Colombian vs. American corn: Quality, chemical composition, mycotoxin content and metabolizable energy

Background: Corn is, quantitatively, one of the most important world crops (ranking second only after wheat) and a key ingredient in animal feeds. Objective: to assess and compare corn quality, mycotoxin content, chemical composition and apparent metabolizable energy (AME) of domestic and imported corn. Methods: Grain quality (USDA grading system) was determined in 30 samples of domestic and 21 samples of imported corn. From each origin, 15 samples were subjected to proximal analysis and 10 were used to determine fatty acid composition. Mycotoxin analysis was conducted on 30 samples of domestic and 23 of imported corn. Results: six of the 30 domestic samples corresponded to US1 grade (highest quality) vs. none of the imported. In the "sample grade" category (lowest quality), 10 and 6 samples corresponded to imported and domestic corn, respectively. Soybeans were found as contaminant in 15 of the 21 imported corn samples. Aspergillus spp. mycotoxins such as ochratoxin A were not detected, and aflatoxins were found in only a few samples at very low levels. Fusariotoxins such as deoxynivalenol and zearalenone were found in 61 and 43% of imported samples, respectively, but in none of the domestic samples. Domestic corn had lower carbohydrate content compared with imported corn (85.4 vs. 86.7%), but higher crude fat (3.8 vs. 3.1%). The AME values for domestic and imported corn were 3,697 and 3,378 kcal/kg, respectively. The fatty acid profiles from both corn types were similar. Conclusion: This study found significant differences between locally-grown and imported corn, particularly in terms of crude fat, AME content, fusariotoxins, and contaminant seeds (soybeans). These findings suggest that locally-grown corn might have nutritional and toxicological advantages over corn imported from the United States.

Antecedentes: El maíz es, cuantitativamente, uno de los cultivos más importantes a nivel mundial (ocupa el segundo lugar después del trigo) y uno de los principales ingredientes en dietas para animales. Objetivo: Evaluar y comparar la calidad del maíz, su contenido de micotoxinas, composición química, y energía metabolizable aparente (AME) del maíz nacional e importado. Métodos: La calidad del grano (sistema de clasificación de la USDA) se determinó en 30 muestras de maíz producido en Colombia y 21 de maíz importado. De cada origen, 15 muestras se sometieron a análisis proximal y 10 se analizaron para determinar el perfil de ácidos grasos. El contenido de micotoxinas se determinó en 30 muestras de maíz nacional y 23 de maíz importado. Resultados: Seis de las treinta muestras nacionales analizadas para calidad de grano correspondieron a grado US1 (la mejor calidad) frente a ninguna de las importadas. En categoría "grado muestra" (la menor calidad) se encontraron 10 y 6 de las muestras de maíz importado y nacional, respectivamente; 15 de las 21 muestras de maíz importado presentaron contaminación con semillas de fríjol soya. No se encontraron micotoxinas de hongos Aspergillus spp. (ocratoxina A), y niveles muy bajos de aflatoxinas en unas pocas muestras. Fusariotoxinas tales como deoxinivalenol y zearalenona se detectaron en el 61 y 43% de las muestras de maíz importado, respectivamente, pero en ninguna muestra de maíz nacional. El maíz nacional presentó menor contenido de carbohidratos (85,4 vs. 86,7%), pero mayor contenido de grasa cruda (3,8 vs. 3,1%) en comparación con el importado, respectivamente. Los valores de AME fueron de 3.697 y 3.378 kcal/kg para el maíz nacional e importado, respectivamente. El perfil de ácidos grasos de ambas procedencias fue similar. Conclusiones: Este estudio encontró diferencias significativas entre el maíz de producción nacional y el importado, en especial en su contenido de grasa cruda y AME, fusariotoxinas, y semillas contaminates (soya). Estos hallazgos sugieren que el maíz de producción nacional puede presentar ventajas de tipo nutricional y toxicológico frente al maíz importado de los Estados Unidos de América.

