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Resumen OBJETIVO: Determinar si la exposición al ondansetrón en el primer trimestre del embarazo se asocia, en general, con mayor riesgo de malformaciones orofaciales, cardiopatías congénitas, defectos del septo interventricular, de labio o paladar hendidos. MÉTODOLOGÍA: Revisión sistemática y metanálisis de estudios aleatorizados, cohortes y casos y controles publicados en las bases de datos de PubMed, EMBASE y LILACS. RESULTADOS: Se incluyeron 15 estudios: 11 de cohorte y 4 de casos y controles, con 245,679 mujeres expuestas al ondansetrón en el primer trimestre del embarazo. No se encontró una asociación estadísticamente significativa con malformaciones congénitas en general (RM 1.1; IC95%: 0.99-1.22; I2: 72%), con cardiopatías congénitas (RM 1.05; IC95%: 0.95-1.19; I2: 78%) y con comunicación interventricular (RM 1.2; IC95%: 0.97-1.45; I2: 85%). Se encontró un pequeño aumento en el riesgo de defectos orofaciales en general (RM 1.17; IC95%: 1.04-1.32; I2:0%), no se encontró un riesgo mayor de defecto de labio (RM 1.01; IC95%: 0.84-1.21; I2%: 0%) ni de paladar hendido (RM 1.16; IC95%: 0.9-1.5; I2: 31%). CONCLUSIÓN: Los resultados muestran que el tratamiento con ondansetrón en el primer trimestre del embarazo no se asocia con un aumento de malformaciones congénitas en general, ni con un incremento de cardiopatías, labio o paladar hendido, pero sí con incremento leve del riesgo de malformaciones orofaciales.

Abstract OBJECTIVE: To determine whether ondansetron exposure in the first trimester is associated with an increased risk of any congenital malformations. As secondary outcomes, determine if it is associated with a higher overall risk of congenital heart disease, interventricular septal defects, orofacial malformations, cleft lip defect (with or without palate) or cleft palate. METHODOLOGY: A systematic review with meta-analysis was carried out. The search was carried out in the following databases: PUBMED, EMBASE and LILACS, randomized studies, cohorts and cases and controls were chosen. RESULTS: 15 studies were included, 11 cohort studies and four case-control studies, with 245,679 women exposed to ondansetron in the first trimester. No statistically significant association was found with overall congenital malformations (OR, 1.1; 95%, CI 0.99-1.22 I2: 72%), nor with congenital heart diseases (OR, 1.05; 95%, CI 0.95-1.19 I2: 78%) not with ventricular septal defects (OR, 1.2 95% CI 0.97 - 1.45 I2: 85%). A small increased risk was found for overall orofacial defects (OR, 1.17 95% CI 1.04 - 1.32 I2:0%), no increased risk was found for lip defect (with or without palate) (OR, 1.01 CI 95% 0.84 -1.21 I2%: 0%) or cleft palate (OR, 1.16 95% CI 0.9 - 1.5 I2: 31%). CONCLUSION: The results show that the use of ondansetron in the first trimester is not associated with an increase in overall congenital malformations, nor with an increase in heart disease, cleft lip and/or palate, but there is a slight increase in the risk of orofacial malformations.

