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The therapeutic potential of medicinal plants is known as an alternative in treatment of human affections; in effect, the conventional application of these medicinal sources has several limitations like low bioavailability, solubility and stability, which affect its pharmacological efficacy. In recent decades, extraordinary advances have been made in new drug delivery systems using nanocarriers. This work consisted in determining the in vitro antifungal activity of the methanolic extract of Euphorbia tirucalli formulated in polymeric nanoparticles. The antifungal activity was determined by the microdilution method in 96-well microplates, applying nanoparticles loaded with plant extract (NP-Ext) obtained by nanoprecipitation on clinical isolates of Trichophyton rubrum and T. interdigitalis. Regarding the nanoparticles, the lots used did not present significant differences in their physicochemical characteristics, with a size of 91.885 ± 1.621nm, polydispersity index of 0.152 ± 0.025 and Z-potential of -6.047 ± 0.987. The quantification of the extract in the polymeric matrix was determined by infrared spectroscopy (FTIR), where an efficiency and encapsulation percentage of 22.15 ± 0.82 and 2.95 ± 0.11, respectively, were obtained. The in vitro antifungal activity of the crude and formulated extract was obtained calculating the Minimum Inhibitory Concentration (MIC) of each one; a MIC of 125 µg/mL was obtained against T. rubrum and T. interdigitalis with the crude extract, while a MIC value of 55.55 and 0.1 µg/mL was obtained with NP-Ext, respectively, against these same. Conclusions: biological activity is closely linked to the phytochemical profile of the extract; while the improvement of said potential with the NP-Ext with the dosage form was directly related to the physicochemical characteristics of the nanocarrier.

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The objective of this study was to determine the serotype distribution and antibiotic resistance of invasive pneumococcal disease (IPD) strains in children from Lima, Peru, before and after the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7), which was introduced in the national immunisation program on 2009. We conducted a prospective, multicentre, passive surveillance IPD study during 2006-2008 and 2009-2011, before and right after the introduction of PCV7 in Peru. The study was performed in 11 hospitals and five private laboratories in Lima, Peru, in patients <18 years old, with sterile site cultures yielding Streptococcus pneumoniae. In total 159 S. pneumoniae isolates were recovered. There was a decrease in the incidence of IPD in children <2 years old after the introduction of PCV7 (18.4/100 000 vs. 5.1/100 000, P = 0.004). Meningitis cases decreased significantly in the second period (P = 0.036) as well as the overall case fatality rate (P = 0.025), including a decreased case fatality rate of pneumonia (16.3% to 0%, P = 0.04). PCV7 serotypes showed a downward trend. Vaccine-preventable serotypes caused 78.9% of IPD cases, mainly 14, 6B, 5, 19F and 23F. A non-significant increase in erythromycin resistance was reported. Our findings suggest that the introduction of PCV7 led to a significant decrease of IPD in children under 2 years old and in the overall case fatality rate.

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BACKGROUND: Around 47-74% of patients with hereditary hemorrhagic telangiectasia (HHT) have hepatic vascular malformations (HVMs); magnetic resonance images (MRI) of the central nervous system (CNS) might show in T1 sequences a hyper-intensity signal in different areas, mainly in the basal ganglia (BG) as consequence of manganese (Mn) deposits as observed in cirrhotic patients. These patients might suffer from different neuropsychiatric disorders (hepatic encephalopathy). In HHT patients, even in the presence of hepatic shunts, hepatocellular function is usually preserved. Additionally, Mn shares iron absorption mechanisms, transferrin and CNS transferrin receptors. In iron deficiency conditions, the Mn may harbor transferrin and access BG. The objectives were to describe frequency of BG Mn deposit-induced lesions (BGMnIL) in HHT patients, its relationship with iron deficiency anemia (IDA) and HVMs. Finally, explore the association between neuropsychological and motor consequences. We performed a cross-sectional study. We determined HHT patients with or without BG-MnIL by the MRI screening of the CNS. We included all patients with lesions and a random sample of those without lesions. All patients underwent standardized and validated neuropsychological assessment to evaluate BG actions. Results were analyzed with multiple logistic regression, adjusting for potential confounders. RESULTS: Among 307 participants from a cohort included in the Institutional HHT Registry, 179 patients had MRI performed and Curaçao Criteria ≥3. The prevalence of BG-MnIL was 34.6% (95%CI 27.69-42.09). While neuropsychological symptoms were present in all patients, BG-MnIL patients performed poorly in three of the neuropsychological tests (serial dotting, line tracing time, number connection test A). HVMs frequency in BG-MnIL was 95.1%, versus 71.4% in those without lesions (p < 0.001). IDA frequency was 90.3% versus 54% (p < 0.001). When IDA is present, estimated risk for BG-MnIL is remarkably high (OR 7.73, 95%CI 2.23-26.73). After adjustment for possible confounders (gender, age, presence of HVMs), IDA was still associated with increased risk of BG-MnIL (adjusted OR 6.32, 95% CI 2.32-17.20; p < 0.001). CONCLUSIONS: Physicians should assess BG-MnIL in HHT patients in CNS-MRI. IDA and HVMs present increased risk of lesions. Patients with BG-MnIL have neuropsychological impairment, and they might benefit from sparing IDA, or undergoing future therapeutic options. TRIAL REGISTRATION: NCT01761981 . Registered January 3rd 2013.

