Especialización de enfermería en anestesiología y reanimación como necesidad formativa en Cuba / Nursing specialization in anesthesiology and resuscitation as a training need in Cuba

Introducción: Las especialidades de posgrado constituyen la formación académica que le proporciona al profesional la actualización, profundización, perfeccionamiento o ampliación de las competencias laborales para el desempeño asistencial que requiere. Objetivo: Explorar la percepción de los enfermeros certificados para la práctica de la anestesiología sobre la necesidad de la formación de enfermeros especialistas en anestesiología y reanimación. Métodos: Se realizó un estudio cualitativo, de tipo Investigación Convergente Asistencial en el Departamento de Docencia e Investigación del Hospital Provincial Pediátrico Universitario de Villa Clara, Cuba, entre los meses de enero y marzo del año 2022. El universo estuvo compuesto por 100 profesionales de enfermería certificados en anestesiología, y la muestra seleccionada a través de un muestreo teórico quedó constituida por 80. Se realizaron entrevistas informales y ocho grupos de discusión en el proceso investigativo. Resultados: Los participantes perciben como necesaria la formación de enfermeros especialistas en anestesiología, reanimación y alivio del dolor. Las estrategias para lograr esta formación deben estar dirigidas a su aprobación por parte de las instancias de posgrado del Ministerio de Salud Pública y el Ministerio de Educación Superior. Conclusiones: Perciben como perentorio la formación de enfermeros especialistas en anestesiología y reanimación, ya que permitirá garantizar la adecuada renovación de este recurso humano, contar con enfermeras capacitadas y capaces de brindar atención anestesiológica óptima, alcanzar un nivel profesional superior que los coloque paralelos a otras áreas del cuidado y formar recursos humanos más jóvenes que tengan un nivel de preparación superior en esta especialidad.

Introduction: Postgraduate specialties constitute the academic training that provides the professional with the updating, deepening, improvement or expansion of labor competencies for the care performance that is required. Objective: to explore the perception of certified nurses for the practice of anesthesiology on the need to train specialist nurses in anesthesiology and resuscitation. Methods: A qualitative study of the Convergent Care Research type was carried out in the Teaching and Research Department of The Provincial Pediatric University Hospital of Villa Clara, Cuba between the months of January and March of the year 2022. The universe was composed of 100 nursing professionals. certificates in anesthesiology and the sample selected through a proven theory was made up of 80. Informal interviews and discussion groups were conducted as instruments in the investigative process. Results: the participants will perceive as necessary the training of specialist nurses in anesthesiology, resuscitation and pain relief. The strategies to achieve this training must be directed to its approval by the postgraduate instances of the Ministry of Public Health and the Ministry of Higher Education. Conclusions: the training of nurses specialized in anesthesiology and resuscitation is imperative, as it will guarantee the adequate renewal of this human resource, have trained nurses capable of providing optimal anesthesiological care, reach a higher professional level than place them parallel to other areas. of care and train younger human resources that have a higher level of preparation in this specialty.

Clinical features and genetic biomarkers associated with different phenotypes of systemic lupus erythematosus in Paraguayan patients.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by a heterogeneous clinical picture that makes the diagnosis and follow-up of these patients difficult. This study aimed to identify correlations between clinical, immunological, and genetic biomarkers and clinical manifestations in SLE. A retrospective study of data from medical records and immunological and genetic studies of SLE patients in Paraguay was carried out. A descriptive analysis was performed based on the type of variable. Human leukocyte antigen (HLA) allele frequencies (DPA1, DPB1, DQA1, DQB1, and DRB1) were calculated, and univariate logistic regression analyses were performed between each of the explanatory variables and the presence or absence of each phenotype. Odds ratios, 95% confidence intervals, and p values were recorded. Associations with p<0.05 were considered statistically significant. 104 SLE patients were included: 86% were female, with a mean age of 32.80±10.36 years. An association was identified between anti-double stranded DNA (anti-dsDNA) and the presence of the renal phenotype and between anti-dsDNA and the absence of the joint and hematological phenotypes. Immunoglobulin M isotype rheumatoid factor was associated with the absence of a renal phenotype. HLA-DQB1*02:02 and HLA-DRB1*07:01 were associated with the cutaneous phenotype. An association was identified between age at disease onset over 30 years and the presence of the joint phenotype. No other associations were identified. Potential clinical, immunological, and genetic biomarkers of phenotypes have been identified in SLE Paraguayan patients.

