Prevalence of polypharmacy and drug interaction in older adults with rheumatic disease.

INTRODUCTION/AIM: Older people with rheumatic diseases tend to have a greater number of associated comorbidities, which will require the use of more drugs, increasing the risk of hospitalizations, complications, and drug interactions. In Mexico, there has been an estimated prevalence of polypharmacy of up to 55%, however there are scarce reports on the topic in our elderly population with rheumatic diseases. We aimed to determine the prevalence of polypharmacy and the association of drug interactions in patients treated for rheumatic disease. METHODS: A retrospective observational study was conducted on patients undergoing treatment for rheumatic diseases who were treated in geriatrics and rheumatology clinics from January to December 2021. The presence of polypharmacy and drug interactions was evaluated using the BOT Plus Pharmacological Surveillance System. The prevalence of polypharmacy and the association of drug interactions were estimated. RESULTS: We evaluated 320 patients, with a mean age of 67.05±5.8 years, predominantly female (85%). The prevalence of polypharmacy was 68.1% (n=218), of which 214 (98.1%) patients had related drug interactions; 27.1% were severe and 53.2% as moderate interactions. Factors related with increased risk of drug interactions were being exposed to hypertension increased the risk of drug interactions (POR 1.75, 95% CI 1.44-2.14; P<0.001), having osteoarthritis (POR 1.21, 95% CI 1.04-1.42; P=0.032) and thyroid disease (POR 1.45, 95% CI 1.28-1.65; P=0.001). The most prevalent serious interactions were leflunomide-methotrexate in 27 (46.5%) patients and buprenorphine-tramadol in 8 (13.7%). CONCLUSIONS: A high prevalence of polypharmacy and drug interactions was observed in elderly patients with rheumatic diseases. The main associated factors were comorbidities, particularly high blood pressure, osteoarthritis and thyroid diseases.

Venta de alimentos saludables y funcionamiento de cantinas escolares de Tobatí. Cumplimiento de la resolución n° 16.264/13

Introducción: La Resolución N° 16.264/13 del Ministerio de Educación y Ciencia (MEC) reglamenta el procedimiento y monitoreo de las cantinas escolares del Paraguay. Su cumplimiento podría prevenir consecuencias negativas en salud pública. Objetivos: Evaluar el cumplimiento de la Resolución N° 16.264/13, venta de alimentos saludables y funcionamiento de cantinas de escuelas públicas de Tobatí. Materiales y métodos: Estudio transversal en las cantinas de 11 escuelas. El instrumento fue una encuesta elaborada en base al Anexo 2 de la mencionada Resolución. Este estudio fue aprobado por el Comité de Ética en Investigación de la FCQ-UNA (Dictamen 242/16). Resultados: Los manipuladores de 8/11 cantinas, afirmaron conocer la Resolución N° 16.264/13 y la mayoría no recibió capacitación correspondiente. En 8/11 establecimientos se constataron que los pisos, paredes y techos no estaban en buen estado; 6/11 mantenían limpias las superficies de contacto con alimentos; 7/8 contaba con ventilación adecuada. En todas las cantinas un solo personal manipula alimentos y dinero en simultáneo, la mayoría de ellos no contaba con la indumentaria adecuada (cofia y delantal). En los establecimientos estudiados, se observó con mayor frecuencia que se comercializaban embutidos y snacks dulces y salados, aunque también frutas y lácteos. No existían minutas con vegetales disponibles ni las preparaciones fritas se reemplazaban por las horneadas. Conclusión: El cumplimiento de la Resolución N° 16.264/13 en la mayoría de estas cantinas escolares fue bajo y en ellas predominó la venta de alimentos con alto contenido energético y escaso valor nutritivo.

Introduction: The Resolution No. 16,264/13 of the Ministry of Education and Science (MEC) regulates the procedure and monitoring of school canteens in Paraguay. Its compliance could prevent negative consequences on public health. Objectives: Evaluate compliance to Resolution No. 16,264/13, sale of healthy food and operation of canteens in public schools in Tobatí. Materials and methods: A Cross-sectional study in 11 schools´ canteens. The questionaire was a survey based on Annex 2 of the Resolution and was approved by the FCQ-UNA Research Ethics Committee (242/16). Results: The food handlers of 8/11 canteens stated that they were familiar with Resolution No. 16.264/13 and most of them received the corresponding training. In 8/11 establishments it was found that floors, walls, and ceilings were not in good condition; 6/11 kept food contact surfaces clean; 7/8 had adequate ventilation. In all the canteens, only one staff handled food and money at the same time, most of them did not have the appropriate clothing (cap and apron). Most of the establishments sold sausages and sweet and salty snacks, where fruits and dairy products were also sold, and no vegetable meal menus available, nor were fried foods replaced by baked foods. Conclusion: compliance to Resolution No. 16,264/13 in most of these school canteens was low and the sale of food with high energy content and low nutritional value predominated.

Venta de alimentos saludables y funcionamiento de cantinas escolares de Tobatí. Cumplimiento de la resolución n° 16.264/13 / Sale of healthy food and performance of school canteens in Tobatí. Compliance to Resolution n° 16.264/13