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BACKGROUND: Brain metastases of testicular germ cell tumor (TGCT) are a rare event. Prognostic is poor and there is not much evidence on optimal management of these patients. PATIENTS AND METHODS: A review of case records of germ cell tumor patients within the Spanish Germ Cell Cancer Group data base from 1994 to 2012 was conducted. RESULTS: Thirty-three out of 6,200 cases (0.5 %). Nineteen patients (57 %) group 1: synchronous, 13 (40 %) group 2: metachronous and only one developed brain metastasis during cisplatin-based chemotherapy (excluded from the analysis). Median serum BHCG levels at initial diagnosis was higher in group 1, whereas elevated AFP serum levels were more common in group 2. Histology in the primary tumor: chorionic carcinoma for group 1 versus embryonal carcinoma for group 2. Mainly solitary brain metastasis in group 2 (54 versus 21 %, respectively). The median overall survival from the diagnosis of central nervous system involvement was 16 months for group 1 (CI 95 % 13.9-18) and 23 months (95 % CI 0-165) for group 2 (log rank p = 0.84). Long-term survivors were practically identical in the two groups (38.9 % group 1 versus 38.5 % group 2). Regardless of the timing of brain metastasis, those patients that achieved complete response to the treatment had better survival (log rank p 0.003). CONCLUSION: Although some distinctive clinical characteristics have been found between patients with synchronous versus metachronous brain metastasis from TGCT, the timing of brain metastasis did not seem to have prognostic influence, but due to the retrospective nature of the analysis and the results should be interpreted with caution.

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The entomopathogenic nematode Heterorhabditis sp. SL0708 (Rhabditida: Heterorhabditidae) isolated from soil in Alcalá, Valle del Cauca (Colombia) was characterised ecologically using Galleria mellonella larvae (L) (Pyralidae: Galleriinae) as hosts. The effect of temperature on the viability, infectivity and reproduction, and of moisture on infectivity and storage in liquid were evaluated in infective juveniles (IJs). Significant differences were found in the viability, infectivity and reproduction of the IJs at different temperatures. No nematodes were recovered at 5 °C and 10 °C, and at 35 °C no infectivity was observed. Average daily nematode recovery was best at 25 °C, and survival of the IJs was low in substrates presenting 13% moisture. The optimal storage temperature for Heterorhabditis sp. SL0708 was between 20 °C and 30 °C, keeping its infectivity for up to 8 weeks.

