Avocado Creole Peel Ameliorates Metabolic Alterations Caused by a High Sucrose Fat Diet in a Wistar Rats Model.

High-sucrose high-fat diets are one of the causes of malnutrition, and may induce metabolic alterations such as dyslipidemia, insulin resistance, and adipogenesis. The objective of this work was to investigate the possible protective effect of traditionally edible avocado creole peel (Persea americana Mill var. drymifolia) when consuming a high-sucrose and fat diet (HSFD). The experimental animal model included 21 male Wistar rats divided in three groups: the control group received a standard diet of purina®, the HSFD group received a high fat diet plus 30% sucrose in drinking water, and finally the HSFD + AP group received the HSFD diet supplemented with 200 mg/kg of avocado peel for 14 weeks. It was observed that alterations included higher cholesterol, glucose, insulin, fatty acids and TNF-α levels as well as lower HDL, and adiponectin. The addition of avocado peel reverted some of these effects, resulting in normal values of triglicerides, insulin and adiponectin, while attenuated the levels of total cholesterol. Liver weight of the group added with avocado peel was similar to the control group. The neuronal density in the hippocampal areas CA1 and dentate gyrus DC were lower in the high glucose fat group, while the ingestion of the avocado peel showed a neuroprotective effect. The avocado creole ingestion reverted or attenuated most of the metabolic effects caused by a high-sucrose fat diet which was attributed to the compounds detected by HPLC-MS and GC-MS that included bioactive polyphenols such as flavanol quercetin, flavanone naringenin, flavan 3-ol catechin, cyanidin 3-glucoside, pelargonidin 3-glucoside, pelargonidin 3-rhamnoside, hydroxydelphinidin, eugenol and estragole.

Predicting Viral Failure in Human Immunodeficiency Virus Perinatally Infected Youth With Persistent Low-Level Viremia on Highly Active Antiretroviral Therapy.

BACKGROUND: Less than optimal adherence with antiretroviral therapy occurs commonly among human immunodeficiency virus HIV)-infected youth. In this study, our object was to identify patterns in the prefailure measurement of viral load (VL) that can reliably predict virological failure (VF) in HIV perinatally infected youth on highly active antiretroviral therapy (HAART). METHODS: We conducted a retrospective chart review of HIV-infected youth with low-level viremia (LLV), defined as an HIV VL between the lower limits of detection (20-75 copies/mL) and 1000 copies/mL. All patients were perinatally infected, under 22 years of age, observed for at least 24 months of consecutive follow-up between May 2008 and July 2014, and received their HIV care at the University of Miami Miller School of Medicine. Of the 349 subjects screened, 100 were eligible for analysis. Virological failure was defined as 3 or more consecutive VLs greater than 1000 copies/mL. Multiple logistic regression and receiver operator characteristic curves were used to identify patterns in VL that ultimately resulted in VF. RESULTS: Fifteen of the 100 patients experienced VF. Higher log10 mean VL, positive slope of the VL (log10 copies/mL per day), and fewer clinic visits were associated with a higher probability of VF. Sensitivity and specificity were .87 and .95, respectively. Resistance was not found in 12 of 15 patients with VF. CONCLUSIONS: Patients with LLV that had fewer clinic visits and a trend toward increasing VLs had an increased risk of VF. Noncompliance seems to be a major component of VF. Physicians should emphasize the critical nature of medication adherence.

First Travel-Associated Congenital Zika Syndrome in the US: Ocular and Neurological Findings in the Absence of Microcephaly.

A 6-day-old female baby with known diagnosis of congenital Zika infection was referred for ophthalmologic examination. The mother (37 years old) was referred for a pruritic rash, conjunctival hyperemia, and malaise at 12 weeks of gestation while still living in Venezuela. Upon arrival to Miami, Zika virus (ZIKV) exposure was confirmed during prenatal screening. At birth, due to the known exposure, a complete congenital ZIKV workup was performed, including brain ultrasound and MRI, which disclosed calcifications in the frontal lobe. Fundus examination revealed a hypopigmented retinal lesion in the left eye that was documented with retinal imaging. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:952-955.].

