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A completely randomized experimental design was conducted to evaluate the effect of the coadministration of Lactiplantibacillus fabifermentans (Lpb. fabifermentans) and inulin/agave fructans mixtures on gut microbiota of healthy Wistar rats. Inulin, Agave salmiana fructans or fructan mixtures (1:1) at 12.5 % w/w, and Lpb. fabifermentans at 109 CFU/mL/day were used in the rats' diet for 35 days. Biochemical parameters, short-chain fatty acids (SCFA), structural changes and the bacterial abundance in rats' cecum were evaluated. A significant decrease (p < 0.05) in glucose, cholesterol and triglycerides levels with fructan mixtures combined with Lpb. Fabifermentans was observed. The weight of the small and large intestines, and cecum was higher than the control; no changes were observed in the heart, liver, spleen and kidneys. SCFA concentration mainly, propionate and butyrate was improved (p < 0.05) throughout the gastrointestinal tract in all treatments. Finally, the administration of Lpb. fabifermentans alone or combined with the fructan mixtures promoted an increase in the abundance of cecum intestinal microbiota: Lactobacillus, Bifidobacterium, Prevotella, Blautia, Faecalibacterium, Butyricimonas, Coprococcus, Akkermansia, Methanobrevibacter, Adlercreutzia, Collinsella, Odoribacter, and Roseburia. The inclusion of fructan mixtures in combination with Lpb. fabifermentans could be a good alternative for the development of functional foods that enhance consumer health.

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Gnathostomiasis in humans is acquired by consumption of any infected second intermediate host or paratenic host. This includes amphibians, snakes and poultry as well as fish. In this work we report for the first time in Mexico the presence of an AdvL3 of Gnathostoma turgidum in the musculature of a wild fish (Gobiomorus dormitor, which also acts as intermediate host for the larvae of G. binucleatum and G. lamothei), from the Papaloapan River, Veracruz; previously, larvae of G. turgidum had only been recorded in amphibians in Mexico and in wild swamp eels from Tampa, Florida, USA. The larva found is extremely small (approximately 1,500 by 140 microns in length and width, respectively), and was obtained by artificial digestion with pepsin after examining the musculature against the light between two glass plates, a method by which it went unnoticed. Our finding of an AdvL3 in this fish, together with a previous molecular phylogenetic analysis revealing that the five species involved in human infections do not nest in the same clade, suggest that all species in the genus are potentially zoonotic. In this context, we strongly recommend the identification of larvae extracted from human patients at specific level, in order to know the role played by the 3 species distributed in Mexico in human cases of gnathostomiasis.

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Prebiotic effects of Agave salmiana fructans at five different doses were evaluated by the growth of Bifidobacterium, Lactobacillus, and Clostridium strains and SCFA production in the cecum and proximal colon of healthy Wistar rats. Mucosal integrity, bacterial proliferation, and inflammatory response were also examined. Growth of Bifidobacterium and Lactobacillus strains was improved by 12.5% doses of fructans in both cecum and proximal colon tissues, and a significant decrease of Clostridium (P < 0.05) was observed. Increases in mucosal thickness, proliferation, and cell adhesion were mainly observed in the cecum. High concentration of butyric acid and total SCFA were contained in the 12.5% doses. This study provides direct evidence of the prebiotic effects of Agave salmiana fructans, demonstrating that a diet supplemented with a 12.5% dose of fructans promotes major growth of probiotic bacteria and could be used as a potential prebiotic ingredient under the conditions used in this study. Taken together, these results further indicate the significance of Agave salmiana fructans as a prebiotic ingredient in the regulation and prevention of gastrointestinal diseases, as well as for the design of functional foods.