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Patent ductus arteriosus (PDA) is frequent in preterm newborns, and its incidence is inversely associated with the degree of prematurity. The first choice of pharmacological treatment is ibuprofen. Several genes, including EPAS1, have been proposed as probable markers associated with a genetic predisposition for the development of PDA in preterm infants. EPAS 1 NG_016000.1:g.84131C>G or rs7557402 has been reported to be probably benign and associated with familial erythrocytosis by the Illumina Clinical Services Laboratory. Other variants of EPAS1 have been previously reported to be benign for familial erythrocytosis because they decrease gene function and are positive for familial erythrocytosis because the overexpression of EPAS1 is a key factor in uncontrolled erythrocyte proliferation. However, this could be inconvenient for ductal closure, since for this process to occur, cell proliferation, migration, and differentiation should take place, and a decrease in EPAS1 gene activity would negatively affect these processes. Single-nucleotide polymorphisms (SNPs) in EPAS1 and TFAP2B genes were searched with high-resolution melting and Sanger sequencing in blood samples of preterm infants with hemodynamically significant PDA treated with ibuprofen at the National Institute of Perinatology. The variant rs7557402, present in the EPAS1 gene eighth intron, was associated with a decreased response to treatment (p = 0.007, OR = 3.53). The SNP rs7557402 was associated with an increased risk of pharmacological treatment failure. A probable mechanism involved could be the decreased activity of the product of the EPAS1 gene.

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Complex molecular mechanisms define our responses to environmental stimuli. Beyond the DNA sequence itself, epigenetic machinery orchestrates changes in gene expression induced by diet, physical activity, stress and pollution, among others. Importantly, nutrition has a strong impact on epigenetic players and, consequently, sustains a promising role in the regulation of cellular responses such as oxidative stress. As oxidative stress is a natural physiological process where the presence of reactive oxygen-derived species and nitrogen-derived species overcomes the uptake strategy of antioxidant defenses, it plays an essential role in epigenetic changes induced by environmental pollutants and culminates in signaling the disruption of redox control. In this review, we present an update on epigenetic mechanisms induced by environmental factors that lead to oxidative stress and potentially to pathogenesis and disease progression in humans. In addition, we introduce the microenvironment factors (physical contacts, nutrients, extracellular vesicle-mediated communication) that influence the epigenetic regulation of cellular responses. Understanding the mechanisms by which nutrients influence the epigenome, and thus global transcription, is crucial for future early diagnostic and therapeutic efforts in the field of environmental medicine.

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The perinatal consequences of SARS-CoV-2 infection are still largely unknown. This study aimed to describe the features and outcomes of pregnant women with or without SARS-CoV-2 infection after the universal screening was established in a large tertiary care center admitting only obstetric related conditions without severe COVID-19 in Mexico City. This retrospective case-control study integrates data between April 22 and May 25, 2020, during active community transmission in Mexico, with one of the highest COVID-19 test positivity percentages worldwide. Only pregnant women and neonates with a SARS-CoV-2 result by quantitative RT-PCR were included in this study. Among 240 pregnant women, the prevalence of COVID-19 was 29% (95% CI, 24% to 35%); 86% of the patients were asymptomatic (95% CI, 76%-92%), nine women presented mild symptoms, and one patient moderate disease. No pregnancy baseline features or risk factors associated with severity of infection, including maternal age > 35 years, Body Mass Index >30 kg/m2, and pre-existing diseases, differed between positive and negative women. The median gestational age at admission for both groups was 38 weeks. All women were discharged at home without complications, and no maternal death was reported. The proportion of preeclampsia was higher in positive women than negative women (18%, 95% CI, 10%-29% vs. 9%, 95% CI, 5%-14%, P<0.05). No differences were found for other perinatal outcomes. SARS-CoV-2 test result was positive for nine infants of positive mothers detected within 24h of birth. An increased number of infected neonates were admitted to the NICU, compared to negative neonates (44% vs. 22%, P<0.05) and had a longer length of hospitalization (2 [2-18] days vs. 2 [2-3] days, P<0.001); these are potential proxies for illness severity. This report highlights the importance of COVID-19 detection at delivery in pregnant women living in high transmission areas.

