RESUMEN

BACKGROUND: Comprehensive antenatal care (ANC) must prioritize competent, evidence-based medical attention to ensure a positive experience and value for its users. Unfortunately, there is scarce evidence of implementing this holistic approach to ANC in low- and middle-income countries, leading to gaps in quality and accountability. This study assessed care competence, women's experiences during the first ANC visit, and the factors associated with these care attributes. METHODS AND FINDINGS: The study analyzed cross-sectional baseline data from the maternal eCohort study conducted in Mexico from August to December 2023. The study adapted the Quality Evidence for Health System Transformation (QuEST) network questionnaires to the Mexican context and validated them through expert group and cognitive interviews with women. Pregnant women aged 18 to 49 who had their first ANC visit with a family physician were enrolled in 48 primary clinics of the Instituto Mexicano del Seguro Social across 8 states. Care competence and women's experiences with care were the primary outcomes. The statistical analysis comprised descriptive statistics, multivariable linear and Poisson regressions. A total of 1,390 pregnant women were included in the study. During their first ANC visit, women received only 67.7% of necessary clinical actions on average, and 52% rated their ANC experience as fair or poor. Women with previous pregnancies (adjusted regression coefficient [aCoef.] -3.55; (95% confidence intervals [95% CIs]): -4.88, -2.22, p < 0.001), at risk of depression (aCoef. -3.02; 95% CIs: -5.61, -0.43, p = 0.023), those with warning signs (aCoef. -2.84; 95% CIs: -4.65, -1.03, p = 0.003), common pregnancy discomforts (aCoef. -1.91; 95% CIs: -3.81, -0.02, p = 0.048), or those who had a visit duration of less than 20 minutes (<15 minutes: aCoef. -7.58; 95% CIs: -10.21, -4.95, p < 0.001 and 15 to 19 minutes: aCoef. -2.73; 95% CIs: -4.79, -0.67, p = 0.010) and received ANC in the West and Southeast regions (aCoef. -5.15; 95% CIs: -7.64, -2.66, p < 0.001 and aCoef. -5.33; 95% CIs: -7.85, -2.82, p < 0.001, respectively) had a higher probability of experiencing poorer care competence. Higher care competence (adjusted prevalence ratio [aPR] 1.004; 95% CIs:1.002, 1.005, p < 0.001) and receiving care in a small clinic (aPR 1.19; 95% CIs: 1.06, 1.34, p = 0.003) compared to a medium-sized clinic were associated with a better first ANC visit experience, while common pregnancy discomforts (aPR 0.94; 95% CIs: 0.89, 0.98, p = 0.005) and shorter visit length (aPR 0.94; 95% CIs: 0.88, 0.99, p = 0.039) were associated with lower women's experience. The primary limitation of the study is that participants' responses may be influenced by social desirability bias, leading them to provide socially acceptable responses. CONCLUSIONS: We found important gaps in adherence to ANC standards and that care competence during the first ANC visit is an important predictor of positive user experience. To inform quality improvement efforts, IMSS should institutionalize the routine monitoring of ANC competencies and ANC user experience. This will help identify poorly performing facilities and providers and address gaps in the provision of evidence-based and women-centered care.

Asunto(s)

RESUMEN

The global prevalence of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is increasing, now affecting 25%-30% of the population worldwide. MASLD, characterized by hepatic steatosis, results from an imbalance in lipid metabolism, leading to oxidative stress, lipoperoxidation, and inflammation. The activation of autophagy, particularly lipophagy, alleviates hepatic steatosis by regulating intracellular lipid levels. Lutein, a carotenoid with antioxidant and anti-inflammatory properties, protects against liver damage, and individuals who consume high amounts of lutein have a lower risk of developing MASLD. Evidence suggests that lutein could modulate autophagy-related signaling pathways, such as the transcription factor EB (TFEB). TFEB plays a crucial role in regulating lipid homeostasis by linking autophagy to energy metabolism at the transcriptional level, making TFEB a potential target against MASLD. STARD3, a transmembrane protein that binds and transports cholesterol and sphingosine from lysosomes to the endoplasmic reticulum and mitochondria, has been shown to transport and bind lutein with high affinity. This protein may play a crucial role in the uptake and transport of lutein in the liver, contributing to the decrease in hepatic steatosis and the regulation of oxidative stress and inflammation. This review summarizes current knowledge on the role of lutein in lipophagy, the pathways it is involved in, its relationship with STARD3, and its potential as a pharmacological strategy to treat hepatic steatosis.

RESUMEN

AIM: To assess the acute effect of empagliflozin versus dapagliflozin administration on flow-mediated vasodilation in patients with type 2 diabetes mellitus. DESIGN: A double-blind clinical trial, at the Experimental and Clinical Therapeutics Institute, University Health Sciences Center, at the Universidad de Guadalajara, in inpatients with T2D according to the 2023 ADA criteria. METHODS: Thirty patients (15 males and 15 females), aged between 35 and 65 years, were included in this study, according to the 2023 ADA criteria. The eligible patients were randomly assigned to three groups: empagliflozin 25 mg once daily, dapagliflozin 10 mg once daily, or placebo once daily. Anthropometric parameters were taken using validated techniques. FMD was measured using a high-resolution semiautomatic ultrasound UNEX-EF 38G (UNEX Co., Ltd., Nagoya, Japan). Arterial tension was determined with the OMRON electronic digital sphygmomanometer (HEM 907 XL, Kyoto, Japan). RESULTS: The group of patients who received empagliflozin had a significantly lower baseline flow-mediated dilation (FMD) compared to the group receiving dapagliflozin (p = 0.017); at the end of this study, the empagliflozin group achieved a comparable FMD to the dapagliflozin group (p = 0.88). CONCLUSION: After the treatment period, the empagliflozin and dapagliflozin groups achieved similar FMD, suggesting a class effect.

