Analysis of information labeling in instructions of antitussive and expectorant drugs in 34 children’s medical institutions / 中国药房

OBJECTIVE To understand the information labeling of children’s medication in the instructions of antitussive and expectorant drugs commonly used in children’s medical institutions， analyze the existing problems， and propose relevant suggestions. METHODS The instructions for 100 antitussive and expectorant drugs commonly used in 20 tertiary children’s hospitals （centers） and 14 maternal and child health hospitals （centers） with regional representativeness in China were collected， and the information labeling of children’s medication in the instructions was investigated and analyzed. RESULTS There were only 7 kinds of antitussive and expectorant drugs for children， and the others were non-specific drugs for children. Among antitussive and expectorant drugs， tablets accounted for 18.00%， injections for 18.00%， and capsules for 4.00%. Among 100 antitussive and expectorant drugs， 72 （72.00%） labeled the usage and dosage for children， 63 （63.00%） labeled the medication items for children， 59 （59.00%） indicated the information of children in the precautions， and pharmacokinetic parameters for children were absent. Compared with imported antitussive and expectorant drugs or the drugs manufactured by joint ventures， there were many missing labeling of medication information for children with Chinese drugs. Among 63 kinds of drug instructions labeled with medication items for children， various instructions information had little guiding significance. CONCLUSIONS There is a lack of labeling in the instructions of antitussive and expectorant drugs for children， and the proportion of special drugs for children remains low. Pediatric drug information in the instructions has little guiding significance for pediatric medication. Relevant departments should further promote the completeness of pediatric medication information in the instructions of antitussive and expectorant drugs to ensure the rational use of children’s medication.

El etiquetado nutricional: su expresión en el contexto mexicano / Nutritional labeling: its expression in the Mexican context

Introduction: Food is a process that carries implicit socio-cultural elements in a specific historical moment. The changes in the diet caused an increase in problems of obesity and Chronic Non-Communicable Diseases in Mexico. Measures have been taken through public policies that seek to reduce the effects of the consumption of foods with high energy value, one of them is the nutritional labeling of foods. Development: As the first axis, a sociohistorical reconstruction is developed around food labeling in Mexico as an initiative that is part of an international public policy to present nutritional information for the selection and consumption of food. In a second moment, an analysis is carried out from a critical position on the implementation and exercise of decision-making for the consumption of said products, since it is subject to a complex network of sociocultural and individual factors that determine and are determinants of styles. and frequency of consumption of the products. Conclusions: The new labeling with nutritional information is an information tool for the selection in food consumption to face the problem of overweight and obesity in Mexico. However, eating habits and practices respond to sociocultural and economic elements that are above healthy lifestyles and a culture of prevention. It is necessary to build and promote community participation-action that promotes tools such as nutritional labeling to make its objectives effective.

Introducción: la alimentación es un proceso que implica elementos socioculturales en un momento histórico concreto. México se encuentra en un problema de salud generalizado de obesidad y enfermedades crónicas no transmisibles. Ante esto se han tomado medidas mediante políticas públicas que buscan disminuir los efectos del consumo de alimentos de alto valor energético, una de ellas es el etiquetado nutricional de los alimentos. Desarrollo: como primer eje se desarrolla una reconstrucción sociohistórica en torno al etiquetado de alimentos en México como iniciativa que forma parte de una política pública internacional para presentar información nutricional para la selección y consumo de los alimentos. En un segundo momento se realiza un análisis desde un posicionamiento crítico sobre la implementación y el ejercicio de las tomas de decisión del consumo de dichos productos, ya que está sujeta a una compleja red de factores socioculturales e individuales que determinan y son determinantes de los estilos y frecuencia de consumo de los productos. Conclusiones: el nuevo etiquetado con información nutricional es una herramienta de información para la selección en el consumo de alimentos para enfrentar el problema de sobrepeso y obesidad en México. Sin embargo, los hábitos y prácticas de alimentación responden a elementos socioculturales y económicos que están por arriba de los estilos de vida saludable y una cultura de prevención. Es necesario construir y promover una participación-acción comunitaria que potencie las herramientas como el etiquetado nutricional para hacer efectivos sus objetivos.

Determinación de transgenicidad y verificación en el etiquetado de alimentos industrializados de maíz en centros de expendio de Lima metropolitana

Introducción. El consumo de alimentos transgénicos constituye un riesgo potencial para la salud. Sin embargo, en el Perú se carece de información actualizada y confiable sobre la presencia de transgénicos en los alimentos y sobre los datos pertinentes en su etiquetado; de igual manera sobre los alimentos que consumen los animales de abasto, cuyos productos van a ser ingeridos por el humano. Objetivo. Determinar la transgenicidad, mediante la detección del promotor 35S, en productos alimenticios industrializados de maíz para consumo humano y animal, que se comercializan en Lima y verificar sí en el etiquetado se menciona si contiene o no secuencias transgénicas. Métodos. Se analizaron 30 muestras de alimentos para consumo humano y 10 para consumo de animales de abasto; y se revisó el etiquetado. Para la extracción del ADN se utilizó el kit Dneasy Mericon Food, para la detección del P35S el método Real Time-PCR empleando el kit Mericon Screen 35S y para determinar la concentración de copias el kit Mericon Quant Mon 810. Resultados. Se detectó el P35S en el 66,66% de las muestras para consumo humano, y en el 90,00% de las muestras para consumo animal. En el etiquetado del 100% de las muestras para consumo humano y animal no se menciona si contiene o no componentes transgénicos. Conclusiones. La detección de contenido transgénico en la mayoría de los alimentos industrializados de maíz para humanos y animales evidencian la necesidad de su mención en el etiquetado y de la implementación de una política exigente en bioseguridad alimentaria.

