Ayuno intermitente: efectos en diversos escenarios clínicos / Intermittent fasting: effects in diverse clinical settings

Introducción: los esquemas de ayuno intermitente (AI) proponen limitar la ingestión de alimentos durante periodos específicos. Se han propuestocomo estrategia dietoterapéutica para tratar distintas condiciones metabólicas en diversos padecimientos, sin embargo, la heterogeneidad entrecada contexto de ayuno intermitente pudiera generar diferentes resultados en parámetros metabólicos.Objetivo: evaluar la aplicación clínica del ayuno intermitente y discernir si ofrece ventajas sobre otras estrategias tradicionales.Métodos: se formularon preguntas estructuradas (PICO) y la metodología se apegó a las guías establecidas por la declaración PRISMA 2020.Se realizó una búsqueda de literatura científica en las plataformas de PubMed, Cochrane Library y Google Scholar.Resultados: se encontraron 3.962 artículos, de los cuales se incluyeron finalmente 56, eliminando 3.906 trabajos que no contestaban directao indirectamente las preguntas estructuradas.Conclusiones: frente a las dietas convencionales, los diversos esquemas de AI no generan ventajas ni desventajas en cuanto a pérdida de pesoo perfil lipídico, aunque en la variante a días alternos se producen mayores reducciones de insulina a las observadas en la restricción energéticacontinua. La heterogeneidad de las intervenciones y poblaciones estudiadas, así como los comparadores, los desenlaces y el tipo de diseñoimposibilitan extrapolar los efectos a todos los escenarios clínicos y generalizar las recomendaciones.(AU)

Introduction: intermittent fasting plans propose to limit food intake during specific periods as nutritional therapeutic strategies to treat differentmetabolic conditions in various clinical entities. However, the heterogeneity between each context of intermittent fasting could generate differentresults in metabolic parameters.Objective: to evaluate the clinical application of intermittent fasting and to discern whether it offers advantages over other traditional strategies.Methods: structured questions were formulated (PICO), and the methodology followed the guidelines established by the PRISMA 2020 statement.The search was conducted in different databases (PubMed, Cochrane Library and Google Scholar).Results: we found 3,962 articles, of which 56 were finally included; 3,906 articles that did not directly or indirectly answer the structuredquestions were excluded.Conclusions: compared to conventional diets, the various AI schemes do not generate advantages or disadvantages in terms of weight loss andlipid profile, although in the alternate-day variant there are greater insulin reductions than those observed in the continuous energy restriction. Theheterogeneity of the interventions, the populations studied, the comparators, the results, and the type of design make it impossible to extrapolatethe effects found in all clinical scenarios and generalize the recommendations.(AU)

[Intermittent fasting: effects in diverse clinical settings]. / Ayuno intermitente: efectos en diversos escenarios clínicos.

Introduction: Introduction: intermittent fasting plans propose to limit food intake during specific periods as nutritional therapeutic strategies to treat different metabolic conditions in various clinical entities. However, the heterogeneity between each context of intermittent fasting could generate different results in metabolic parameters. Objective: to evaluate the clinical application of intermittent fasting and to discern whether it offers advantages over other traditional strategies. Methods: structured questions were formulated (PICO), and the methodology followed the guidelines established by the PRISMA 2020 statement. The search was conducted in different databases (PubMed, Cochrane Library and Google Scholar). Results: we found 3,962 articles, of which 56 were finally included; 3,906 articles that did not directly or indirectly answer the structured questions were excluded. Conclusions: compared to conventional diets, the various AI schemes do not generate advantages or disadvantages in terms of weight loss and lipid profile, although in the alternate-day variant there are greater insulin reductions than those observed in the continuous energy restriction. The heterogeneity of the interventions, the populations studied, the comparators, the results, and the type of design make it impossible to extrapolate the effects found in all clinical scenarios and generalize the recommendations.