La Resolución N° 16.264/13 del Ministerio de Educación y Ciencia (MEC) reglamenta el procedimiento y monitoreo de las cantinas escolares del Paraguay. Su cumplimiento podría prevenir consecuencias negativas en salud pública. Evaluar el cumplimiento de la Resolución N° 16.264/13, venta de alimentos saludables y funcionamiento de cantinas de escuelas públicas de Tobatí. Estudio transversal en las cantinas de 11 escuelas. El instrumento fue una encuesta elaborada en base al Anexo 2 de la mencionada Resolución. Este estudio fue aprobado por el Comité de Ética en Investigación de la FCQ-UNA (Dictamen 242/16). Los manipuladores de 8/11 cantinas, afirmaron conocer la Resolución N° 16.264/13 y la mayoría no recibió capacitación correspondiente. En 8/11 establecimientos se constataron que los pisos, paredes y techos no estaban en buen estado; 6/11 mantenían limpias las superficies de contacto con alimentos; 7/8 contaba con ventilación adecuada. En todas las cantinas un solo personal manipula alimentos y dinero en simultáneo, la mayoría de ellos no contaba con la indumentaria adecuada (cofia y delantal). En los establecimientos estudiados, se observó con mayor frecuencia que se comercializaban embutidos y snacks dulces y salados, aunque también frutas y lácteos. No existían minutas con vegetales disponibles ni las preparaciones fritas se reemplazaban por las horneadas. El cumplimiento de la Resolución N° 16.264/13 en la mayoría de estas cantinas escolares fue bajo y en ellas predominó la venta de alimentos con alto contenido energético y escaso valor nutritivo.

The Resolution No. 16,264/13 of the Ministry of Education and Science (MEC) regulates the procedure and monitoring of school canteens in Paraguay. Its compliance could prevent negative consequences on public health. Evaluate compliance to Resolution No. 16,264/13, sale of healthy food and operation of canteens in public schools in Tobatí. A Cross-sectional study in 11 schools´ canteens. The questionaire was a survey based on Annex 2 of the Resolution and was approved by the FCQ-UNA Research Ethics Committee (242/16). The food handlers of 8/11 canteens stated that they were familiar with Resolution No. 16.264/13 and most of them received the corresponding training. In 8/11 establishments it was found that floors, walls, and ceilings were not in good condition; 6/11 kept food contact surfaces clean; 7/8 had adequate ventilation. In all the canteens, only one staff handled food and money at the same time, most of them did not have the appropriate clothing (cap and apron). Most of the establishments sold sausages and sweet and salty snacks, where fruits and dairy products were also sold, and no vegetable meal menus available, nor were fried foods replaced by baked foods. compliance to Resolution No. 16,264/13 in most of these school canteens was low and the sale of food with high energy content and low nutritional value predominated.

Retirada de elementos de osteosíntesis asociados a cirugías de trauma maxilofacial en hospital público de Santiago de Chile. Estudio retrospectivo de 4 años / Removal of osteosynthesis elements associated with maxillofacial trauma surgery in a public hospital in Santiago, Chile. Retrospective study of 4 years

Introducción: El manejo quirúrgico del trauma maxilofacial implica el uso elementos de osteosíntesis (OTS) para la reducción abierta y fijación interna rígida. Sin embargo, existen razones que determinan su retirada. El objetivo de este estudio fue evaluar la prevalencia de la retirada del material de osteosíntesis y sus causas en el Hospital San José de Santiago de Chile entre los años 2018 y 2021.Metodología: Estudio retrospectivo descriptivo. Se seleccionaron pacientes intervenidos quirúrgicamente por trauma maxilofacial durante el periodo de 4 años. Se analizaron número de pacientes operados, edad, género, comorbilidades, sitio de fractura, cantidad de cirugías de retirada y tiempo en posición de dichos elementos. Referente a la remoción, se obtuvo localización y etiología.Resultados: Las cirugías por trauma maxilofacial correspondieron a 176; de estas, 17 (9,66 %) requirieron la retirada de OTS, retirando un total de 19 elementos. La edad promedio fue 36,5 años. El género masculino predominó sobre el femenino (3,25:1). La zona anatómica frecuente de retirada fue la mandíbula (94,7 %), especialmente el ángulo mandibular. Las principales causas fueron exposición de placa y/o tornillos y la infección del sitio quirúrgico (36,8 %). La mayoría de las retiradas de OTS ocurrieron antes de los 12 meses (84 %) con un tiempo promedio en posición de 10,23 meses.Conclusiones: Los resultados encontrados muestran una baja prevalencia de la retira de OTS, los hombres son los más afectados, el sitio anatómico de retiro frecuente es el hueso mandibular, las causas principales son la exposición de la placa o infección. Estos hallazgos son concordantes con lo reportado en la literatura. (AU)

Introduction: Surgical management of maxillofacial trauma involves the use of osteosynthesis elements (OTS) for open reduction and rigid internal fixation. However, there are reasons that determine their removal. The aim of this study was to evaluate the prevalence of osteosynthesis material removal and its causes at Hospital San José in Santiago de Chile between 2018 and 2021.Methodology: Retrospective descriptive study. Patients who underwent surgery for maxillofacial trauma during the 4-year period were selected. The number of operated patients, age, gender, comorbidities, fracture site, number of removal surgeries and time in position of these elements were analyzed. Regarding removal, location and etiology were obtained.Results: There were 176 surgeries for maxillofacial trauma, of which 17 (9.66 %) required the removal of OTS, removing a total of 19 elements. The average age was 36.5 years. The male gender predominated over the female (3.25:1). The frequent anatomical area of removal was the mandible (94.7 %), especially the mandibular angle. The main causes were plaque and/or screw exposure and surgical site infection (36.8 %). Most OTS removals occurred before 12 months (84 %) with an average time in position of 10.23 months.Conclusions: The results found show a low prevalence of OTS removal, males are the most affected, the frequent anatomical site of removal is the mandibular bone, the main causes are plaque exposure or infection. These findings are consistent with those reported in the literature. (AU)

Langerhans cell histiocytosis in the mandibular condyle and ramus. Endoscopic diagnosis. Case report / Histiocitosis de células de Langerhans en cóndilo y rama mandibular. Diagnóstico por vía endoscópica. Reporte de un caso