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The entomopathogenic nematode Heterorhabditis sp. SL0708 (Rhabditida: Heterorhabditidae) isolated from soil in Alcalá, Valle del Cauca (Colombia) was characterised ecologically using Galleria mellonella larvae (L) (Pyralidae: Galleriinae) as hosts. The effect of temperature on the viability, infectivity and reproduction, and of moisture on infectivity and storage in liquid were evaluated in infective juveniles (IJs). Significant differences were found in the viability, infectivity and reproduction of the IJs at different temperatures. No nematodes were recovered at 5 °C and 10 °C, and at 35 °C no infectivity was observed. Average daily nematode recovery was best at 25 °C, and survival of the IJs was low in substrates presenting 13% moisture. The optimal storage temperature for Heterorhabditis sp. SL0708 was between 20 °C and 30 °C, keeping its infectivity for up to 8 weeks.(AU)

O nematoide entomopatogênico colombiano Heterorhabditis sp. SL0708, isolado do solo de Alcalá, Valle del Cauca (Colombia), foi caracterizado ecologicamente utilizando-se como hospedeiro lagartas de Galleria mellonella (L) (Pyralidae:Galleriinae). O efeito da temperatura na viabilidade, na infecção e na reprodução, e da umidade na infecção e do armazenamento em líquido foi avaliado em juvenis infectantes (JIs). Diferenças significativas na viabilidade, na infecção e na reprodução dos JIs foram observadas nas diferentes temperaturas. Não foram recuperados nematoides a 5 °C e 10 °C, e não se observou infecção a 35 °C. A maior média diária de recuperação de nematoides foi a 25 °C. Por outro lado, a sobrevivência dos JIs foi baixa nos substratos com unidades de 13% e a melhor temperatura de armazenamento para SL0708 foi entre 20 °C e 30 °C, mantendo a infecção até oito semanas.(AU)

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The entomopathogenic nematode Heterorhabditis sp. SL0708 (Rhabditida: Heterorhabditidae) isolated from soil in Alcalá, Valle del Cauca (Colombia) was characterised ecologically using Galleria mellonella larvae (L) (Pyralidae: Galleriinae) as hosts. The effect of temperature on the viability, infectivity and reproduction, and of moisture on infectivity and storage in liquid were evaluated in infective juveniles (IJs). Significant differences were found in the viability, infectivity and reproduction of the IJs at different temperatures. No nematodes were recovered at 5 °C and 10 °C, and at 35 °C no infectivity was observed. Average daily nematode recovery was best at 25 °C, and survival of the IJs was low in substrates presenting 13% moisture. The optimal storage temperature for Heterorhabditis sp. SL0708 was between 20 °C and 30 °C, keeping its infectivity for up to 8 weeks.

O nematoide entomopatogênico colombiano Heterorhabditis sp. SL0708, isolado do solo de Alcalá, Valle del Cauca (Colombia), foi caracterizado ecologicamente utilizando-se como hospedeiro lagartas de Galleria mellonella (L) (Pyralidae:Galleriinae). O efeito da temperatura na viabilidade, na infecção e na reprodução, e da umidade na infecção e do armazenamento em líquido foi avaliado em juvenis infectantes (JIs). Diferenças significativas na viabilidade, na infecção e na reprodução dos JIs foram observadas nas diferentes temperaturas. Não foram recuperados nematoides a 5 °C e 10 °C, e não se observou infecção a 35 °C. A maior média diária de recuperação de nematoides foi a 25 °C. Por outro lado, a sobrevivência dos JIs foi baixa nos substratos com unidades de 13% e a melhor temperatura de armazenamento para SL0708 foi entre 20 °C e 30 °C, mantendo a infecção até oito semanas.

