Prevención y promoción de la salud de heridas mediante el uso ambulatorio de la termografía portátil. Estudio piloto / Prevention and promotion of wound health through the ambulatory use of portable thermography. Pilot study

Introducción y objetivo: Las heridas crónicas requieren seguimiento continuo para evaluación y prevención de complicaciones. Esta evaluación es subjetiva, sujeta a errores y consume mucho tiempo y dinero para pacientes y salud pública. Proponemos utilizar modelos tridimensionales y termográficos que complementan la evaluación de heridas. Material y método: Estudio piloto en 6 casos en donde se propone la creación de modelos tridimensionales termográficos a partir de imágenes obtenidas con dispositivos portátiles de bajo costo. Resultados: Muestran patrones de diferencias de temperaturas que parecen relacionarse con el comportamiento del área de esta herida. Conclusiones: Observamos la utilidad de una herramienta de visualización de bajo costo e indicadores objetivos cuantitativos y cualitativos de la evolución de heridas, así como la posibilidad de realizar la monitorización en zonas remotas en donde hay falta de especialistas, ya que al proveer métricas, ayudaría en su seguimiento y evaluación.(AU)

Background and objective: Chronic wounds require regular monitoring for evaluation and prevention of complications. Such assessment remains subjective, prone to error, and it is often a time-consuming and costly process for patients and public health. We propose to use three-dimensional thermographic models that can complement wound assessment. Methods: A pilot study in 6 participants where three-dimensional thermographic models were created from images obtained with low-cost portable devices. Results: The results show patterns of temperature differences that seem to be related to the behavior of the wound area. Conclusions: We observe its usefulness in providing a low-cost visualization tool and objective quantitative and qualitative indicators of the evolution of wounds, as well as the possibility of monitoring in remote areas where there is a lack of specialists, since by providing metrics, it would help in their monitoring and evaluation.(AU)

Simple Sequence Repeat Markers Reveal Genetic Diversity and Population Structure of Bolivian Wild and Cultivated Tomatoes (Solanum lycopersicum L.).

The western part of South America is a centre of diversity for tomatoes, but genetic diversity studies are lacking for parts of that region, including Bolivia. We used 11 simple sequence repeat (SSR) markers (including seven novel markers) to evaluate genetic diversity and population structure of 28 accessions (four modern cultivars, four advanced lines, nine landraces, 11 wild populations), and to compare their genetic variation against phenotypic traits, geographical origin and altitude. In total, 33 alleles were detected across all loci, with 2-5 alleles per locus. The top three informative SSRs were SLM6-11, LE20592 and TomSatX11-1, with polymorphism information content (PIC) of 0.65, 0.55 and 0.49, respectively. The genetic diversity of Bolivian tomatoes was low, as shown by mean expected heterozygosity (He) of 0.07. Analysis of molecular variance (AMOVA) revealed that 77.3% of the total variation was due to variation between accessions. Significant genetic differentiation was found for geographical origin, cultivation status, fruit shape, fruit size and growth type, each explaining 16-23% of the total variation. Unweighted Pair Group Method with Arithmetic Mean (UPGMA) tree and principal coordinate analysis (PCoA) scatter plot both revealed differentiation between accessions with determinate flowers and accessions with indeterminate flowers, regardless of cultivation status. The genetic profiles of the accessions suggest that the Bolivian tomato gene pool comprises both strictly self-pollinating and open-pollinating genotypes.

Diabetes Status is Associated With Plantar Soft Tissue Stiffness Measured Using Ultrasound Reverberant Shear Wave Elastography Approach.

INTRODUCTION: The purpose of this study was to investigate the association between the mechanical properties of plantar soft tissue and diabetes status. METHOD: 51 (M/F: 21/30) participants with prediabetes onset (fasting blood sugar [FBS] level > 100 mg/dL), age >18 years, and no lower limb amputation were recruited after ethical approval was granted from Pontificia Universidad Catolica del Peru ethical review board. Ultrasound reverberant shear wave elastography was used to assess the soft tissue stiffness at the 1st metatarsal head (MTH), 3rd MTH, and the heel at both feet. RESULTS: Spearman's rank-order correlation (rho) test indicated a significant (P < .05) positive correlations between FBS level and the plantar soft tissue shear wave speed at the 1st MTH: rho = 0.402 (@400 Hz), rho = 0.373 (@450 Hz), rho = 0.474 (@500 Hz), rho= 0.395 (@550 Hz), and rho = 0.326 (@600 Hz) in the left foot and rho = 0.364 (@450 Hz) in the right foot. Mann-Whitney U test indicated a significantly (P < .05) higher shear wave speed in the plantar soft tissue with the following effect sizes (r) at the 1st MTH of the left foot at all tested frequencies: r = 0.297 (@450 Hz), r = 0.345 (@500 Hz), r = 0.322 (@550 Hz), and r = 0.275 (@600 Hz), and at the 1st MTH of right foot r = 0.286 (@400 Hz) in diabetes as compared with the age and body mass index matched prediabetes group. CONCLUSION: An association between fasting blood sugar level and the stiffness of the plantar soft tissue with higher values of shear wave speed in diabetes versus prediabetes group was observed. This indicated that the proposed approach can improve the assessment of the severity of diabetic foot complications with potential implications in patient stratification.