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The prebiotic effect of agave fructans (Agave salmiana) was evaluated through the growth of two lactic acid bacterial (LAB) strains (Lactobacillus casei and Bifidobacterium lactis). The immune system was activated through the stimulation of peripheral blood mononuclear cells (PBMC) of healthy subjects testing fructans, LAB or a mixture of these compounds at different concentrations. Immune responses, such as early cell activation (CD69), cell cycle progression, nitric oxide (NO) production and the expression of transcription factors for lymphocyte differentiation, were analyzed. Compared with other fructans, the extracted agave fructans showed the highest prebiotic activity and increased levels of CD69 expression, proliferative activity and NO production when administered with the probiotic L. casei. The Th1 lymphocyte differentiation produced through LAB stimulation was greatly diminished after the incorporation of agave fructans. In conclusion, these types of fructans (A. salmiana) are involved in the activation and selective differentiation of cells of the immune system through interactions with probiotics. Thus, agave fructans represent a novel immunomodulator that might benefit the functional food industry.

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The glass transition temperature of model food systems prepared with several glucose/fructose/sucrose mass fractions was studied using differential scanning calorimetry (DSC). A distance-based experimental design for mixtures of 3 components was used to establish the proportion of sugars of the model systems. Thus, 32 compositions including individual sugars and sugar mixtures, both binary and ternary were prepared and analyzed. Thermograms showing the complete process of heating-cooling-reheating were used to determine the precise glass transition temperature during cooling (T(g)(c)) or reheating (T(g)(H) in amorphous sugars. The Scheffe cubic model was applied to experimental results to determine the influence of sugar composition on the glass transition temperature (P < 0.05). The final model proved to be appropriate (R(2) > 0.97, CV < 9%, model significance <0.0001) to predict the T(g) values of any dry mixture of amorphous fructose, glucose, and sucrose.

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Objetivos del trabajo: 1) comparar la estimación de bilirrubina sérica obtenida por medición transcutánea, BiliCheck, con valores obtenidos espectrofotométricamente y por high performance liquid chromatography (Gold Standard), 2) Determinar puntos de corte de los valores de BiliCheck en los cuales se obtiene la máxima sensibilidad y especificidad, 3) Determinar si el color de la piel, peso de nacimiento, edad gestacional y sexo interfieren con la medición transcutánea de bilirrubina en recién nacidos

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Objetivos del trabajo: 1) comparar la estimación de bilirrubina sérica obtenida por medición transcutánea, BiliCheck, con valores obtenidos espectrofotométricamente y por high performance liquid chromatography (Gold Standard), 2) Determinar puntos de corte de los valores de BiliCheck en los cuales se obtiene la máxima sensibilidad y especificidad, 3) Determinar si el color de la piel, peso de nacimiento, edad gestacional y sexo interfieren con la medición transcutánea de bilirrubina en recién nacidos

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OBJECTIVE: To describe the clinical and epidemiological features of severe acute poisonings in an adult population. DESIGN: Retrospective analysis of clinical cases. PATIENTS AND METHODS: Analysis of the clinical charts, risk factors and main outcomes of 55 acute poisoned patients admitted to an intensive care unit (ICU). RESULTS: Of the 55 clinical charts reviewed, female prevailed over male gender with a relation of 1.5:1, the average age was 32 years (16-83 years), the major etiologic factor for the acute poisonings were drugs in 35 cases (64%), and home or work chemicals in 20 cases (36%). The mechanisms of intoxication/poisoning were: attempted or successful suicide in 51 cases (93%), accidental poisoning in three cases (5%), and iatrogenic in one case (2%). Precipitating factors were major depressive disorder in 29 cases (53%), dysthymic disorder in 12 cases (22%) and adjustment disorder with depressive mood or impulsive act in nine cases (16%). Associated feature comorbid conditions were: homosexuality, schizophrenia, drug addiction, AIDS, other chronic diseases, and previous suicide attempts. Outcomes were 33 (60%) patients discharged from the ICU without sequela, seven (13%) with permanent severe sequela and 15 (27%) deaths. CONCLUSIONS: There was a high rate of suicides related with depressive disorders in a predominantly female population. Drug products were used more frequently than home or work chemicals. Although advanced life support and antidotal treatments were available, mortality was high. Areas where injury prevention efforts might have an influence on adult poisoning morbidity and mortality include management of depression as well suitable control of drugs and chemicals.