Introduction. Consumption of transgenic foods constitutes a potential health risk. However, in Peru there is a lack of updated and reliable information on the presence of transgenics in food and on the relevant data on their labeling; in the same way about the food consumed by animals for supply, whose products are going to be ingested by humans. Objetive. To determine the transgenicity, through the detection of the 35S promoter, in industrialized corn food products for human and animal consumption, which are marketed in Lima and to verify if the labeling mentions whether or not it contains transgenic sequences. Methods. 30 food samples for human consumption and 10 for consumption by animals for production were analyzed; and the labeling was revised. The Dneasy Mericon Food kit was used for DNA extraction, the Real Time-PCR method for P35S detection using the Mericon Screen 35S kit, and the Mericon Quant Mon 810 kit to determine the copy concentration. Results. P35S was detected in 66,66% of the samples for human consumption, and in 90.00% of the samples for animal consumption. The labeling of 100% of the samples for human and animal consumption does not mention whether or not it contains transgenic components. Conclusions. The detection of transgenic content in the majority of industrialized corn foods for humans and animals demonstrates the need to mention them on the label and the implementation of a demanding policy on food biosafety.

Etiquetado frontal de advertencia nutricional de alimentos y bebidas pre-envasados. Postura intersectorial de expertos en Centro América y República Dominicana / Front-of-package warning labelling system for pre-packaged foods and beverages: an intersectoral position of expertsin Central American and Dominican Republic

La región latinoamericana ha sido pionera en la implementación del etiquetado frontal de advertencia nutricional (EFAN), mismo que ha demostrado su eficacia y efectividad para identificar correctamente cuando un producto contiene cantidades excesivas de nutrientes asociados a Enfermedades no transmisibles (ENT). Sin embargo, ningún país del Sistema de la Integración Centroamericana (SICA); que incluye a Belice, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panamá y República Dominicana, lo ha adoptado. Por esta razón, el Instituto de Nutrición de Centro América y Panamá, convocó a un grupo de expertos de la academia y la sociedad civil con el objetivo de establecer una postura técnica, basada en la mejor evidencia científica, en relación al etiquetado frontal para los nutrientes críticos de alimentos y bebidas pre- envasados en la región centroamericana. Se presenta evidencia específica de la región del SICA que demuestran la superioridad del EFAN frente a otros etiquetados como las Guías Diarias de Alimentación (GDA), el semáforo y el Nutriscore para seleccionar opciones más saludables. Dentro del marco de los derechos de la niñez y de los consumidores, se brindan argumentos y se hace un llamado a los gobiernos para la pronta adopción del EFAN como una política costo-efectiva para la prevención de ENT. Además, se proveen recomendaciones para su monitoreo y evaluación, así como recomendaciones de otras políticas costo-efectivas como la regulación de la publicidad de alimentos no saludables dirigido a la niñez y adolescencia, entre otros, para la prevención de las ENT y la creación de ambientes y sistemas alimentarios más saludables y sostenibles(AU)

The Latin American region has been a pioneer in the implementation of a front- of-pack warning labeling system (FOPWL), which has demonstrated its efficacy and effectiveness in correctly identifying when a product contains excessive amounts of nutrients associated with Non-Communicable Diseases (NCDs). However, countries of the Central American Integration System (SICA); which includes Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama and the Dominican Republic, have no adopted it. For this reason, the Institute of Nutrition of Central America and Panama convened a group of experts from academia and civil society with the aim of establishing an evidence-based technical position, in relation to front-of-pack labelling for critical nutrients of pre-packaged foods and beverages in the Central American region. Specific evidence from the SICA region demonstrating the superiority of FOPWL over other labels such as the Guideline Daily Amount (GDA), the traffic light and Nutriscore to select healthier choices is presented. Within the framework of children's and consumer rights, arguments are provided, and a call is made to governments for the prompt adoption of FOPWL as a cost-effective policy for the prevention of NCDs. In addition, recommendations for its monitoring and evaluation are provided, as well as recommendations for other cost-effective policies such as the regulation of unhealthy food advertising aimed at children and adolescents, among others, for the prevention of NCDs and the creation ofhealthier and more sustainable environments and food systems(AU)

Aplicación del perfil de nutrientes de la OPS en productos ultraprocesados, inclusive en alimentos fortificados / Application of PAHO's nutrient profile in ultra-processed products, including fortified foods

Resumen Introducción: en la actualidad se recomienda limitar el consumo de productos ultraprocesados por su alto contenido en azúcar, grasas totales, grasas saturadas, grasas trans y sodio. El etiquetado frontal es una estrategia destinada a fortalecer en el consumidor su capacidad de elegir, pero la estrategia de adición de micronutrientes realizada por la industria alimentaria contribuye a que los consumidores sobrestimen su calidad nutricional. El objetivo de este estudio fue analizar según el modelo del Perfil de Nutrientes (PN) de la Organización Panamericana de la Salud (OPS), un grupo de productos ultraprocesados disponibles en el mercado argentino y aplicar el modelo de forma diferenciada en productos fortificados por la industria alimentaria. Materiales y método: estudio de campo, transversal, descriptivo. Se aplicó el perfil de nutrientes considerando: azúcares libres, grasas totales, grasas saturadas, grasas trans y sodio, en productos fortificados y sin fortificación. Cada una de las categorías generales de alimentos: galletitas dulces, alfajores, chocolates, golosinas, helados, cereales, bebidas, dulces untables, snacks salados y lácteos, fueron divididas en subcategorías, integradas por diferentes productos. Se realizó un análisis estadístico descriptivo por subcategorías. Resultados: la muestra se conformó por 682 productos y todos superaron el punto de corte de al menos un nutriente en cantidad excesiva. El 100% de los productos fortificados (n=146) presentó cantidad excesiva de algún nutriente, el 41,1% tuvo un nutriente en cantidad excesiva y el 50,7% dos nutrientes. 95,7-100% de los productos de los grupos cereales de desayuno, chocolatadas, yogures bebibles y en pote, se categorizaron como con cantidad excesiva de azúcares libres. Conclusiones: todos los productos analizados presentaron al menos un nutriente del PN de referencia, en cantidad excesiva. Los mismos productos tenían adición de vitaminas, minerales o fibra. Se visibiliza la necesidad de realizar estudios que investiguen si esta estrategia induce confusión en el consumidor al momento de elegir.

