Nutritional imbalances in a Mexican vegan group: urgent need for country-specific dietary guidelines / Desequilibrios nutricionales en un grupo mexicano de veganos: necesidad de guías alimentarias para cada país

Introduction: vegan diets exclude the consumption of animal-derived products, and health advantages have been reported when followed. However, heterogeneous eating habits, food availability, and sociocultural characteristics among regions could lead to different physiological results Case reports: twelve patients following a strict vegan diet for an uninterrupted period of ≥ 3 years were subjected to clinical assessment. Patients significantly exceeded the suggested intake for sugar, presented six mineral deficiencies, and exhibited three vitamins below the recommended consumption. We further identified hyperglycemia, hypertriglyceridemia, subnormal serum vitamin B12 concentrations, as well as macrocytosis and microcytic anemia in several participants. Discussion: this Mexican vegan diet is strongly influenced by endemic and cultural adaptations that could limit the benefits reported in other populations. Professional guidance is required to avoid specific deficiencies with potential repercussions. We urge country-specific vegan guidelines considering local eating habits, food availability, and sociocultural perspectives around food (AU)

Introducción: la dieta vegana excluye el consumo de productos de origen animal y se ha vinculado con una disminución del riesgo de morbimortalidad. Sin embargo, los distintos hábitos alimentarios entre países podrían condicionar los beneficios reportados para las dietas basadas en vegetales. Casos clínicos: doce pacientes siguiendo una estricta dieta vegana por ≥ 3 años se sometieron a una evaluación clínica. Exhibieron una ingestión de azúcar que supera el consumo sugerido, presentaron tres deficiencias vitamínicas y seis de minerales. Se identificó la presencia de hiperglucemia, hipertrigliceridemia, concentraciones séricas subnormales de vitamina B12, macrocitosis y anemia microcítica en varios participantes. Discusión: la dieta vegana de este grupo resultó fuertemente influenciada por adaptaciones culturales que podrían limitar los beneficios reportados en otras poblaciones. Se requiere orientación profesional para evitar desequilibrios nutricionales. Enfatizamos la necesidad del desarrollo de guías alimentarias y de práctica clínica que consideren los hábitos alimentarios locales, la disponibilidad de alimentos en la región y las perspectivas socioculturales en torno a la dieta vegana (AU)

Neuronal Nsun2 deficiency produces tRNA epitranscriptomic alterations and proteomic shifts impacting synaptic signaling and behavior.

Epitranscriptomic mechanisms linking tRNA function and the brain proteome to cognition and complex behaviors are not well described. Here, we report bi-directional changes in depression-related behaviors after genetic disruption of neuronal tRNA cytosine methylation, including conditional ablation and transgene-derived overexpression of Nsun2 in the mouse prefrontal cortex (PFC). Neuronal Nsun2-deficiency was associated with a decrease in tRNA m5C levels, resulting in deficits in expression of 70% of tRNAGly isodecoders. Altogether, 1488/5820 proteins changed upon neuronal Nsun2-deficiency, in conjunction with glycine codon-specific defects in translational efficiencies. Loss of Gly-rich proteins critical for glutamatergic neurotransmission was associated with impaired synaptic signaling at PFC pyramidal neurons and defective contextual fear memory. Changes in the neuronal translatome were also associated with a 146% increase in glycine biosynthesis. These findings highlight the methylation sensitivity of glycinergic tRNAs in the adult PFC. Furthermore, they link synaptic plasticity and complex behaviors to epitranscriptomic modifications of cognate tRNAs and the proteomic homeostasis associated with specific amino acids.