Langerhans cell histiocytosis (LCH) is a rare disease caused by uncontrolled proliferation and accumulation of immature bone marrow-derived myeloid dendritic cells. It is common in the pediatric population under 15 years of age and usually affects bones such as the skull, femur and mandibular body. This study presents the case of a 6-year-old female patient, with a bone lesion in the right mandibular ramus and condyle at an unusual location. A sample of the pathological tissue was taken by intraoral endoscopy to avoid comorbidities and esthetic sequelae. After a joint medical evaluation, the lesion was diagnosed as a monofocal LCH with special site involvement, establishing a single systemic treatment with indomethacin, as opposed to the chemotherapy regimen recommended by the International Histiocyte Society, in order to reduce the adverse effects of the latter. Two months after the beginning of the pharmacological treatment, reosification of the affected area was observed, with no recurrences after the end of the treatment. (AU)

La histiocitosis de células de Langerhans (LCH) es una afección rara originada por proliferación y acumulación descontrolada de células dendríticas mieloides inmaduras derivadas de la médula ósea. Su presentación es común en población pediátrica menor a 15 años, y suele afectar a huesos como el cráneo, fémur y cuerpo mandibular.En esta publicación se presenta el caso de un paciente de género femenino de 6 años, con lesión ósea en rama y cóndilo mandibular derecho de localización poco frecuente. Destaca la toma de muestra del tejido patológico mediante vía endoscópica intraoral con el fin de evitar comorbilidades y secuelas estéticas. Después de una evaluación médica conjunta, se diagnosticó como LCH monofocal con compromiso de sitio especial, estableciendo un tratamiento único de forma sistémica con indometacina, diferente a la quimioterapia recomendada por la Sociedad Internacional de Histiocitosis, de tal forma que disminuya los efectos adversos de esta. Se observó a los 2 meses de iniciado el tratamiento farmacológico reosificación de la zona afectada y sin recidivas posterior al término de este. (AU)

Estiloidectomía Bilateral por Abordaje Extraoral en Paciente con Síndrome de Eagle del Hospital San José, Chile: Reporte de un Caso y Revisión Actualizada de la Literatura

El síndrome de Eagle es una condición anatómica infrecuente caracterizada por la elongación del proceso estiloides generalmente por osificación del ligamento estilohioides. Clínicamente se presenta como una larga historia de dolor crónico cervicofacial tratado por múltiples especialistas y mediante variadas estrategias terapéuticas, caracterizado por sensación de cuerpo extraño faríngeo, trismus, disfagia, otalgia, tinitus, dificultad para la fonación y movilidad reducida del cuello. El promedio de longitud del proceso estiloides es de 2,5 cm. La etiología de este síndrome es poco conocida. El diagnóstico requiere de un alto índice de sospecha, basado fundamentalmente en la anamnesis y el examen físico que se confirma con tomografía computarizada o radiografía panorámica. Ya identificada la elongación, el paciente podrá recibir un tratamiento conservador o quirúrgico dependiendo de la severidad de los síntomas. El manejo conservador incluye fisioterapia, infiltración con anestésicos locales o corticoides y tratamiento con fármacos antiinflamatori os, anticonvulsivos o antidepresivos. El manejo quirúrgico consiste en fracturar el proceso estiloides bajo anestesia general, a través de abordajes transorales o transcervicales. El objetivo de este estudio es presentar el caso de una paciente de género femenino que consultó por dolor cervicofacial crónico bilateral en el servicio de Cirugía Cabeza y cuello y Maxilofacial del Hospital San José de Santiago y una revisión actualizada de la literatura sobre el síndrome de Eagle, abarcando sus aspectos clínicos relevantes enfocado en su diagnóstico y tratamiento.

Eagle syndrome is a rare anatomical condition characterized by elongation of the styloid process, usually due to ossification of the stylohyoid ligament. Clinically, it presents as a long history of recurrent cervicofacial pain, treated by multiple specialists and through various therapeutic strategies, characterized by pharyngeal foreign body sensation, trismus, dysphagia, otalgia, tinnitus, difficulty with phonation and reduced mobility of the neck. The average length of the styloid process is 2.5 cm. The etiology of the syndrome is poorly understood. Diagnosis requires a high index of suspicion, based mainly on history and physical examination confirmed with computed tomography (CT) or panoramic radiography. Once the elongation has been identified, the patient may receive conservative or surgical treatment depending on the severity of the symptoms. Conservative management includes physical therapy, infiltration with local anesthetics or corticosteroids, and treatment with anti-inflammatory, anticonvulsant, or antidepressant drugs. Surgical management consists of fracturing the styloid process under general anesthesia, through transoral or transcervical approaches. In this paper we present a case of a female patient who consulted for recurrent bilateral cervicofacial pain in the Head and Neck and Maxillofacial Surgery service of San José Hospital in Santiago and an updated review on Eagle's syndrome literature, focused on relevant clinical aspects such as diagnosis and treatment.

Clostridioides difficile: Characterization of the circulating toxinotypes in an Argentinean public hospital / Clostridioides difficile: caracterización de los toxinotipos circulantes en un hospital público de Argentina

Abstract Clostridioides difficile is a spore-forming anaerobe microorganism associated to nosocomial diarrhea. Its virulence is mainly associated with TcdA and TcdB toxins, encoded by their respective tcdA and tcdB genes. These genes are part of the pathogenicity locus (PaLoc). Our aim was to characterize relevant C. difficile toxinotypes circulating in the hospital setting. The tcdA and tcdB genes were amplified and digested with different restriction enzymes: EcoRI for tcdA; HincII and AccI for tcdB. In addition, the presence of the cdtB (binary toxin) gene, TcdA and TcdB toxins by dot blot and the cytotoxic effect of culture supernatants on Vero cells, were evaluated. Altogether, these studies revealed three different circulating toxinotypes according to Rupnik's classification: 0, I and VIII, being the latter the most prevalent one. Even though more studies are certainly necessary (e.g. sequencing analysis), it is worth noting that the occurrence of toxinotype I could be related to the introduction of bacteria from different geographical origins. The multivariate analysis conducted on the laboratory values of individuals infected with the most prevalent toxinotype (VIII) showed that the isolates associated with fatal outcomes (GCD13, GCD14 and GCD22) are located in regions of the biplots related to altered laboratory values at admission. In other patients, although laboratory values at admission were not correlated, levels of urea, creatinine and white blood cells were positively correlated after the infection was diagnosed. Our study reveals the circulation of different toxinotypes of C. difficile strains in this public hospital. The variety of toxinotypes can arise from pre-existing microorganisms as well as through the introduction of bacteria from other geographical regions. The existence of microorganisms with different pathogenic potential is relevant for the control, follow-up, and treatment of the infections.