Abstract Introduction: it is currently recommended to limit the consumption of ultra-processed products because of their high content of sugar, total fats, saturated fats, trans fats and sodium. Front labelling is a strategy aimed at strengthening consumer choice, but the micronutrient addition strategy carried out by the food industry contributes to consumers overestimating their nutritional quality. The objective of this study was to analyze, following the model of the Nutrient Profile (PN) of the Pan American Health Organization (PAHO), a group of ultra-processed products available in the Argentine market and apply the model in a differentiated way in products fortified by the food industry. Materials and method: field study, cross-sectional, descriptive. The nutrient profile was applied considering: free sugars, total fats, saturated fats, trans fats and sodium, both in fortified and unfortified products. Each of the general food categories: sweet cookies, alfajores, chocolates, sweets, ice cream, cereals, beverages, spreadable sweets, salty snacks and dairy products, were divided into subcategories, made up of different products. A descriptive statistical analysis by subcategories was performed. Results: the sample consisted of 682 products and all exceeded the cut-off point of at least one nutrient in excessive quantity. 100% of the fortified products (n=146) had an excessive amount of some nutrient, 41.1% had an excess nutrient and 50.7% two nutrients. 95.7-100% of the products of the breakfast cereals, chocolate, drinking and potted yogurts groups were categorized as having excessive amounts of free sugars. Conclusions: all the products analyzed presented at least one nutrient from the reference NP, in excessive quantity. The same products had added vitamins, minerals or fiber. The need for studies to research whether this strategy induces confusion in the consumer when choosing is made visible.

Declaración de información nutricional en el etiquetado de bebidas y alimentos procesados y ultraprocesados ofertados en una cadena de supermercados de Lima en el 2022 / Nutritional information on the labels of processed and ultra-processed foods and beverages marketed in a supermarket chain in Lima in 2022

RESUMEN Objetivos. Estimar la cantidad de bebidas y alimentos procesados y ultraprocesados que declaran información nutricional en su empaque y describir las características de esta información, así como determinar la presencia de información nutricional en los productos con octógonos. Materiales y métodos. Se tomaron fotografías del etiquetado de 4404 bebidas y alimentos procesados y ultraprocesados ofertados en supermercados de Lima Metropolitana. La información declarada en la etiqueta se recogió y se registró en la versión móvil y web del Programa de Información de Etiquetas de Alimentos (FLIP por sus siglas en inglés). Se analizaron las variables correspondientes a la declaración de información nutricional, la forma en que se declara dicha información y la declaración de la misma en bebidas y alimentos con octógonos. Resultados. De todos los productos recolectados solo el 71,4% declara algún tipo de información nutricional. De estos, el 13,8% declara la información nutricional en texto y no en tabla, además sólo 56,3% la declara por cada 100 gramos o mililitros. Del total de alimentos con el octógono «Contiene grasas trans¼, sólo 19,2% declara su contenido. Conclusiones. Más de la cuarta parte de bebidas y alimentos envasados expendidos en el mercado peruano no declaran información nutricional de ningún tipo, y de los que declaran, existe una que lo hace en diferentes formatos y unidades. Además, se halló que hay una proporción de bebidas y alimentos para cada tipo de octógono que no declaran la información del nutriente advertido en el mismo.

ABSTRACT Objectives. To estimate the number of processed and ultra-processed beverages and foods that provide nutritional information on their packaging, and to describe the characteristics of this information, as well as to determine the presence of nutritional information on products with octagons. Materials and methods. Photographs were taken of the labels of 4404 processed and ultra-processed beverages and foods marketed in supermarkets in Metropolitan Lima. The information on the label was collected and registered in the mobile and web version of the Food Label Information Program (FLIP). We analyzed variables related to the nutritional information, the way in which such information is declared and the information in beverages and foods with octagons. Results. Only 71.4% of the products had some type of nutritional information. Of these, 13.8% provided the nutritional information as a text and not in a table, and only 56.3% declared it per 100 grams or milliliters. Of the total number of foods with the octagon "Contains trans fats", only 19.2% declared their content. Conclusions. More than a quarter of the beverages and packaged foods in the Peruvian market did not provide nutritional information of any kind, and of those that did, only one did so in different formats and units. In addition, we found that a proportion of beverages and foods for each type of octagon did not declare information of the nutrient that is mentioned in the octagon.

Labeling of medications in anesthesia: colors and letters that save lives

Medication errors are the cause of severe lesions and complications, particularly with regards to injectable medications. During anesthesia, several drugs are administered simultaneously and quite easily the wrong medication may be administered, leading to morbidity and mortality. Different strategies have been devised to reduce error, including the use of color and letters to facilitate the identification of the various medications and improving safety in anesthesia.

Los errores asociados a la administración de medicamentos son una causa de graves lesiones y complicaciones sobre todo con los medicamentos inyectables. En un acto anestésico se administran distintos medicamentos y de manera simultánea, en el que fácilmente se puede administrar un medicamento errado causando morbilidad y mortalidad. Se han establecido diferentes estrategias para disminuir el error, entre estas el uso de colores y letras para facilitar su identificación y mejorar la seguridad en anestesia.

Azul de metileno, opción para la marcación de cáncer colorrectal pre procedimiento mínimamente invasivo. Reporte de caso

El cáncer colorrectal es una patología común que causa aproximadamente 861,000 muertes al año. Se presenta el caso de un paciente masculino de 50 años, con hipertensión arterial y Diabetes mellitus tipo II, con diagnóstico de neoplasia en colon descendente, al cual se le realizó procedimiento mínimamente invasivo, posterior a marcación tumoral con azul de metileno por medio de endoscopia de vías digestiva bajas. Postoperatorio adecuado, sin complicaciones. El tratamiento de elección para el cáncer colorrectal sin metástasis es la exeresis oncológica. Actualmente, el manejo quirúrgico recomendado es por medio de procedimiento mínimamente invasivo, sin embargo, es un desafío puesto que en algunos casos la identificación de la lesión es difícil y adicionalmente requiere una curva de aprendizaje pronunciada. Por lo anterior, utilizamos el azul de metileno para la marcación del tumor previo procedimiento, con excelentes resultados, sin complicaciones. La marcación tumoral con azul de metileno previa al procedimiento mínimamente invasivo es seguro, útil, económico y de bajo riesgo.