Recommendations for the prevention and diagnosis of asthma in children: Evidence from international guidelines adapted for Mexico

BACKGROUND: With the availability of high-quality asthma guidelines worldwide, one possible approach of developing a valid guideline, without re-working the evidence, already analysed by major guidelines, is the ADAPTE approach, as was used for the development of National Guidelines on asthma. METHODS: The guidelines development group (GDG) covered a broad range of experts from medical specialities, primary care physicians and methodologists. The core group of the GDG searched the literature for asthma guidelines 2005 onward, and analysed the 11 best guidelines with AGREE-II to select three mother guidelines. Key clinical questions were formulated covering each step of the asthma management. RESULTS: The selected mother guidelines are British Thoracic Society (BTS), GINA and GEMA 2015. Responses to the questions were formulated according to the evidence in the mother guidelines. Recommendations or suggestions were made for asthma treatment in Mexico by the core group, and adjusted during several rounds of a Delphi process, taking into account: 1. Evidence; 2. Safety; 3. Cost; 4. Patient preference - all these set against the background of the local reality. Here the detailed analysis of the evidence present in BTS/GINA/GEMA sections on prevention and diagnosis in paediatric asthma are presented for three age-groups: children with asthma ≤5 years, 6-11 years and ≥12 years. CONCLUSIONS: For the prevention and diagnosis sections, applying the AGREE-II method is useful to develop a scientifically-sustained document, adjusted to the local reality per country, as is the Mexican Guideline on Asthma

No disponible

Hernioplastias inguinales transabdominal Preperitoneal: análisis de una serie de casos / Transabdominal inguinal hernioplasties Preperitoneal: analysis of a series of cases

La hernia inguinal tiene una incidencia entre 6,3 y 23,5 hernias por 10.000 habitantes, siendo uno de los procedimientos más comunes en cirugía, con más de 20 millones de reparaciones globales por año. Una de las técnicas de abordaje por videolaparoscopía es la vía transabdominal preperitoneal (TAPP). OBJETIVOS: Describir la experiencia en una serie de casos de cirugía de hernia plastia por la vía TAPP. PACIENTES Y MÉTODO: Diseño del estudio: observacional descriptivo. Población: pacientes operados de hernioplastías inguinales por vía laparoscópica en la Clínica Universitaria Reina Fabiola, Córdoba, Argentina, durante el periodo de febrero de 2016 a febrero de 2017. RESULTADOS: Se estudiaron 47 pacientes operados; 44 (93.2 %) hombres, con un promedio de edad de 40.53 (18-65) años y de índice de masa corporal de 28.6 (24-51.2) kg/m2. Se operaron 89 hernias, 42 (89.3 %) bilaterales y 5 (10.7 %) unilaterales. Al 100 % de los pacientes se les practicó la técnica TAPP. Existieron 3 (3.33 %) recidivas. No hubo mortalidad en la serie. CONCLUSIONES: Las hernioplastías inguinales laparoscópica presentan una curva de aprendizaje rápida en cirujanos experimentados, con bajas tasas de morbilidad y recidivas. (AU)

The inguinal hernia has an incidence between 6.3 and 23.5 hernias per 10,000 inhabitants, being one of the most common procedures in surgery, with more than 20 million global repairs per year. One of the techniques of videolaparoscopy approach is the transabdominal preperitoneal (TAPP). OBJECTIVES: To describe the experience in a series of cases of hernia surgery by TAPP. PATIENTS AND METHODS: Study design: descriptive observational. Population: patients undergoing laparoscopic inguinal hernioplasty at the Clínica Universitaria Reina Fabiola, Córdoba, Argentina during the period from February 2016 to February 2017. RESULTS: 47 operated patients were studied; 44 (93.2%) men, with an average age of 40.53 (18-65) years and a body mass index of 28.6 (24-51.2) kg / m2. We operated 89 hernias, 42 (89.3%) bilateral and 5 (10.7%) unilateral. 100% of the patients underwent the TAPP technique. There were 3 (3.33%) recurrences. There was no mortality in the series. CONCLUSIONS: Laparoscopic inguinal hernioplasty has a rapid learning curve in experienced surgeons, with low morbidity and recurrence rates. (AU)

Recommendations for the prevention and diagnosis of asthma in children: Evidence from international guidelines adapted for Mexico.