Antecedentes: O milho é quantitativamente uma das culturas mais importantes em nível mundial (ocupando o segundo lugar depois do trigo), sendo um dos principais ingredientes em dietas para animais. Objetivo: Avaliar e comparar a qualidade do milho, o teor de micotoxinas, a composição química e a energia metabolizável aparente (EMA) do milho nacional e importado. Métodos: A qualidade do grão (sistema de classificação do USDA) foi determinada em 30 amostras de milho produzido na Colômbia e 21 amostras de milho importado. Quinze amostras de cada tipo de milho foram submetidas a análise proximal e dez amostras de cada milho foram analisadas para determinar o perfil de ácidos graxos. O conteúdo de micotoxinas foi determinado em 30 amostras de milho da Colômbia e em 23 amostras de milho importado. Resultados: Seis das trinta amostras colombianas analisadas para qualidade de grão corresponderam a grau US1 (melhor qualidade) frente a nenhuma das amostras importadas. Na categoria "grau amostra" (menor qualidade) foram encontradas 10 e 6 amostras de milhos importados e colombianos, respectivamente; Quinze das 21 amostras de milho importado apresentaram contaminação com sementes de feijão soja. Não foram encontradas micotoxinas de fungos Aspergillus spp. (ocratoxina A) ou apenas níveis muito baixos em poucas amostras (aflatoxinas). As fusariotoxinas, deoxinivalenol e zearalenona foram detectadas em 61 e 43% das amostras de milho importado, respectivamente, mas não foram detectadas em nenhuma amostra do milho colombiano. O milho colombiano apresentou menor conteúdo de carboidratos (85,4 vs. 86,7%) porém maior conteúdo de gordura crua (3,8 vs. 3,1%). Os valores de AME foram 3.697 e 3.378 kcal/kg para as amostras de milho colombiano e importado, respectivamente. O perfil de ácidos graxos de ambos tipos de milho foi similar. Conclusões: Os resultados do presente estudo mostram diferenças significativas entre o milho de origem colombiana e o milho importado dos Estados Unidos, em especial no conteúdo de gordura crua e AME, fusariotoxinas e sementes contaminantes (soja). Estes achados sugerem que o milho de produção colombiana pode apresentar vantagens de tipo nutricional e toxicológica frente ao milho importado dos Estados Unidos.

Profile of Crohn's disease patients who underwent anorectal examination under anesthesia

Introduction: Crohn's disease (CD) is an inflammatory bowel disease, and in ~ 30% of cases it is associated with perianalmanifestations. To identify the extent of the damage and to implement an appropriate treatment, anorectal examination under anesthesia (EUA) is fundamental. Objective: To describe the profile of patients who underwent anorectal EUA in university and private hospitals in the state of Bahia, Brazil. Methodology: A retrospective, descriptive study with 46 patients who underwent anorectal EUA between March, 2016 and November, 2019. Results: A total of 62 anorectal EUAs were performed in 46 patients. With an average age of 36.8 years, the female gender was predominant (52.2%) among these patients. Anal fistulas were the most frequent findings (83.8%), and in most cases they were treated with a seton placement (69.4%). The main recommended surgical indication was a proper evaluation and identification of perianal disease, followed by drainage of the abscess and therefore immunobiological therapy (59.6%). Conclusion: In the present study, the profile of CD patients was similar to those found in the literature, with a high rate of complex anal fistulas. Additional studies are still necessary to further comprehend and treat this particular and debilitating manifestation of the disease. (AU)

A survey of US hospitals' criteria for the allocation of remdesivir to treat COVID-19.