Colorectal cancer is a common pathology, causing approximately 861,000 deaths a year. The case a 50-year-old male patient, with arterial hypertension and type II diabetes mellitus, with a diagnosis of neoplasia in the descending colon, which was performed minimally invasive procedure, after tumor marking with methylene blue by means of endoscopy of lower digestive tracts. Adequate postoperative period, without complications. The treatment of choice for colorectal cancer without metastasis is oncological exeresis. Currently the recommended surgical management is by means of a minimally invasive procedure, however, it is a challenge since in some cases the identification of the lesion is difficult and additionally requires a pronounced learning curve. Therefore, we use methylene blue for the marking of the tumor after the procedure, with excellent results, without complications. Methylene blue tumor marking prior to the minimally invasive procedure is safe, useful, inexpensive, and low risk.

Avaliação da rotulagem de cosméticos clareadores de pele comercializados em Juazeiro, Bahia, Brasil / Evaluation of the labeling of skin lightening cosmetics marketed in Juazeiro, Bahia, Brazil

A hiperpigmentação da pele, principalmente na região facial, resulta em um incômodo estético que afeta a qualidade de vida do indivíduo, levando a busca por produtos clareadores. Este estudo avaliou a conformidade dos rótulos de cosméticos comercializados como "produtos clareadores de pele", bem como a existência de substâncias clareadoras proibidas neste tipo de produto. Foi realizada uma análise transversal descritiva qualitativa no período de abril a maio de 2022, em busca por cosméticos comercializados em estabelecimentos farmacêuticos e lojas de produtos cosméticos localizadas no município de Juazeiro/BA. Foram selecionados 18 produtos e os desvios de rotulagem identificados com base na legislação utilizada vigente à época do estudo, foram: ausência de informações sobre advertências/restrições de uso e número de registro incompleto, equivalente a 16,7% (n = 3) das amostras. A hidroquinona, proibida nesse tipo de produto, foi encontrada em um cosmético (5,5%). Embora a maioria das amostras analisadas esteja em conformidade com as exigências legais, os resultados evidenciam descumprimentos, indicando a necessidade de uma fiscalização mais rigorosa a fim de evitar possíveis danos à saúde do usuário.

Skin hyperpigmentation, particularly in the facial region, can be an aesthetic nuisance that affects an individual's quality of life, leading them to seek out whitening products. This study evaluated the compliance of cosmetics labels marketed as "skin lightening products", and assessed the presence of whitening substances prohibited in this type of product. A qualitative, descriptive, cross-sectional analysis was conducted between April and May 2022 in Juazeiro, Bahia, Brazil, focusing on cosmetics sold in pharmaceutical establishments and cosmetic product stores. Eighteen products were selected, and labeling deviations identified based on the legislation in force at the time of the study. These included a lack of information on warnings/use restrictions and incomplete registration numbers, affecting 16.7% (n = 3) of the samples. Hydroquinone, prohibited in this type of product by the legislation, was detected in one cosmetic (5.5%). Although most of the analyzed samples comply with legal requirements, the observed non-compliance highlights the need for more stringent inspection to prevent potential harm to user's health.

Analysis of labeling infant's formulas to children allergic to the protein in cow's milk / Análise da rotulagem de fórmulas infantis para lactentes com alergia a proteína do leite de vaca

Introduction: breastfeeding is the most effective way to feed the child in the first six months of life exclusively and up to two years as a complementary form, as it provides a healthy development. However, in some situations it is impossible among them in children with food allergies such as Cow's Milk Protein Allergy (APLV). This condition can be defined as an adverse reaction of the immune system, caused by antigens present in the food that triggers the allergy.Objective: analyze the information on the labeling of infant formulas for infants with allergies to cow's milk protein (APLV), sold in pharmacies in Sobral/CE.Methods: cross-sectional, exploratory, quantitative and qualitative study. After data collection, the labels were analyzed based on a check list composed by the current legislation in accordance with RDC 45/2011, measuring the number of adjustments and inadequacies.Results: of the seven formulas analyzed, five were 100% adequate, when considering all the provisions that made up the check list. Of these were FAB-1 B, FAB-1 C, FAB-1 E, FAB-1 F, FAB-2 A, they were all in accordance with the dimensions established by RDC 45/2011, it is already in relation to formulas with inadequacy we observed that FAB-1 A was 2.22% in dimension two in which the micronutrient riboflavin was above the recommended range and FAB-1 D was 2.22% in dimension two, the carbohydrate macronutrient above the recommended range. In view of this, what we observed was that most of the formulas analyzed were within the labeling standards specified in Resolution RDC 45/2011, despite the many regulatory standards that govern the labeling and marketing of infant foods, it was realized that there is still a need for regulation stricter in this regard so that the legislation is fully complied with.Conclusion: according to what was evaluated about formulas for infants with APLV in relation to the labeling standards of the current legislation, some inadequacies were found. Therefore, this study showed a greater number of non-conformities in relation to the essential characteristics of composition and quality, despite the many regulatory standards that govern the labeling and marketing of infant foods, it is clear that they are still not fully complied with. It was found that we still need to evolve in the Elaboration, execution and inspection of the labels of formulas for infants with Allergy to Cow's Milk Protein (APLV), in order to minimize these non-conformities and offer the best food within the recommended standard, however these studies are necessary in order to better show and discuss the legislation referring to these products.