Guía de práctica clínica para la detección temprana, diagnóstico y tratamiento de la fase aguda de intoxicación de pacientes con abuso o dependencia del alcohol Parte I: Tamización, detección temprana y factores de riesgo en pacientes con abuso o dependencia del alcohol / Clinical practice guide for early detection, diagnosis and treatment of the acute intoxication phase in patients with alcohol abuse or dependencepart i: screening, early detection and risk factors in patients with alcohol abuse or dependence

Introducción: El alcohol es la segunda sustancia psicotrópica más usada en el mundo y el tercer factor de riesgo para muerte prematura y discapacidad. Su uso nocivo es un problema de salud pública mundial, dado su impacto personal, laboral, familiar, económico y social. Hasta el 70 % de las personas en riesgo de tener problemas con el alcohol no se detectan en la práctica médica, lo que hace pensar que se requieren medidas de tamizaje específicas que permitan la detección temprana y lleven a un tratamiento oportuno. Este artículo presenta la evidencia encontrada en tamización de abuso y dependencia de alcohol y en tamización e identificación de factores de riesgo; también presenta la evidencia relacionada con síndrome de abstinencia, delirium tremens y encefalopatía de Wernicke, con el fin promover una de detección temprana y un tratamiento oportuno. Método: Revisiones sistemáticas de la evidencia disponible y evaluación de las guías pertinentes identificadas en la literatura, para decidir, en cada pregunta, si se adopta o se adapta a una recomendación ya existente, o si se desarrollan recomendaciones de novo. Para las recomendaciones de novo y aquellas adaptadas, se realizó una síntesis de la evidencia, se elaboraron tablas de evidencia y se formularon las recomendaciones basadas en evidencia. Resultados: Se encuentra evidencia y se realizan recomendaciones para tamización pertinente y búsqueda de factores de riesgo, con el fin de realizar un diagnóstico y un manejo oportuno de abuso y dependencia a alcohol y sus complicaciones: síndrome de abstinencia, delirium tremens y encefalopatía de Wernicke...

Introduction: Worldwide, alcohol is the second most-used psychotropic substance and the third risk factor for early death and disability. Its noxious use is a world public health problem given its personal, labor, family, economic and social impact. 70 % of people under risk of having alcohol problems go undetected in medical practice, a fact that underlines the need for specific screening measures allowing early detection leading to timely treatment. This article presents evidence gathered by alcohol abuse and dependence screening as well as by risk factor identification and screening. It also presents evidence concerning withdrawal symptoms, delirium tremens and Wernicke’s encephalopathy in order to promote early detection and timely treatment. Methodology: Systematic revision of the evidence available together with an evaluation of pertinent guidelines found in literature so as to decide whether to adopt or adapt the existing recommendation for each question or to develop de novo recommendations. For de novo recommendations as well as those adapted, it was carried out an evidence synthesis, together with evidence tables and formulation of recommendations based on the evidence. Results: Evidence was found and recommendations were made for the pertinent screening and search of risk factors, in order to perform a diagnosis and carry out a timely management of alcohol abuse, dependence and ensuing complications: withdrawal syndrome, delirium tremens and Wernicke’s encephalopathy...

Guía de práctica clínica para la detección temprana, diagnóstico y tratamiento de la fase aguda de intoxicación de pacientes con abuso o dependencia del alcohol: Parte II: Evaluación y manejo de los pacientes con intoxicación aguda por alcohol / Clinical practice guide for early detection, diagnosis and treatment of the acute intoxication phase in patients with alcohol abuse or dependence Part II: evaluation and management of patients with acute alcohol intoxication

Introducción: El alcohol es la segunda sustancia psicotrópica más usada en el mundo y el tercer factor de riesgo para muerte prematura y discapacidad. Su uso nocivo es un problema de salud pública mundial, dado su impacto personal, laboral, familiar, económico y social. Es de suma importancia la identificación de intoxicación aguda por alcohol, el síndrome de abstinencia alcohólica y sus complicaciones, como delirium tremens y encefalopatía de Wernicke, para garantizar de esta manera un tratamiento oportuno para estos pacientes. Este artículo busca presentar la evidencia encontrada para el abordaje y el tratamiento de estas presentaciones clínicas. Método: Revisiones sistemáticas de la evidencia disponible y se evaluaron las guías pertinentes identificadas en la literatura, para decidir, en cada pregunta, si se adopta o se adapta a una recomendación ya existente, o bien, si se desarrollan recomendaciones de novo. Para las recomendaciones de novo y aquellas adaptadas, se realizó una síntesis de la evidencia, se elaboraron tablas de evidencia y se formularon las recomendaciones basadas en evidencia. Resultados: Se encuentra evidencia y se realizan recomendaciones para abordaje y tratamiento pertinente de intoxicación alcohólica aguda, síndrome de abstinencia, delirium tremens y encefalopatía de Wernicke...

