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The new labdane [(3R*,4aR*,7S*,10aS*,10bR*)-3-ethenyl-3,4a,7,10a-tetramethyl-dodecahydro-1H-naphtho-[2,1-b]-pyran-7-yl]-methylbenzoate together with other 7 labdanes were isolated from the aerial parts of Buddleja marrubiifolia. Compound structures were elucidated by spectroscopic methods. Some compounds showed moderate to weak antimicrobial activity towards a panel of bacterial and fungal pathogens. In addition, trans-biformene (2) and ribenol acetate (8) showed to be highly cytotoxic with LC50 < 1 µg/mL, the other compounds showed moderate cytotoxic effect with a LC50 range of 6.008-15.26 µg/mL. For all isolated compounds, no inflammatory response was observed.

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Plasmonic photothermal therapy (PPTT) has been used as an alternative to chemotherapy for the elimination of resistant microorganisms; however, its in situ evaluation has not been well studied. In the present study, we assessed the antimicrobial activity of a chitosan-based hydrogel embedded with gold nanorods (Ch/AuNRs) using a low power infrared diode laser. The antibacterial activity was measured in both Gram-positive and -negative strains, including clinical isolates of multidrug-resistant pathogens. The cytotoxic effect, cellular proliferation, and the expression of the pro-inflammatory (IL-6 and TNF-α) and anti-inflammatory (IL-10) cytokines were quantified in a murine model of macrophages. Results showed a potent antimicrobial activity of the Ch/AuNRs with MICs ≤4 µg/mL, very low cytotoxicity with cell viability above 80%, and the macrophage proliferation was not affected for a period of 48 h. These results suggest that our Ch/AuNR-embedded hydrogel could be an option to locally control chronic nosocomial infections using PPTT.

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Background: Hepatocellular carcinoma (HCC) is the sixth most frequent tumor worldwide and it is responsible for approximately 750 000 deaths each year. It is the third leading cause of cancer death in Mexico. Despite the existing therapeutic regimens, HCC has a poor prognosis with a life expectancy of approximately one month in advanced cases. The use of celecoxib and pentoxifylline has recently been reported in tumor patients with promising results due to its anti-inflammatory, antiangiogenic, antifibrotic and proapoptotic effects. Nonetheless, the combination of both drugs for the treatment of HCC has never been employed. Clinical case: 58-year-old male patient, who arrived to the examination room for presenting nausea, jaundice, asthenia, adynamia and encephalopathy grade I-II. The patient had a history of alcoholism for 47 years and diagnosis of cirrhosis in Child C stage. An image with focal lesion in the right lobe of 8 x 8 cm, which was highly vascularized, suggested HCC by means of imaging studies (ultrasound, computed axial tomography [CAT] and magnetic resonance imaging). Management began in January, 2015, and continues until today with 400 mg of pentoxifylline every 12 hours, 200 mg of celecoxib every 12 hours and vitamin supplements. Conclusion: After one month, patient showed a surprising response, reduction in tumor size almost in its entirety, improvement of clinical condition, and turned into Child A stage. Eight months after treatment it was observed by CAT that the tumor had practically disappeared. Patient has survived for more than two years. These results are encouraging; however, it is necessary to conduct multicenter studies that prove the efficacy of the treatment.

Introducción: El hepatocarcinoma (HPC) es el sexto tumor más frecuente a nivel mundial y provoca aproximadamente 750 000 muertes al año. Representa la tercera causa de muerte por cáncer en México. A pesar de los esquemas terapéuticos existentes, el pronóstico en el HPC es malo, con un promedio aproximado de vida de un mes en casos avanzados. Recientemente se ha reportado el uso de celecoxib y pentoxifilina en pacientes tumorales con resultados prometedores debido a sus efectos antiinflamatorios, antiangiogénicos, antifibróticos y proapoptóticos. Sin embargo, nunca han sido usados en combinación para el tratamiento de HPC. Caso clínico: Paciente masculino de 58 años que acudió a consulta por presentar náuseas, ictericia, astenia, adinamia y encefalopatía grado I-II; tenía antecedente de alcoholismo durante 47 años y diagnóstico de cirrosis en estadio Child C. Mediante ultrasonido, tomografía axial computarizada (TAC) y resonancia magnética se evidenció una imagen con lesión focal en lóbulo derecho de 8 x 8 cm, altamente vascularizada, sugestiva de HPC. Se inició manejo en enero de 2015 y el paciente continúa hasta la fecha con pentoxifilina (400 mg/12 h), celecoxib (200 mg/12 h) y suplementos vitamínicos. Conclusión: Después de un mes el paciente mostró una respuesta sorprendente, reducción del tamaño de la lesión casi en su totalidad, mejoría del estadio clínico y cambió a un estadio Child A. Ocho meses después de implementar el tratamiento se observó por medio de TAC que el tumor casi había desaparecido. El paciente ha sobrevivido por más de dos años. Los resultados son alentadores; sin embargo, es necesario realizar estudios multicéntricos que demuestren su real eficacia.