BACKGROUND: With the availability of high-quality asthma guidelines worldwide, one possible approach of developing a valid guideline, without re-working the evidence, already analysed by major guidelines, is the ADAPTE approach, as was used for the development of National Guidelines on asthma. METHODS: The guidelines development group (GDG) covered a broad range of experts from medical specialities, primary care physicians and methodologists. The core group of the GDG searched the literature for asthma guidelines 2005 onward, and analysed the 11 best guidelines with AGREE-II to select three mother guidelines. Key clinical questions were formulated covering each step of the asthma management. RESULTS: The selected mother guidelines are British Thoracic Society (BTS), GINA and GEMA 2015. Responses to the questions were formulated according to the evidence in the mother guidelines. Recommendations or suggestions were made for asthma treatment in Mexico by the core group, and adjusted during several rounds of a Delphi process, taking into account: 1. Evidence; 2. Safety; 3. Cost; 4. Patient preference - all these set against the background of the local reality. Here the detailed analysis of the evidence present in BTS/GINA/GEMA sections on prevention and diagnosis in paediatric asthma are presented for three age-groups: children with asthma ≤5 years, 6-11 years and ≥12 years. CONCLUSIONS: For the prevention and diagnosis sections, applying the AGREE-II method is useful to develop a scientifically-sustained document, adjusted to the local reality per country, as is the Mexican Guideline on Asthma.

Silvopastoral System Economical and Financial feasibility with Jatropha curcas L. in Manabí, Ecuador / Viabilidad económica y financiera de sistemas silvopastoriles con Jatropha curcas L. en Manabí, Ecuador

ABSTRACT Objective. To assess the economic and financial feasibility of traditional silvopastoral systems for the biofuels production as a contribution to the sustainability of "Piñón for Galapagos" project. Materials and methods. A survey was conducted to 450 small livestock producer in 10 cantons of the Manabí province in order to collect basic agronomic knowledge, management, establishment and costs involved in production of the Piñón ((Jatropha curcas L.)/Savoy (Megathyrsus maximus) silvopastoral systems. For Piñón CP041 production recording plantation in live fence were stablished and for the tradition Piñón, the production of 10 sites were recorded, both systems since 2009. With those data were calculated the following economic indicators: ratio benefit/cost, net present value (NPV), internal rate ratio (IRR) and land expectation value (LEV). Results. The study exhibited a production decrease of Piñón with the passage of time. The CP041 INIAP improved silvopastoral system Piñón showed a B/C 1.07, NPV of USD$ 404.11, LEV US$ 970.23 and IRR of 18%. Followed by silvopastoral system with a local Piñón with a B/C 1.06, NPV of USD$ 363.66, LEV USD$ 873.10 and IRR of 17% and finally silvopastoral system without harvesting Piñón with a B/C 1.05, NPV of USD$ 285.72, LEV USD$ 685.99 and IRR of 15%. Conclusions. The alternative biofuels production was the silvopastoral systems (INIAP CP041)/Savoya in Manabí and is economically feasible. This system does not compete for arable land for food production and would not affect food security.

RESUMEN Objetivo. Evaluar la viabilidad económica y financiera de los sistemas silvopastoriles tradicionales para la producción de Biocombustibles como aporte a la sostenibilidad del proyecto "Piñón para Galápagos". Materiales y Métodos. Se llevaron a cabo encuestas a 450 pequeños productores ganaderos de 10 cantones de la provincia de Manabí con la finalidad de colectar información agronómica, manejo, costos implicados en establecimiento y producción de los sistemas silvopastoriles vigentes de Piñón (Jatropha curcas L.)/Saboya (Megathyrsus maximus). Para recopilar datos de producción del Piñón establecido en cercas vivas de Piñón INIAP CP041 e igualmente se registró la producción de sistemas en 10 sitios, desde el año 2009. Con estos datos se calcularon los siguientes indicadores financieros radio beneficio/costo (B/C), valor actual neto (VAN), tasa interna de retorno (TIR) y valor de expectativa de la tierra (VET). Resultados. El estudio mostró una disminución de la producción del Piñón con el transcurso del tiempo. El sistema silvopastoril mejorado con Piñón INIAP CP041 mostró B/C 1.07, VAN de USD$ 404.11, VET USD$ 970.23 y TIR de 18%. Seguido del sistema silvopastoril con Piñón local con un B/C 1.06, VAN de USD$ 363.66, VET USD$ 873.10 y TIR de 17% y finalmente sistema silvopastoril sin cosecha del Piñón con un B/C 1.05, VAN de USD$ 285.72, VET USD$ 685.99 y TIR de 15%. Conclusiones. La alternativa de producción de biocombustibles con sistemas silvopastoriles Piñón (INIAP CP041)/Saboya en Manabí es el sistema de mayor rentabilidad y no competiría por superficies de cultivo para la producción de alimentos, sin afectar a la seguridad alimentaria.