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Acid mine drainage is one of the main environmental hazards to ecosystems worldwide and it is directly related to mining activities. In Ecuador, such acidic-metallic waters are drained to rivers without treatment. In this research, we tested a laboratory combined (Ca-Mg) Dispersed Alkaline Substrate (DAS) system as an alternative to remediate acid drainage from the Zaruma-Portovelo gold mining site, at El Oro, Ecuador. The system worked at low and high flow hydraulic rates during a period of 8 months, without signs of saturation.. Analysis of physico-chemical parameters and water composition (ICP-OES, ICP-MS) demonstrated that treatment effectively increased water pH and promoted the retention of about 80% of Fe, Al, Mn and Cu. Under acid conditions As, Cr and Pb concentrations decreased with Fe and possible precipitation of jarosite and schwertmannite. However, the homogeneous depletion of Cr at pH above 6 could be related to ferrihydrite or directly with Cr (OH)3 precipitation. After DAS-Ca, sulphate, phosphate and rare earth elements (REE) concentrations decreased to 1912, 0.85 and 0.07 mg/L respectively, while DAS-Mg contributed to form a complex model of minor carbonate and phosphate phases as main sink of REE. DAS-Mg also promoted the retention of most divalent metals at pH values over seven. Thus, this low cost treatment could avoid environmental pollution and international conflicts. Anyway, further investigations are needed to obtain higher Zn retention values. Graphical abstract.

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OBJECTIVE: To demonstrate changes in hepatic volume and vascular indices in fetuses with intrauterine growth restriction (IUGR) compared with normal-growth fetuses, using a noninvasive method (three-dimensional power Doppler ultrasound). METHODS: The present cross-sectional study was conducted between September 1 and November 30, 2014, at a maternal-fetal medicine unit in Bogotá, Colombia; it included consecutive women at 24-34 weeks of pregnancy. The fetal liver volume and indices of hepatic vascularization were determined with three-dimensional power Doppler ultrasonography and compared between fetuses with and without a diagnosis of IUGR. Results A total of 119 women met study inclusion criteria; 97 fetuses had no growth restriction, whereas 22 fetuses had IUGR. The latter group had decreased liver volume (57.85 ± 29.71 mL vs 86.99 ± 31.24 mL; P=0.010) and increased vascular indices (vascularization index, 47.92 ± 34.44 versus 22.46 ± 18.95; flow index, 71.39 ± 42.01 versus 41.11 ± 23.24; vascularization flow index, 47.94 ± 47.96 versus 13.67 ± 22.38; P=0.003 for all comparisons). CONCLUSION: Liver volume was decreased and liver vascular indices values were increased in fetuses with IUGR. These findings imply that evaluation of hepatic vascularization with three-dimensional hepatic Doppler could be useful in the diagnosis of IUGR.

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Introducción: En Colombia existen muchos mitos, y se observa diferentes abordajes de la fiebre. Sin embargo, no hay datos locales que muestren esta situación. El Objetivo de este estudio es Identificar los conocimientos, creencias, y manejos de la fiebre entre los padres consultantes. Materiales y Métodos: Estudio descriptivo, observacional, transversal, se aplicó un cuestionario a una muestra tomada conveniencia de 200 padres que consultaron al servicio de urgencia del hospital. Resultados: Se realizaron 200 encuestas. El 59% de los padres se encontraban en secundaria. El 84,5% de la población pertenecía a los estratos 1 y 2 y vivía en zona urbana. El 52% utilizaban termómetros o tiras plásticas para medir la temperatura. El 81,5% administró antibiótico solo cuando el médico lo prescribe. Las variables sociodemográficas de los padres, que tuvieron una relación estadísticamente significativa se relacionaron en el conocimiento, manejo y creencias de la fiebre fueron: edad de los padres, nivel educativo, estrato socieconomico y número de hijos. Conclusiones: Se encontraron falencias en el conocimiento de los padres en conceptos de fiebre y toma de temperatura. Los padres se basan en consultas previas al médico para la administración de medicamentos. En el manejo de la fiebre, la mayoría de padres utilizan medios físicos para disminuirla concomitante con el uso de antipiréticos; con respecto a las creencias, en nuestra región (Pasto - Nariño) siguen siendo utilizadas las terapias tradicionales para el manejo de fiebre.

