María del Socorro Romero-Figueroa

Intestinal Dysbiosis and Rheumatoid Arthritis: A Link between Gut Microbiota and the Pathogenesis of Rheumatoid Arthritis

Characterization and understanding of gut microbiota has recently increased representing a wide research field, especially in autoimmune diseases. Gut microbiota is the major source of microbes which might exert beneficial as well as pathogenic effects on human health. Intestinal microbiomes role as mediator of inflammation has only recently emerged. Microbiota has been observed to differ in subjects with early rheumatoid arthritis compared to controls, and this finding has commanded this study as a possible autoimmune process. Studies with intestinal microbiota have shown that rheumatoid arthritis is characterized by an expansion and/or decrease of bacterial groups as compared to controls. In this review, we present evidence linking intestinal dysbiosis with the autoimmune mechanisms involved in the development of rheumatoid arthritis.

Trasplante renal en lupus eritematoso sistémico: comparación de la supervivencia del injerto con otras causas de enfermedad renal terminal

INTRODUCTION End-stage renal disease (ESRD) due to lupus nephritis (LN) occurs in 10%-30% of patients. Initially systemic lupus erythematosus (SLE) was a contraindication for kidney transplantation (KT). Today, long-term graft survival remains controversial. Our objective was to compare the survival after KT in patients with SLE or other causes of ESRD. METHODS All SLE patients who had undergone KT in a retrospective cohort were included. Renal graft survival was compared with that of 50 controls, matched for age, sex, and year of transplantation. Survival was evaluated by the Kaplan-Meier test and the Cox proportional hazards model. RESULTS Twenty-five subjects with SLE were included. The estimated 1-year, 2- and 5-year survival rates for patients with SLE were 92%, 66% and 66%. Renal graft survival did not differ between patients with SLE and other causes of ESRD (P=.39). The multivariate analysis showed no significant difference in graft survival between the two groups (hazard ratio, HR=1.95, 95% confidence interval [CI] 0.57-6.61, P=.28). The recurrence rate of LN was 8% and was not associated with graft loss. Acute rejection was the only variable associated with graft loss in patients with SLE (HR=16.5, 95% CI 1.94-140.1, P=.01). CONCLUSIONS Renal graft survival in SLE patients did not differ from that reported for other causes of ESRD.

Aumento de la práctica de higiene de manos secundaria a la capacitación mediante un curso en línea al personal de salud de un hospital de segundo nivel de atención

Las infecciones asociadas a la atención de la salud son consideadas los efectos adversos más frecuentes derivados de la atención ospitalaria. El factor de riesgo identificado con más frecuencia es a contaminación cruzada, desde pacientes u objetos contaminaos hacia otros pacientes, utilizando generalmente como vehículo e transmisión las manos de los profesionales de salud1. A pesar de a evidencia científica, no es posible lograr el apego a la higiene e las manos, por lo que es necesario seguir buscando estrategias ue incidan sobre esta variable para lograr un cambio en la actitud el personal de salud. La Organización Mundial de la Salud (OMS) desarrolló e impleentó en 2005 un programa denominado «Manos limpias salvan idas», una estrategia multimodal con 5 pilares: cambio de sistema, ormación, educación, evaluación, clima institucional de seguriad y retroalimentación, por medio de recordatorios en el sitio de rabajo2. Una de las acciones importantes es el proceso educativo, or lo que el objetivo del estudio fue identificar si existía modificaión del porcentaje en el cumplimiento de la higiene de manos del ersonal de salud secundaria a la capacitación mediante un curso n línea. Se realizó un estudio cuasiexperimental que incluyó a 305 médios y 650 enfermeras de un hospital de segundo nivel de atención n todos los turnos laborales, utilizando como maniobra de interención un curso en línea de higiene de manos de 20 h de duración esarrollado por la División de Innovación Educativa del Instituto exicano del Seguro Social con los contenidos propuestos para apacitación por la OMS. Se utilizó un cuestionario autoaplicable e conocimientos sobre higiene de manos propuesto por la OMS ue consta de 16 reactivos enfocados a la evaluación de conociientos con variables de tipo dicotómico y 9 reactivos de opción últiple. Dicho instrumento se aplicó antes y después del curso n línea. El cumplimiento se definió como una oportunidad para la igiene de las manos mediante el lavado de manos/desinfección de cuerdo con los 5 momentos y fue evaluado mediante observación irecta por 2 observadores, uno de ellos del personal hospitalario apacitado y otro como observador externo. El periodo de segui-