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EMLA© es una crema al 5 por ciento con una mezcla eutéctica de 25 mg/g de lidocaína y 25 mg/g de prilocaína que produce anestesia y/o analgesia dérmica después de una aplicación tópica. Se emplea desde 1979 y se usa clínicamente como anestésico local en varias especialidades. En otorrinolaringología se usa para realizar miringotomías e inserción de tubos de ventilación y en el manejo de fracturas nasales. Por ser la aplicación en crema difícil y engorrosa, se confeccionó una solución que mantiene la concentración de los anestésicos primitivos, o sea 25 mg/g de lidocaína y 25 mg/g de prilocaína, los que se diluyen en propilén glicol. El objetivo de esta investigación es mostrar nuestra experiencia clínica con el uso de esta solución de EMLA©, sus ventajas cuando se usa en diversos procedimientos en el oído externo y medio, además de su inocuidad cuando se usa en el oído medio con inflamación crónica, tal como ocurre con las gotas otológicas antibióticas que contienen medicamentos ototóxicos. Se empleó la solución de EMLA© en 23 pacientes cuya edad fluctuó entre 14 y 92 años en los que se realizaron 31 procedimientos. Se introdujeron algunas gotas de solución de EMLA©, las que se mantenían en contacto con el epitelio mediante motas de algodón impregnadas con la misma solución con el fin de que el paciente pudiera esperar el tiempo necesario sin cansarse, como sería el caso de que tuviera que mantener la cabeza inclinada, durante media a una hora. En todas las evaluaciones del dolor se empleó una escala de categoría numérica de 0 a 10 puntos. En aquellos casos en que la solución se aplicó en el oído medio con inflamación crónica, se evaluó subjetiva y objetivamente la audición y el equilibrio. Los resultados obtenidos demostraron que en 20 procedimientos (64,5 por ciento) se obtuvo una efectiva analgesia/anestesia después de la aplicación de la solución, en 8 procedimientos (25,8 por ciento) hubo una analgesia regular que, en todo caso, permitió terminar el procedimiento, y en 3 procedimientos (9,7 por ciento) el resultado fue malo teniendo éste que ser suspendido. En la presente casuística no hubo reacciones adversas sobre el oído interno al aplicar la solución en el oído medio en otitis media crónica. Sin embargo, con posterioridad hemos visto dos casos con oído perforado que han presentado una supresión transitoria de la actividad vestibular, con vértigo, náusea y vómitos que ha durado unas cuatro horas, con restablecimiento completo

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Ciclosporina A es una nueva alternativa terapéutica utilizada en pacientes con dermatitis atópica severa, tanto en niños como en adultos, con excelente respuesta y tolerancia. Presentamos 15 pacientes en un rango de edad de 4 a 14 años, con diagnóstico de dermatitis atópica severa a quien se les administro Neoral (una nueva formulación de ciclosporina, en microemulsión oral), a una dosis de 3 a 3,5 mg/kg/día, por in período de 1 a 3 meses, se obtuvo una buena respuesta terapéutica sin efecto secundarios de importancia. Concluimos que la Ciclosporina A en microemulsión es una buena alternativa terapéutica en los pacientes en edad pediátrica con diagnóstico de dermatitis atópica severa

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Se realizó un estudio de la embriogénesis del oído medio humano entre la 5a y la 17a semana de gestación, utilizando 50 individuos (9 embriones y 41 fetos), los cuales fueron fijados, realizándose técnicas de tinción corrientes (hematoxilina-eosina), histoquímicas, tricrómicas e inmunohistoquímicas (anticuerpos monoclonales antilaminina, anticolágeno IV, antineurofilamentos). Seis fetos fueron procesados para microscopía electrónica de barrido, intentando obtener la mayor información posible del material humano. El análisis de los resultados reveló que el desarrollo del oído medio humano es mas tardío que el de los animales, distinguimos un crecimiento interesante de la tuba auditiva y como esta recubre a los huesecillos formando sus mesos, describimos la fijación de la platina del estribo a la pared medial de la caja timpánica en un período específico del desarrollo y la posterior formación, por muerte celular programada de la ventana oval y un nuevo pericondrio, hecho llamativo en la embriogénesis. En los embriones y fetos estudiados se describe la formación de nudos epidérmicos en la membrana timpánica (en su capa epitelial), dentro del desarrollo normal de esta estructura. Este hallazgo, no ha sido comunicado en la literatura. Con el conocimiento actual y el avance en la tecnología, se puede utilizar técnicas mas avanzadas de tinciones histológicas, inmunohistoquímicas y el uso de microscopio de barrido, para esclarecer las interrogantes del desarrollo del oído medio humano, agregando nueva información a lo tradicionalmente conocido

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Se han estudiado las malformaciones torácicas en cinco gemelos dobles toracópagos del tercer trimestre. No existen alteraciones en cabeza, cuello ni miembros superiores. Estos defectos corresponden a la pared torácica, cuya corrección aparece relativamente fácil. El mayor grado de anormalidad aparece a nivel del corazón y grandes vasos. Corazón único que necesariamente obligaría al sacrificio de uno de los niños al intentar una separación, con muy pocas expectativas de sobrevida a pesar del uso de técnicas quirúrgicas muy avanzadas

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