PURPOSE: To determine how hospitals across the United States determined allocation criteria for remdesivir, approved in May 2020 for treatment of coronavirus disease 2019 (COVID-19) through an emergency use authorization, while maintaining fair and ethical distribution when patient needs exceeded supply. METHODS: A electronic survey inquiring as to how institutions determined remdesivir allocation was developed. On June 17, 2020, an invitation with a link to the survey was posted on the Vizient Pharmacy Network Community pages and via email to the American College of Clinical Pharmacy's Infectious Disease Practice and Research Network listserver. RESULTS: 66 institutions representing 28 states responded to the survey. The results showed that 98% of surveyed institutions used a multidisciplinary team to develop remdesivir allocation criteria. A majority of those teams included clinical pharmacists (indicated by 97% of respondents), adult infectious diseases physicians (94%), and/or adult intensivists (69%). Many teams included adult hospitalists (49.2%) and/or ethicists (35.4%). Of the surveyed institutions, 59% indicated that all patients with COVID-19 were evaluated for treatment, and 50% delegated initial patient identification for potential remdesivir use to treating physicians. Prioritization of remdesivir allocation was often determined on a "first come, first served" basis (47% of respondents), according to a patient's respiratory status (28.8%) and/or clinical course (24.2%), and/or by random lottery (22.7%). Laboratory parameters (10.6%), comorbidities (4.5%), and essential worker status (4.5%) were rarely included in allocation criteria; no respondents reported consideration of socioeconomic disadvantage or use of a validated scoring system. CONCLUSION: The COVID-19 pandemic has exposed the inconsistencies of US medical centers' methods for allocating a limited pharmacotherapy resource that required rapid, fair, ethical and equitable distribution. The medical community, with citizen participation, needs to develop systems to continuously reevaluate criteria for treatment allocation as additional guidance and data emerge.

Social distancing measures could have reduced estimated deaths related to COVID-19 in Brazil / Medidas de distanciamento social podem ter reduzido as mortes estimadas relacionadas à COVID-19 no Brasil

Social distancing was planned as a preventive measure to control the extensive spread of COVID-19. COVID-19-related deaths in Brazil were analyzed during the period of social distancing measures. Mortality data for COVID-19 was obtained from the Worldometer website (www.worldometer.info). Deaths were estimated up to the 31st day after the occurrence of the 5th COVID-19-related death in Brazil. Social distance was measured using Google's community mobility reports (https://www.google.com/covid19/mobility/). The Brazilian epidemic curves were interconnected, and mathematical models were evaluated to fit the mortality estimation curves. The optimistic model was defined in the opening period of social distancing and, therefore, in the lower mobility (40-60%). The realistic model was calculated according to relaxed social distance measures (<40%) and the pessimistic model was calculated based on the transmission rate between 2-3. Thus, the equations of the mathematical models provided the outcomes for the date of June 9, 2020, as follows: realistic model with 40,623 deaths, pessimistic model with 64,310 deaths and the optimistic model with a projection of 31,384 deaths. As a result of these analyzes, on May 24, 2020, there were a total of 22,965 deaths related to COVID-19, and those deaths included within the proposed mathematical models were 17,452 for the optimistic model, 22,623 for the realistic model and 32,825 for the pessimistic model. Thus, it is concluded that social distancing measures promoted by the Brazilian public managers contributes to the reduction in approximately ten thousand deaths related to COVID-19 in the current pandemic scenario.

INTRODUÇÃO: O distanciamento social foi planejado como uma medida preventiva para controlar a disseminação extensiva da COVID-19. Nós analisamos as mortes relacionadas à COVID-19 no Brasil durante o período de medidas de distanciamento social. Os dados de mortalidade do COVID-19 foram obtidos no site da Worldometer (www.worldometer.info). As mortes foram estimadas até o 31º dia após a 5ª morte. O distanciamento social foi medido por meio dos relatórios de mobilidade comunitária COVID-19; Google (https://www.google.com/covid19/mobility/). As curvas epidêmicas brasileiras foram interligadas e os modelos matemáticos foram avaliados para se ajustarem às curvas de estimativa de mortalidade. O modelo otimista foi fundado no período de abertura da distância social e, portanto, na menor mobilidade (40-60%). O modelo realista foi calculado de acordo com medidas de distanciamento social relaxado (<40%) e o modelo pessimista foi calculado com base em R0 entre 2-3. Sob essa situação, o modelo matemático realista estimou 40.623 mortes em 9 de junho de 2020, enquanto o modelo pessimista antecipou 64.310 mortes e o modelo otimista projetou 31.384. Até hoje (24 de maio de 2020), um total de 22.965 foram relatadas, enquanto nosso modelo projetou 17.452 para o modelo otimista, 22.623 para o modelo realista e 32.825 para o modelo pessimista. Observamos movimento reduzido ao longo deste período. Em resumo, o modelo matemático sugere que a mobilidade reduzida da comunidade diminuiu o total estimado de mortes relacionadas à COVID-19 no Brasil. Enfatizamos que mais procedimentos metodológicos serão necessários para confirmar esta teoria