Resumen Clostridioides difficile es un anaerobio esporulado que se asocia con episodios de diarreas hospitalarias. Su virulencia se encuentra vinculada, principalmente, a las toxinas TcdA y TcdB, codificadas por sus respectivos genes, tcdA y tcdB, que son parte de un locus de patogenicidad (PaLoc). Nuestro objetivo fue caracterizar los toxinotipos de C. difficile circulantes en un hospital público. Los genes tcdA y tcdB fueron amplificados y digeridos con diferentes enzimas de restricción: EcoRI para tcdA; HincII y AccI para tcdB. Además, se evaluó la presencia de cdtB (gen de la toxina binaria B) y de las toxinas A y B (por dot blot), así como el efecto citotóxico de sobrenadantes de cultivo sobre células Vero. En conjunto, estos estudios revelaron tres toxinotipos circulantes según la clasificación de Rupnik: 0, I y VIII; el más prevalente fue el último. Aunque son necesarios más estudios (ej., secuenciación), es interesante notar que la presencia del toxinotipo I podría estar relacionada con la introducción de bacterias de diferente origen geográfico. En los pacientes infectados con el toxinotipo VIII, el análisis multivariante de los resultados de laboratorio mostró que los aislamientos asociados a decesos (GCD13, GCD14 y GCD22) estaban situados en regiones de los biplots relacionados con valores de laboratorio alterados al momento de la internación. En los otros pacientes, aunque no se observó correlación entre los valores de laboratorio al momento de la internación y la evolución clínica, los niveles de urea, creatinina y recuento de glóbulos blancos estuvieron correlacionados positivamente entre sí una vez diagnosticada la infección. Nuestro estudio revela la circulación de diferentes toxinotipos de C. difficile en un mismo hospital público. La variedad de toxinotipos puede originarse a partir de microorganismos preexistentes en la región, así como también por la introducción de bacterias provenientes de otras regiones geográficas. La existencia de microorganismos con diferente potencial patogénico es relevante para el control, el seguimiento y el tratamiento de las infecciones.

A wheat kinase and immune receptor form host-specificity barriers against the blast fungus.

Since emerging in Brazil in 1985, wheat blast has spread throughout South America and recently appeared in Bangladesh and Zambia. Here we show that two wheat resistance genes, Rwt3 and Rwt4, acting as host-specificity barriers against non-Triticum blast pathotypes encode a nucleotide-binding leucine-rich repeat immune receptor and a tandem kinase, respectively. Molecular isolation of these genes will enable study of the molecular interaction between pathogen effector and host resistance genes.

Clostridioides difficile: Characterization of the circulating toxinotypes in an Argentinean public hospital.

Clostridioides difficile is a spore-forming anaerobe microorganism associated to nosocomial diarrhea. Its virulence is mainly associated with TcdA and TcdB toxins, encoded by their respective tcdA and tcdB genes. These genes are part of the pathogenicity locus (PaLoc). Our aim was to characterize relevant C. difficile toxinotypes circulating in the hospital setting. The tcdA and tcdB genes were amplified and digested with different restriction enzymes: EcoRI for tcdA; HincII and AccI for tcdB. In addition, the presence of the cdtB (binary toxin) gene, TcdA and TcdB toxins by dot blot and the cytotoxic effect of culture supernatants on Vero cells, were evaluated. Altogether, these studies revealed three different circulating toxinotypes according to Rupnik's classification: 0, I and VIII, being the latter the most prevalent one. Even though more studies are certainly necessary (e.g. sequencing analysis), it is worth noting that the occurrence of toxinotype I could be related to the introduction of bacteria from different geographical origins. The multivariate analysis conducted on the laboratory values of individuals infected with the most prevalent toxinotype (VIII) showed that the isolates associated with fatal outcomes (GCD13, GCD14 and GCD22) are located in regions of the biplots related to altered laboratory values at admission. In other patients, although laboratory values at admission were not correlated, levels of urea, creatinine and white blood cells were positively correlated after the infection was diagnosed. Our study reveals the circulation of different toxinotypes of C. difficile strains in this public hospital. The variety of toxinotypes can arise from pre-existing microorganisms as well as through the introduction of bacteria from other geographical regions. The existence of microorganisms with different pathogenic potential is relevant for the control, follow-up, and treatment of the infections.

Correlación del índice de masa corporal y de la circunferencia de cintura de las niñas y adolescentes con su ascendencia femenina hasta la tercera generación

