sociales que actuaImente ese consideran un medio de comunicaci√≥n con mucha influencia dentro de la sociedad, 5) se adentra al campo de la psicolog√≠a y la tanatolog√≠a ante los recursos resilientes que presentan las familias ante la muerte de un hijo, 6) es una investigaci√≥n dedicada a identificar Ias diferentes percepciones que tienen las mujeres y los hombres en relaci√≥n a la felicidad y la desdicha dentro del matrimonio, 7) es un an√°lisis Transgeneracional para aportar las referencias familiares que permiten la permanencia del abuso sexual infantil en tres generaciones, de las cuales en la √ļltima generaci√≥n se rompe ese secreto avallazador al romper el silencio, 8) es un ensayo acerca del juego terap√©utico desde el punto de vista psicoanal√≠tico, en el que se advierte ese juego en el que entra el paciente con el psicoanalista, 9) la metodolog√≠a de la observaci√≥n para la integraci√≥n de la pericial en psicolog√≠a, en donde se denotan desde la parte jur√≠dica como se fundamente esta pericial y fortalece el logro del dictamen para tener un buen dictamen, 10) es una propuesta de construcci√≥n y validez del instrumento BP-22 Bienestar Psicol√≥gico en el √°mbito de la educaci√≥n superior, 11) se identifica a Ios procesos eIectoraIes como complicados, de tal manera que abre un panorama al marketing de los partidos pol√≠ticos para conducir la voluntad ciudadana, y adem√°s ayuda al posicionamiento de los partidos, 12) aporta una base sobre Ios procesos identificatorios en eI movimiento estudiantiI de Ia UNAM deI a√Īo de I999, pIante√°ndoIo desde dos ejes de an√°lisis: las identidades universitarias y el apartado del texto, que permiten configurar eI movimiento estudiantiI como un acontecimiento capaz de generar articulaciones nuevas de solidaridad. AI finaI deI Iibro se encuentran Ias s√≠ntesis curricuIares de cada uno de los autores, que aportaron sus investigaciones para la integraci√≥n y generaci√≥n de nuevos aportes cient√≠ficos.Como su nombre lo indica COMPARTIENDO SABERES DE EDUCACI√ďN Y HUMANIDADES, es un Iibro que denota eI deseo de integrar conocimiento para la comunidad estudiantil, llevarlos al inter√©s de la investigaci√≥n a trav√©s de la participaci√≥n de los investigadores de diferentes √°reas como: la educaci√≥n, las ciencias sociales y las humanidades. Que les permite tener no solo un espacio en la difusi√≥n de los avances de sus estudios, sino que adem√°s permite el generar el inter√©s de qui√©n lo lee en diferentes formas de investigaci√≥n, se encuentran estudios tanto cualitativos como cuantitativos, desde descriptivos hasta un nivel de intervenci√≥n en la pr√°ctica de estas √°reas.Universidad Aut√≥noma del Estado de m√©xic

    Risk factors for developing ventilator-associated lower respiratory tract infection in patients with severe COVID-19:a multinational, multicentre study, prospective, observational study

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    Around one-third of patients diagnosed with COVID-19 develop a severe illness that requires admission to the Intensive Care Unit (ICU). In clinical practice, clinicians have learned that patients admitted to the ICU due to severe COVID-19 frequently develop ventilator-associated lower respiratory tract infections (VA-LRTI). This study aims to describe the clinical characteristics, the factors associated with VA-LRTI, and its impact on clinical outcomes in patients with severe COVID-19. This was a multicentre, observational cohort study conducted in ten countries in Latin America and Europe. We included patients with confirmed rtPCR for SARS-CoV-2 requiring ICU admission and endotracheal intubation. Only patients with a microbiological and clinical diagnosis of VA-LRTI were included. Multivariate Logistic regression analyses and Random Forest were conducted to determine the risk factors for VA-LRTI and its clinical impact in patients with severe COVID-19. In our study cohort of 3287 patients, VA-LRTI was diagnosed in 28.8% [948/3287]. The cumulative incidence of ventilator-associated pneumonia (VAP) was 18.6% [610/3287], followed by ventilator-associated tracheobronchitis (VAT) 10.3% [338/3287]. A total of 1252 bacteria species were isolated. The most frequently isolated pathogens were Pseudomonas aeruginosa (21.2% [266/1252]), followed by Klebsiella pneumoniae (19.1% [239/1252]) and Staphylococcus aureus (15.5% [194/1,252]). The factors independently associated with the development of VA-LRTI were prolonged stay under invasive mechanical ventilation, AKI during ICU stay, and the number of comorbidities. Regarding the clinical impact of VA-LRTI, patients with VAP had an increased risk of hospital mortality (OR [95% CI] of 1.81 [1.40-2.34]), while VAT was not associated with increased hospital mortality (OR [95% CI] of 1.34 [0.98-1.83]). VA-LRTI, often with difficult-to-treat bacteria, is frequent in patients admitted to the ICU due to severe COVID-19 and is associated with worse clinical outcomes, including higher mortality. Identifying risk factors for VA-LRTI might allow the early patient diagnosis to improve clinical outcomes. Trial registration: This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