Introducción: Introducción: los esquemas de ayuno intermitente (AI) proponen limitar la ingestión de alimentos durante periodos específicos. Se han propuesto como estrategia dietoterapéutica para tratar distintas condiciones metabólicas en diversos padecimientos, sin embargo, la heterogeneidad entre cada contexto de ayuno intermitente pudiera generar diferentes resultados en parámetros metabólicos. Objetivo: evaluar la aplicación clínica del ayuno intermitente y discernir si ofrece ventajas sobre otras estrategias tradicionales. Métodos: se formularon preguntas estructuradas (PICO) y la metodología se apegó a las guías establecidas por la declaración PRISMA 2020. Se realizó una búsqueda de literatura científica en las plataformas de PubMed, Cochrane Library y Google Scholar. Resultados: se encontraron 3.962 artículos, de los cuales se incluyeron finalmente 56, eliminando 3.906 trabajos que no contestaban directa o indirectamente las preguntas estructuradas. Conclusiones: frente a las dietas convencionales, los diversos esquemas de AI no generan ventajas ni desventajas en cuanto a pérdida de peso o perfil lipídico, aunque en la variante a días alternos se producen mayores reducciones de insulina a las observadas en la restricción energética continua. La heterogeneidad de las intervenciones y poblaciones estudiadas, así como los comparadores, los desenlaces y el tipo de diseño imposibilitan extrapolar los efectos a todos los escenarios clínicos y generalizar las recomendaciones.

Bioprinted Human Lung Cancer-Mimics for Tissue Diagnostics Applications.

Developing a reproducible and secure supply of customizable control tissues that standardizes for the cell type, tissue architecture, and preanalytics of interest for usage in applications including diagnostic, prognostic, and predictive assays, is critical for improving our patient care and welfare. The conventionally adopted control tissues directly obtained from patients are not ideal because they oftentimes have different amounts of normal and neoplastic elements, differing cellularity, differing architecture, and unknown preanalytics, in addition to the limited supply availability and thus associated high costs. In this study, we demonstrated a strategy to stably produce tissue-mimics for diagnostics purposes by taking advantage of the three-dimensional (3D) bioprinting technology. Specifically, we take anaplastic lymphoma kinase-positive (Alk+) lung cancer as an example, where a micropore-forming bioink laden with tumor cells was combined with digital light processing-based bioprinting for developing native-like Alk+ lung cancer tissue-mimics with both structural and functional relevancy. It is anticipated that our proposed methodology will pave new avenues for both fields of tissue diagnostics and 3D bioprinting significantly expanding their capacities, scope, and sustainability.

Holobiont Urbanism: sampling urban beehives reveals cities' metagenomes.

BACKGROUND: Over half of the world's population lives in urban areas with, according to the United Nations, nearly 70% expected to live in cities by 2050. Our cities are built by and for humans, but are also complex, adaptive biological systems involving a diversity of other living species. The majority of these species are invisible and constitute the city's microbiome. Our design decisions for the built environment shape these invisible populations, and as inhabitants we interact with them on a constant basis. A growing body of evidence shows us that human health and well-being are dependent on these interactions. Indeed, multicellular organisms owe meaningful aspects of their development and phenotype to interactions with the microorganisms-bacteria or fungi-with which they live in continual exchange and symbiosis. Therefore, it is meaningful to establish microbial maps of the cities we inhabit. While the processing and sequencing of environmental microbiome samples can be high-throughput, gathering samples is still labor and time intensive, and can require mobilizing large numbers of volunteers to get a snapshot of the microbial landscape of a city. RESULTS: Here we postulate that honeybees may be effective collaborators in gathering samples of urban microbiota, as they forage daily within a 2-mile radius of their hive. We describe the results of a pilot study conducted with three rooftop beehives in Brooklyn, NY, where we evaluated the potential of various hive materials (honey, debris, hive swabs, bee bodies) to reveal information as to the surrounding metagenomic landscape, and where we conclude that the bee debris are the richest substrate. Based on these results, we profiled 4 additional cities through collected hive debris: Sydney, Melbourne, Venice and Tokyo. We show that each city displays a unique metagenomic profile as seen by honeybees. These profiles yield information relevant to hive health such as known bee symbionts and pathogens. Additionally, we show that this method can be used for human pathogen surveillance, with a proof-of-concept example in which we recover the majority of virulence factor genes for Rickettsia felis, a pathogen known to be responsible for "cat scratch fever". CONCLUSIONS: We show that this method yields information relevant to hive health and human health, providing a strategy to monitor environmental microbiomes on a city scale. Here we present the results of this study, and discuss them in terms of architectural implications, as well as the potential of this method for epidemic surveillance.