RESUMEN Introducción: La intergeneracionalidad nutricional es reconocida como uno de los factores que influye en el aumento de la prevalencia de obesidad, principalmente a través de generaciones maternas. Poco se conoce sobre esta situación en nuestro país. Objetivo: evaluar la correlación del índice de masa corporal (IMC) y la circunferencia de cintura (CC) de niñas y adolescentes con su ascendencia femenina hasta la tercera generación durante los meses de julio a setiembre del 2019. Materiales y Métodos: Estudio analítico de corte transversal en 98 tríos (niñas y adolescentes, madres y abuelas maternas). Se recolectaron datos antropométricos de los tríos (peso, talla y CC). Se realizaron correlaciones entre: el IMC de la madre y la abuela con el puntaje Z del IMC/E de las niñas y adolescentes y la CC de la madre con las niñas y adolescentes. Se aplicó el coeficiente de correlación de Pearson. Investigación aprobada por Comité de Ética (Dictamen 460/19). Resultados: en promedio las niñas y adolescentes tuvieron 10,1±1,1 años, 0,8±1,6 DE puntaje Z IMC/Edad y 69,5±9,7 cm de CC; las madres tenían 37,4±6,8 años, 13 años de escolaridad, 28,8±7,3 kg/m2 de IMC y 92,1±13,4 cm de CC; y las abuelas 64,9±10,8 años, 7 años de escolaridad y 28,7±6,9 kg/m2 de IMC (Sobrepeso). La correlación del IMC de la madre con el puntaje Z de las niñas y adolescentes fue r: 0,2937 (p0,05). La correlación de CC entre madre-niña fue r: 0,264, (p<0,05). Conclusión: el IMC y la CC de las niñas y adolescentes se correlaciona con el IMC y CC de las madres, pero su potencia no es muy fuerte. Las hijas de madres obesas tienen mayor IMC medido por puntaje Z.

ABSTRACT Introduction: Nutritional intergenerationality is recognized as one of the factors that influences the increase in obesity prevalence, mainly through maternal generations. Little is known about this situation in our country. Objective: to evaluate the correlation of the body mass index (BMI) and the waist circumference (WC) of girls and adolescents compared to their female ancestry up to the third generation during the months of July to September 2019. Materials and methods: This was an analytical, cross-sectional study of 98 trios (girls and adolescents, maternal mothers and grandmothers). Anthropometric data of the trios (weight, height and WC) were collected. Correlations were made between: the BMI of the mother and the grandmother with the Z score of the BMI/E of the girls and adolescents and the WC of the mother with the girls and adolescents. Pearson's correlation coefficient was applied. The study was approved by the Ethics Committee (Approval # 460/19). Results: On average, the girls and adolescents were 10.1±1.1 years old, had a BMI/Age Z score of 0.8±1.6 SD and a WC of 69.5±9.7 cm; the mothers were 37.4±6.8 years old, had 13 years of schooling, BMI 28.8±7.3 kg/m2 and WC 92.1±13.4 cm; and the grandmothers 64.9±10.8 years, had 7 years of schooling and 28.7±6.9 kg/m2 BMI (Overweight). The correlation of the BMI of the mother with the Z score of the girls and adolescents was r: 0.2937 (p0.05). The WC correlation between mother and girl was r: 0.264, (p<0.05). Conclusion: The BMI and WC of girls and adolescents correlate with the BMI and WC of mothers, but its power is not very strong. The daughters of obese mothers have higher BMI measured by Z score.

Characterization of Microbial Diversity in Decayed Wood from a Spanish Forest: An Environmental Source of Industrially Relevant Microorganisms.

Rotting wood is inhabited by a large diversity of bacteria, fungi, and insects with complex environmental relationships. The aim of this work was to study the composition of the microbiota (bacteria and fungi) in decaying wood from a northwest Spanish forest as a source of industrially relevant microorganisms. The analyzed forest is situated in a well-defined biogeographic area combining Mediterranean and temperate macrobioclimates. Bacterial diversity, determined by metagenome analyses, was higher than fungal heterogeneity. However, a total of 194 different cultivable bacterial isolates (mainly Bacillaceae, Streptomycetaceae, Paenibacillaceae, and Microbacteriaceae) were obtained, in contrast to 343 fungal strains (mainly Aspergillaceae, Hypocreaceae, and Coniochaetaceae). Isolates traditionally known as secondary metabolite producers, such as Actinobacteria and members of the Penicillium genus, were screened for their antimicrobial activity by the detection of antibiotic biosynthetic clusters and competitive bioassays against fungi involved in wood decay. In addition, the ability of Penicillium isolates to degrade cellulose and release ferulic acid from wood was also examined. These results present decaying wood as an ecologically rich niche and a promising source of biotechnologically interesting microorganisms.

Population genomic analysis of Aegilops tauschii identifies targets for bread wheat improvement.

Aegilops tauschii, the diploid wild progenitor of the D subgenome of bread wheat, is a reservoir of genetic diversity for improving bread wheat performance and environmental resilience. Here we sequenced 242 Ae. tauschii accessions and compared them to the wheat D subgenome to characterize genomic diversity. We found that a rare lineage of Ae. tauschii geographically restricted to present-day Georgia contributed to the wheat D subgenome in the independent hybridizations that gave rise to modern bread wheat. Through k-mer-based association mapping, we identified discrete genomic regions with candidate genes for disease and pest resistance and demonstrated their functional transfer into wheat by transgenesis and wide crossing, including the generation of a library of hexaploids incorporating diverse Ae. tauschii genomes. Exploiting the genomic diversity of the Ae. tauschii ancestral diploid genome permits rapid trait discovery and functional genetic validation in a hexaploid background amenable to breeding.

Fluoruro diamino de plata. Lo que necesitamos saber / Diamine silver fluoride. What we need to know

Introducción: El fluoruro diamino de plata deriva de la unión del nitrato de plata y fluoruro. Reduce el avance de la caries y la degeneración de colágeno en la dentina. Impide la desmineralización y fomenta la remineralización del esmalte y la dentina. Por su sencilla aplicación es un material de gran interés en aquellos niños con ansiedad o poco colaboradores. El objetivo de esta revisión es comparar las recomendaciones de uso, frecuencia y porcentaje de aplicación del fluoruro diamino de plata en dentición temporal. Métodos: Se realizó una búsqueda en las bases de datos Pubmed/Medline y Science Direct usando términos Mesh. Se han incluido estudios realizados en pacientes entre 0 y 5 años, publicados entre 2016-2020. Resultados: Se obtuvieron 12 artículos para examinar y contrastar los protocolos de porcentaje y continuidad de aplicación del fluoruro diamino de plata. Dicho material ha sido analizado en referencia a diversas variables como su frecuencia de aplicación, concentración y seguimiento, entre otros. Se describen los resultados de fluoruro diamino de plata en el microbioma presente en la placa de individuos y se cotejan los rasgos de microbioma asistentes en la placa entre la caries detenida y activa después de tratamiento. Gracias a las ventajas de este material se consigue un mejor manejo de conducta del paciente, disminuyendo su ansiedad. Conclusiones: Según los resultados analizados la aplicación más efectiva del fluoruro diamino de plata es al 38% cada 6 meses. (AU)