RESUMEN

A series of hybrid inhibitors, combining pharmacophores of known kinase inhibitors bearing anilino-purines (ruxolitinib, ibrutinib) and benzohydroxamate HDAC inhibitors (nexturastat A), were generated in the present study. The compounds have been synthesized and tested against solid and hematological tumor cell lines. Compounds 4d-f were the most promising in cytotoxicity assays (IC50 ≤ 50 nM) vs. hematological cells and displayed moderate activity in solid tumor models (EC50 = 9.3-21.7 µM). Compound 4d potently inhibited multiple kinase targets of interest for anticancer effects, including JAK2, JAK3, HDAC1, and HDAC6. Molecular dynamics simulations showed that 4d has stable interactions with HDAC and members of the JAK family, with differences in the hinge binding energy conferring selectivity for JAK3 and JAK2 over JAK1. The kinase inhibition profile of compounds 4d-f allows selective cytotoxicity, with minimal effects on non-tumorigenic cells. Moreover, these compounds have favorable pharmacokinetic profiles, with high stability in human liver microsomes (e.g., see t1/2: >120 min for 4f), low intrinsic clearance, and lack of significant inhibition of four major CYP450 isoforms.

Asunto(s)

RESUMEN

BACKGROUND: Mortality rates in patients with COVID-19 undergoing mechanical ventilation in the intensive care unit are high. The causes of this mortality have been rigorously investigated. The aim of the present study is to establish mortality risk factors related to lung mechanics measured at days 1 and 5 in patients with covid-19 ARDS managed with invasive mechanical ventilation in the intensive care unit. METHODS: A retrospective observational multicenter study including consecutive patients with a confirmed diagnosis of COVID-19-induced ARDS, admitted to three institutions and seven intensive care units in the city of Bogota between May 20, 2020 and May 30, 2022 who required mechanical ventilation for at least five days. Data were collected from the medical records of patients who met the inclusion criteria on day 1 and day 5 of mechanical ventilation. The primary outcome assessed was mortality at day 30. RESULTS: A total of 533 consecutive patients admitted with ARDS with COVID-19 were included. Ventilatory ratio, plateau pressure and driving pressure measured on day 5 were significantly higher in non-survivors (p < 0.05). Overall, 30-day follow-up mortality was 48.8%. The increases between day 1 and day 5 in the ventilatory ratio (OR 1.42, 95%CI 1.03-2.01, p = 0.04), driving pressure (OR 1.56, 95%CI 1.10-2.22, p = 0.01); and finally plateau pressure (OR 1.9, 95%CI 1.34-2.69, p = 0.001) were associated with an increased risk of death. There was no association between deterioration of PaO2/FIO2 index and mortality (OR 1.34, 95%CI 0.96-1.56, p = 0.053). CONCLUSIONS: Ventilatory ratio, plateau pressure, driving pressure, and age were identified as independent risk factors for 30-day mortality in patients with ARDS due to COVID-19 on day 5 of invasive mechanical ventilation.

Asunto(s)

RESUMEN

RESUMEN Analizamos el uso de microhábitat para las diferentes clases etarias entre épocas climáticas y comparamos la diversidad de presas consumidas por los machos y hembras adultas de Craugastor berkenbuschii en un arroyo tropical del sureste de México. Los datos fueron colectados en diez transectos de 100 x 15 m, separados entre sí por 25 m de distancia entre ellos. Los muestreos diurnos y nocturnos se realizaron mensualmente entre septiembre 2017 y agosto 2018. A cada individuo observado le registramos el sexo, la clase etaria y el microhábitat utilizado al momento del avistamiento. Las presas consumidas fueron extraídas mediante lavados estomacales in situ. Registramos un total de 437 individuos; 165 fueron adultos, 162 juveniles y 110 crías. Los microhábitats utilizados fueron roca, hojarasca, suelo, tronco, rama, hojas y raíz, de los cuales roca fue el más utilizado independientemente de la época del año y clases etarias. Se identificaron 21 órdenes de presas, 19 órdenes en hembras y 11 en machos. El índice de diversidad verdadera (1D), mostró valores similares para machos y hembras, con 9,67 y 9,08 respectivamente. El índice de distintividad taxonómica promedio (A+) determinó que las hembras consumen una mayor diversidad de presas que los machos, con 5,12 y 4,25, respectivamente. Los resultados muestran que las diferentes clases etarias de C. berkenbuschii aprovechan una gran variedad de microhábitats entre épocas climáticas y que existen diferencias entre las presas consumidas entre machos y hembras adultas.