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This is an observational retrospective study. Our goal is to describe the local dermonecrotic reaction occurring after a spider bite in eleven pediatric patients. In seven (63.7%), the spider was identified as Loxosceles reclusa, and in four, bites were presumptive. The main symptoms and signs were pain, erythema, swelling, blisters, and vasculitis in five patients. There was a significant relationship between the time of onset before the treatment and the severity of the lesions (63.4 hours in the severe cases vs 14.4 hours in the mild cases, p < 0.05), as well the time spent in the emergency room (50 hours vs 10 hours respectively, p < 0.05). Treatment with dapsone, 1 mg/kg/24 h, and/or paracetamol and dicloxacillin was successful; one case required surgical treatment. No systemic loxoscelism occurred in this patient.

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STUDY OBJECTIVE: To evaluate the efficacy of N-acetylcysteine (N-AC) alone or combined with multiple-dose activated charcoal (AC) in the treatment of acetaminophen (ACT) overdose. DESIGN: Prospective observational case series of 14 consecutive pediatric patients. Group A (n = 7) were treated only with N-AC and group B (n = 7) with N-AC combined with AC. Plasma ACT concentrations were measured at 0.0, 24 and 48 h. As a measure of ACT disappearance, half-life of elimination (t1/2 beta) and exogenous body clearance (ClB) were calculated. RESULTS: Group A, Initial and final mean ACT plasmatic levels were 27 micrograms/mL and 4 micrograms/mL; t1/2 beta of 17 h and ClB 0.640 mL.kg.min. Group B, 27 micrograms/mL and 0.66 microgram/mL; t1/2 beta of 10 h and ClB 1.092 mL.kg.min. For both t1/2 beta and ClB differences, p < 0.05 (SS). CONCLUSION: N-AC significantly decreased the plasma ACT levels in both treatments; however, there were several advantages with the combined therapy: AC enhanced the efficacy of N-AC according with the higher eliminatión of the overdosed drug (97.6% vs. 85.2%), the t1/2 beta decreased 42%, and the ClB increased 70% in relation to the group A. Data of this study suggested that N-AC plus AC is more effective than N-AC alone in enhancing ACT elimination in overdosed patients and that it provided additional hepatoprotective benefit.

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A 14-year-old female attempted suicide by ingesting the organophosphate methyl parathion. A severe acute poisoning developed with the characteristic symptomatology: muscarinic, nicotinic and neurologic, as well serum cholinesterase activity decreased 88%. An extrapyramidal syndrome appeared suddenly nine days after the onset with ocular and buccal crisis, neck and trunk dystonic movements, and hypertonia and tremors. The patient improved with the administration of i.v. diphenhydramine. Other causes of toxic extrapyramidalism and organophosphate intermediate syndrome were discarded. Although an absolute causal relationship of the transient extrapyramidal symptomatology to the organophosphate exposure cannot be clearly established in this case, we speculate a possible delayed inhibition of the dopaminergic receptors in the substantia nigra and the basal ganglia.

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Yucuyahui (zoapatle-Montanoa tomentosa), is a wild herb used as a folk oxytocic-remedy. Eight pregnant women drank infusions of the herb during the labor and their newborns showed cardiorespiratory depression that needs basic or advanced life support to recover. They improved during the first minutes with an average Apgar score at one minute of 4.5, and 7.4 at ten minutes (p < 0.05). A negative correlation was found between the number of ingested infusions and the Apgar score at the one minute (r = -0.65). Simultaneous administration of alcoholic beverages in three of the pregnant woman did not contribute to deep depression in their neonates. The mechanism of M Tomentosa action is still unknown, but it is possible that it is similar to other oxytocic-drugs, as oxytocin or ergot alkaloids, with which Montanoa shares uterine and systemic effects.