Introduction: Worldwide, alcohol is the second most-used psychotropic substance and the third risk factor for early death and disability. Its noxious use is a world public health problem given its personal, labor, family, economic and social impact. The identification of acute alcohol intoxication is extremely important, as well as the alcohol withdrawal syndrome and its complications, such as delirium tremens and Wernicke’s encephalopathy in order to grant a timely treatment for those patients. This article introduces the evidence found so as to face and treat these clinic manifestations. Methodology: Systematic revision of the evi dence available together with an evaluation of pertinent guidelines found in literature so as to decide whether to adopt or adapt the existing recommendation for each question or to develop de novo recommendations. For de novo recommendations as well as those adapted, it was carried out an evidence synthesis, together with evidence tables and formulation of recommendations based on the evidence. Results: Evidence was found and recommendations were made for the diagnosis and treatment of acute alcohol intoxication, withdrawal syndrome, delirium tremens and Wernicke’s encephalopathy...

[Clinical Practice Guide for Early Detection, Diagnosis and Treatment of the Acute Intoxication Phase in Patients with Alcohol Abuse or Dependence: Part II: Evaluation and Management of Patients with Acute Alcohol Intoxication]. / Guía de práctica clínica para la detección temprana, diagnóstico y tratamiento de la fase aguda de intoxicación de pacientes con abuso o dependencia del alcohol: Parte II: Evaluación y manejo de los pacientes con intoxicación aguda por alcohol.

INTRODUCTION: Worldwide, alcohol is the second most-used psychotropic substance and the third risk factor for early death and disability. Its noxious use is a world public health problem given its personal, labor, family, economic and social impact. The identification of acute alcohol intoxication is extremely important, as well as the alcohol withdrawal syndrome and its complications, such as delirium tremens and Wernicke's encephalopathy in order to grant a timely treatment for those patients. This article introduces the evidence found so as to face and treat these clinic manifestations. METHODOLOGY: Systematic revision of the evidence available together with an evaluation of pertinent guidelines found in literature so as to decide whether to adopt or adapt the existing recommendation for each question or to develop de novo recommendations. For de novo recommendations as well as those adapted, it was carried out an evidence synthesis, together with evidence tables and formulation of recommendations based on the evidence. RESULTS: Evidence was found and recommendations were made for the diagnosis and treatment of acute alcohol intoxication, withdrawal syndrome, delirium tremens and Wernicke's encephalopathy.

[Clinical Practice Guide for Early Detection, Diagnosis and Treatment of the Acute Intoxication Phase in Patients with Alcohol Abuse or Dependence: Part I: Screening, Early Detection and Risk Factors in Patients with Alcohol Abuse or Dependence]. / Guía de práctica clínica para la detección temprana, diagnóstico y tratamiento de la fase aguda de intoxicación de pacientes con abuso o dependencia del alcohol: Parte I: Tamización, detección temprana y factores de riesgo en pacientes con abuso o dependencia del alcohol.

INTRODUCTION: Worldwide, alcohol is the second most-used psychotropic substance and the third risk factor for early death and disability. Its noxious use is a world public health problem given its personal, labor, family, economic and social impact. 70 % of people under risk of having alcohol problems go undetected in medical practice, a fact that underlines the need for specific screening measures allowing early detection leading to timely treatment. This article presents evidence gathered by alcohol abuse and dependence screening as well as by risk factor identification and screening. It also presents evidence concerning withdrawal symptoms, delirium tremens and Wernicke's encephalopathy in order to promote early detection and timely treatment. METHODOLOGY: Systematic revision of the evidence available together with an evaluation of pertinent guidelines found in literature so as to decide whether to adopt or adapt the existing recommendation for each question or to develop de novo recommendations. For de novo recommendations as well as those adapted, it was carried out an evidence synthesis, together with evidence tables and formulation of recommendations based on the evidence. RESULTS: Evidence was found and recommendations were made for the pertinent screening and search of risk factors, in order to perform a diagnosis and carry out a timely management of alcohol abuse, dependence and ensuing complications: withdrawal syndrome, delirium tremens and Wernicke's encephalopathy.