Estrategia formativa para perfeccionar el autocuidado en pacientes con fractura de cadera / Training strategy to improve self-care in patients with hip fracture

Introducción: Los medios de enseñanzas son los ejes vertebrales de gran parte de las acciones de enseñanzas y aprendizaje desarrolladas en cualquiera de los niveles o modalidades de la educación. Objetivos: Sistematizar y resaltar los fundamentos y ventajas de la guía de autoayuda sobre la fractura de cadera en el adulto mayor, como medio de enseñanza en la superación profesional del médico de la atención primaria. Métodos: Analítico ­ sintético, hipotético ­ deductivo, análisis documental y la entrevista. Resultados: Se elaboró una guía de autoayuda sobre fractura de cadera en el adulto mayor, a partir de falencias detectadas en la atención primaria de salud, que limitan el desempeño de los médicos de este nivel en actividades de promoción de salud en este grupo social. La guía de autoayuda fue diseñada y estructurada, como medio de enseñanza de estrategias de superación profesional, determinando las particularidades del contenido que se desea enseñar y las que se necesitan aprender por estos profesionales, para mejorar su desempeño en la promoción de salud en relación con el adulto mayor con fractura de cadera. Su creación fue concebida como elemento dinamizador del contenido unido a los demás componentes del proceso en busca de lograr los objetivos propuestos. Conclusiones: Se presenta una guía de la colección de autoayuda sobre fractura de cadera en el adulto mayor, diseñado, pensado y elaborado como medio de enseñanza a utilizar en la superación profesional del médico de la atención primaria de salud donde se resaltan los fundamentos teóricos que lo sustentan.

Introduction: Teaching media are the backbone of a large part of the teaching and learning actions developed at every educational level or modality. Objectives: To systematize and highlight the rationale and advantages of the self-help guide for hip fracture in the elderly, considered as a teaching tool in the professional improvement of primary health care ( PHC). Methods: Analytical - synthetic, hypothetical - deductive, documentary analysis and interview. Results: A self-help guide for hip fracture in the elderly was developed, based on deficiencies detected on PHC, which limit the performance of doctors at this level in health promotion activities for the mentioned social group. The self-help guide was designed and structured as a means of teaching professional improvement strategies by determining the content particularities to be taught and those to be learned by these professionals, in order to improve their performance in health promotion for the elderly with hip fracture. This self- help guide was conceived as a dynamic element of the content, that relates to the other components of the process in search of achieving the proposed objectives. Conclusions: We present a self-help collection guide for hip fracture in the elderly, designed, conceived, and elaborated as a teaching tool to be used in the professional improvement of the PHC, and we highlight theoretical foundations

Tinnitus prevalence in Europe: a multi-country cross-sectional population study.

BACKGROUND: Tinnitus prevalence studies report large variability across countries that might be due to inconsistent research methods. Our study aimed to report a single Pan-European estimate for tinnitus prevalence and investigate the effect of individual and country-level characteristics on prevalence. We explored the relationships of healthcare resource use and hearing difficulty with tinnitus symptoms. METHODS: Between 2017-2018, a cross-sectional European Tinnitus Survey (ETS) was conducted in 12 European Union nations (Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania, and Spain), using a standardised set of tinnitus-related questions and response options in country-specific languages. We recruited 11,427 adults aged ≥18 years. FINDINGS: Prevalence of any tinnitus was 14·7% (14·0% in men and 15·2% in women), ranging from 8·7% in Ireland to 28·3% in Bulgaria. Severe tinnitus was found in 1·2% participants (1·0% in men and 1·4% in women), ranging from 0·6% in Ireland to 4·2% in Romania. Tinnitus prevalence significantly increased with increasing age and worsening of hearing status. Healthcare resource use for tinnitus increased with increasing tinnitus symptom severity. INTERPRETATION: This is the first multinational report of Pan-European tinnitus prevalence using standardised questions. The overall prevalence estimates refine previous findings, although widespread inter-country heterogeneity was noted. The results indicate that more than 1 in 7 adults in the EU have tinnitus. Extrapolating to the overall population, approximately 65 million adults in EU28 have tinnitus, 26 million have bothersome tinnitus and 4 million have severe tinnitus. FUNDING: National Institute for Health Research, European Union's Horizon 2020, Medical Research Council, and GENDER-Net Co-Plus Fund.