Introduction: In Colombia there are many myths, and different approaches to fever are observed. However, there is no local data describing this situation. The objective of this study is to identify the knowledge, beliefs, and management of fever among parents requesting consultation. Materials and Methods: This was a descriptive, observational and cross-sectional study. A questionnaire was applied to a convenience sample of 200 parents who consulted at the emergency department of the hospital. Results: 200 surveys were carried out. 59% of parents were in high school. 84.5% of the population belonged to stratas 1 and 2 and lived in an urban area. 52% used thermometers or plastic strips to measure the temperature. 81.5% administered antibiotics only when the doctor prescribed it. The sociodemographic variables of the parents, which were significantly statistically e related to the knowledge, management and beliefs of the fever were: age of the parents, educational level, socioeconomic status and number of children. Conclusions: We found knowledge gaps in parents regarding fever and temperature measurement. Parents administer medications after consulting with a physician. In managing fever, most parents used physical means to reduce fever along with antipyretics. Regarding beliefs, in our region (Pasto - Nariño) traditional therapies for the management of fever are still used.

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Nontyphoid Salmonella strains are some of the leading causes of foodborne illnesses worldwide; however, there is very limited information on the presence and characteristics of Salmonella in the food production chain in developing countries. In this study, pulsed-field gel electrophoresis (PFGE) was used for molecular subtyping and for monitoring the ecology and transmission of Salmonella isolates in a slaughter facility in Mexico in an attempt to determine specific steps that need to be improved to reduce Salmonella contamination in beef carcasses. A total of 94 isolates from a Salmonella stock culture collection originally obtained from a single vertically integrated feedlot and beef abattoir in Mexico were analyzed. A total of 26 unique PFGE patterns were identified, 38.5% of them corresponding to a single serotype. High concordance (88.4%) was found between serotype and PFGE banding subtype. Salmonella Kentucky and Salmonella Give were the most clonal subtypes in this study, and Salmonella Muenster was the most diverse, with 11 banding patterns identified. A total of 73.7, 70.6, and 85.7% of the PFGE subtypes identified from preevisceration, precooler, and chilled carcasses, respectively, were identified only at those specific points and not at any previous or subsequent steps of the slaughter process, suggesting that each step is in itself a source of Salmonella contamination. Salmonella Mbandaka was more likely to be recovered from feces than from any of the steps of the slaughter process. The genetic diversity and distribution of PFGE subtypes in the processing facility highlight the need to implement antimicrobial interventions and improve sanitation procedures at various points to avoid further Salmonella dissemination into the meat supply.

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Bedaquiline (BDQ) has been proven to be effective in the treatment of multidrug-resistant tuberculosis. We hypothesized that BDQ could be a potential agent to treat nontuberculous mycobacterial (NTM) infection. The objective of this study was to evaluate the in vitro activity of BDQ against rapidly growing mycobacteria by assessing the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) against 18 NTM strains. For MIC determination we performed the resazurin microtitre assay broth dilution, and for the MBC the c.f.u. was determined. BDQ exhibited a strong inhibitory effect against most NTM tested; however, for some NTM strains the MBC was significantly higher than the MIC. A new finding is that Mycobacterium flavescens has a mutation in the gene atpE associated with natural resistance to BDQ. These preliminary promising results demonstrate that BDQ could be potentially useful for the treatment of NTM.

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It is known that cholesterol plays a key role for Mycobacterium tuberculosis (Mtb) adaptation and survival within the host, thus contributing to the establishment of dormancy. It has been extensively demonstrated that fatty acids are the main energy source of Mtb during infection and dormancy, and it has been proposed that these molecules are implicated in reactivation of bacilli from a dormant state. We used in vitro models to analyze Mtb gene expression during dormancy and reactivation when fatty acids and cholesterol are the unique carbon source in the media. Our results suggest that cholesterol might function as a signal to trigger Mtb expression of some genes required for stress protection earlier than the one induced by fatty acids alone, indicating that cholesterol is very favorable for its development. This process is so conducive that cholesterol-adapted bacilli can reactivate their growth after NRP2 dormancy state even 10 min post ventilation. Thus, we hypothesize that cholesterol is not only involved in Mtb dormancy but that it also plays a critical role for favorable and almost immediate reactivation from an in vitro long-lasting dormant state induced by hypoxia.

