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The potential of chicken eggs as a nutritionally complete protein and source of key micronutrients during the first 1000 days post-conception has been progressively recognized across the globe, particularly in resource-poor settings. Fluctuation of egg nutrient content by season is relatively unknown, which may influence international food composition databases and outcomes in intervention studies using egg supplementation. To better interpret the findings of The Saqmolo' Project, we conducted comprehensive nutrient analyses on eggs produced during the wet and dry seasons in the highlands of central Guatemala. We randomly collected 36 shell eggs from a local farm during both seasons, hard-boiled, and prepared them for transport to the United States, where they were pooled and assessed for their nutrient composition. Methods of the Association of Official Analytical Chemists, the American Oil Chemists Society, and the American Association of Cereal Chemists were utilized to determine total energy, moisture, ash, total protein, total fat, fatty acids, total carbohydrates, 12 vitamins, 11 minerals, and carotenoids, by season, in some instances with modifications. Differences in nutrient composition between de-shelled hard-boiled eggs collected between seasons were assessed using an analysis of variance (ANOVA) and Tukey's family error rate comparison test. Most nutrients in eggs produced in the highlands of central Guatemala differed negligibly (but statistically significantly) based on seasonality. Only vitamins A and E, folate, choline, and calcium fluctuated at clinically significant levels relative to the AI/RDA for infants 7-12 months. Total energy, protein, trans fatty acids, moisture, and vitamin D3 levels did not differ between seasons (p > .05). Further multi-year sampling is needed to examine how seasonal variation affects the nutrient composition of eggs. These data may be used to supplement existing national and regional food composition databases.

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BACKGROUND: Home gardening is a strategy to improve nutrition and food security. More information is needed about optimizing gardens in different contexts. OBJECTIVE: The aim was to identify implementation barriers and facilitators for a home gardening intervention in rural Guatemala and inform future larger-scale interventions in the region. DESIGN: A mixed-methods implementation study using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework was conducted from January 2019 to July 2020. PARTICIPANTS/SETTING: Families (n = 70) in rural Guatemala participated in the intervention. Staff (n = 4), families (n = 6), and community stakeholders (n = 3) participated in interviews or focus groups. INTERVENTION: Participating households received seeds and seedlings for 16 crops, garden construction materials, agronomist-delivered education and assistance, and a standard-of-care nutrition program. MAIN OUTCOME MEASURES: Implementation data were collected from program records and observations, participant surveys, and interviews and focus groups. Crop count and nutritional functional diversity of home gardens were assessed. STATISTICAL ANALYSES PERFORMED: Descriptive statistics were calculated for quantitative outcomes. Qualitative data were double-coded and organized into overarching themes. RESULTS: Reach: Ninety percent of eligible households participated. Child nutritional eligibility criteria was a barrier to reach. EFFECTIVENESS: Participants and stakeholders felt the intervention improved access to diverse foods. Cultivated crops increased an average of five species (95% confidence interval [CI], 4-6) at 6 months, although not all were consumed. Adoption: The main community adoption barrier was water sourcing for garden irrigation. IMPLEMENTATION: Raised beds were the most common gardening method, with good adoption of agricultural best practices. Gray water filters and flexible implementation were important for participation. Maintenance: Crops failure rates were low. Seed availability was a sustainability challenge. Direct costs were 763 USD per household. CONCLUSIONS: Interest and engagement with a home garden intervention in Guatemala were high. Gaps between garden production and consumption, access to water, and seed sourcing should be addressed in future work.

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Home gardens may help address childhood malnutrition in low- and middle-income countries. In this quasi-experimental pilot study, the Academy of Nutrition and Dietetics, in collaboration with Maya Health Alliance, evaluated the feasibility of augmenting a standard-of-care nutrition-specific package for Maya children with length-for-age z score ≤-2 (stunting) in rural Guatemala with a nutrition-sensitive home garden intervention. Two agrarian municipalities in Guatemala were included. Families of 70 children with stunting from 1 municipality received the standard-of-care package (food supplementation, multiple micronutrient powders, monthly nutrition home visits, group nutrition classes). Families of 70 children with stunting from another municipality received the standard-of-care package plus a home garden intervention (garden materials, monthly agricultural home visits, agriculture classes). Maternal and child dietary diversity, household food insecurity, child growth, and agricultural indicators were collected at baseline and 6 months later and were analyzed using mixed linear and logistic regression models. Compared with the standard-of-care group, the garden intervention group had improved child (odds ratio [OR] 3.66, 95% CI 0.89-15.10, P = 0.07) and maternal dietary diversity (OR 2.31, 95% CI 0.80-6.65, P = 0.12) and decreased food insecurity (OR 0.38, 95% CI 0.11-1.35, P = 0.14); however, these effects were not statistically significant. Participation in gardens predicted a higher length-for-age z-score (change difference [CD] 0.22 SD, 95% CI 0.05-0.38, P = 0.009), greater crop species count (CD 2.97 crops, 95% CI 1.79-4.16, P < 0.001), and greater nutritional functional diversity (CD 0.04 points, 95% CI 0.01-0.07, P = 0.006) than standard-of-care alone. Home garden interventions are feasible in rural Guatemala and may have potential benefits for child growth when added to other nutrition-specific interventions.