Particulate matter in aerosols produced by two last generation electronic cigarettes: a comparison in a real-world environment.

The design of e-cigarettes (e-cigs) is constantly evolving and the latest models can aerosolize using high-power sub-ohm resistance and hence may produce specific particle concentrations. The aim of this study was to evaluate the aerosol characteristics generated by two different types of electronic cigarette in real-world conditions, such as a sitting room or a small office, in number of particles (particles/cm3). We compared the real time and time-integrated measurements of the aerosol generated by the e-cigarette types Just Fog and JUUL. Real time (10s average) number of particles (particles/cm3) in 8 different aerodynamic sizes was measured using an optical particle counter (OPC) model Profiler 212-2. Tests were conducted with and without a Heating, Ventilating Air Conditioning System (HVACS) in operation, in order to evaluate the efficiency of air filtration. During the vaping sessions the OPC recorded quite significant increases in number of particles/cm3. The JUUL e-cig produced significantly lower emissions than Just Fog with and without the HVACS in operation. The study demonstrates the rapid volatility or change from liquid or semi-liquid to gaseous status of the e-cig aerosols, with half-life in the order of a few seconds (min. 4.6, max 23.9), even without the HVACS in operation. The e-cig aerosol generated by the JUUL proved significantly lower than that generated by the Just Fog, but this reduction may not be sufficient to eliminate or consistently reduce the health risk for vulnerable non e-cig users exposed to it.

Nivel de riesgo y dependencia asociados con el consumo de sustancias adictivas en adolescentes de Santa Elena, Ecuador / Level of risk and dependence associated with the consumption of addictive substances in adolescents from Santa Elena, Ecuador

Introducción: el consumo de sustancias adictivas por los adolescentes constituye un creciente problema a nivel mundial. Ecuador tiene los reportes más elevados con respecto a otros países de Sudamérica. Objetivo: determinar el nivel de riesgo y la dependencia asociados con el consumo de sustancias en los adolescentes. Material y métodos: estudio descriptivo, transversal en una muestra no probabilística, intencional de 431 adolescentes de las Unidades Educativas de la Provincia Santa Elena de 2018 al 2020 donde se aplicó la prueba de detección de consumo de alcohol, tabaco y sustancias. Resultados: las sustancias psicotrópicas más utilizada son las bebidas alcohólicas en 60,2 %; existe predominio del inicio de consumo de sustancias entre los 14 y 18 años de edad y el 4.4 % revelan haber presentado inconvenientes en su salud por el consumo de estas sustancias. Conclusión: existe un bajo nivel de percepción del riesgo de los adolescentes en relación al consumo de sustancias lo que señala la necesidad de reforzar el conocimiento del daño potencial que ocasionan en este grupo vulnerable

Introduction: the consumption of addictive substances by adolescents constitutes a growing problem worldwide. Ecuador has the highest reports compared to other countries in South America. Objective: to determine the level of perception of risk of adolescents in relation to the consumption of addictive substances. Material and methods: descriptive, cross-sectional study in a non-probabilistic, intentional sample of 431 adolescents. Results: the most used psychotropic substances are alcoholic beverages in 60.2%. There is a predominance of the onset of substance use between 14 and 18 years of age and 4.4% reveal having presented health problems due to the consumption of these substances. Conclusion: there is a low level of perception of the risk of adolescents in relation to the consumption of substances, which indicates the need to reinforce the knowledge of the potential harm they cause in this vulnerable group.

Prevalence and determinants of early childhood caries in Italy.