An Adhesive Bioink toward Biofabrication under Wet Conditions.

Three-dimensional (3D) bioprinting is driving significant innovations in biomedicine over recent years. Under certain scenarios such as in intraoperative bioprinting, the bioinks used should exhibit not only cyto/biocompatibility but also adhesiveness in wet conditions. Herein, an adhesive bioink composed of gelatin methacryloyl, gelatin, methacrylated hyaluronic acid, and skin secretion of Andrias davidianus is designed. The bioink exhibits favorable cohesion to allow faithful extrusion bioprinting in wet conditions, while simultaneously showing good adhesion to a variety of surfaces of different chemical properties, possibly achieved through the diverse bonds presented in the bioink formulation. As such, this bioink is able to fabricate sophisticated planar and volumetric constructs using extrusion bioprinting, where the dexterity is further enhanced using ergonomic handheld bioprinters to realize in situ bioprinting. In vitro experiments reveal that cells maintain high viability; further in vivo studies demonstrate good integration and immediate injury sealing. The characteristics of the bioink indicate its potential widespread utility in extrusion bioprinting and will likely broaden the applications of bioprinting toward situations such as in situ dressing and minimally invasive tissue regeneration.

Molecularly cleavable bioinks facilitate high-performance digital light processing-based bioprinting of functional volumetric soft tissues.

Digital light processing bioprinting favors biofabrication of tissues with improved structural complexity. However, soft-tissue fabrication with this method remains a challenge to balance the physical performances of the bioinks for high-fidelity bioprinting and suitable microenvironments for the encapsulated cells to thrive. Here, we propose a molecular cleavage approach, where hyaluronic acid methacrylate (HAMA) is mixed with gelatin methacryloyl to achieve high-performance bioprinting, followed by selectively enzymatic digestion of HAMA, resulting in tissue-matching mechanical properties without losing the structural complexity and fidelity. Our method allows cellular morphological and functional improvements across multiple bioprinted tissue types featuring a wide range of mechanical stiffness, from the muscles to the brain, the softest organ of the human body. This platform endows us to biofabricate mechanically precisely tunable constructs to meet the biological function requirements of target tissues, potentially paving the way for broad applications in tissue and tissue model engineering.

A multifunctional micropore-forming bioink with enhanced anti-bacterial and anti-inflammatory properties.

Three-dimensional (3D) bioprinting has emerged as an enabling tool for various biomedical applications, such as tissue regeneration and tissue model engineering. To this end, the development of bioinks with multiple functions plays a crucial role in the applications of 3D bioprinting technologies. In this study, we propose a new bioink based on two immiscible aqueous phases of gelatin methacryloyl (GelMA) and dextran, further endowed with anti-bacterial and anti-inflammatory properties. This micropore-forming GelMA-dextran (PGelDex) bioink exhibited excellent printability with vat-polymerization, extrusion, and handheld bioprinting methods. The porous structure was confirmed after bioprinting, which promoted the spreading of the encapsulated cells, exhibiting the exceptional cytocompatibility of this bioink formulation. To extend the applications of such a micropore-forming bioink, interleukin-4 (IL-4)-loaded silver-coated gold nanorods (AgGNRs) and human mesenchymal stem cells (MSCs) were simultaneously incorporated, to display synergistic anti-infection behavior and immunomodulatory function. The results revealed the anti-bacterial properties of the AgGNR-loaded PGelDex bioink for both Gram-negative and Gram-positive bacteria. The data also indicated that the presence of IL-4 and MSCs facilitated macrophage M2-phenotype differentiation, suggesting the potential anti-inflammatory feature of the bioink. Overall, this unique anti-bacterial and immunomodulatory micropore-forming bioink offers an effective strategy for the inhibition of bacterial-induced infections as well as the ability of immune-regulation, which is a promising candidate for broadened tissue bioprinting applications.