Introdução: a amamentação é a forma mais eficaz de alimentar a criança nos primeiros seis meses de vida exclusivamente e até os dois anos como forma complementar, pois proporciona um desenvolvimento saudável. No entanto, em algumas situações, é impossível entre eles em crianças com alergia alimentar, como a alergia à proteína do leite de vaca (APLV). Essa condição pode ser definida como uma reação adversa do sistema imunológico, causada por antígenos presentes nos alimentos que desencadeiam a alergia.Objetivo: analisar as informações sobre a rotulagem de fórmulas infantis para lactentes com alergia à proteína do leite de vaca (APLV), comercializadas em farmácias de Sobral/CE.Método: estudo transversal, exploratório, quantitativo e qualitativo. Após a coleta de dados, os rótulos foram analisados com base em um check list composto pela legislação vigente de acordo com a RDC 45/2011, mensurando o número de adequações e inadequações.Resultados: das sete fórmulas analisadas, cinco foram 100% adequadas, quando consideradas todas as disposições que compunham o check list. Destes eram FAB -1 B, FAB -1 C, FAB -1 E, FAB -1 F, FAB -2 A, todos estavam de acordo com as dimensões estabelecidas pela RDC 45/2011, já está em relação às fórmulas com inadequação observamos que FAB-1 A foi de 2,22% na dimensão dois em que a micronutriente riboflavina estava acima da faixa recomendada e FAB-1 D foi de 2,22% na dimensão dois, o macronutriente carboidrato acima da faixa recomendada. Diante disso, o que observamos foi que a maioria das fórmulas analisadas estava dentro dos padrões de rotulagem especificados na Resolução, apesar das inúmeras normas regulamentadoras que regem a rotulagem e comercialização de alimentos infantis, percebeu-se que ainda existe necessidade de regulamentação mais rigorosa nesse sentido, para que a legislação seja integralmente cumprida.Conclusão: de acordo com o que foi avaliado sobre as fórmulas para lactentes com APLV em relação aos padrões de rotulagem da legislação vigente foram encontradas algumas inadequações. Portanto esse estudo apresentou maior número de inconformidades em relação as características essênciais de composição e qualidade, apesar das muitas normas regulamentadoras que regem a rotulagem e comercialização de alimentos infantis, percebe-se que ainda não são totalmente cumpridas. Verificou-se que ainda precisamos evoluir na Elaboração, execussão e fiscalização dos rótulos das fórmulas para lactentes com Alergia a Proteína do Leite de Vaca (APLV), a fim de minimizar essas não conformidades e ofererer o melhor alimento dentro do padrão preconizado, no entanto faz-se necessários estes estudos a fim de mostrar e discutir melhor as legislações referentes a esses produtos.

Prevalencia y factores asociados a la revisión del etiquetado nutricional por adultos en el Perú

Introducción: La ausencia o poca revisión del etiquetado nutricional es muy frecuente, y estas brindan información sobre la calidad de los alimentos que se van a adquirir y consumir. Objetivo: Determinar la prevalencia de la frecuente revisión del etiquetado nutricional (REN) y sus factores asociados. Métodos: Estudio transversal analítico que evalúa los datos de la Vigilancia Alimentaria Nutricional por Etapas de Vida (VIANEV) de 2017-2018. La REN se consideró frecuente cuando el adulto leyó siempre o casi siempre la tabla de nutrientes de productos que adquiere y/o consume. Se hicieron estimaciones y análisis bivariados, se determinaron factores asociados empleando un modelo lineal generalizado de familia Poisson con enlace log bajo imputación múltiple. Resultados: Se encontró que el 62,4% no revisa el etiquetado del contenido nutricional. Solo 14,9% de los adultos lo hace frecuentemente. Para el modelo crudo, la educación superior se asoció con mayor prevalencia de REN (RP=10,79; IC95%: 1,49-78,16); y una menor prevalencia en el área rural (RP=0,47; IC95%: 0,31-0,73) y tener al menos una Necesidad Básica Insatisfecha (RP=0,56; IC95%: 0,33-0 ,98). En el modelo ajustado se encontró asociación para divorciados (RP: 4,24; IC95%: 1,91 a 9,41), convivientes (RP: 1,61; IC95%: 1,04 a 2,47) y quienes consumían 5 a más porciones de fruta o verduras al día (RP: 1,77; IC95%: 1,28 a 2,44). Conclusiones: La revisión de etiquetas nutricionales no es un comportamiento usual en adultos, y su realización se asoció en los divorciados, convivientes y con los que consumen 5 a más porciones de frutas y verduras.

Introduction: The absence or little review of nutritional labeling is very frequent, and these provide information on the quality of the food that is going to be acquired and consumed. Objective: To determine the prevalence of the frequent review of nutritional labeling (REN) and its associated factors. Methods: Analytical cross-sectional study that evaluates the data from the Nutritional Food Surveillance by Life Stages (VIANEV) from 2017-2018. REN was considered frequent when the adult always or almost always read the table of nutrients of the products they purchase and/or consume. Estimates and bivariate analyzes were made, associated factors were determined using a generalized linear model of the Poisson family with log link under multiple imputation. Results: It was found that 62,4% do not review the nutritional content labeling. Only 14,9% of adults do so frequently. For the crude model, higher education was associated with a higher prevalence of REN (PR=10,79; 95%CI: 1,49-78,16); and a lowerprevalence in rural areas (PR=0,47; 95%CI: 0,31-0,73) and having at least one Unsatisfied Basic Need (PR=0,56; 95%CI: 0,33-0,98). In the adjusted model, an association was found for divorcees (PR=4,24; 95%CI: 1,91-9,41), cohabiting (PR=1,61; 95%CI: 1,04-2,47) and those who consumed 5 or more servings of fruit or vegetables per day (PR=1,77; 95%CI: 1,28-2,44). Conclusions: The review of nutritional labels is not a usual behavior in adults, and its performance was associated with divorced people, cohabitants and with those who consume 5 or more servings of fruits and vegetables.

Polyinosinic-polycytidylic acid affecting the expressions of Bcl-2 and Bax after cerebral ischemia-reperfusion in hyperlipidemic rats and its neuroprotective effect / 解剖学报