AIM: Still limited data from representative surveys are available on the prevalence of Early Childhood Caries (ECC; i.e., the presence of one or more decayed, missing, or filled tooth surfaces in any primary tooth in a child aged 71 months or younger), particularly for infant. We conducted a survey in Italian children aged 0 to 71 months. MATERIALS AND METHODS: A cross-sectional study on ECC was conducted in Italy in 2018 on a sample of parents who were members of an online panel. Using an online questionnaire, 2,522 parents provided information on a total sample of 3,000 children, representative of the Italian population aged 0-71 months. RESULTS: ECC prevalence was 8.2% overall, 2.9% in children aged 0-23 months, 6.2% in children aged 24-47 and 14.7% in children aged 48-71 months (p for trend<0.001). ECC was more frequently observed among children using baby bottle with milk to fall asleep (multivariate odds ratio, OR, 1.36, 95% confidence interval, CI: 1.03-1.78), baby bottle with sugary beverages (OR 2.87, 95% CI: 2.05-4.03) and pacifier with sugary substances (OR 2.49, 95% CI: 1.79-3.47), consuming beverages other than water (OR for ?1/day vs never 2.29, 95% CI: 1.35-3.90), a higher number of snacks between meals (OR for ?3 vs <2 meals 2.05, 95% CI: 1-38-3.06), a lower frequency of tooth brushing (OR for <1 vs ?2 times/day 2.26, 95% CI: 1.42-3.58) and a high number of siblings (compared to 0, OR for ?2 siblings 2.28, 95% CI: 1.56-3.34). ECC increased with parents' mean age (p for trend=0.048), parents' smoking habit (OR for at least one smoker 1.54, 95% CI: 1.17-2.03), parents' poor oral hygiene (OR for ?1 vs >1 time/day of tooth brushing 1.42, 95% CI: 1.03-1.96) and high number of caries (OR for ?7 vs 0 caries was 2.38, 95% CI: 1.35-4.20). CONCLUSION: The present large and representative survey for the first time shows that ECC might be frequent also among infants. We confirm that ECC might be prevented if parents follow simple good practices. Information campaign and intervention programmes are needed to inform parents about unfavourable habits that favour the onset of ECC.

Protección solar en el trabajo asociado a características laborales en trabajadores de Latinoamérica: estudio base / Sun protection at work associated with the job characteristics of Latin America workers: base study

RESUMEN Los efectos nocivos de la radiación solar han sido reportados, pero casi no se ha estudiado la población laboral de Latinoamérica. Este es un estudio transversal analítico realizado en ocho países. Las preguntas sobre protección solar se tomaron de trabajos previos; además, se preguntó por las características laborales; ambos datos se cruzaron para obtener datos estadísticos de asociación. De los 3.222 trabajadores encuestados, el 71% (2270) tenía piel mestiza. Hubo asociación del enrojecimiento de la piel según la cantidad de horas de exposición solar directa (p<0,001) e indirecta (p<0,001). El 47% (995) usaban protector/bloqueador solar, el 54% (1150) usaban ropa adecuada y el 50% (1056) usaban alguna gorra o sombrero; siendo estadísticamente diferente el medio de adquisición de dichos equipos. El 21% (446) no usaba ninguno de los equipos de protección personal ante los efectos del sol. Concluimos que es alarmante el bajo porcentaje de trabajadores que reciben adecuada protección contra los efectos de la radiación solar. Esto podría generar problemas a corto, mediano y largo plazo entre los empleados, lo que podría aumentar la morbi-mortalidad y el riesgo de cáncer de piel.