Tratamiento de adicciones en Colombia / Treatment of addiction in Colombia

Introducción: Frente a la polémica sobre la penalización de la dosis personal y la pretensión inicial de forzar a los consumidores a tratarse, es importante precisar los contextos legal, epidemiológico, social y clínico de la problemática y los tratamientos disponibles en el país. Objetivo: Revisar los aspectos epidemiológicos, sociales y de comorbilidad de los trastornos adictivos y relacionarlos con las características de los centros de tratamiento existentes en el país. Método: Búsqueda en bases de datos Pubmed, EBSCO, Host y OVID SP, utilizando como palabras clave: adicción, tratamiento, comorbilidad y sustancias psicoactivas (SPA). Se priorizaron los trabajos publicados en la última década con estricta metodología científica. Se incluyeron publicaciones anteriores por tratarse de los primeros estudios epidemiológicos nacionales sobre consumo de SPA. Resultado: El consumo de SPA continúa en aumento. Está frecuentemente asociado con enfermedad mental (trastorno de personalidad, trastorno bipolar I y II, trastornos de ansiedad y psicosis), por lo que se requiere manejo profesional especializado. Conclusión: El consumo de SPA (un problema de salud pública), necesita un tratamiento integrado que considere las individualidades del sujeto y su comorbilidad. Los centros de tratamiento disponibles en el país son insuficientes para satisfacer la demanda. Un gran número de ellos carecen de los elementos mínimos para garantizar una atención adecuada, así como la identificación de patología dual...

Introduction: In the face of recent debates linked to the penalization of the personal dose and the intention of implementing a mandatory rehabilitation treatment for consumers it is important to analyze all legal, epidemiological, social and clinical contexts of the problem and the treatment options available in the country. Objective: To review the epidemiological, social and comorbidity aspect of the addictive conducts and establish a relationship with the characteristics of the treatment centers existing in the country. Method: A research using Pubmed, EBSCO, Host and OVID SP databases, using keywords such as addiction, treatment, comorbidity, psychoactive substances (PAS). The works, published in the last decade were prioritized using strict scientific methodology. Prior publications were included since they were the first national epidemiological studies on PAS. Results: The PAS consumption continues to expand in the country and is strongly associated to mental illness (personality disorders, bipolar I and II disorder, anxiety disorders and psychosis). These can be identified and treated by specialized professionals. Conclusion: The PAS consumption (a public health issue) requires an integrated treatment that takes into consideration the particularities of each subject and its co morbidity. The available treatment centers are insufficient to satisfy the demand. A vast number of them do not have the minimum elements to guarantee an adequate treatment and to identify the dual pathology involved...

Practice of feeding premasticated food to infants: a potential risk factor for HIV transmission.

OBJECTIVES: Although some caregivers are known to premasticate food for infants, usually during the weaning period, HIV transmission has not been linked to this practice. We describe 3 cases of HIV transmission in the United States possibly related to this practice. PATIENTS AND METHODS: Three cases of HIV infection were diagnosed in children at ages 9, 15, and 39 months; clinical symptomatology prompted the testing. A thorough investigation to rule out alternative modes of transmission was conducted. In addition, phylogenetic comparisons of virus from cases and suspected sources were performed by using the C2V3C3 or gp41 region of env and the p17 coding region of gag. RESULTS: In 2 cases, the mothers were known to be infected with HIV, had not breastfed their children, and perinatal transmission of HIV had previously been ruled out following US HIV testing guidelines. In the third case, a great aunt who helped care for the child was infected with HIV, but the child's mother was not. All 3 children were fed food on multiple occasions that had been premasticated by a care provider infected with HIV; in 2 cases concurrent oral bleeding in the premasticating adult was described. Phylogenetic analyses supported the epidemiologic conclusion that the children were infected through exposure to premasticated food from a caregiver infected with HIV in 2 of the 3 cases. CONCLUSIONS: The reported cases provide compelling evidence linking premastication to HIV infection, a route of transmission not previously reported that has important global implications including being a possible explanation for some of the reported cases of "late" HIV transmission in infants, so far attributed to breastfeeding. Until the risk of premastication and modifying factors (eg, periodontal disease) are better understood, we recommend that health care providers routinely query children's caregivers and expecting parents who are infected with HIV or at risk of HIV infection about this feeding practice and direct them to safer, locally available, feeding options.

Synthesis and antitumor activity of mechercharmycin A analogues.

Several analogues of the cytotoxic thiopeptide IB-01211 or mechercharmycin A (1) have been synthesized. The cytotoxicity of 1 and the synthesized analogues were evaluated against a panel of three human tumor cell lines. Thiopeptide 1 and the most active derivatives 2 and 3c were chosen for further studies on effects on cell cycle progression and induction of apoptosis. Interestingly, the inhibition of cell division and activation of a programmed cell death by apoptosis were detected.