ABSTRACT We analyzed microhabitat use for different age classes between climatic seasons and compared the diversity of prey consumed by adult males and females of Craugastor berkenbuschii in a tropical stream in southeastern Mexico. The data was collected in ten transects of 100 x 15 m, separated from each other by 25 m of the distance between them. Day and night sampling was carried out monthly between September 2017 and august 2018. For each observed individual, we recorded the sex, age class, and microhabitat used at the time of the sighting. The consumed prey was extracted by means of in situ stomach washings. We registered a total of 437 individuals; 165 were adults, 162 were juveniles, and 110 were young. The microhabitats used were rock, litter, soil, trunk, branch, leaves, and root, of which rock was the most used regardless of the time of year and age classes. Twenty-one orders of prey were identified, 19 orders in females and 11 in males. The true diversity index (1D) showed similar values for males and females, with 9.67 and 9.08 respectively. The average taxonomic distinctness index (A+) determined that females consume a greater diversity of prey than males, with 5.12 and 4.25, respectively. The results show that the different age classes of C. berkenbuschii take advantage of a wide variety of microhabitats between climatic seasons and that there are differences between the prey consumed between adult males and females.

RESUMEN

Resumen ANTECEDENTES: El teratoma es un tumor casi siempre benigno, con una amplia variabilidad en su localización, extremadamente rara, en el ligamento redondo. CASO CLÍNICO: Paciente de 30 años, con antecedente de un embarazo a término. En la revisión ecográfica se reportó una lesión quística paraovárica izquierda de 46 x 35 mm, sin componente sólido, graso ni calcificaciones. En el examen ginecológico se palpó una masa por encima del útero, orientada hacia el lado izquierdo, no dolorosa. El resto del examen físico trascurrió sin otras alteraciones. La impresión diagnóstica inicial fue de teratoma abdominopélvico sustentada en la ecografía transvaginal en la que los ovarios se observaron normales, con una masa de ecogenicidad mixta de 50 x 40 x 46 mm, con áreas ecolúcidas y ecogénicas de intensidad variable hacia la fosa iliaca izquierda superior, sin contacto con el ovario. El ligamento redondo se seccionó a ambos lados de la masa y se extrajo sin complicaciones; el reporte histopatológico fue de: teratoma quístico maduro. CONCLUSIONES: El ligamento redondo es una localización infrecuente de los quistes dermoides que debe considerarse en los diagnósticos diferenciales de las masas pélvicas; es susceptible de tratamiento quirúrgico por vía laparoscópica.

Abstract BACKGROUND: Teratoma is an almost always benign tumor, with a wide variability in its location; its location in the round ligament is extremely rare. CLINICAL CASE: 30-year-old patient, with a history of a full-term pregnancy. On routine ultrasound examination, a 46 x 35 mm left paraovarian cystic lesion was reported, with no solid, fatty component or calcifications. In the gynecological examination a mass was palpated above the uterus, oriented to the left side, non-painful. The rest of the physical examination passed without other alterations. The initial diagnostic impression was of abdomino-pelvic teratoma supported by transvaginal ultrasound in which the ovaries were normal, with a mass of mixed echogenicity of 50 x 40 x 46 mm, with echolucent and echogenic areas of variable intensity towards the left superior iliac fossa, without contact with the ovary. The round ligament was sectioned on both sides of the mass and removed without complications; the histopathologic report was: mature cystic teratoma. CONCLUSIONS: The round ligament is an infrequent location of dermoid cysts that should be considered in the differential diagnoses of pelvic masses; it is amenable to surgical treatment laparoscopically.

RESUMEN

OBJECTIVE: To summarize the available evidence of TAP Block in efficacy in laparoscopic or robotic hysterectomy. DATA SOURCES: We searched databases and gray literature for randomized controlled trials in which transversus abdominis plane (TAP) block was compared with placebo or with no treatment in patients who underwent laparoscopic or robot-assisted hysterectomy. METHOD OF STUDY SELECTION: Two researchers independently evaluated the eligibility of the selected articles. TABULATION, INTEGRATION, AND RESULTS: Seven studies were selected, involving 518 patients. Early postoperative pain showed a difference in the mean mean difference (MD): - 1.17 (95% confidence interval [CI]: - 1.87-0.46) in pain scale scores (I2 = 68%), which was statistically significant in favor of using TAP block, but without clinical relevance; late postoperative pain: DM 0.001 (95%CI: - 0.43-0.44; I2 = 69%); opioid requirement: DM 0.36 (95%CI: - 0.94-1.68; I2 = 80%); and incidence of nausea and vomiting with a difference of 95%CI = - 0.11 (- 0.215-0.006) in favor of TAP. CONCLUSION: With moderate strength of evidence, due to the high heterogeneity and imbalance in baseline characteristics among studies, the results indicate that TAP block should not be considered as a clinically relevant analgesic technique to improve postoperative pain in laparoscopic or robotic hysterectomy, despite statistical significance in early postoperative pain scale scores. CLINICAL TRIAL NUMBER AND REGISTRY: PROSPERO ID - CRD42018103573.