ABSTRACT The harmful effects of solar radiation have been reported, but the work population in Latin America has hardly been studied. The objective is describe the type of sun protection they use and find associations according to their characteristics in Latin American workers. The methodology isCross-sectional analytical study carried out in 8 countries, the questions of sun protection were taken from previous work, in addition, asked about the labor characteristics; Both were crossed to obtain association statistics. Our results: Of the 3.222 workers surveyed, 71% (2270) had mestizo skin. There was association of skin redness according to the number of hours of direct (p <0.001) and indirect sun exposure (p <0.001). 47% (995) wore the sunscreen / protector, 54% (1150) wore appropriate clothing and 50% (1056) wore a cap or hat; statistically different according to the means of acquisition of such equipment (p value <0.001 for all three cases). 21% (446) did not wear any personal protective equipment to the effects of the sun. It is alarming that the low percentage of workers who receive adequate protection against the effects of solar radiation can cause problems in the short, medium and long term among employees. This could increase morbidity and mortality and the risk of skin cancer. It is important to do more research in this regard, as this issue is of utmost importance because of the changes that have occurred in radiation levels, which could generate a public health problem in this work group.

Review of the scientific evidence and technical opinion on noncaloric sweetener consumption in gastrointestinal diseases. / Revisión de la evidencia científica y opinión técnica sobre el consumo de edulcorantes no calóricos en enfermedades gastrointestinales.

The present review of noncaloric sweeteners (NCSs) by the Asociación Mexicana de Gastroenterología was carried out to analyze and answer some of the most frequent questions and concerns about NCS consumption in patients with gastrointestinal disorders, through a thorough review of the medical literature. A group of gastroenterologists and experts on nutrition, toxicology, microbiology, and endocrinology reviewed and analyzed the published literature on the topic. The working group formulated conclusions, based on the scientific evidence published, to give an opinion with respect to NCS ingestion. Current evidence does not confirm the carcinogenic potential of NCSs. However, the studies analyzed showed that saccharin could have a proinflammatory effect and that polyols can cause gastrointestinal symptoms and manifestations, depending on the dose and type of compound. The ingestion of xylitol, erythritol, sucralose, aspartame, acesulfame K, and saccharin could increase the secretion of the gastrointestinal hormones that regulate intestinal motility, and stevia and its derivatives could have a favorable effect on the percentage of liver fat. Caution should be taken in recommending aspartame consumption in patients with chronic liver disease because it reduces the ratio of branched-chain amino acids to aromatic amino acids. In addition, NCS ingestion could modify the composition of the intestinal microbiota, having an effect on gastrointestinal symptoms and manifestations. It is important to continue conducting causality studies on humans to be able to establish recommendations on NSC consumption.

Training simulation for oral and maxillofacial surgeons based on the techniques of arthroscopy in the temporomandibular joint.

Arthroscopy is a diagnostic-therapeutic technique used in the treatment of disorders of the temporomandibular joint (TMJ). The difficulties of arthroscopy lie in the manipulation of the tools, which is why training in the technique of triangulation in artificial models is essential. We developed a training system based on the techniques of arthroscopy in the TMJ, using simulators. The first simulator was a metal box containing three holes for insertion of the instruments, and the second was a human artificial model made of polymers. We found that they facilitated training in the techniques of arthroscopy, which subsequently reduced operating time and led to a better execution of skills in reality.

Effects of the detailed protein composition of milk on curd yield and composition measured by model micro-cheese curd making of individual milk samples.

The effect of the contents of casein (CN) and whey protein fractions on curd yield (CY) and composition was estimated using 964 individual milk samples. Contents of αS1-CN, αS2-CN, ß-CN, γ-CN, glycosylated κ-CN (Gκ-CN), unglycosylated κ-CN, ß-LG, and α-LA of individual milk samples were measured using reversed-phase HPLC. Curd yield and curd composition were measured by model micro-cheese curd making using 25 mL of milk. Dry matter CY (DMCY) was positively associated with all casein fractions but especially with αS1-CN and ß-CN. Curd moisture decreased at increasing ß-CN content and increased at increasing γ-CN and Gκ-CN content. Due to their associations with moisture, Gκ-CN and ß-CN were the fractions with the greatest effect on raw CY, which decreased by 0.66% per 1-standard deviation (SD) increase in the content of ß-CN and increased by 0.62% per 1-SD increase in the content of Gκ-CN. The effects due to variation in percentages of the casein fractions in total casein were less marked than those exerted by contents. A 1-SD increase in ß-CN percentage in casein (+3.8% in casein) exerted a slightly negative effect on DMCY (ß = -0.05%). Conversely, increasing amounts of αS1-CN percentage were associated with a small increase in DMCY. Hence, results suggest that, at constant casein and whey protein contents in milk, the DMCY depends to a limited extent on the variation in the αS1-CN:ß-CN ratio. κ-Casein percentage did not affect DMCY, indicating that the positive relationship detected between the content of κ-CN and DMCY can be attributed to the increase in total casein resulting from the increased amount of κ-CN and not to variation in κ-CN relative content. However, milk with increased Gκ-CN percentage in κ-CN also shows increased raw CY and produces curds with increased moisture content. Curd yield increased at increasing content and relative proportion of ß-LG in whey protein, but this is attributable to an improved capacity of the curd to retain water. Results obtained in this study support the hypothesis that, besides variation in total casein and whey protein contents, variation in protein composition might affect the cheese-making ability of milk, but this requires further studies.