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Resumen Objetivo: Evaluar el conocimiento y la aplicación de la prueba de tamizaje neonatal de las cardiopatías congénitas críticas mediante el uso de la oximetría de pulso entre diferentes médicos en el área pediátrica. Métodos: Estudio descriptivo y analítico, mediante encuesta sobre: el conocimiento, la capacitación y la aplicación de la prueba de tamizaje, en los médicos que atienden a recién nacidos en Cali, Colombia. Se establecieron asociaciones entre: la formación profesional, la capacitación y el conocimiento de la prueba. Se realizaron pruebas no paramétricas validando el error alfa < 5%. Resultados: 100 encuestados: 21 médicos generales o familiares, 50 pediatras, 21 residentes y 8 neonatólogos. 62% conocían la prueba de tamizaje, 19% afirmaron recibir capacitación, 24% la realizaban a todos los neonatos previo egreso siendo significativamente mayor en el grupo de pediatras. 25% conocían todas las respuestas correctas de la prueba y solo hay diferencias significativas entre los residentes de pediatría y los otros profesionales. Conclusiones: Existe un conocimiento general sobre la necesidad de realizar la detección precoz de las cardiopatías congénitas críticas en los recién nacidos por parte de los médicos, aunque no hay una adecuada capacitación sobre los aspectos fisiopatológicos que se pueden evaluar con la toma de la pulsioximetría de pulsos en las primeras 24 horas de vida.

Abstract Objective: To assess knowledge and implementation of the neonatal screening for critical congenital heart diseases by means of a pulse oximetry between several physicians in the pediatric ward. Methods: Descriptive and analytical study with a survey about knowledge, capability and implementation of screening test carried out by physicians assisting newborns in Cali, Colombia. Associations between professional training, capability and knowledge of the test were established. Nonparametric tests were conducted validating alpha error <5%. Results: 100 survey respondents: 21 general or family practitioners, 50 pediatricians, 21 residents and 8 neonatologists. 62% knew the screening test, 19% had received training, 24% conducted it on all newborns prior to admission, the pediatrician group being significantly higher. 25% know all correct answers for the test and significant differences can only be found between the pediatric residents and other physicians. Conclusions: General knowledge of the need to carry out early detection of critical congenital heart diseases exists amongst physicians, though there is no proper training about pathophysiological aspects that can be assessed with a pulse oximetry during the first 24 hours of life.

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Gold mining is known to generate important economic products but also to produce several types of contamination/pollution. We report here the first data about Hg concentrations in the soils of the Yacuambi River in the Ecuadorian Amazon. We analyzed soil samples to assess the extent of contamination caused by gold placer mining in this area. Hg concentrations in soils exceeded the local background concentrations. High concentrations of Mn, As, Pb, Cr, Cu, Fe and Zn in some soil samples were probably derived from the geology of the site, which is rich in polysulfides and metamorphic rocks. Placer mining may accelerate the natural release of these elements to the environment by the exposure of the bedrock to the atmosphere. Accumulation of Hg in the river soils may be a potential source of toxicity for aquatic life and a risk to human health in the future.