Introduction: Silver diamine fluoride is derived from the union of silver nitrate and fluoride. Reduce the progression of cavities and collagen degeneration in the dentin. Prevents demineralization and promotes remineralization of enamel and dentin. Due to its simple application, it is a material of great interest to those children with anxiety or little collaborators. The objective of this review is to compare the recommendations for use, frequency and percentage of application of silver diamine fl uoride in primary dentition. Methods: The Pubmed / Medline and Science Direct databases were searched using Mesh terms. Studies carried out in patients between 0 and 5 years old, published between 2016-2020, have been included. Results: Twelve articles were obtained to examine and contrast the protocols of percentage and continuity of application of silver diamine fluoride. This material has been analyzed in reference to various variables such as its frequency of application, concentration and monitoring, among others. The results of silver diamine fluoride in the microbiome present in the plate of individuals are described and the assisting microbiome traits in the plate are compared between the arrested and active caries after treatment. Thanks to the advantages of this material, a better management of the patient’s behavior is achieved, reducing their anxiety. Conclusions: According to the results analyzed, the most effective application of silver diamine fl uoride is at 38% every 6 months. (AU)

Efectos de las Técnicas Manuales Orofaciales en la Disminución del Dolor Cervical. Una Revisión Bibliográfica / Effects of Orofacial Manual Techniques in the Reduction of Cervical Pain. A Bibliographic Review

Introducción: La prevalencia anual de dolor cervical oscila entre un 16,7% y un 75,1%, durando alrededor de 6 meses o más en el 14% de los casos, desencadenando en restricción del movimiento y dolor principalmente. Esto podría deberse a la relación entre la cabeza, columna cervical y estructuras relacionadas a la articulación temporomandibular (ATM). El objetivo de esta investigación es describir a través de la evidencia científica el efecto de las técnicas manuales orales en la disminución del dolor cervical. Métodos: Se incluyeron ensayos clínicos aleatorizados y revisiones sistemáticas encontrados en las bases de datos PubMed, Cochrane y PEDro. Realizando la extracción de datos a través de una tabla estructurada para cada tipo de estudio. Resultados: De 10 estudios seleccionados, 3 corresponden a revisiones sistemáticas y 7 a ensayos clínicos, donde la disminución del dolor cervical fue significativa al aplicar la terapia manual con ejercicios por sobre la terapia manual por sí sola. Por otro lado, las técnicas orofaciales fueron beneficiosas al combinarlas con terapia manual en comparación con un tratamiento habitual. No se encontraron diferencias significativas al aplicar ejercicios de Maitland y movilizaciones en comparación con ejercicios de flexibilidad, fortalecimiento, ejercicios de Mulligan y movilizaciones. Conclusión: Los resultados son debatibles, ya que la terapia manual por sí sola o combinada con ejercicios es la técnica más efectiva no solo en la disminución del dolor cervical, también en la mejoría de la calidad de vida.

Introduction: The annual prevalence of cervical pain ranges from 16.7% to 75.1%, lasting about 6 months or more in 14% of cases, triggering mainly movement restriction and pain. This could be due to the relationship between the head, cervical spine and structures related to the temporomandibular joint (TMJ). The objective of this research is to describe through scientific evidence the effect of oral techniques in reducing cervical pain. Methods: Randomized clinical trials and systematic reviews found in the PubMed, Cochrane and PEDro databases were included. Data extraction was done through a structured table for each type of study. Results: Out of 10 selected studies, 3 correspond to systematic reviews and 7 to clinical trials, where the decrease in neck pain was significant when applying manual therapy with exercises over manual therapy alone. On the other hand, orofacial techniques were beneficial when combined with manual therapy compared to an usual treatment. No significant differences were found when applying Maitland exercises and mobilizations compared to flexibility, strengthening, Mulligan exercises, and mobilizations (p<0.05). Conclusion: The results are debatable, as manual therapy alone or combined with exercises is the most effective technique not only in reducing neck pain, but also in improving quality of life.

Association between low bone mineral density and periodontitis in generally healthy perimenopausal women.

BACKGROUND: The association between low bone mineral density (BMD) and periodontitis in perimenopausal women is controversial. The purpose of this study was to determine whether osteoporosis or osteopenia is associated with periodontal disease in a population of adult women. METHODS: A sample of over-45-year-old women with or without low BMD underwent lumbar spine and hip bone densitometry and a complete periodontal examination. The extent/severity or absence of periodontal disease was noted using two different case definitions. Data were gathered on socio-economic status, medication history, systemic co-morbidities, alcohol or tobacco use as well as serum levels of calcium and vitamin D. RESULTS: One hundred seventy three women aged between 45 and 72 years old were recruited with a mean age of 57.8 years. One hundred and three had decreased BMD (61 with osteoporosis and 42 with osteopenia) and 70 were healthy. Moderate or severe periodontitis was present in 52.6% of the women. Multivariate analysis showed a clear association between low BMD and periodontitis, but only in women above 58 years old and independent of tobacco consumption or oral hygiene. CONCLUSION: In this sample of generally healthy perimenopausal women, low BMD was associated with clinical attachment level (CAL). Women over 58 years old with decreased BMD presented with a higher mean percentage of sites with CAL ≥ 4 mm as well as CAL ≥ 6 mm when compared to controls, independent of active smoking status or poor oral hygiene.