The Mexican consensus on the diagnosis and treatment of diverticular disease of the colon. / Consenso mexicano sobre el diagnóstico y tratamiento de la enfermedad diverticular del colon.

Since the publication of the 2008 guidelines on the diagnosis and treatment of diverticular disease of the colon by the Asociación Mexicana de Gastroenterología, significant advances have been made in the knowledge of that disease. A systematic review of articles published in the medical literature from January 2008 to July 2018 was carried out to revise and update the 2008 guidelines and provide new evidence-based recommendations. All high-quality articles in Spanish and English published within that time frame were included. The final versions of the 43 statements accepted in the three rounds of voting, utilizing the Delphi method, were written, and the quality of evidence and strength of the recommendations were established for each statement, utilizing the GRADE system. The present consensus contains new data on the definition, classification, epidemiology, pathophysiology, and risk factors of diverticular disease of the colon. Special emphasis is given to the usefulness of computed tomography and colonoscopy, as well as to the endoscopic methods for controlling bleeding. Outpatient treatment of uncomplicated diverticulitis is discussed, as well as the role of rifaximin and mesalazine in the management of complicated acute diverticulitis. Both its minimally invasive alternatives and surgical options are described, stressing their indications, limitations, and contraindications. The new statements provide guidelines based on updated scientific evidence. Each statement is discussed, and its quality of evidence and the strength of the recommendation are presented.

Consenso mexicano sobre el diagnóstico y tratamiento de la enfermedad diverticular del colon / The Mexican consensus on the diagnosis and treatment of diverticular disease of the colon

Desde la publicación en 2008 de las guías de diagnóstico y tratamiento de la enfermedad diverticular del colon de la Asociación Mexicana de Gastroenterología ha habido avances significativos en el conocimiento de esta enfermedad. Se realizó una revisión sistemática de la literatura en PubMed de enero de 2008 a julio de 2018 con el fin de revisar y actualizar las guías 2008 y proporcionar nuevas recomendaciones basadas en la evidencia. Se incluyeron todas las publicaciones en español e inglés, de alta calidad. Se redactaron los enunciados, que fueron votados utilizando el método Delphi. Se estableció la calidad de la evidencia y la fuerza de las recomendaciones según el sistema GRADE para cada enunciado. Cuarenta y tres enunciados fueron finalmente votados y calificados. Se informan nuevos datos sobre definición, clasificación, epidemiología, fisiopatología y factores de riesgo. Se revisó con especial énfasis la utilidad de la tomografía computarizada y de la colonoscopia, así como los métodos endoscópicos para el control de la hemorragia. Se discutió sobre el tratamiento ambulatorio de la diverticulitis no complicada, el papel de la rifaximina y la mesalazina, en el manejo de la diverticulitis aguda complicada tanto en sus alternativas mínimamente invasivas hasta las opciones quirúrgicas con énfasis en sus indicaciones, limitaciones y contraindicaciones. Los nuevos enunciados proporcionan directrices basadas en la evidencia actualizada. Se presentan la discusión, el grado y la fuerza de la recomendación de cada uno de ellos.

Permeability of hair to cadmium, copper and lead in five species of terrestrial mammals and implications in biomonitoring.