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The aim of the study was to evaluate tympanic thermometry when compared with conventional glass-mercury thermometry, in 186 consecutive pediatric patients. In patients of less than 6 years of age (n = 120), there were no differences between tympanic and rectal measurements, in febrile and afebrile ranges, and significantly different when compared with axillary range. Similar data were reported in children of more than than 6 years of age (n = 65), in whom oral temperatures replace the rectal one. Using the tympanic thermometer as the standard measurement device, the accuracy of rectal, oral and axillary thermometers in determining a febrile state was examined. When tympanic temperature was 38 degrees C, a febrile state was considered, in this condition sensitivity for rectal measurement was of 73%, for oral 64%, and 23 and 29% for the axillary, according to the age group: specificity was of 100% in all the them. According to our data, tympanic measurement was consistent with glass-mercurial, rectal and oral, temperature in a pediatric population. Advantages of tympanic thermometry are its good correlation with central temperature, substantial time reduction of measurement (1 second), easy and non-invasive procedure, improved patient comfort, and lack of mercurial thermometry disadvantages. The conclusion is that tympanic thermometry becomes an acceptable option for pediatric temperature measurement.

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OBJECTIVE: To study the use of total intravenous anesthesia with propofol as an anesthetic model for orthotopic liver transplantation (OLT) in pigs. ANIMALS AND METHOD: Fifteen OLT were performed in pigs using portacava-jugular veno-venous shunt with an injector pump. Anesthesia was maintained by perfusion of 10 mg/kg/h propofol. Hemodynamic and biochemical measurements were recorded at the following times: AO, baseline; AI, five minutes before removal of the liver; B1, five minutes later but before starting the bypass injector pump; B2, five minutes after starting the injector pump; B3, five minutes before reperfusion; C1, five minutes after starting reperfusion, and C2, after aortic declamping. RESULTS: No cases of malignant hyperthermia appeared. When the liver was removed cardiac output decreased (p < 0.01), as did mean arterial pressure (p < 0.01), mixed venous saturation (p < 0.05), pulmonary capillary pressure and temperature (p < 0.05). Pulmonary vascular resistances increased (p < 0.05). CONCLUSIONS: The use of total intravenous anesthesia with propofol is a satisfactory experimental anesthetic model for OLT in pigs, and it prevents the possible appearance of malignant hyperthermia.

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We present a case of acute lethal poisoning by oil of "epazote" (oil of chenopodium), in a 2 y 9 m female. The volatile oil was administered according to the advice of a "curandera" (female healer), in a total quantity of 40 ml. Clinical features of the poisoning were: vomiting, deep coma, seizures, mydriasis, apnea, metabolic acidosis, neurogenic shock and death. The EEG suggested a diffuse encephalopathy, the CT scan with an image of severe brain edema and ventricular collapse. Relevant postmortem findings were brain edema and neuronal necrosis, pneumonia, enteritis, pericholangitis, mild pancreatitis and tubular necrosis. The phytochemical analysis of volatile oil identified ascaridol, the main active compound of the chenopodium herbs, in a quantity of 39 mg/ml (1,560 mg in the dose administered), and Chenopodium graveolens as the plant employed to prepare it. According to the age of the patient, 60 mg of ascaridol would be the recommended dose formerly used in the treatment of parasitic disease. Thus 1,560 mg was 26 times higher than the recommended dose, and exceeded by 56% the dose of 1,000 mg reported as lethal in humans.

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Twelve pediatric patients with acute poisonings caused by carbamazepine, digoxin and acetylsalicylic acid were treated with multiple doses of activated charcoal combined with a saline cathartic (adsorption surface of activated charcoal nearly 950 m2/g). This procedure was effective to shorten the plasmatic levels of the drugs, besides the clinical improvement of the poisoned patients. The average initial and final levels of the drugs were: carbamazepine 21.64 and 0.9 micrograms/ml (lowering 95.81%, p < 0.05), digoxin 5.14 and 1.1 ng/ml (lowering 78.6%, P < 0.05) and acetylsalicylic acid 418.5 and 57.5 micrograms/ml, respectively, (lowering 86.3%, p < 0.05). These results suggest the usefulness of activated charcoal in the clearance of the four overdosed drugs.

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