OBJETIVO: Resumir as evidências disponíveis sobre a eficácia do bloqueio TAP em histerectomia laparoscópica ou robótica. FONTES DE DADOS: Pesquisamos bancos de dados e literatura cinza por ensaios clínicos randomizados nos quais o bloqueio do plano transverso do abdome (TAP na sigla em inglês) foi comparado com placebo ou com nenhum tratamento em pacientes que foram submetidos a histerectomia laparoscópica ou assistida por robô. MéTODOS DE SELEçãO DE ESTUDOS: Dois pesquisadores avaliaram independentemente a elegibilidade dos artigos selecionados. TABULAçãO, INTEGRAçãO E RESULTADOS: Sete estudos foram selecionados envolvendo 518 pacientes. A dor pós-operatória precoce apresentou diferença nas médias (DM) de: -1 17 (intervalo de confiança [IC] de 95%: - 1 87­0 46) nos escores da escala de dor (I2 = 68%) o que foi estatisticamente significativo a favor do uso do bloqueio TAP mas sem relevância clínica; dor pós-operatória tardia: DM 0001 (IC95%: - 043­044; I2 = 69%); necessidade de opioides: DM 0 36 (95%CI: - 0 94­168; I2 = 80%); e incidência de náuseas e vômitos com diferença de 95% CI = - 011 (- 0215­0006) a favor do TAP. CONCLUSãO: Com moderada força de evidência devido à alta heterogeneidade e ao desequilíbrio nas características basais entre os estudos os resultados indicam que o bloqueio do TAP não deve ser considerado como uma técnica analgésica clinicamente relevante para melhorar a dor pós-operatória em histerectomia laparoscópica ou robótica apesar da significância estatística nas pontuações da escala de dor pós-operatória inicial. NúMERO E REGISTRO DO ENSAIO CLíNICO:: PROSPERO ID - CRD42018103573.

Asunto(s)

RESUMEN

Abstract Objective To summarize the available evidence of TAP Block in efficacy in laparoscopic or robotic hysterectomy. Data Sources We searched databases and gray literature for randomized controlled trials in which transversus abdominis plane (TAP) block was compared with placebo or with no treatment in patients who underwent laparoscopic or robot-assisted hysterectomy. Method of Study Selection Two researchers independently evaluated the eligibility of the selected articles. Tabulation, Integration, and Results Seven studies were selected, involving 518 patients. Early postoperative pain showed a difference in the mean mean difference (MD): - 1.17 (95% confidence interval [CI]: - 1.87-0.46) in pain scale scores (I2=68%), which was statistically significant in favor of using TAP block, but without clinical relevance; late postoperative pain: DM 0.001 (95%CI: - 0.43-0.44; I2=69%); opioid requirement: DM 0.36 (95%CI: - 0.94-1.68; I2=80%); and incidence of nausea and vomiting with a difference of 95%CI=- 0.11 (- 0.215-0.006) in favor of TAP. Conclusion With moderate strength of evidence, due to the high heterogeneity and imbalance in baseline characteristics among studies, the results indicate that TAP block should not be considered as a clinically relevant analgesic technique to improve postoperative pain in laparoscopic or robotic hysterectomy, despite statistical significance in early postoperative pain scale scores. Clinical Trial Number and Registry: PROSPERO ID - CRD42018103573.

Resumo Objetivo Resumir as evidências disponíveis sobre a eficácia do bloqueio TAP em histerectomia laparoscópica ou robótica. Fontes de Dados Pesquisamos bancos de dados e literatura cinza por ensaios clínicos randomizados nos quais o bloqueio do plano transverso do abdome (TAP na sigla em inglês) foi comparado com placebo ou com nenhum tratamento em pacientes que foram submetidos a histerectomia laparoscópica ou assistida por robô. Métodos de Seleção de Estudos Dois pesquisadores avaliaram independentemente a elegibilidade dos artigos selecionados. Tabulação, Integração e Resultados Sete estudos foram selecionados envolvendo 518 pacientes. A dor pós-operatória precoce apresentou diferença nasmédias (DM) de: -1 17 (intervalo de confiança [IC] de 95%: - 1 87-0 46) nos escores da escala de dor (I2=68%) o que foi estatisticamente significativo a favor do uso do bloqueio TAP mas sem relevância clínica; dor pós-operatória tardia: DM 0001 (IC95%: - 043-044; I2=69%); necessidade de opioides: DM0 36 (95%CI: - 0 94-168; I2=80%); e incidência de náuseas e vômitos com diferença de 95% CI=- 011 (- 0215-0006) a favor do TAP. Conclusão Com moderada força de evidência devido à alta heterogeneidade e ao desequilíbrio nas características basais entre os estudos os resultados indicam que o bloqueio do TAP não deve ser considerado como uma técnica analgésica clinicamente relevante para melhorar a dor pós-operatória em histerectomia laparoscópica ou robótica apesar da significância estatística nas pontuações da escala de dor pósoperatória inicial. Número e Registro do Ensaio Clínico: PROSPERO ID - CRD42018103573.