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Adequate nutrition during the complementary feeding period is critical for optimal child growth and development and for promoting long-term educational attainment and economic potential. To prioritize limited public health resources, there is a need for studies that rigorously assess the influence of multicomponent integrated nutrition interventions in children younger than age 2 years in different contexts. This study aimed to describe the rationale and protocol for the Saqmolo' Project using the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. The Saqmolo' (ie, "egg" in the Mayan language, Kaqchiquel) Project is an individually randomized, partially blinded, controlled comparative effectiveness trial to evaluate the influence of adding delivery of a single whole egg per day to local standard nutrition care (ie, growth monitoring, medical care, deworming medication, multiple micronutrient powders for point-of-use food fortification [chispitas], and individualized complementary and responsive feeding education for caregivers) for 6 months, compared with the local standard nutrition care package alone, on child development, growth, and diet quality measures in rural indigenous Mayan infants aged 6 to 9 months at baseline (N = 1,200). The study is being executed in partnership with the Wuqu' Kawoq/Maya Health Alliance, a primary health care organization located in central Guatemala. Primary outcomes for this study are changes in global development scores, assessed using the Guide for Monitoring Global Development and the Caregiver Reported Child Development Instruments. Secondary outcomes include changes in infant hemoglobin, anthropometric measures (including z scores for weight for age, length for age, weight for length, and head circumference for age), and diet quality as measured using the World Health Organization's infant and young child feeding indicators. The results of the Saqmolo' Project may help to inform public health decision making regarding resource allocation for effective nutrition interventions during the complementary feeding period.

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En 1872, el dermatólogo austro-húngaro Moritz Kaposi describió -por primera vez- esta enfermedad clínica y la llamó Sarcoma Múltiple Pigmentado Idiopático, que afecta a varones judíos y de áreas mediterráneas. En 1956 describieron una variedad endémica en África ecuatorial. En la década de los 60 se describió una tercera variedad en pacientes sometidos a trasplante renal e inmunodeprimidos. En la década de los 80 se comunicaron los primeros casos asociados al Virus de la Inmunodeficiencia Humana. Caso clínico: Se presentó el caso de un paciente portador del Virus de la Inmunodeficiencia Humana que fue atendido en el Hospital Carlos Andrade Marín de la ciudad de Quito, por presentar lesiones exofíticas distribuidas en la región inguinal, genital y ano-perineal, con secreción amarillenta de mal olor, edema de la bolsa escrotal y del muslo derecho. El diagnosticó fue Sarcoma de Kaposi asociada al virus de Inmunodeficiencia Humana. La evolución desfavorable y el estadio avanzado de la enfermedad provocaron la muerte del paciente. Discusión: El Sarcoma de Kaposi (SK) es una neoplasia maligna vascular, más frecuente en pacientes inmunocomprometidos, conlleva una alta morbilidad y mortalidad. El diagnóstico requiere una confirmación histológica de la celularidad neoplásica y la presencia del VHH-8.

In 1872 the Austro Hungarian dermatologist Moritz Kaposi described this clinical entity for the first time and called Idiopathic Pigmented Multiple Sarcoma that affected male Jews from Mediterranean areas. In 1956 an endemic variety in equatorial Africa was reported. In the 1960s, a third variety was described in patients undergoing renal transplantation and receiving immunosuppression. In the 80s appeared in patients infected with the Human Immunodeficiency Virus. Case report: The case of a patient previously diagnosed as a carrier of human immunodeficiency virus treated at Carlos Andrade Marín Hospital, Quito Ecuador, for having exophytic lesions distributed in the inguinal, genital and ano-perineal regions, with a fetid yellowish discharge, scrotal and right thigh edema. A diagnosis of Kaposi's sarcoma associated to acquired immunodeficiency virus was made. After an unsatisfactory evolution and due to the advanced stage of the disease, the patient died. Discussion: Kaposi's Sarcoma (KS) is a malignant vascular neoplasm, more frequent in immunocompromised patients. It has a high morbidity and mortality. The diagnosis requires histological confirmation of neoplastic cellularity and the presence of HHV-8.

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