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La hipermovilidad articular generalizada (HAG) y su asociación con dolor articular,en pediatría, sigue siendo controvertida. En la literatura revisada no se encontraronpublicaciones colombianas al respecto.Objetivos: El objetivo general fue identificar la relación entre HAG y dolor articular, en ninos ˜de 4 a 17 anos ˜ en Pasto, Colombia.Materiales y métodos: Estudio descriptivo, analítico, tipo casos y controles. Se tomó la poblaciónde un colegio de Pasto, Colombia, a quienes se les realizó una encuesta sobre dolorarticular. Para definir la HAG se aplicaron los criterios de Beighton, considerando 5 o máscriterios positivos.Resultados: Se incluyeron 576 estudiantes, edad promedio de 9,7 anos ˜ (±3 DE). La prevalenciade HAG fue de 52%, el 20% de los estudiantes refirió dolor articular. Al relacionar dolorarticular con HAG, se observó: OR = 0,68 con p = 0,07 (IC95% 0,44-1,04). La comparación entredolor localizado en articulaciones hipomóviles en estudiantes con HAG y sin HAG mostróOR = 4,80 con p = 0,0001 (IC 95% 2,17-10,63).Conclusiones: La prevalencia de HAG fue de 52%, siendo mayor en mujeres (66%). La prevalenciade dolor fue del 20%. El 17 y 23% de los estudiantes con y sin HAG, respectivamente,presentaron dolor articular.En el grupo evaluado no se encontró relación entre dolor articular y HAG. El resultado nocambió al estratificar por grupos de edad y sexo.Se encontró que los estudiantes con HAG tuvieron mayor probabilidad de presentar doloren articulaciones, con rango de movilidad aumentado, que los que no tuvieron HAG...

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Objetivo: describir el nivel de conocimientos acerca del diagnóstico, tratamiento y pronóstico de la isoinmunización materna entre los especialistas de Ginecología y Obstetricia afiliados a la Asociación Bogotana de Perinatología (ABP). Materiales y métodos: estudio descriptivo de corte transversal. Entre noviembre de 2012 y marzo de 2013, se aplicó una encuesta elaborada por especialistas en Medicina Materno-Fetal (MMF). Se excluyeron los profesionales que ejercen su actividad fuera del territorio nacional, aquellos que no han practicado la obstetricia durante los últimos diez años y a quienes no suministraron la totalidad de la información requerida. El instrumento estuvo compuesto por 18 preguntas organizadas en tres dominios: características sociodemográficas, información sobre la práctica clínica y conocimientos. Se utilizó estadística descriptiva para el análisis en la materia. Resultados: el instrumento se aplicó a 220 profesionales de los cuales 127 (57,7 %) respondieron la encuesta en su totalidad y fueron incluidos en el análisis. El 32 % de los obstetras y el 45 % de los especialistas en MMF identificaron correctamente el punto de corte para el coombs indirecto. El 43 y 62 % de los obstetras y especialistas en MMF reconocieron el papel de la velocimetría de la arteria cerebral media para el diagnóstico de anemia fetal, y el 82 y 76 % respectivamente la utilizarían en el seguimiento del feto anémico. Tan solo el 76 % de los obstetras y el 66 % de los especialistas en MMF reconocen las indicaciones de culminar la gestación en caso de anemia fetal, en tanto que el 90 y 97 % (respectivamente) identificaron cuándo realizar cordocentesis y transfusión in utero. Finalmente, el 37 % de los obstetras y el 48 % de los especialistas en MMF no reconocen a la curva de Queenan-Liley como una alternativa cuando no hay acceso al Doppler fetal. Conclusión: existe una importante variabilidad con respecto al nivel de conocimientos de los obstetras y especialistas en MMF en cuanto al diagnóstico, tratamiento y seguimiento de las gestantes con isoinmunización. Se requieren más estudios que caractericen la variabilidad en la práctica clínica acerca del diagnóstico y tratamiento de la isoinmunización materna en Colombia.