Asunto(s)

RESUMEN

Lipid-related disorders, which primarily affect metabolic tissues, including adipose tissue and the liver are associated with alterations in lysosome homeostasis. Obesity is one of the more prevalent diseases, which results in energy imbalance within metabolic tissues and lysosome dysfunction. Less frequent diseases include Niemann-Pick type C (NPC) and Gaucher diseases, both of which are known as Lysosomal Storage Diseases (LSDs), where lysosomal dysfunction within metabolic tissues remains to be fully characterized. Adipocytes and hepatocytes share common pathways involved in the lysosome-autophagic axis, which are regulated by the function of cathepsins and CD36, an immuno-metabolic receptor and display alterations in lipid diseases, and thereby impacting metabolic functions. In addition to intrinsic defects observed in metabolic tissues, cells of the immune system, such as B cells can infiltrate adipose and liver tissues, during metabolic imbalance favoring inflammation. Moreover, B cells rely on lysosomes to promote the processing and presentation of extracellular antigens and thus could also present lysosome dysfunction, consequently affecting such functions. On the other hand, growing evidence suggests that cells accumulating lipids display defective inter-organelle membrane contact sites (MCSs) established by lysosomes and other compartments, which contribute to metabolic dysfunctions at the cellular level. Overall, in this review we will discuss recent findings addressing common mechanisms that are involved in lysosome dysregulation in adipocytes and hepatocytes during obesity, NPC, and Gaucher diseases. We will discuss whether these mechanisms may modulate the function of B cells and how inter-organelle contacts, emerging as relevant cellular mechanisms in the control of lipid homeostasis, have an impact on these diseases.

RESUMEN

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is an effective mode of consolidation therapy for children with high-risk acute leukemia. In high-income countries, match sibling donor (MSD) and match unrelated donor (MUD) HSCT have similar outcomes, but data are scarce in upper-middle-income countries. Our objective was to compare MSD and MUD HSCT outcomes for children with acute leukemia in Argentina. PATIENTS AND METHODS: This was a single-institution retrospective cohort study. We included children with acute leukemia who underwent HSCT with either MSD or MUD between 2014 and 2019. RESULTS: The study included 45 patients who received MSD (n=27) or MUD (n=18) for acute leukemia. Event-free survival was not significantly different between MSD (62.3±10.7%) versus MUD (54.2±15.0%; P=0.54) at 5 years. Similarly, there was no significant difference in 5-year overall survival between MSD (71.9±9.8%) versus MUD (65.1±13.5%; P=0.38). The cumulative incidence of treatment-related mortality (P=0.31), cumulative incidence of relapse (P=0.99), and proportion with acute-graft-versus-host disease (P=0.76) and chronic-graft-versus-host disease (P=0.68) were also not significantly different. CONCLUSIONS: In Argentina, we did not show significant differences in outcomes between MSD and MUD HSCT for children with high-risk leukemia. Future work should focus on strategies to reduce the relapse risk in children with high-risk leukemia in upper-middle-income countries.

Asunto(s)

RESUMEN

The Mesoamerican slider Trachemysvenusta is endemic to Central America and Southern Mexico. Several human-mediated disturbances, including habitat degradation and illegal hunting for food, have impacted its populations along the Usumacinta river basin. The extent to which these disturbances have affected the genetic diversity and population structure of T. venusta inhabiting the basin remains unresolved. To this end, we analyzed eight microsatellite markers in five wild populations of T. venusta from the middle and lower reaches of the basin as well as one captive population. Our results show high levels of genetic diversity for all analyzed populations, low F ST values, high gene flow and no genetic structure, indicating an absence of genetic differentiation across sites and, thus, a single panmictic population for the basin. Evidence of a genetic bottleneck was observed in two of the wild populations (and the captive one), indicating some impact from disturbances, whether from poaching or habitat fragmentation, despite the seemingly high connectivity of most populations. Results are discussed in terms of the relative importance of genetic parameters for the conservation of T. venusta, particularly in light of the importance of demographic stochasticity in local conditions undergoing rapid changes.

Asunto(s)

RESUMEN

Gold mining is the largest source of mercury (Hg) pollution worldwide. The discharge of mercury in the environment bears direct human health risks and is likely to increase cascading effects throughout local food chains. In the Peruvian Amazon the mining process consists of slashing and burning trees, followed by extraction of gold-bearing sediment, amalgamation with Hg and gold recovery, leading each year to the degradation of 6,000-10,000 ha and the release of 180 metric tons of Hg per year to the enviroment. The purpose of this study was to determine soil Hg levels in soils of abandoned alluvial gold mine spoils and undisturbed forest in the Madre de Dios region, the epicenter of alluvial gold mining in Peru. We selected gold mine spoils of the two most important technologies locally applied for gold extraction, i.e., Minimally Mechanized Mining (MMM) and Highly Mechanized Mining (HMM), in the native communities of Laberinto and Kotzimba, respectively. We collected 127 and 35 soil samples (0-20cm depth) from potentially contaminated sites and undisturbed forest, respectively. Physicochemical analysis and determination of Hg levels were determined for all soil samples. None of the samples had Hg concentrations above Peruvian, Canadian and British Environmental Quality Standards for Agricultural Soil (6.6mg/kg). Hg levels in MMM and HMM were not significantly different between the two areas. The main variables explaining variation of soil Hg concentrations were the vegetation cover, soil organic matter, soil pH and clay particle content, which explained up to 80% of data set variation. Surprisingly, highest Hg concentrations were found in untouched old-growth forest bordering the mine spoils, but there was also a trend of increasing Hg concentrations with the regenerating vegetation. Our findings suggest that Hg concentrations in old mine spoils are low and shouldn't stand in the way of efforts to restore soil conditions and develop sustainable land uses. However, it is urgent to end the use of Hg in mining operation to decrease human and environmental risks.