The capacity of mammal hair to absorb toxic metals and its utility in biomonitoring has been broadly studied. Though these metal-binding properties has generally been attributed to the sulphur contained in cysteine, an amino acid that forms part of keratin, there are not many experimental studies that analyze the role of sulphur in the external deposition of potentially toxic metallic elements in order to better understand the potential of hair in biomonitoring and generate better tools for differentiating between internal and external deposition of contaminants. In this study, an experimental analysis is carried out using a scanning electron microscope on hairs of five terrestrial mammal species (Peromyscus furvus, P. maniculatus, Glossophaga soricina, Artibeus jamaicensis and Marmosa mexicana) treated with cadmium, copper and lead salts. We quantified absorbed metals as well as natural elements of the hair by energy dispersive X-ray spectroscopy (EDS) to analyze using simple statistics the role of sulphur in the absorption Cd, Cu and Pb. Given the lack of studies comparing the mechanisms of deposition of metal elements among different orders of Class Mammalia, external morphology was considered to be an important factor in the deposition of metallic particles of Cd, Cu and Pb. Bat species (Glossophaga soricina, Artibeus jamaicensis) showed a high concentration of particles in their scales, however, no between-species differences in metal absorption were observed, and during the exogenous deposition metal particles do not permeate the medulla. These results suggest that the sulphur in hair itself cannot bind metals to hair cuticle and that hair absorption capacity depends on a variety of factors such as aspects of hair morphology.

Mexican consensus on dyspepsia / Consenso mexicano sobre la dispepsiaMexican consensus on dyspepsia

Desde la publicación de las guías de dispepsia 2007 de la Asociación Mexicana de Gastroenterología ha habido avances significativos en el conocimiento de esta enfermedad. Se realizó una revisión sistemática de la literatura en PubMed (01/2007 a 06/2016) con el fin de revisar y actualizar las guías 2007 y proporcionar nuevas recomendaciones basadas en evidencia. Se incluyeron todas las publicaciones en español e inglés, de alta calidad. Se redactaron enunciados que fueron votados utilizando el método Delphi. Se estableció la calidad de la evidencia y la fuerza de las recomendaciones según el sistema GRADE para cada enunciado. Treinta y un enunciados fueron redactados, votados y calificados. Se informan nuevos datos sobre definición, clasificación, epidemiología y fisiopatología. La endoscopia debe realizarse en dispepsia no investigada cuando hay datos de alarma o falla al tratamiento. Las biopsias gástricas y duodenales permiten confirmar infección por Helicobacter pylori y excluir enfermedad celiaca, respectivamente. Establecer una fuerte relación médico-paciente, cambios en la dieta y en el estilo de vida son útiles como medidas iniciales. Los bloqueadores H2, inhibidores de la bomba de protones, procinéticos y fármacos antidepresivos son efectivos. La erradicación de H. pylori puede ser eficaz en algunos pacientes. Con excepción de Iberogast y rikkunshito, las terapias complementarias y alternativas carecen de beneficio. No existe evidencia con respecto a la utilidad de prebióticos, probióticos o terapias psicológicas. Los nuevos enunciados proporcionan directrices basadas en la evidencia actualizada. Se presenta la discusión, el grado y la fuerza de la recomendación de cada uno de ellos.

Abstract Since the publication of the 2007 dyspepsia guidelines of the Asociación Mexicana de Gastroenterología, there have been significant advances in the knowledge of this disease. A systematic search of the literature in PubMed (01/2007 to 06/2016) was carried out to review and update the 2007 guidelines and to provide new evidence-based recommendations. All high-quality articles in Spanish and English were included. Statements were formulated and voted upon using the Delphi method. The level of evidence and strength of recommendation of each statement were established according to the GRADE system. Thirty-one statements were formulated, voted upon, and graded. New definition, classification, epidemiology, and pathophysiology data were provided and include the following information: Endoscopy should be carried out in cases of uninvestigated dyspepsia when there are alarm symptoms or no response to treatment. Gastric and duodenal biopsies can confirm Helicobacter pylori infection and rule out celiac disease, respectively. Establishing a strong doctor-patient relationship, as well as dietary and lifestyle changes, are useful initial measures. H2-blockers, proton-pump inhibitors, prokinetics, and antidepressants are effective pharmacologic therapies. H. pylori eradication may be effective in a subgroup of patients. There is no evidence that complementary and alternative therapies are beneficial, with the exception of Iberogast and rikkunshito, nor is there evidence on the usefulness of prebiotics, probiotics, or psychologic therapies. The new consensus statements on dyspepsia provide guidelines based on up-to-date evidence. A discussion, level of evidence, and strength of recommendation are presented for each statement. © 2017 Asociacion Mexicana de Gastroenterologiia.