    Hitos Demográficos del Siglo XXI: Migración Internacional

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    La migraci√≥n ha sido una constante en la historia mundial. Sin embargo, las migraciones que han tenido lugar desde principios del siglo XXI no tienen precedentes, ya que recientemente √©stas han alcanzado su mayor volumen en la historia y presentan caracter√≠sticas que las diferencian de las observadas en periodos anteriores, lo que ha propiciado una nueva conceptualizaci√≥n del fen√≥meno, enmarcada en lo que algunos estudiosos llaman ‚Äúla nueva era‚ÄĚ de las migraciones internacionales (Arango, 2003, mencionado por Fern√°ndez, 2005). Este nuevo ciclo se caracteriza por una profusa re-configuraci√≥n del mapa migratorio mundial, el cual parece dar cuenta hoy, de una aut√©ntica mundializaci√≥n migratoria, con una fuerte tendencia a la diversificaci√≥n de rutas y conexiones origen-destino. El nuevo mapa es el correlato de un escenario de globalizaci√≥n econ√≥mica, cultural e informacional, que estimula que segmentos amplios de la poblaci√≥n respondan cada vez m√°s r√°pidamente a informaciones y oportunidades que se originan m√°s all√° de las fronteras nacionales (CONAPO, 2009). De esta forma la nueva era de la globalizaci√≥n, se ha convertido en un asunto de especial trascendencia. Por un lado, la mejora y expansi√≥n de los sistemas de comunicaci√≥n y transporte y la significativa reducci√≥n del tiempo y coste de desplazamiento, as√≠ como las disparidades econ√≥micas y la existencia de situaciones sociales y pol√≠ticas extremas han propiciado el crecimiento de los movimientos transnacionales de personas y la intensificaci√≥n de las presiones migratorias. En este sentido, Espa√Īa nunca ha sido ajena al fen√≥meno de las corrientes migratorias. As√≠ por ejemplo, en los √ļltimos a√Īos y durante la primera mitad del siglo XX y parte de la segunda, grandes contingentes de espa√Īoles emigraron hacia diferentes puntos de Am√©rica Latina y Europa en busca de un empleo y mejor calidad de vida. Pero fue a finales del siglo pasado cuando Espa√Īa, impulsada por el acelerado ritmo de crecimiento econ√≥mico adoptado en parte gracias a su integraci√≥n econ√≥mica en Europa, pas√≥ de ser una econom√≠a emisora de emigrantes a una receptora de inmigrantes. Sin embargo, el fen√≥meno de la inmigraci√≥n en Espa√Īa cobr√≥ verdadera importancia hasta principios del siglo XXI, cuando las fuertes oleadas masivas de personas provenientes de pa√≠ses en v√≠as de desarrollo se dejaron sentir en su estructura poblacional y actividad laboral; de √©sta manera, durante el primer quinquenio de este siglo si al 1 de enero del a√Īo 2000 los residentes extranjeros en Espa√Īa eran 0.9 millones (que representaban 2.3 por ciento de las personas empadronadas) al 1 de enero de 2005 ya eran 3.7 millones, es decir, 8.5 por ciento de la poblaci√≥n residente en el pa√≠s, habi√©ndose por tanto cuadriplicado el efectivo de extranjeros en tan s√≥lo cinco a√Īos (Gonz√°lez, 2006: 2-3; Gil, 2007: 1). Con base en lo anterior, el objetivo del presente trabajo consisti√≥ en analizar las caracter√≠sticas de los flujos de inmigraci√≥n actuales en Espa√Īa procedentes de pa√≠ses latinoamericanos, enmarcados en la nueva re-configuraci√≥n del mapa migratorio mundial

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

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    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

    Identification of regulatory variants associated with genetic susceptibility to meningococcal disease.