El imaginario juvenil urbano sobre la migración y la vida en Estados Unidos / The youth urban imaginarium of migration and life in United States / O imaginário juvenil urbano sobre a migração e a vida nos Estados Unidos

Mi objetivo principal en este artículo es analizar el imaginario de la migración y la vida en Estados Unidos, que tiene la juventud de la Zona Metropolitana de Guadalajara, Jalisco, México. Específicamente intento ilustrar, desde la voz de los jóvenes y las jóvenes, la conformación de esa serie de significaciones imaginarias de futuro. Oriento el tema desde el enfoque cualitativo constituido por el método biográfico interpretativo, a partir de relatos de vida y entrevistas. Los hallazgos revelan que este imaginario tiene diferentes construcciones: el imaginario que se forma a partir de expectativas laborales, afectivas, económicas y educativas, impregnadas de un sentido material y económico; y, por otro lado, el que está compuesto por deseos, ilusiones y expectativas desde lo afectivo y lo emocional, como es el reencuentro familiar y la consolidación de una vida en pareja.

My main objective in this article is to analyze the imaginarium of migration and life in the United States, which prevails among the young people from the Guadalajara, Jalisco Metropolitan Area, México. Specifically I try to illustrate, from the voice of the young, the conformation of that series of imaginary meanings of future. I orient the topic from the qualitative approach consisting in the biographical interpretative method, from life stories and interviews. The findings reveal that this imaginarium has different constructions: on one hand, the imaginarium that is made up of employment, affective, economic and educational expectations, impregnated of a material, economic sense; and on the other hand, the one that is made up of desires, illusions and expectations from the affective and emotional outlooks, such as family reunification and the consolidation of a couple’s life.

O meu objetivo principal com este artigo é analisar o imaginário da migração e da vida nos Estados Unidos construído pela juventude da Área Metropolitana de Guadalajara, Jalisco, México. Especificamente pretendo ilustrar a partir da voz dos jovens, a conformação dessa série de significações imaginárias do futuro. Oriento o tema a partir da abordagem qualitativa construída a partir do método biográfico interpretativo, baseado em histórias de vida e entrevistas. Os resultados revelam que este imaginário tem diferentes construções: o imaginário que se forma a partir de expectativas de trabalho, afetivas, econômicas e educativas impregnadas de um sentido material e econômico; e por outro lado, aquele que é composto de desejos, ilusões e expectativas desde o afetivo e do emocional como o reencontro familiar e a consolidação de uma vida de casado.

Minério de ferro, geologia econômica e redes de experts entre Wisconsin e Minas Gerais, 1881-1914 / Iron ore, economic geology and networks of experts between Wisconsin and the state of Minas Gerais, 1881-1914

O presente artigo trata da “descoberta” do minério de ferro brasileiro a partir de duas perspectivas. A primeira analisa a crescente ênfase das geociências em sua aplicação prática e em sua globalidade desde a segunda metade do século XIX. Enquanto no Brasil a geologia econômica foi integrada passo a passo às instituições do Estado, no nível global ela viveu momento de triunfo com o 11 o Congresso Geológico Internacional, em 1910. A segunda trata de uma rede social específica com papel decisivo na corrida pelo minério de ferro brasileiro: experts transnacionais movimentandose entre as lógicas do mercado e as da academia. O artigo mostra a importância das negociações locais na incorporação do subsolo mineiro ao espaço global de mineração.

This article deals with the “discovery” of Brazilian iron ore from two perspectives. The first examines the increasing emphasis of the geosciences and their practical application and global reach since the second half of the nineteenth century. While in Brazil economic geology was integrated step by step into state institutions, at the global level it experienced its moment of triumph with the 11th International Geological Congress in 1910. The second deals with a specific social network with a decisive role in the race for Brazilian iron ore: with transnational experts juggling between the logic of the market and that of the academy. The article reveals the importance of local negotiations in the incorporation of the subsoil of Minas Gerais into the global space of mining.