Objective To observe the effect of polyinosinic-polycytidylic acid ( Poly-IC ) treatment on the expressions of Bcl-2 and Bax after cerebral ischemia-reperfusion ( I / R ) injury in fryperlipidemia rats, and to detect the cerebral infarction, blood-brain barrier permeability and behavioral injury symptoms, to explore the neuroprotective effect of Poly-IC treatment on cerebral I /R injury in fryperlipidemia rats. Methods Hyperlipidemia rats were randomly divided into cerebral I /R group, Poly-IC pretreatment group, Poly-IC post-treatment group and sham operation group, 20 rats in each group. Neurobehavioral performance of rats in each group was recorded according to neurobehavioral score of 0-4 points. Blood-brain barrier permeability of rats in each group was detected by Evans blue staining. TTC staining was used to observe the cerebral infarction in each group. Apoptotic cells in the cerebral cortex of rats in each group was observed by TUNEL staining. The relative expression levels of Bcl-2 and Bax were determined by Western blotting. Results Compared with the sham group, the symptoms of neurobehavioral damage in the I/R group were serious and the score increased significantly (P<0. 05). The scores of Poly-IC pretreatment and post-treatment groups were significantly lower than that of I/R group (P<0. 05). Evans blue staining result showed that the blood-brain barrier permeability of the I/R group was significantly higher than that of the sham group (P<0. 05) , and Poly-IC pretreatment or post-treatment could significantly reduce the blood-brain barrier permeability ( P < 0. 05 ) . No infarct was observed in the sham group with uniform red staining, while white infarct was observed in the brain tissue of the I/R group. Compared with the I/R group, the volume of infarct in both Poly-IC pretreatment and post-treatment groups reduced significantly (P<0. 05). The apoptosis index in cerebral cortex of rats in I/R group was significantly higher than that in sham group ( P < 0 .05 ) , while the apoptosis index in Poly-IC pretreatment or post-treatment group was significantly lower than that in I/R group(P<0. 05 ) . The result of Western blotting showed that, compared with the sham group, the expression of Bax in the I/R group was significantly increased(P<0. 05) , the expression of Bcl-2 was significantly decreased(P<0. 05). Compared with the I/R group, the expression of Bax in the Poly-IC pretreatment or post-treatment group reduced significantly ( P < 0. 05 ) , the expression of Bcl-2 increased significantly(P<0. 05). Conclusion Poly-IC pretreatment or post-treatment can improve the symptoms of neurobehavioral injury, reduce the damage of blood-brain barrier, reduce the volume of cerebral infarction, decrease the apoptosis index of nerve cells, play a neuroprotective effect on cerebral ischemia reperfusion injury in rats with hyperlipidemia, and this protective effect may be related to the change of Bcl-2 and Bax expression levels.

Preparation and Biodistribution of 131I-labeled Hepatoma Nucleic Acid Nanotrain / 中山大学学报(医学科学版)

ObjectiveTo construct 131Ⅰ-labeled hepatoma nucleic acid nanotrain and to explore its feasibility as a new nuclide carrier targeting hepatoma. MethodsThree short nucleic acid chains self-assembled to a long nucleic acid chain after being annealed， and 131Ⅰ-NT was obtained by radioiodine labeling using chloramine T method. The labeling efficiency and radiochemical purity of the nanoparticles were measured by paper chromatography. The stability of the labeled products in vitro at different temperatures and different storage solvents was detected. The specific uptake of nanoparticles by hepatocellular carcinoma cells was observed by laser confocal microscopy， and the radioactive uptake ratio of 131Ⅰ-NT combined with human hepatocellular carcinoma cell HepG2 and normal hepatocyte L02 was measured. The biodistribution of 131Ⅰ-NT was obtained through injecting 131Ⅰ-NT into HepG2 tumor-bearing mice via tail vein. ResultsThe labeling rate of 131Ⅰ-NT was （93.05±0.74） %， and the radiochemical purity post purification was （98.35±0.32） %. Its radiochemical purity in PBS and pure serum at 4℃ for 24 h was （92.77±0.04） % and （89.43±0.2） %， respectively. The radioactivity uptake rate of HepG2 cells was higher than that of L02 cells after 131Ⅰ-NT was incubated with two kinds of cells for 2 h significantly. After injection of 131Ⅰ-NT through tail vein， the radioactive uptake per gram of tumor tissue were （4.9±0.55）%ID/g， （10.12±0.32）%ID/g and （4.25±0.31）%ID/g at 30 min， 1 h and 2 h， respectively. The T/M ratio was 7.33±2.04， 36.54±12.72 and 44.93±7.90 respectively. ConclusionsThe 131Ⅰ-labeled long chain nucleic acid nanotrain was constructed successfully， which possesses relatively high stability in vitro ， and high targeting ability to HepG2 cells in vitro and HepG2 tumor-bearing mouse model. Our study demonstrated that 131Ⅰ-NT may be a potential radionuclide carrier targeting human liver cancer， which provides a new idea for the targeted radionuclide diagnosis and treatment of hepatocellular carcinoma.

Influence of bronchopulmonary dysplasia on cerebral blood flow in preterm infants: a prospective study based on arterial spin labeling / 中国当代儿科杂志

OBJECTIVES@#To investigate local cerebral blood perfusion in preterm infants with bronchopulmonary dysplasia (BPD) based on cerebral blood flow (CBF) values of arterial spin labeling (ASL).@*METHODS@#A prospective study was conducted on 90 preterm infants with a gestational age of <32 weeks and a birth weight of <1 500 g who were born in the Department of Obstetrics and admitted to the Department of Neonatology in the Third Affiliated Hospital of Zhengzhou University from August 2021 to June 2022. All of the infants underwent cranial MRI and ASL at the corrected gestational age of 35-40 weeks. According to the presence or absence of BPD, they were divided into a BPD group with 45 infants and a non-BPD group with 45 infants. The two groups were compared in terms of the CBF values of the same regions of interest (frontal lobe, temporal lobe, parietal lobe, occipital lobe, thalamus, and basal ganglia) on ASL image.@*RESULTS@#Compared with the non-BPD group, the BPD group had a significantly lower 1-minute Apgar score, a significantly longer duration of assisted ventilation, and a significantly higher incidence rate of fetal distress (P<0.05). After control for the confounding factors such as corrected age and age at the time of cranial MRI by multiple linear regression analysis, compared with the non-BPD group, the BPD group still had higher CBF values of the frontal lobe, temporal lobe, parietal lobe, occipital lobe, basal ganglia, and thalamus at both sides (P<0.05).@*CONCLUSIONS@#BPD can increase cerebral blood perfusion in preterm infants, which might be associated with hypoxia and a long duration of assisted ventilation in the early stage.