Objective: To describe the level of knowledge regarding the diagnosis, treatment and prognosis of maternal isoimmunisation among Gynaecology and Obstetrics specialists, members of ABP (Asociación Bogotana de Perinatología). Materials and methods: Cross-sectional descriptive study. A questionnaire prepared by specialists in Maternal and Foetal Medicine (MFM) was administered between November 2012 and March 2013. Professionals practicing outside the national territory, those who had not practiced over the past ten years, and those who did not provide all the information required were excluded. The tool consisted of 18 questions organized in three domains: socio-demographic characteristics, information about clinical practice, and knowledge of the subject. A descriptive statistical analysis was used. Results: Of the 220 practitioners who were given the questionnaire, 127 (57.7%) completed the survey and were included in the analysis. The cut-off point for the indirect Coombs was correctly identified by 32% of the obstetricians and by 45% of the specialists in MFM. The role of middle cerebral artery velocimetry for the diagnosis of foetal anaemia was recognized by 43% and 62% of obstetricians and specialists in MFM, and 82% and 76%, respectively, would use it for the follow-up of foetuses with anaemia. Only 76% of obstetricians and 66% of MFM specialists recognized the indications for delivering the baby in cases of foetal anaemia, whereas 90% and 97%, respectively, identified the timing for cordocentesis and in utero transfusion. Finally, 37% of obstetricians and 48% of MFM specialists did not recognize the Queenan-Liley curve as an option in cases where there is no access to foetal Doppler. Conclusion: There is an important variability in the level of knowledge among obstetricians and MFM specialists regarding the diagnosis, treatment and follow-up of pregnant women with isoimmunisation. Additional studies are required to characterize the variability in clinical practice regarding the diagnosis and treatment of maternal isoimmunisation in Colombia.

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UNLABELLED: Strong evidence supports the idea that fatty acids rather than carbohydrates are the main energy source of Mycobacterium tuberculosis during infection and latency. Despite that important role, a complete scenario of the bacterium's metabolism when lipids are the main energy source is still lacking. Here we report the development of an in vitro model to analyze adaptation of M. tuberculosis during assimilation of long-chain fatty acids as sole carbon sources. The global lipid transcriptome revealed a shift toward the glyoxylate cycle, the overexpression of main regulators whiB3, dosR, and Rv0081, and the increased expression of several genes related to reductive stress. Our evidence showed that lipid storage seems to be the selected mechanism used by M. tuberculosis to ameliorate the assumed damage of reductive stress and that concomitantly the bacilli acquired a slowed-growth and drug-tolerant phenotype, all characteristics previously associated with the dormant stage. Additionally, intergenic regions were also detected, including the unexpected upregulation of tRNAs that suggest a new role for these molecules in the acquisition of a drug-tolerant phenotype by dormant bacilli. Finally, a set of lipid signature genes for the adaptation process was also identified. This in vitro model represents a suitable condition to illustrate the participation of reductive stress in drugs' activity against dormant bacilli, an aspect scarcely investigated to date. This approach provides a new perspective to the understanding of latent infection and suggests the participation of previously undetected molecules. IMPORTANCE: Mycobacterium tuberculosis establishes long-lasting highly prevalent infection inside the human body, called latent tuberculosis. The known involvement of fatty acids is changing our understanding of that silent infection; however, question of how tubercle bacilli globally adapt to a lipid-enriched environment is still an unanswered. With the single change of providing fatty acids as carbon sources, the bacilli switch on their program related to dormant stage: slowed growth, accumulation of lipid bodies, and development of drug tolerance. In this stage, unexpected and previously unknown participants were found to play putatively important roles during the process. For the first time, this work compares the global transcriptomics of bacteria by using strand-specific RNA sequencing under two different growth conditions. This study suggests novel targets for the control of tuberculosis and provides a new straightforward in vitro model that could help to test the activity of drugs against dormant bacilli from a novel perspective.