Asunto(s)

RESUMEN

Introduction: Annona macroprophyllata Donn. Smith. (Annonaceae) (syn. Annona diversifolia Saff.) is a valued fruit tree species known as papausa. In Mexico and Central America, this fruit has become an important crop because of its tasty flavor and high pulp content. Its fruits are frequently damaged by the incidence of wasps of the genus Bephratelloides Girault (Hymenoptera: Eurytomidae), which develop inside the seeds. Objective: To report the interaction of Bephratelloides cubensis Ashmead during its life cycle in fruits of A. macroprophyllata. Methods: We periodically collected fruits in different states of growth recording a) oviposition, b) the moment of evident infection, c) the development of the wasps inside the seeds, and d) their emergence as adults. We also determined the proportion of damaged fruits and seeds. Results: The data indicate that wasps preferred to oviposit on fruits with a diameter of less than 8 cm, oviposition was more frequent between 11:00 am and 03:00 pm., and there was 26 % infestation of fruits, and 9 % of seeds. Conclusion: It is an obligatory interaction for the wasp, the highest proportion of attack on fruits was in the early stages of fruit development and control actions should focus on the protection of these early stages.

Introducción: Annona macroprophyllata Donn. Smith. (Annonaceae) es una especie de árbol frutal, conocida como papausa. En México y América Central, esta fruta se ha convertido en un cultivo importante y valorado debido a su delicioso sabor y la cremosa textura de su pulpa. Sus frutos son frecuentemente dañados por la incidencia de avispas del género Bephratelloides Girault (Hymenoptera: Eurytomidae), que se desarrollan dentro de las semillas. Objetivo: Describir la interacción de Bephratelloides cubensis Ashmead durante su ciclo de vida en frutos de A. macroprophyllata. Método: Recolectamos frutos en diferentes estados de crecimiento registrando a) la ovoposición, b) el momento de la infección evidente, c) el desarrollo de las avispas dentro de las semillas, y d) su emergencia como adultos. También determinamos la proporción de frutas y semillas dañadas. Resultados: Los datos indican que las avispas preferían ovipositar en frutas con un diámetro de menos de 8 cm, la oviposición era más frecuente entre las 11:00 a.m. y las 3:00 p.m., y que había un 26 % de la infestación en las frutas y un 9 % en semillas. Conclusión: Es una interacción obligada para la avispa y la mayor proporción de ataque a los frutos fue en las etapas tempranas de desarrollo de frutos y las acciones de control se deberían enfocar a la protección de estas etapas.

Asunto(s)

RESUMEN

Existe una tendencia mundial de incremento en prevalencia de enfermedades no transmisibles, que se caracterizan por un estado pro-inflamatorio crónico. Por lo tanto, es importante estudiar la relación entre alimentos y salud. La palta (Persea americana), sobresale en la industria por su valor nutricional. El procesamiento de la palta genera gran cantidad de subproductos, que contienen bioactivos con propiedades beneficiosas, como polifenoles. El objetivo del presente trabajo fue caracterizar cuatro extractos de palto (acuoso e hidroalcohólico; de hoja y de cáscara) y analizar sus posibles propiedades anti-inflamatorias in vitro. Fueron determinados polifenoles totales (con el método de Folin­Ciocalteau) y capacidad antioxidante (por FRAP y DPPH) de los extractos. Las propiedades anti-inflamatorias de los extractos fueron determinadas por la liberación de NO y de TNF-, y por la expresión génica de TNF-. Los resultados indican que los extractos hidroalcohólicos presentan más polifenoles (p<0,001) y capacidad antioxidante (p<0,001, por FRAP) que los acuosos. Mas aún, observamos que los extractos hidroalcohólicos de hojas presentaron mayores efectos anti-inflamatorios in vitro, especialmente el hidroalcohólico de hoja en liberación de NO (p<0,001, frente a tratamiento con LPS), acuosos e hidroalcohólicos en liberación de TNF- (p<0,05), y solo los hidroalcohólicos en la expresión de TNF- (p<0,01). En conclusión, los extractos hidroalcohólicos de palto, y especialmente el de hoja, presentan propiedades anti-inflamatorias in vitro que pueden ser consideradas para aplicaciones en mejoría de salud humana.

There is a worldwide trend of increasing prevalence of non-communicable diseases characterized by a chronic inflammatory state. Therefore, it is important to study the relationship between food and health. Avocado (Persea americana) stands out in food industry for its nutritional value. Industrials process of avocado generates a large number of by-products, which contain phytochemical compounds with antioxidant properties, such as polyphenols. The objective of the present research was to characterize four aqueous and hydroalcoholic extracts from avocado leaves and peels and analyze it possible anti-inflammatory properties in vitro. Total polyphenol content (with the Folin-Ciocalteau method) and antioxidant capacity (by FRAP and DPPH) were determined. Extracts inflammatory features were measured by NO and TNF- release, and by TNF- gene expression. Our results indicated that hydroalcoholic extracts present higher total polyphenol content (p<0.001) and antioxidant capacity (p<0.001, by FRAP) than the aqueous ones. Furthermore, we report that hydroalcoholic leaves extract presented greater in vitro anti-inflammatory effect, especially the leave hydroalcoholic regarding NO release (p<0.001, against LPS treatment), aqueous and hydroalcoholics regarding TNF- release (p<0.05), and only the hydroalcoholic in the TNF- gene expression (p<0.01). In conclusion, the avocado hydroalcoholic extracts, and especially from leaves, present in vitro anti-inflammatory features that might be considered for human health improvement applications.