Epidemiología del paciente pediátrico quemado en el Hospital Baca Ortiz, Quito, Ecuador / Epidemiology of the burned pediatric patient at Baca Ortiz Hospital, Quito, Ecuador

Introducción y objetivo. Las quemaduras son un problema mundial de salud pública por su gran impacto físico, psicológico, económico y social. El objetivo de este trabajo es describir las características epidemiológicas de los pacientes pediátricos con quemaduras en nuestro entorno asistencial. Material y método. Realizamos un estudio descriptivo retrospectivo tomando como universo al total de pacientes pediátricos con quemaduras atendidos en el Hospital Baca Ortiz de Quito, Ecuador, de enero a diciembre del 2016. Resultados. Recogimos un total de 343 pacientes pediátricos con quemaduras de los que 180 requirieron hospitalización (52.48%), con predominio de menores de 5 años (67.6%). El género masculino fue el más afectado (55.7%) y las quemaduras por líquido caliente representaron el 70.6%. Las de mayor estancia hospitalaria fueron las quemaduras eléctricas. Registramos una mortalidad del 1.1% relacionada con quemaduras por fuego, de más del 50% de superficie corporal y con compromiso de vía aérea. Conclusiones. Los menores de 5 años son más vulnerables para sufrir quemaduras. La principal etiología fue líquido hirviente. Los casos fatales tuvieron relación con quemaduras por fuego y lesión de vía aérea. Las quemaduras eléctricas son devastadoras, la severidad de sus lesiones ocasiona mayor estancia hospitalaria y un aumento de la necesidad de amputación de la extremidad afectada

Background and objective. Burns are considered a public health problem worldwide due to the great physical, psychological, economic and social impact they cause. The objective of this paper is to describe epidemiological characteristics of pediatric patients with burns in our regional area. Methods. A retrospective descriptive study was carried out taking as universe total number of pediatric patients with burns treated at Baca Ortiz Hospital in Quito, Ecuador, from January to December 2016. Results. We studied 343 pediatric patients with burns of which 180 required hospitalization (52.48%). Predominance of younger than 5 years old (67.6%) was observed. Masculine gender was most affected (55.7%), burns caused by hot liquid reported a frequency of 70.6%. Electric burns reported longer hospital stay. Mortality of 1.1% was registered related to burns caused by fire, greater than 50% of body surface area and airway commitment. Conclusions. Children younger than 5 years old are most vulnerable to burn. Hot liquid was the main etiology of burns. Fatal cases were related to burns caused by fire and airway injury. Electric burns are devastating; severity of injuries causes longer hospital stay and greater need for amputation of affected limb

Profesionales de enfermería docentes de la Universidad Nacional de Cajamarca frente a la profesión y la política / Professional nursing teachers at the National University of Cajamarca in front of the profession and politics

Investigación exploratoria sobre las actitudes y comportamientos ante la profesión y la política presentes en las representaciones colectivas de 74 docentes de la Escuela de Enfermería sede central de Cajamarca y secciones de Chota y Jaén. La metodología aplicada fue la Historia Oral obtenida en entrevistas semiestructuradas y la recuperación histórica de las dimensiones del cotidiano profesional de enfermería, salud y educación. La revisión histórica del origen social de la profesión de Enfermería permitió comprender y explicar las actitudes, comportamientos y representaciones colectivas de las enfermeras. El análisis de las políticas de salud y educación condujeron a comprender la política educacional de Enfermería y la formación del enfermero en el país. Se trabajaron los resultados a través del análisis cruzado, priorizando los relatos más significativos que evidenciaron la relación establecida entre el poder y el saber médico en la profesión, así como el condicionamiento de estereotipos de femineidad y masculinidad propios de nuestra sociedad androcéntrica. La finalidad esencial del estudio es ofrecer horizontes para nuevas investigaciones en las instituciones de enseñanza y buscar las estrategias necesarias para revertir situaciones descubiertas, contribuyendo así al establecimiento de relaciones equitativas de poder y saber en la profesión, creadoras a su vez, de una identidad profesional más autónoma en la historia de la profesión que, por cierto, en el país aún no se ha escrito.