Plantar Soft Tissue Characterization Using Reverberant Shear Wave Elastography: A Proof-of-Concept Study.

Plantar soft tissue stiffness provides relevant information on biomechanical characteristics of the foot. Therefore, appropriate monitoring of foot elasticity could be useful for diagnosis, treatment or health care of people with complex pathologies such as a diabetic foot. In this work, the reliability of reverberant shear wave elastography (RSWE) applied to plantar soft tissue was investigated. Shear wave speed (SWS) measurements were estimated at the plantar soft tissue at the first metatarsal head, the third metatarsal head and the heel from both feet in five healthy volunteers. Experiments were repeated for a test-retest analysis with and without the use of gel pad using a mechanical excitation frequency range between 400 and 600 Hz. Statistical analysis was performed to evaluate the reliability of the SWS estimations. In addition, the results were compared against those obtained with a commercially available shear wave-based elastography technique, supersonic imaging (SSI). The results indicate a low coefficient of variation for test-retest experiments with gel pad (median: 5.59%) and without gel pad (median: 5.83%). Additionally, the values of the SWS measurements increase at higher frequencies (median values: 2.11 m/s at 400 Hz, 2.16 m/s at 450 Hz, 2.24 m/s at 500 Hz, 2.21 m/s at 550 Hz and 2.31 m/s at 600 Hz), consistent with previous reports at lower frequencies. The SWSs at the plantar soft tissue at the first metatarsal head, third metatarsal head and heel were found be significantly (p<0.05) different, with median values of 2.42, 2.16 and 2.03 m/s, respectively which indicates the ability of the method to differentiate between shear wave speeds at different anatomical locations. The results indicated better elastographic signal-to-noise ratios with RSWE compared to SSI because of the artifacts presented in the SWS generation. These preliminary results indicate that the RSWE approach can be used to estimate the plantar soft tissue elasticity, which may have great potential to better evaluate changes in biomechanical characteristics of the foot.

Impact of Cations (Na+, K+, Mg+2) and Anions (F-, Cl-, SO42-) Leaching from Filters Packed with Natural Zeolite and Ferric Nanoparticles for Wastewater Treatment.

Natural zeolites have been employed to adsorb contaminants in water. This study is aimed to evaluate the cation and anion leaching from the zeolite after the wastewater was passed through filters packed with a natural zeolite (heulandite-CaAl2Si7O18·6H2O). Eight treatments were evaluated in a 2 × 2 × 2 factorial treatment design. Factor A was the zeolite with two levels: 127 g and 80.4 g. Factor B was the nanoparticles with two levels: one bag (3.19 g) and two bags (6.39 g); and Factor C was the use of a magnet: with and without. There were two replications; hence, a total of 16 filters were employed. The water was obtained from a municipal wastewater treatment plant (MWTP). The cations (Na+, K+; Mg+2 and Ca+2) and anions (F-, Cl- and SO42-) were measured before (influent = IW) and after filtering (effluent = EW) three times. All treatments leached the cations Na+ (EW in a range of 175 to 232 ppm), K+ (EW in a range of 15.4 to 33.2 ppm), and Mg+2 (EW in a range of 7.40 to 10.8 ppm) but did not leach Ca+2. Likewise, the treatments leached the anions F- (EW in a range of 7.59 to 8.87 ppm), Cl- (EW in a range of 85.9 to 120 ppm), and SO42- (EW in a range of 139 to 146 ppm). We conclude that this natural zeolite leaches cations (except Ca+2) and anions in MWTP passed through filters. Therefore, its application in wastewater treatment should be considered for purposes such as agriculture and animal production and not for drinking water.

Vigilancia epidemiología nutricional / Surveillance nutritional epidemiology

Un sistema de vigilancia epidemiológica para que sea eficiente, debe ser representativo de las diferentes condiciones existentes, tener cobertura suficiente, bien definida las actividades de cada uno de sus componentes y ser oportuno en sus conclusiones y recomendaciones