Nelson Rockefeller e a atuacao da American International Association for Economic and Social Development: debates sobre missao e imperialismo no Brasil, 1946-1961 / Nelson Rockefeller and the activities of the American International Association for Economic and Social Development: the debate concerning mission and imperialism in Brazil, 1946-1961

Analisa a bibliografia sobre Nelson Rockefeller e a atuação no Brasil da American International Association for Economic and Social Development. Expõe interpretações otimistas sobre as ações de Rockefeller e da agência, bem como a corrente de pensamento que o caracterizou como um dos principais representantes do imperialismo norte-americano, seja como representante político na década de 1960, seja como idealizador de atividades de interesse privado. Procura demonstrar que as ações individuais ou da agência coadunavam com as elites locais, que influenciavam o remodelamento e a operacionalização dos projetos de cooperação técnica.

The article analyzes the bibliography on Nelson Rockefeller and the activities of the American International Association for Economic and Social Development in Brazil. It describes optimistic interpretations of Rockefeller's and the association's work, as well as the nationalist stream of thought, which characterized him as one of the chief representatives of U.S. imperialism, both as a political representative in the 1960s and as the mind behind endeavors of interest to the private sector. It is shown that at the individual and agency levels alike, these initiatives involved direct ties to the local elites, who influenced the reshaping and operationalization of technical cooperation projects.

Informing public policy toward binational health insurance: Empirical evidence from California / Información para las políticas públicas sobre seguros binacionales de salud: evidencia empírica de California

Objective. To estimate reimbursement rate differences between Mexico and US based physicians reimbursed by a binational health insurance (BHI) plan and US payers, respectively; and show the relationship between plan benefit designs and health care utilization in Mexico. Materials and methods. Data include 33 841 and 53 909 HMO enrollees in California from Sistemas Médicos Nacionales (SIMNSA) and Salud con Health Net, respectively. We use descriptive statistical methods. Results. SIMNSA's physician reimbursement rates averaged 50.7% (95% CI: 34.5%-67.0%) of Medi-Cal's, 28.3% (95% CI: 19.6%-37.0%) of Medicare's, and 22% of US private plans'. Each year, 99.4% of SIMNSA enrollees but only 0.1% of Salud con Health Net enrollees obtained care in Mexico. Conclusion. SIMNSA only covers emergency and urgent care in the US, while Salud con Health Net covers comprehensive care with higher patient cost sharing than in Mexico. To realize potential savings, plans need strong incentives to increase utilization in Mexico.

Objetivo. Estimar diferencias en tasas de reembolso y utilización de servicios médicos cubiertos por seguros binacionales de salud (SBS) y aquellos de planes públicos y privados de EUA. Material y métodos. Con métodos estadísticos descriptivos se analizan datos de 33 841 afiliados a Sistemas Médicos Nacionales (SIMNSA) y 53 909 de Salud con Health Net en California. Resultados. Las tasas de reembolso de SIMNSA son en promedio 50.7% (95% IC: 34.5%-67.0%) de aquellas de Medi-Cal, 28.3% (95% IC: 19.6%-37.0%) de Medicare, y 22% de los planes privados de EUA. Cada año, 99.4% de afiliados a SIMNSA, pero sólo 0.1% de Salud con Health Net obtienen atención en México. Conclusión. SIMNSA sólo cubre gastos de emergencia y atención urgente en EUA, mientras que Salud con Health Net cubre servicios de atención integrales. Los planes de SBS pueden lograr ahorros importantes con más incentivos para que la atención ocurra en México.

Importance of dose selection in novel oral anticoagulants for atrial fibrillation / Importancia de seleccionar la dosis de los nuevos anticoagulantes orales para fibrilación auricular

There are several excellent alternatives to warfarin on the horizon for atrial fibrillation. Results from the trials, as well as pharmacokinetic data from the edoxaban studies, suggest that dose selection, based on pharmacokinetic and pharmacodynamic properties, is a critical component in the development of novel anticoagulants. Greater flexibility in dosing with edoxaban and the opportunity for dose adjustment throughout the ENGAGE AF-TIMI 48 trial may be advantageous in the competitive field of novel oral anticoagulants.