Glucagon-like peptide 1 and Glucagon-like peptide 2 in relation to osteoporosis in non-diabetic postmenopausal women.

Osteoporosis results from an imbalance in bone remodeling, which is known to follow a circadian rhythm determined by a functional relationship between intestine and bone tissue. Specific intestinal peptides have been identified as mediators. Glucagon-like peptide 1 and glucagon-like peptide 2, have been associated with bone health. Our main objective was to determine whether postprandial plasma levels of glucagon-like peptide 1, glucagon-like peptide 2 and dipeptidyl-peptidase 4 activity, are associated with osteoporosis in non-diabetic postmenopausal women. We studied non-diabetic postmenopausal women with osteoporosis diagnosed by dual-energy X-ray absorptiometry (cases, n = 43) and age-matched (±1 yr) controls without osteoporosis or a history of osteoporotic fracture (n = 43). We measured postprandial plasma levels of glucagon-like peptide 1, glucagon-like peptide 2, and dipeptidyl-peptidase 4 activity, bone mineral density, and baseline levels of bone remodeling markers and analyzed the food intake using a food-frequency questionnaire. Postprandial glucagon-like peptide 1 values were lower (p < 0.001) in cases, µ (SEM) = 116.25 (2.68), than in controls, µ (SEM) = 126.79 (2.68). Glucagon-like peptide 1 was associated with reduced osteoporosis risk in the crude logistic regression analysis [OR (95% CI) = 0.724 (0.53-0.97), p = 0.031] and adjusted analysis [OR = 0.603 (0.38-0.94), p = 0.027]. We found no association of glucagon-like peptide 2, or dipeptidyl-peptidase 4 activity with osteoporosis. Postprandial glucagon-like peptide 1 levels are related to osteoporosis and osteoporosis risk in non-diabetic postmenopausal women. Further studies are required to verify these findings.

Dysphagia in the burn patient: Experience in a National Burn Reference Centre.

INTRODUCTION: Major burn patients are exposed to different invasive procedures for wound management or medical stabilization. Dysphagia is a frequent adverse effect of burns in the presence of invasive airway procedures and facial wounds. OBJECTIVE: To estimate the prevalence of dysphagia, to determine the degree of severity, and to report clinical characteristics that could contribute to the appearance of dysphagia in patients admitted to a National Burn Reference Centre. METHODS: An observational cross-sectional study was conducted in a burn reference centre over a 6-month period. All patients admitted to the burn service of a National Reference Centre were included. A clinical bedside swallowing assessment was performed in patients referred to a Speech-Language Pathologist (SLP). The presence or absence of dysphagia was evaluated, and the degree of severity was measured according to the Dysphagia Outcome and Severity Scale (DOSS). RESULTS: Fifty-four participants were recruited. The prevalence of dysphagia over a 6-month period was 27.78% (n=15) of the total burn patients admitted to the Burn Unit. The severity of dysphagia varied from mild (26.7%), mild-moderate (33.3%), moderate (20%), moderate-severe (13.3%), to severe (6.7%). All dysphagia patients had orotracheal intubation history with an average length of 18 days, as opposed to the non-dysphagia group, of which 75% of the participants had orotracheal intubation history for an average of 8.5 days. Statistically non-significant associations were found between dysphagia and demographic aspects or clinical characteristics (p>0.05). CONCLUSION: 27.78% of burn patients presented dysphagia, with differences in the degree of severity. Presence and duration of orotracheal intubation stands out as a condition of interest. The SLP inclusion in the burn team is presented as a valuable input in order to minimize risks associated with swallowing impairment.

Doble carga de malnutrición en madres y niños menores de cinco años de edad de dos comunidades indigenas del Departamento Central / Double burden of malnutrition in mothers and children under five years of age in two indugenous communities of the Central Departament

Introducción: Debido a la migración y urbanización, la población indígena se expone a cambios tanto en hábitos alimentarios como en actividades realizadas, adoptando una dieta y estilo de vida occidental, pudiendo generar en ellos malnutrición, tanto por exceso, como por carencia. Objetivo: Determinar la frecuencia de la doble carga de malnutrición en el binomio madrehijo menor de cinco años de edad de dos comunidades indígenas del Departamento Central. Materiales y Métodos: Diseño transversal en el cual se realizaron encuestas y mediciones antropométricas en 42 madres, y sus hijos (60 niños/as menores de cinco años de edad). Para determinar el estado nutricional del niño se emplearon las curvas de la OMS/2007. Se utilizó estadística descriptiva para la presentación de los resultados y el protocolo fue aprobado por el Comité de ética CEI (333/17V2). Resultados: 26,3 años fue la media de edad de las madres, los diagnósticos predominantes en ellas fueron sobrepeso (35,7%) y obesidad (30,9%), además un 80,9% presentó algún riesgo cardiometabólico según la circunferencia de cintura. En relación a los niños el promedio de edad fue de 24 meses, los diagnósticos fueron desnutrición global (15%), desnutrición aguda (8,8%), malnutrición por exceso (53%) y desnutrición crónica (33,3%) y según la circunferencia craneana el 52,8% se encontró eutrófico. Hubo la misma proporción de niños eutróficos y con desnutrición crónica con madres con malnutrición por exceso. Conclusión: La mitad de los niños eutróficos tienen madres con malnutrición por exceso, al igual que la otra mitad de niños con desnutrición crónica, por lo que no se constata una tendencia de doble carga de malnutrición en el hogar.