Detection of Actinomyces spp. in cervical exudates from women with cervical intraepithelial neoplasia or cervical cancer

Purpose. Under certain circumstances, Actinomyces behaves as an opportunistic microorganism and can cause actinomycosis, a chronic and inflammatory granulomatous infection. The purpose of this project was to detect the presence of Actinomyces in cervical exudates from women with cervical intraepithelial neoplasia (CIN) and women with cervical cancer. Methodology. Cervical samples from 92 women were divided into three groups: CIN, cervical cancer and healthy women. Metagenomic DNA extraction was performed following the Qiagen QIAamp Mini Kit protocol. A specific fragment (675 bp) was amplified by PCR in order to detect the presence of Actinomycetales. Samples in which Actinomycetales was detected were subjected to separate amplification reactions with primer pairs for A. israelii, A. viscosus, A. meyeri and A. odontolyticus. Amplified products were observed by 2% agarose gel electrophoresis. Results. Actinomyces were found in 10% of women with CIN, 36.6% of women with cervical cancer and 9% of healthy women. The species identified in this study were A. meyeri in 14/92 samples (15.2%), A. viscosus in 10/92 samples (10.8%), A. odontolyticus in 4/92 samples (4.3%) and A. israelii in 6/92 samples (6.5%). Conclusion. Patients with cervical cancer had a higher prevalence of the presence of Actinomyces compared to the CIN and control groups. This is the first study in which a deliberate search of this genus has been performed in women with cervical pathologies. The use of specific primers for each species facilitated their detection in comparison with traditional isolation methods. More information is necessary to understand the molecular mechanisms involved in the complex role that bacterial communities may play in the development of cancer (and vice versa).

Original breveExpresión de interferón gamma en la infección por el virus del papiloma humano y por Chlamydia trachomatis en muestras cervicalesExpression of gamma interferon during HPV and Chlamydia trachomatis infection in cervical samples

INTRODUCTION The aim of this study was to mesure the expression of gamma interferon in HPV and Chlamydia trachomatis infection in squamous intraepithelial lesions. METHOD Samples from 100 patients diagnosed by colposcopy with or without squamous intraepithelial lesions were used in the present study. Each patient was found to be infected by HPV and C.trachomatis. Relative gamma interferon mRNA expression was assessed using a real-time reverse transcriptase PCR assay (RT-PCR). RESULTS The relative units of expression of gamma interferon mRNA were 13, 1.8 and 0.3, for HPV and C.trachomatis co-infection, or HPV or C.trachomatis infection, respectively. CONCLUSION HPV and C.trachomatis could overstimulate the expression of gamma interferon.

Expresión de interferón gamma en la infección por el virus del papiloma humano y por Chlamydia trachomatis en muestras cervicales

INTRODUCTION The aim of this study was to mesure the expression of gamma interferon in HPV and Chlamydia trachomatis infection in squamous intraepithelial lesions. METHOD Samples from 100 patients diagnosed by colposcopy with or without squamous intraepithelial lesions were used in the present study. Each patient was found to be infected by HPV and C.trachomatis. Relative gamma interferon mRNA expression was assessed using a real-time reverse transcriptase PCR assay (RT-PCR). RESULTS The relative units of expression of gamma interferon mRNA were 13, 1.8 and 0.3, for HPV and C.trachomatis co-infection, or HPV or C.trachomatis infection, respectively. CONCLUSION HPV and C.trachomatis could overstimulate the expression of gamma interferon.