Existen excelentes alternativas al tratamiento con warfarina en el campo de la fibrilación auricular. Los resultados de los ensayos con RE-LY, ROCKET-AF y ARISTOTLE, así como los datos fármaco cinéticos obtenidos en estudios con edoxaban, sugieren que la selección de la dosis, basada en propiedades fármaco cinéticas y fármaco dinámicas, es un componente crítico en el desarrollo de nuevos anticoagulantes. Una mayor flexibilidad en establecer la dosis de edoxaban y la oportunidad de ajustar la dosis mediante ENGAGE AF-TIMI 48, puede constituir una ventaja en el campo de los nuevos anticoagulantes orales.

Cardiología "basada en la evidencia": aplicaciones prácticas de la epidemiología. IV. Modelos de predicción de riesgo cardiovascular / Evidence-Based Cardiology: practical applications from epidemiology. IV Cardiovascular risk prediction

La estimación del riesgo cardiovascular basal de un paciente sin enfermedad establecida, permite ajustar la intensidad de la intervención preventiva de acuerdo a la probabilidad de desarrollar complicaciones cardiovasculares. El cardiólogo necesita conocer las características de los modelos de predicción de riesgo CV disponibles, sus ventajas y limitaciones.

Cardiovascular risk assessment in patients without established disease allows to match the intensity of risk factor modification to the underlying hazard for cardiovascular events. The cardiologist needs to know the characteristics of current risk prediction algorithms, their advantages and limitations.

Cardiología "basada en la evidencia": Aplicaciones prácticas de la epidemiología. III. Capacidad diagnóstica de una prueba clínica / Evidence-Based Cardiology: practical applications from epidemiology. III. Diagnostic capacity of a clinical test

Este artículo revisa de manera práctica las diferentes características de validez de una prueba diagnóstica. En particular, se destaca la razón de probabilidad como una herramienta que facilita el uso de conceptos epidemiológicos en el diagnóstico clínico.

This article reviews different characteristics of validity in a clinical diagnostic test. In particular, we emphasize the likelihood ratio as an instrument that facilitates the use of epidemiologic concepts in clinical diagnosis.

Cardiología "basada en la evidencia": aplicaciones prácticas de la epidemiología. II. El uso de biomarcadores / Evidence-Based Cardiology: practical applications from epidemiology. II. The use of biomarkers

El uso de biomarcadores que muestran una asociación con el desarrollo de enfermedad cardiovascular necesita una valoración cuidadosa de la calidad de la evidencia que establece su relación. Aunque los estudios observacionales han sido fundamentales para establecer la importancia de los factores de riesgo tradicionales, únicamente podemos hacer escrutinio e intervenir sobre biomarcadores cuando existe evidencia benéfica de estudios aleatorios clínicos controlados bien diseñados.

The use of biomarkers that show an association with the development of cardiovascular disease needs a careful evaluation in regard to the quality of evidence that establishes their relationship. Although observational studies have been paramount to establish the importance of the traditional risk factors, we can only screen and intervene on biomarkers when there is demonstrated benefit in well-designed randomized clinical trials.

Médicos, pacientes e Homeopatia nos EUA / Physicians, patients and Homeopathy in the USA

A autora apresenta aspectos da História da Homeopatia nos EUA (da obra coordenada por Martin Dinges Weltgeschichte der Homõopathie, Munchen 1996).

Política externa dos EUA e a integração hemisférica / x

O artigo focaliza o processo de integração hemisférica com base na óptica da política externa dos EUA, procurando chamar a atenção para as relações entre os aspectos políticos e econômicos contidos na questão. Faz ainda algumas considerações sobre as tendências e perspectivas do atual governo Bush.

This article examines the process of hemispheric integration from the perspective of United States foreign policy, while highlighting the relationships between various political and economic aspects of the issue. Further, it offers some observations regarding trends of the current Bush administration.