Asunto(s)

RESUMEN

RESUMEN La obesidad es una enfermedad multifactorial definida como acumulación patológica de grasa. Su prevalencia ha aumentado enormemente en el mundo. Chile presenta una de las mayores prevalencias de obesidad de la OCDE. Su casuística simplificada comprende una diferencia sostenida entre gasto e ingesta de energía, manteniendo un delta positivo traducido en mayor acumulación de grasa. No obstante, la etiología completa de esta enfermedad comprende también factores psicológicos, genéticos, ambientales, etc. El ambiente juega un papel clave en la predisposición al consumo de alimentos, a la realización de ejercicio físico, incluso afectando la susceptibilidad genómica, exacerbando o disminuyendo la carga genética. Esta modificación de susceptibilidad genética por el ambiente se conoce como epigenética, que se refiere a una serie de modificaciones por "sobre" la genética que son altamente modificables por factores ambientales. Se ha descrito que algunas de estas modificaciones pueden heredarse de una generación a otra, lo que otorga otro nivel de complejidad al estudio de nuevas terapias complementarias para frenar la tendencia al sobrepeso. En la presente revisión se describe cuales son las modificaciones epigenéticas más frecuentes encontradas, su relación con obesidad y dieta, y finalmente como se relaciona con la transmisión transgeneracional de esta patología.

ABSTRACT Obesity is a multifactorial disease defined by a pathological accumulation of body fat. Its prevalence has increased greatly across the world. Chile has one of the highest prevalence of obesity among OCDE countries. It is caused by a sustained difference between energy expenditure and intake, keeping a positive delta, which drives fat accumulation. However, its etiology is comprised several factors: psychological, genetics, environmental, etc. The environment plays a key role in the predisposition towards food consumption, the adoption of exercise, and genetic susceptibility, increasing or decreasing the genetic load towards obesity. This modification of susceptibility is known as epigenetics, which refers to modifications "over" genetics, which are highly modifiable by environmental factors. Some of these modifications can be inherited from one generation to another, granting a higher complexity level regarding designing novel complementary therapies against obesity. Thus, the present review described which epigenetic modifications are related to obesity and different dietary patterns, and finally how epigenetic modifications can be related to transgenerational transmission of obesity.

Asunto(s)

RESUMEN

This study evaluates the nutritional status of children and women of an indigenous Yanomamigroup, and seeks to clarify associated factors. It was a cross-sectional study, carried out in 17 villages, in 2014. For evaluation of nutritional status we used 2006 growth standards to assign height-for-age (stunting)Z-scores (Z), weight-for-age Z (underweight) and weight-for-height Z (wasting and overweight), using the software WHO-Anthro and WHO-AnthroPlus. Short stature (SS) was defined as values lower 145cm for mothers over the age of 18. The Poisson regression was made in R software. Among children under 60 months the prevalences were: stunting 83.8%; underweight 50%; wasting 5.4%; and overweight 2.7%. In 59.5% of the children there was severe stunting, and 68.1% of the mothers were SS. Prevalence ratio (PR) for severe stunting was higher in age group 36-59 months, in comparison with age group 0.1-23 (PR = 1.3; CI 95%: 1.1-2.3), as did also children of mothers with SS, when compared to the children of mothers without SS (PR = 2.1; CI 95%; 1.2-3.6). The alarming rates of stunting and severe stunting reveal the seriousness of the nutritional situation children. The association of severe stunting in infants and in mothers reflects the intergenerational nature of the problem.

O objetivo do estudo foi avaliar o estado nutricional de crianças e mulheres indígenas Yanomami e elucidar fatores associados. Estudo transversal, realizado em 17 aldeias, em 2014. Para a avaliação do estado nutricional utilizou-se as curvas de crescimento de 2006 e os escores-Z (ESZ) de estatura/idade (E/I), peso/idade (P/I), peso/estatura (P/E), os quais foram gerados nos programas WHO-Anthro e WHO-AnthroPlus. Estatura inferior a 145cm foi o descritor de baixa estatura materna nas > 18 anos. A regressão de Poisson e as análises estatísticas foram efetuadas no software R, versão 3.1.2. Nos < 5 anos a prevalência de baixa E/I foi 83,8%, de baixo P/I 50%, de baixo P/E 5,4% e de sobrepeso 2,7%. Em 59,5% das crianças observou-se muito baixa E/I e em 68,1% das mães baixa estatura. As crianças de 36-59 meses apresentaram maior risco de baixa estatura severa, em comparação com as de 0,1-23 (RP = 1,3; IC 95%: 1,1-2,3), assim como os filhos de mães com estatura < 145cm, em relação aos filhos de mães com estatura > 144cm (RP = 2,1; IC 95%;1,2-3,6). As alarmantes prevalências de baixa estatura severa revelam a grave situação nutricional das crianças. Já a associação de baixa estatura severa nas crianças e baixa estatura materna reflete o caráter intergeracional do problema.