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BACKGROUND: The obesity has been shown to increase the severity of A/H1N1 infection and the development of acute respiratory distress syndrome (ARDS) and organ involvement. METHODS: Circulating levels of C-peptide, insulin, glucagon, leptin, acute phase reactants (procalcitonin, C-reactive protein, tissue plasminogen activator, and serum amyloids A and P), were measured in samples from 32 critically ill patients with A/H1N1 virus infection, 17 of whom had ARDS complicated by acute kidney injury (AKI) and 15 of whom had ARDS but did not develop AKI. RESULTS: Patients with ARDS and AKI (ARDS/AKI) had higher BMI and higher levels of C-peptide, insulin, leptin, procalcitonin and serum amyloid A compared to those ARDS patient who did not develop AKI. Adjusting for confounding variables using logistic regression analysis, higher levels of C-peptide (>0.75 ng/mL) (OR=64.8, 95% CI = 2.1-1980, p = 0.0006) and BMI>30 Kg/m(2) (OR = 42.0, 95% CI = 1.2-1478, p = 0.04) were significantly associated with the development of AKI in ARDS patients. CONCLUSION: High levels of C-peptide and BMI>30 kg/m(2) were associated with the development of AKI in ARDS patients due to A/H1N1 infection. These metabolic/obesity indicators, together with the profiles of pro-inflammatory acute phase proteins, may be important links between obesity and poor outcomes in A/H1N1 09 infection.

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OBJECTIVE: To assess the quality of care provided at medical units that provide services to Medical Insurance for a New Generation (SMNG) enrollees. MATERIALS AND METHODS: The tracer methodology was used in a sample of 82 medical units selected in fifteen states of Mexico and data collected in November 2009. RESULTS: Problems were found to locate the minimal number of the 18 medical charts requested in three of the tracers. The first level of care on the average reports that the quality of the process of care is 6, in a 10 point scale. In the second level improves and the third level of care is better qualified. CONCLUSIONS: The tracer methodology has enabled us to assess the quality of care. There is room for improvement in the medical units of the state health services, to that end should be directed the efforts in the health system in Mexico.

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OBJECTIVE: To assess the quality of care provided at medical units that provide services to Medical Insurance for a New Generation (SMNG) enrollees. MATERIALS AND METHODS: The tracer methodology was used in a sample of 82 medical units selected in fifteen states of Mexico and data collected in November 2009. RESULTS: Problems were found to locate the minimal number of the 18 medical charts requested in three of the tracers. The first level of care on the average reports that the quality of the process of care is 6, in a 10 point scale. In the second level improves and the third level of care is better qualified. CONCLUSIONS: The tracer methodology has enabled us to assess the quality of care. There is room for improvement in the medical units of the state health services, to that end should be directed the efforts in the health system in Mexico.

OBJETIVO: Evaluar la calidad de la atención en unidades médicas que prestan servicios a afiliados al Seguro Médico para una Nueva Generación (SMNG). MATERIAL Y MÉTODOS: Se utilizó la metodología de trazadores en una muestra de 82 unidades médicas seleccionadas en quince estados de la República mexicana y los datos fueron recolectados en noviembre de 2009. RESULTADOS: En tres de los trazadores no se encontró el número de expedientes en las 18 unidades médicas. En el primer nivel de atención se reporta que la calidad del proceso de atención es de 6 en una escala de 0 a 10. La calidad mejora en el segundo nivel, y es la más alta en el tercer nivel. CONCLUSIONES: Se evaluó la calidad e identificaron oportunidades de mejora en la calidad de las unidades médicas del SMNG. Hacia ese objetivo deben ser dirigidos los esfuerzos en el sistema de salud en México.

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En un grupo de mujeres que realizaban o habían realizado trabajo remunerado, se exploró con qué frecuencia al establecerse la relación laboral se les impusieron restricciones o condicionantes para su función reproductiva. Una de cada tres mujeres se enfrentaron a ese hecho. Hipotéticamente se esperaba un mayor número de restricciones entre quienes tienen condiciones desventajosas dentro del mercado laboral; sin embargo hubo mayor referencia de restricciones en mujeres con actividades calificadas, estabilidad en el empleo y seguridad social. Esto permite suponer que los empleadores cuando se ven obligados a brindar más prestaciones, establecen desde el ingreso restricciones precisas y por otra parte a quienes no se les plantean explícitamente restricciones, las condiciones mismas de establecimiento de la relación laboral las limita en tanto ni adquieren permanencia estable en el trabajo y se elude otorgarles la protección de la seguridad social, lo que a su vez probablemente influye en que no se tenga un control adecuado en caso de gestación.

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