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BACKGROUND: Nontuberculous mycobacteria (NTM) are environmental opportunistic pathogens found in natural and human-engineered waters, including drinking water distribution systems and household plumbing. This pilot study examined the frequency of occurrence of NTM in household potable water samples in Mexico City. Potable water samples were collected from the "main house faucet" and kitchen faucet. The presence of aerobic-mesophilic bacteria (AMB), total coliforms (TC), fecal coliforms (FC) and NTM species were determined. Mycobacteria species were identified by PCR restriction enzyme pattern analysis (PRA) of the 65-kDa heat shock protein gene (hsp65) and sequencing of the hypervariable region 2 (V2) of the 16S rRNA gene and of the rpoB gene. RESULTS: AMB (<100 CFU/ml) were present in 118 out of 120 samples; only two samples were outside guidelines ranges (>100 CFU/ml). TC and FC were detected in four and one samples, respectively. NTM species were recovered from 16% samples (19/120) and included M. mucogenicum (nine), M. porcinum (three), M. avium (three), M. gordonae (one), M. cosmeticum (one), M. fortuitum (one), and Mycobacterium sp (one). All household water samples that contained NTM complied with the standards required to grade the water as "good quality" potable water. CONCLUSION: Household potable water may be a potential source of NTM infection in Mexico City.

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La mayor parte de los estudios señalan que las mujeres embarazadas tienen un mayor riesgo para la influenza. Este riesgo es mayor si se tiene una condición médica subyacente, son de edad avanzada, o tienen una exposición en el tercer trimestre. Sobre las pruebas diagnósticas, la RT-PCR ha demostrado ser la más sensible y específica para la detección del virus del AH1N1/09. El embarazo no debe considerarse como una contraindicación para el uso de medicamentos como el Oseltamivir o Zanamivir puesto que los beneficios del tratamiento son mayores que los riesgos teóricos del uso de antivirales. No se han encontrado diferencias estadísticamente significativas en el uso de Oseltamivir frente a Zanamivir. El objetivo de este artículo es hacer una revisión de la literatura sobre el estado del arte del virus AH1N1/09 en el embarazo, su diagnóstico y tratamiento. Se realizó una búsqueda en las bases de datos de MEDLINE y COCHRANE de estudios sobre Influenza AH1N1/09 en embarazo.

Most studies show that pregnant women are at increased risk for influenza. This risk is higher if you have an underlying medical condition, are elderly or have exposure in the third trimester. About the diagnostic tests, the RT- PCR has demonstrated be the most sensitive and specific for the detection of AH1N1/09 virus. Pregnancy should not be regarded as a contraindication for the use of drugs such as oseltamivir or zanamivir since the benefits of treatment outweigh the theoretical risks of the use of antivirals. No statistically significant differences in the use of oseltamivir against zanamivir. The aim of this article is to review the literature on the state of the art virus AH1N1/09 in pregnancy, diagnosis, treatment and prevention. A search in the databases MEDLINE and COCHRANE studies on Influenza AH1N1/09 in pregnancy.

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La preeclampsia afecta entre el 5 y 7% de todas las mujeres embarazadas y sigue siendo una causa importante de mortalidad y morbilidad maternal y perinatal, es particularmente devastadora en los países en desarrollo. La etiología de la preeclampsia es desconocida. En la actualidad, cuatro hipótesis son objeto de investigación exhaustiva: (1) Disfunción de la perfusión placentaria con aumento de factores angiogénicos y bioquímicos, (2) Alteraciones metabólicas relacionadas con el incremento de las adipoquinas, (3) Inadecuada adaptación inmune y (4) Factores genéticos relacionados con la expresión de genes implicados en esta patología.

Preeclampsia affects between 5% and 7% of all pregnancies and remains a major cause of maternal and perinatal mortality and morbidity, and it is particularly devastating in developing countries. The etiology of preeclampsia is unknown. At present, 4 hypotheses are the subject of extensive investigation, as follows: (1) Dysfunction of placental perfusion with increased angiogenic and biochemical factors, (2) Metabolic disorders related to the increase in adipokinas, (3) Inadequate immune adaptation and (4) Genetic factors related to the expression of genes involved in this pathology.