Asunto(s)

RESUMEN

Resumo O objetivo do estudo foi avaliar o estado nutricional de crianças e mulheres indígenas Yanomami e elucidar fatores associados. Estudo transversal, realizado em 17 aldeias, em 2014. Para a avaliação do estado nutricional utilizou-se as curvas de crescimento de 2006 e os escores-Z (ESZ) de estatura/idade (E/I), peso/idade (P/I), peso/estatura (P/E), os quais foram gerados nos programas WHO-Anthro e WHO-AnthroPlus. Estatura inferior a 145cm foi o descritor de baixa estatura materna nas > 18 anos. A regressão de Poisson e as análises estatísticas foram efetuadas no software R, versão 3.1.2. Nos < 5 anos a prevalência de baixa E/I foi 83,8%, de baixo P/I 50%, de baixo P/E 5,4% e de sobrepeso 2,7%. Em 59,5% das crianças observou-se muito baixa E/I e em 68,1% das mães baixa estatura. As crianças de 36-59 meses apresentaram maior risco de baixa estatura severa, em comparação com as de 0,1-23 (RP = 1,3; IC 95%: 1,1-2,3), assim como os filhos de mães com estatura < 145cm, em relação aos filhos de mães com estatura > 144cm (RP = 2,1; IC 95%;1,2-3,6). As alarmantes prevalências de baixa estatura severa revelam a grave situação nutricional das crianças. Já a associação de baixa estatura severa nas crianças e baixa estatura materna reflete o caráter intergeracional do problema.

Abstract This study evaluates the nutritional status of children and women of an indigenous Yanomamigroup, and seeks to clarify associated factors. It was a cross-sectional study, carried out in 17 villages, in 2014. For evaluation of nutritional status we used 2006 growth standards to assign height-for-age (stunting)Z-scores (Z), weight-for-age Z (underweight) and weight-for-height Z (wasting and overweight), using the software WHO-Anthro and WHO-AnthroPlus. Short stature (SS) was defined as values lower 145cm for mothers over the age of 18. The Poisson regression was made in R software. Among children under 60 months the prevalences were: stunting 83.8%; underweight 50%; wasting 5.4%; and overweight 2.7%. In 59.5% of the children there was severe stunting, and 68.1% of the mothers were SS. Prevalence ratio (PR) for severe stunting was higher in age group 36-59 months, in comparison with age group 0.1-23 (PR = 1.3; CI 95%: 1.1-2.3), as did also children of mothers with SS, when compared to the children of mothers without SS (PR = 2.1; CI 95%; 1.2-3.6). The alarming rates of stunting and severe stunting reveal the seriousness of the nutritional situation children. The association of severe stunting in infants and in mothers reflects the intergenerational nature of the problem.

Asunto(s)

RESUMEN

The seeds of Annona macroprophyllata Donn. Sm. contain idioblasts with toxic acetogenins, including laherradurin and rolliniastatin-2, in relatively high proportions. Both metabolites are cataloged as potent insecticides for several species, even so, the wasp Bephratelloides cubensis Ashmead fulfills almost its entire life cycle inside the seeds of this and other annonaceous species, to such a degree, that they constitute a strong selection pressure. In order to document the chemical relationship between the two species, it is reported for the first time in this paper the presence of idioblasts and acetogenins during the ontogenic development of the seeds of A. macroprophyllata, and contrasted with the development of B. cubensis. The results indicate that idioblasts with laherradurin and rolliniastatin-2 acetogenins are formed in the middle stages of the endospermic development, also that both acetogenins are biosynthesized simultaneously, and that their proportion is dependent on the degree of development. The acetogenins are present in high amounts that suppose a sufficient toxic barrier and, in this case, laherradurin is the most abundant (> 1000 µg g dry weight-1). The wasp B. cubensis only emerges from the seeds to copulate and returns for oviposition; its larval phase coincides with the appearance of acetogenins, so it feeds on the acetogenic endosperm. The absence of acetogenins in the tissues and excreta of the insect supposes a metabolization of the molecules, which would explain the tolerance to its toxicity.

Asunto(s)

RESUMEN

The gold rush in the Amazon Region caused an increase of mercury (Hg) levels in the environment, and, consequently, raised human exposure. Once released into aquatic systems, Hg could generate methylmercury (MeHg), an extremely toxic compound, which is accumulated through trophic chains. Several studies have provided evidences of the brain sensitivity to MeHg, as well as, of the fetus vulnerability during pregnancy. The main objective of this study was to estimate the Mild Mental Retardation (MMR) in Amazonian populations, caused by prenatal exposure to MeHg, using the methodology proposed by Poulin (2008), which quantifies the environmental burden of disease. The estimates of the MMR burden, attributed to prenatal MeHg exposure, were based on the calculation of Disability-Adjusted Life Years (DALY), which were obtained from MMR incidence rate in the studied populations. At the local level, the MMR incidence rate calculations were based on primary data of MeHg exposure of riverine women at childbearing age. The MMR incidence rate was equal to 5.96/1,000 infants, which would result in 2.0 IQ points loss in 34.31% of the newborns. The estimated DALY/1,000 infants was equal to 71.2, while the DALY was 576. For the regional estimates, different exposure scenarios were created. The calculated DALY varied from 3,256 to 65,952 per year.

Asunto(s)