Identification of GntR as regulator of the glucose metabolism in Pseudomonas aeruginosa.

In contrast to Escherichia coli, glucose metabolism in pseudomonads occurs exclusively through the Entner-Doudoroff (ED) pathway. This pathway, as well as the three routes to generate the initial ED pathway substrate, 6-phosphogluconate, is regulated by the PtxS, HexR and GtrS/GltR systems. With GntR (PA2320) we report here the identification of an additional regulator in Pseudomonas aeruginosa PAO1. GntR repressed its own expression as well as that of the GntP gluconate permease. In contrast to PtxS and GtrS/GltR, GntR did not modulate expression of the toxA gene encoding the exotoxin A virulence factor. GntR was found to bind to promoters PgntR and PgntP and the consensus sequence of its operator was defined as 5'-AC-N-AAG-N-TAGCGCT-3'. Both operator sites overlapped with the RNA polymerase binding site and we show that GntR employs an effector mediated de-repression mechanism. The release of promoter bound GntR is induced by gluconate and 6-phosphogluconate that bind with similar apparent affinities to the GntR/DNA complex. GntR and PtxS are paralogous and may have evolved from a common ancestor. The concerted action of four regulatory systems in the regulation of glucose metabolism in Pseudomonas can be considered as a model to understand complex regulatory circuits in bacteria.

Genetic parameters of measures and population-wide infrared predictions of 92 traits describing the fine composition and technological properties of milk in Italian Simmental cattle.

The objectives of this study were to estimate, for the Italian Simmental cattle population, genetic parameters for 92 traits and their infrared predictions (IP) and to investigate the genetic relationship between measured traits (MT) and IP. Data for milk fat fatty acid composition (n = 1,040), detailed protein composition (n = 3,337), lactoferrin (n = 558), pH (n = 3,438), coagulation properties (n = 3,266), curd yield and composition obtained by a micro-cheese making procedure (n = 1,177), and content of Ca, P, Mg, and K (n = 689) were obtained using reference laboratory analysis. Infrared prediction for all the investigated traits was performed using 143,198 spectra records belonging to 17,619 Italian Simmental cows. (Co)variance components for MT and their IP were estimated in a set of bivariate animal model REML analyses and genetic correlations between MT and IP were estimated using all IP obtained at the population level. A significant positive relationship was observed between the coefficient of determination of the infrared prediction models and the phenotypic and genetic variation of the IP. The decrease in the estimated genetic variance of IP compared with MT was on average 64%. For traits exhibiting calibration models with coefficients of determination in cross-validation (R2CV) greater than 0.9, the decrease in the genetic variance ranged from approximately 20 to 50%. Most traits (88 out of 92) exhibited lower heritability estimates for IP than for the corresponding MT. The estimated genetic correlations between IP and MT (ra) were in general very high. A positive relationship (r = 0.57) between R2CV of calibration models and the estimated ra has been detected. For calibration models exhibiting R2CV higher than 0.75, ra were greater than 0.9. The variability in the estimated correlations increased when R2CV decreased, and for calibration models of moderate predictive ability, estimates of ra ranged from 0.2 to 1. Genetic parameter estimates suggested that IP can be used as indicator traits in breeding programs for the enhancement of fine composition and technological properties of milk. The genetic gain achievable selecting for IP is expected to be high for fatty acid composition, minerals, and for technological properties of milk, whereas it will be low for casein and whey protein composition and for the content of lactoferrin.