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    Non-coding genetic variants play an important role in driving susceptibility to complex diseases but their characterization remains challenging. Here, we employed a novel approach to interrogate the genetic risk of such polymorphisms in a more systematic way by targeting specific regulatory regions relevant for the phenotype studied. We applied this method to meningococcal disease susceptibility, using the DNA binding pattern of RELA - a NF-kB subunit, master regulator of the response to infection - under bacterial stimuli in nasopharyngeal epithelial cells. We designed a custom panel to cover these RELA binding sites and used it for targeted sequencing in cases and controls. Variant calling and association analysis were performed followed by validation of candidate polymorphisms by genotyping in three independent cohorts. We identified two new polymorphisms, rs4823231 and rs11913168, showing signs of association with meningococcal disease susceptibility. In addition, using our genomic data as well as publicly available resources, we found evidences for these SNPs to have potential regulatory effects on ATXN10 and LIF genes respectively. The variants and related candidate genes are relevant for infectious diseases and may have important contribution for meningococcal disease pathology. Finally, we described a novel genetic association approach that could be applied to other phenotypes

    Clinical guide of the Spanish Society of Nephrology on the prevention and treatment of peritoneal infection in peritoneal dialysis

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    [Resumen] Las infecciones peritoneales siguen constituyendo una complicaci√≥n muy relevante de la di√°lisis peritoneal, por su incidencia todav√≠a elevada y por sus importantes consecuencias cl√≠nicas, en t√©rminos de mortalidad, fracaso de la t√©cnica y costes para el sistema sanitario. Las pr√°cticas de prevenci√≥n y tratamiento de esta complicaci√≥n muestran una notable heterogeneidad derivada, entre otros factores, de la complejidad del problema y de la escasez de evidencia cl√≠nica que permitan responder de manera clara a muchas de las dudas planteadas. El prop√≥sito de este documento es proporcionar una revisi√≥n completa y actualizada de los m√©todos de diagn√≥stico, prevenci√≥n y tratamiento de estas infecciones. El documento se ha elaborado tomando como referencia de partida la gu√≠a m√°s reciente de la Sociedad Internacional de Di√°lisis Peritoneal (2016). Mientras que para el cap√≠tulo diagn√≥stico se ha adoptado una estructura m√°s narrativa, el an√°lisis de las medidas de prevenci√≥n y tratamiento ha seguido una metodolog√≠a sistem√°tica (Grading of Recommendations, Assessment, Development and Evaluation [GRADE]), que especifica el nivel de evidencia y la fuerza de las sugerencias y recomendaciones propuestas, y facilita actualizaciones futuras de la gu√≠a. La gran extensi√≥n y numerosas recomendaciones o sugerencias emanadas de la revisi√≥n ponen de manifiesto la complejidad y gran n√ļmero de facetas a tener en cuenta para un adecuado abordaje de esta importante complicaci√≥n de la di√°lisis peritoneal.[Abstract] Peritoneal infections still represent a most feared complication of chronic peritoneal dialysis, due to their high incidence and relevant clinical consequences, including direct mortality, technique failure and a significant burden for the health system. The practices for prevention and treatment of this complication show a remarkable heterogeneity emerging, among other factors, from the complexity of the problem and from a paucity of quality evidence which could permit to respond clearly to many of the raised questions. The purpose of this document is to provide a complete and updated review of the main methods of diagnosis, prevention and treatment of these infections. The document has been elaborated taking as a reference the most recent guidelines of the International Society of Peritoneal Dialysis (2016). The diagnostic considerations are presented in a narrative style while, for prevention and therapy, we have used a systematic methodology (Grading of Recommendations, Assessment, Development and Evaluation [GRADE]), which specifies the level of evidence and the strength of the proposed suggestions and recommendations and facilitates future updates of the document. The length of the document and the many suggestions and recommendations coming out of the review underline the large number and the complexity of the factors to be taken into consideration for an adequate approach to this complication of peritoneal dialysis

    Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

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    Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

    Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study