Optimization of multiple headspace solid-phase microextraction for the quantification of volatile compounds in dry fermented sausages.

Multiple headspace solid-phase microextraction (HS-SPME) is a stepwise method that eliminates the influence of the matrix sample on the quantitative analysis of solid samples. The process was optimized for the analysis of volatile compounds in dry fermented sausages by gas chromatography and mass spectrometry. Different amounts of fermented sausages and different vial volumes were studied to obtain the theoretical exponential decay of the peak area of the four successive extractions in order to calculate the total area in the sausage. The highest number of volatile compounds analyzed by multiple HS-SPME in dry fermented sausages was obtained in a 10 mL headspace vial with 0.07 g of sample in the presence of water, 0.75 mg butylated hydroxytoluene, and 0.5 g sodium chloride. Finally, the method was characterized in terms of linearity and detection limits and applied to analyze the volatile compounds present in fermented sausages manufactured with either nitrate or nitrite.

Synthesis of IB-01211, a cyclic peptide containing 2,4-concatenated thia- and oxazoles, via Hantzsch macrocyclization.

[structure: see text] An efficient and versatile convergent synthesis of IB-01211 based on a combination of peptide and heterocyclic chemistry is described. The key step in the synthesis is macrocyclization through intramolecular Hantzsch formation of the thiazole ring. Dehydration of a free primary alcohol to furnish the exocyclic methylidene present in the natural product was applied during the macrocyclization.

Estudio del polimorfismo de debrisoquina en una muestra de la población cubana / Study of debrisoquine polymorphism in a sample of the Cuban population

Las diferencias en la capacidad con que cada individuo metaboliza una droga por una vía determinada tiene relevancia clínica para medicamentos de amplio uso, de estrecho margen de seguridad, si esa es la principal vía en la eliminación de la droga, o si el número de alternativas terapéuticas es limitada; por tanto, la información farmacogenética es esencial en la terapéutica individualizada y contribuye a un uso racional de medicamentos. Como el citocromo P4502D6 (CYP2D6) cataliza más del 65 por ciento de los fármacos comúnmente empleados en la práctica habitual, se propusó identificar la presencia de diferentes fenotipos metabolizadores del CYP2D6 en una muestra de 104 sujetos de la población cubana. Se determinó la razón metabólica entre las concentraciones urinarias de debrisoquina y su metabolito 4OH-debrisoquina, cuantificados mediante cromatografía líquida de alta resolución. Se encontró que el 3,84 por ciento de los individuos estudiados son metabolizadores lentos

Estudio del polimorfismo de debrisoquina en una muestra de la población cubana / Study of debrisoquine polymorphism in a sample of the Cuban population

Las diferencias en la capacidad con que cada individuo metaboliza una droga por una vía determinada tiene relevancia clínica para medicamentos de amplio uso, de estrecho margen de seguridad, si esa es la principal vía en la eliminación de la droga, o si el número de alternativas terapéuticas es limitada; por tanto, la información farmacogenética es esencial en la terapéutica individualizada y contribuye a un uso racional de medicamentos. Como el citocromo P4502D6 (CYP2D6) cataliza más del 65 por ciento de los fármacos comúnmente empleados en la práctica habitual, se propusó identificar la presencia de diferentes fenotipos metabolizadores del CYP2D6 en una muestra de 104 sujetos de la población cubana. Se determinó la razón metabólica entre las concentraciones urinarias de debrisoquina y su metabolito 4OH-debrisoquina, cuantificados mediante cromatografía líquida de alta resolución. Se encontró que el 3,84 por ciento de los individuos estudiados son metabolizadores lentos(AU)

A program to increase seat belt use along the Texas-Mexico border.

A school-based, bilingual intervention was developed to increase seat belt use among families living along the Texas-Mexico border. The intervention sought to increase seat belt use by changing perceived norms within the community (i.e., making the nonuse of seat belts less socially acceptable). The intervention was implemented in more than 110 classrooms and involved more than 2100 children. Blind coding, validity checks, and reliability estimates contributed to a rigorous program evaluation. Seat belt use increased by 10% among children riding in the front seat of motor vehicles in the intervention community, as compared with a small but nonsignificant decline in use among control community children. Seat belt use among drivers did not increase.