Causes of False-Positive Results in 68Ga-Labeled Fibroblast Activation Protein Inhibitor PET/CT Imaging / 中国医学科学院学报

Objective To investigate the causes of false-positive results in the 68Ga-labeled fibroblast activation protein inhibitor (68Ga-FAPI-04) PET/CT imaging. Methods The imaging data of 547 patients undergoing 68Ga-FAPI-04 PET/CT examination in the Department of Nuclear Medicine of the Affiliated Hospital of Southwest Medical University from September 2020 to May 2021 were retrospectively collected.Two experienced nuclear medicine diagnostic physicians analyzed the clinical data,relevant imaging examinations,laboratory examinations,pathological results and follow-up results of the patients with false-positive results. Results The 68Ga-FAPI-04 PET/CT imaging of 547 patients showed false-positive results in 99 (18.1%) patients,including 56 males and 43 females.The postoperative pathological examination confirmed false-positive results in 13 patients,including 1 patient of thyroiditis,2 patients of pulmonary tuberculosis,1 patient of bone tuberculosis,2 patients of pulmonary inflammatory pseudotumor,1 patient of pulmonary sarcoidosis,1 patient of pulmonary benign fibroma,1 patient of organic pneumonia,2 patients of renal angiomyolipoma,1 patient of mass pancreatitis,and 1 patient of pancreatic mucinous cystadenoma.The medical history,relevant imaging examination,and long-term follow-up confirmed false-positive results in 86 patients.Specifically,the false-positive uptake in the neck,chest,abdomen,bone joint,and skin occurred in 8 (9.3%),13 (15.1%),5 (5.8%),57 (66.3%),and 3 (3.5%) patients,respectively.Inflammation-related uptake appeared in 83 (83.8%) patients with false-positive imaging results,of which arthritis (23 patients) and osteophyte (29 patients) were the most common.Sixteen (16.2%) patients showed the false-positive uptake related to fibroblasts. Conclusion 68Ga-FAPI-04 PET/CT imaging will show non-malignant tumor false-positive results,which are mainly associated with inflammation and fibroblasts.

Case Report: Arterial Spin Labeling Perfusion MRI Contribution for Clinical Implementation of Brain Disease

@#Currently, ASL is widely used as an additional breakthrough sequence in MRI due to acquiring reliable results. The case report aims to prove the efficacy and effectiveness of a quantitative method of ASL sequence through the calculation of the cerebral blood flow (CBF) on CBF maps in different cases. ASL sequence has been done on four patients with different cases. Then, the authors put 2 regions of interest (ROI) for measurement in normal and different regions on CBF maps and then calculated the average value result from CBF maps. ASL has been proven as a reliable and breakthrough sequence in MRI for detecting brain disease with a non-invasive method through the calculation of CBF value. ASL should be used as an additional protocol in brain examinations because it allows radiologists to assess the significance of CBF values using a quantitative method that is more reliable and non-invasiv

Distribution features of resident CD8 + T cells in human esophageal cancer tissues and its effects on the prognosis / 中华消化杂志

Objective:To explore the distribution features of resident CD8 + T cells infiltration in human esophageal cancer tissues and its clinical significance. Methods:Data from the Cancer Genome Atlas database were retrieved, the correlation between CD103 + CD8 + T cells and infiltration degree of conventional type 1 dendritic cell (cDC1), conventional type 2 dendritic cell (cDC2), type 3 dendritic cell(DC3) was investigated. From January 2006 to December 2008, 78 esophageal cancer tissues and 75 adjacent normal tissues from 78 esophageal cancer patients were collected by Shanghai Outdo Biotechnology Co., Ltd, the clinical data of patients was followed up by telephone until July 2015. The distribution of CD8 + T cells and CD103 + CD8 + T cells in cancer tissues and adjacent normal tissues was detected by multi-color labeling techniques and multispectral tissue imaging. The differences of the number and the ratio of CD8 + T cells and CD103 + CD8 + T cells in cancer tissues and adjacent normal tissues were compared. The Kaplan-Meier survival curves of patients with tissue infiltration of CD8 + T cells and CD103 + CD8 + T cells at different levels were drawn through the R language " survminer" package, and the best cut-off value was obtained. TNM stage, pathological stage and other clinical parameters of patients with high and low infiltration of CD8 + T cells, CD103 + CD8 + T cells were compared. Wilcoxon rank sum test, chi-square test, log-rank test and Cox proportional risk regression model statistical analysis were used to evaluate the prognostic value of the above indicators. Spearman correlation analysis was used for correlation analysis. Results:In the cancer tissues of patients with esophageal cancer, the infiltration degree of CD103 + CD8 + T cells was positively correlated with the infiltration degree of cDC1 cells, cDC2 cells and DC3 cells ( r=0.67, 0.53 and 0.47, all P<0.001). The percentage of CD8 + T cells in all cells in the whole tissue core of tumor tissues (63.09% (42.14%, 76.21%)) was higher than that of adjacent normal tissues (2.56% (1.68%, 5.38%)), and the difference was statistically significant ( U=41.00, P<0.001). The proportion of CD103 + CD8 + T cells in all cells in the whole tissue core of tumor tissues (7.92% (1.60%, 20.61%)) was higher than that of adjacent normal tissues (0.04% (0.01%, 0.10%)), and the difference was statistically significant ( U=857.50, P<0.001). The percentage of high CD8 + T cells infiltration in esophageal cancer tissues of patients with pathological stage Ⅰ+ Ⅱ was lower than that of patients with stage Ⅲ+ Ⅳ (57.9%, 33/57 vs. 85.7%, 18/21); the percentage of high CD103 + CD8 + T cells in CD8 + T cells in esophageal cancer tissues of patients with TNM stage Ⅰ+ Ⅱ was lower than that of patients with stage Ⅲ+ Ⅳ (21.6%, 8/37 vs. 48.8%, 20/41), and the differences were both statistically significant ( χ2=5.25 and 6.23, P=0.022 and 0.013). The results of Kaplan-Meier survival analysis and univariate Cox proportional risk regression model showed that the overall survival (OS) of patients with high CD8 + T cell infiltration was longer than that of patients with low CD8 + T cell infiltration ( HR=0.57, 95% confidence interval (95% CI) 0.34 to 0.96, P=0.034). There was no significant difference in OS between patients with high CD103 + CD8 + T cell infiltration and patients with low CD103 + CD8 + T cell infiltration ( HR=0.66, 95% CI 0.40 to 1.08, P>0.05). Conclusion:The high infiltration of CD103 + CD8 + T cells in esophageal cancer tissues are expected to be used as a prognostic predictor for patients with esophageal cancer, which is an important component of anti-tumor immune response in tumor microenvironment of esophageal cancer.