Introduction: Due to migration and urbanization, the indigenous population is exposed to changes in eating habits and activities, adopting a western diet and lifestyle, and can generate malnutrition in them, both by excess and by lack. Objective: To determine the frequency of the double burden of malnutrition in the mother-child binomial under five years of age of two indigenous communities of the Central Department. Materials and Methods: Cross-sectional design in which anthropometric surveys and measurements were conducted on 42 mothers and their children (60 children under five years of age). To determine the nutritional status of the child, the WHO / 2007 curves were used. Descriptive statistics were used to present the results and the protocol was approved by the IEC Ethics Committee (333/17V2). Results: 26.3 years was the average age of the mothers, the predominant diagnoses in them were overweight (35.7%) and obesity (30.9%), in addition 80.1% presented some cardiometabolic risk according to the circumference of waist. In relation to children, the average age was 24 months, diagnoses were global malnutrition (15%), acute malnutrition (8.8%), malnutrition due to excess (53%) and chronic malnutrition (33.3%) and according to the cranial circumference, 52.8% were found to be eutrophic. There was the same proportion of eutrophic and chronically malnourished children with mothers with excess malnutrition. Conclusion: Half of the eutrophic children have mothers with excess malnutrition and, like the other half, children with chronic malnutrition, so there was no tendency for a double burden of malnutrition in the home

Elaboración de productos panificados a partir de premezcla de harinas aptas para celíacos enriquecidas con hierro y vitaminas del complejo B y su aceptabilidad / Preparation of bakery products from premix of flours suitable for celiac people and enriched with iron and vitamin B complex and their acceptability

La Ley 20.830/98 reglamenta el enriquecimiento de la harina, sin embargo, no contempla a la premezcla de harinas aptas para celíacos. Aproximadamente 50% de los celíacos presenta anemia, por lo es necesario elaborar productos cuyas características nutricionales, sensoriales y funcionales sean óptimas. El objetivo del trabajo fue enriquecer con hierro y vitaminas del complejo B (mix) la premezcla de harinas apta para celíacos y evaluar la aceptabilidad de dos panificados de alta demanda poblacional elaborados a partir de la premezcla. En cocinas especializadas para celíacos se elaboraron panes y palitos, cada uno en dos versiones (con mix y sin mix), se presentaron en envases individuales y etiquetados forma numérica para la degustación. Se evaluó la aceptabilidad de los panificados utilizando una escala hedónica de 9 puntos a través de un cuestionario autoadministrado. Se utilizó la prueba t de Student para la comparación de promedios obtenidos. Participaron 105 celíacos (81% mujeres), el promedio de edad fue 34,5±10,9 años Según auto-reporte el 60% cursó con anemia. La puntuación global promedio de aceptabilidad fue: pan sin mix 7,42±1,33puntos; pan con mix 8,00±1,06 puntos; palito sin mix 7,91±1,05 puntos y palito con mix 7,86±1,17 puntos. Se realizó el análisis de la premezcla apta para celíacos y se constató que la misma cumple con el aporte de micronutrientes (hierro, B1, B2, B3 y ácido fólico). En este estudio, los panes con mix tuvieron mayor aceptabilidad que aquellos sin mix. En el caso de los palitos no se observaron diferencias en la aceptabilidad entre productos (con mix vs sin mix)(AU)

Complicaciones durante el soporte enteral en adultos mayores en un hospital de referencia / Complications during enteral support of elderly adults in a referral hospital

Los adultos mayores corresponden una población vulnerable a presentar complicaciones durante su hospitalización, pudiendo aparecer una de estas complicaciones durante el soporte enteral, por ello el objetivo de este trabajo fue identificar las complicaciones gastrointestinales, infecciosas y mecánicas durante el soporte enteral en adultos mayores institucionalizados. El diseño fue transversal, en el cual se analizaron fichas de adultos de 60 o más años de edad, de ambos sexos, con indicación de soporte nutricional enteral, internados en el Hospital Geriátrico Dr. Gerardo Buongermini del IPS. Se realizó la revisión retrospectiva de 48 historias clínicas, analizándose los datos demográficos, clínicos, de soporte y las complicaciones mediante estadística descriptiva La mediana de la edad fue 82,5 años y el 54,2% era del sexo femenino. El 72,9% de los pacientes estaba internado en clínica médica, el 52,1% presentó algún tipo de complicación durante al soporte enteral, siendo estas en orden decreciente: gastrointestinales (60%), infecciosas (44%) y mecánicas (20%). Se encontró que la diarrea (10/11) fue la principal complicación gastrointestinal. Dentro de las infecciosas, la broncoaspiración (8/11), y la única complicación mecánica fue el autoretiro de la sonda. Todos los pacientes (4/4) con formula artesanal o mixta presentaron complicaciones y estas fueron más frecuentes en pacientes con forma de administración tipo bolo y por método de infusión continua. En conclusión alrededor de la mitad de los adultos mayores presentaron algún tipo de complicación durante el soporte enteral.

The elderly correspond to a population that is vulnerable to complications during hospitalization, and complications may appear during enteral support. The objective was to identify gastrointestinal, infectious and mechanical complications during enteral support in hospitalized older adults. A crossed-sectional descriptive study was carried out using the medical records of adults aged 60 and above who had indication of enteral nutritional support and hospitalized for any pathology at the Dr. Gerardo Buongermini Geriatric Hospital from IPS. Complying with the estimated sample about size, 48 medical records were analyzed and information aboutdemographic and clinical data, support and complications, was collected. The median age was 82.5 years, 54.2% were women, 72.9% of the patients were hospitalized in the medical clinic area. Fifty two point one percent presented some type of complication during enteral support, the frequency of complications was as follows: gastrointestinal (60%), infectious (44%) and mechanical complications (20%). Diarrhea (10/11) was the main gastrointestinal complication, the broncoaspiration (8/11) among complications infectious, and the only mechanical complication was the removal of the catheter. All patients (4/4) with craft formula or mixed formula had complications and these were more frequent in patients with bolus administration and y continuous infusion. In conclusion about half of older adults presented some type of complications during enteral support.