Application value of endoscopic Nd-Fe-B magnet ring tracer technique to laparoscopy for colorectal lesions (with video) / 中华消化内镜杂志

Objective:To explore the clinical application value of preoperative colonoscopic marking by Nd-Fe-B magnet ring to assist laparoscopy.Methods:A total of 51 patients with colorectal tumor who underwent radical laparoscopy from January 2020 to October 2021 at the Department of Gastrointestinal Surgery, Guizhou Provincial People's Hospital were recruited. The patients were marked by Nd-Fe-B magnet ring under endoscopy one day before the operation, another magnet ring was sent into the abdominal cavity during the radical laparoscopy through cannula. The two magnet rings were attracted and clung to each other to orient the lesions. The basic information of patients, location of preoperative marks under endoscopy and laparoscopy conditions were recorded.Results:All 51 Nd-Fe-B magnet rings were successfully located to the position of colorectal tumor and fixed. According to the location of the lesions, there were 15 cases of transverse colon, 12 cases of descending colon, 19 cases of sigmoid colon, and 5 cases of upper rectal segment. According to the lesion type, there were 21 cases of colon cancer, 25 cases of polyp carcinomatosis, and 5 cases of laterally spreading tumors with partial carcinomatosis. There were 5 cases with positive margins after endoscopic mucosal resection and 1 case with positive margin after endoscopic submucosal dissection. All lesions were accurately located during the operation. The marking time was 4.1±1.2 min (3-6 min) before the operation and the localization time was 1.5±1.1 min (0.9-5.3 min) during the operation. All magnet rings were removed from the body by laparoscope. The mean distances between the tumor and the cutting edge of the proximal and distal intestinal segments were 5.5 cm and 6.3 cm, respectively. No complications such as colon mucosal injury, bleeding, intestinal perforation or local inflammatory reactions occurred.Conclusion:Nd-Fe-B magnet ring tracer technique for laparoscopic orientation is simple, fast, accurate and safe with no need for additional equipment or apparatus, which is worthy of clinical application.

Automatic radiolabeling of the norepinephrine transporter targeted tracer 18F-mFBG and evaluation of 18F-mFBG PET/CT imaging in pheochromocytoma / 中华核医学与分子影像杂志

Objective:To fulfill the automatic radiolabeling of the norepinephrine transporter (NET) trancer 18F-meta-fluorobenzylguanidine (mFBG), and explore the 18F-mFBG PET/CT imaging effect of pheochromocytoma. Methods:On the basis of the chemical structure of mFBG, a spirocyclic iodonium ylide was used as the precursor to undergo a 3-step reaction sequence (radiofluorination, deprotection and neutralization) on AllinOne synthesis module. Purification by high performance liquid chromatography and formulation were conducted to generate 18F-mFBG. The corresponding quality control tests of 18F-mFBG product was performed. Afterwards, a postoperative patient with pheochromocytoma underwent 18F-mFBG PET/CT imaging. Results:The radiosynthesis was accomplished within 70 min, and 18F-mFBG was obtained in (17.8±2.4)% non-decay-corrected radiochemical yield ( n=5), with radiochemical purity >97% and molar activity >59.2 GBq/μmol. Sterility test, bacterial endotoxins test, abnormal toxicity test and the acetonitrile residue all met the requirements of Pharmacopoeia of the People′ s Republic of China (2020 Volume Ⅳ). The 18F-mFBG PET/CT imaging disclosed high uptake in pheochromocytoma and clear localization of lesions. Conclusions:The automatic radiolabeling of the NET targeted tracer 18F-mFBG is successfully realized by commercially available synthesis module, and the production quality meets all requirements for clinical translation. 18F-mFBG has a potential to image neuroendocrine lesions in clinical setting.

68Ga production with cyclotron solid target and automated synthesis of 68Ga labeled drugs / 中华核医学与分子影像杂志

Objective:To produce 68Ga and automatically synthesize 68Ga-labeled drugs based on low-energy medical cyclotron solid target system. Methods:68Zn was electroplated on the surface of the target by electrodeposition. According to the principle of 68Zn(p, n) 68Ga nuclear reaction, 68Zn was irradiated by the 10 MeV medical cyclotron solid target system (30 μA, 30 min) to produce 68Ga, and the activity, nuclear purity, half-life and content of metal impurities of purified product were determined. 68Ga-prostate specific membrane antigen (PSMA)-11 and 68Ga-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) were synthesized automatically using 68Ga respectively, and the quality control analyses of drug properties, concentration, pH, radiochemical purity, sterility and bacterial endotoxin were carried out. Results:The electroplating mass of 68Zn was (43.71±0.87) mg ( n=35), the yield of 68Ga after irradiation was (10.96±0.67) GBq ( n=35), and the measured half-life was (67.64±0.06) min ( n=7). Only 511 keV energy peak was detected by the gamma spectrometer. After purification, (6.85±0.12) GBq ( n=35) of pure 68Ga was obtained, and the purification efficiency was (62.46±0.96)% (non-attenuated correction, n=35). The metal impurity contents of Zn and Fe were (0.18±0.06) and (1.25±0.43) μg/GBq ( n=5), which met the requirements of European Pharmacopoeia. Three batches of 68Ga-PSMA-11 and 68Ga-DOTATATE were automatically synthesized, with the yield, concentration and radiochemical purity of (3.54±0.14) and (2.74±0.20) GBq, (294.97±11.58) and (228.17±16.32) GBq/L, (99.73±0.11)% and (99.45±0.25)%, respectively. Both sterility and bacterial endotoxin were qualified. Conclusion:High-yield and qualified nuclide 68Ga and 68Ga-labeled drugs are successfully prepared through the low-energy medical cyclotron solid target system and the automated purification and synthesis module, which provide a strong guarantee for clinical practice.