Análisis de la evidencia disponible para el consumo de edulcorantes no calóricos. Documento de expertos / Analysis of the available evidence for the intake of non-caloric sweeteners. Expert document

Resumen Los edulcorantes no calóricos representan una buena alternativa para sustituir los sabores dulces sin la respuesta fisiológica que genera el consumo de azúcares. Por sí solos no son herramientas para el control de peso. Su consumo debe ir acompañado de una dieta correcta y un estilo de vida saludable que incluya actividad física. Su utilidad radica en proporcionar el agradable sabor dulce sin el aporte energético. La inocuidad de cada uno de los compuestos aprobados está comprobada y se reevalúa constantemente para tomar en cuenta los resultados de nuevos estudios. Debido a que no existe un edulcorante perfecto, la variedad ayuda a que se desarrollen productos cada vez más agradables para el consumidor. Este trabajo es fruto de una revisión exhaustiva de la bibliografía y de las discusiones de un panel de expertos de diversas especialidades: toxicología, ginecoobstetricia, pediatría, endocrinología, nutrición, medicina interna, salud pública y medicina preventiva, en el que se analizó extensamente la bibliografía se revisó una variedad de trabajos científicos que responden a las interrogantes que habitualmente se hacen los profesionales de la salud acerca de seguridad en diferentes grupos etáreos y con afecciones específicas, ingestión diaria admisible, etc.

Abstract Non-caloric sweeteners are a good alternative to replace the sweet flavors without the physiological response generated by the consumption of sugars. Alone they are not tools for weight control. Its intake must be accompanied by a proper diet and a healthy lifestyle that includes physical activity. Its usefulness lies in providing a pleasant sweet taste without the energy intake. The safety of each of the compounds is tested and approved and constantly reassessed to take into account the results of new studies. Since there is no perfect sweetener, variety helps that more and more pleasing to the consumer products are developed. This work is the result of a comprehensive review of the literature and discussions of a panel of experts from various specialties: toxicology, obstetrics and gynecology, pediatrics, endocrinology, nutrition, internal medicine, public health and preventive medicine, where literature was widely analyzed reviewing a variety of scientific papers that address the questions that usually are made by health professionals on safety in different age groups and with specific diseases, acceptable daily intake, etc.

Current Proteomic Methods to Investigate the Dynamics of Histone Turnover in the Central Nervous System.

Characterizing the dynamic behavior of nucleosomes in the central nervous system is vital to our understanding of brain-specific chromatin-templated processes and their roles in transcriptional plasticity. Histone turnover-the complete loss of old, and replacement by new, nucleosomal histones-is one such phenomenon that has recently been shown to be critical for cell-type-specific transcription in brain, synaptic plasticity, and cognition. Such revelations that histones, long believed to static proteins in postmitotic cells, are highly dynamic in neurons were only possible owing to significant advances in analytical chemistry-based techniques, which now provide a platform for investigations of histone dynamics in both healthy and diseased tissues. Here, we discuss both past and present proteomic methods (eg, mass spectrometry, human "bomb pulse labeling") for investigating histone turnover in brain with the hope that such information may stimulate future investigations of both adaptive and aberrant forms of "neuroepigenetic" plasticity.

Seasons and planting densities interaction on forage production of eight hybrids maize, Ecuador / Interacción época/densidad de siembra sobre la producción de ocho híbridos de maíz forrajeros, Ecuador

Objective. To assess the interaction effect of the season and planting densities on the production of eight INIAP corn hybrids. Materials and methods. A research process was conducted in 2013. It was applied a split - split plot design with three replication and Tukey test was used. It was evaluated two planting seasons (28 January and 8 April), they were placed in large plots. Two planting densities (65.500 y 125.000 plants/ha), that were located in the subplots and eight INIAP corn hybrids arranged in the sub- subplots. The evaluated variables were Fresh Matter, Dry Matter, Plant Height and Crude Protein Results. Fresh Matter and Crude Protein productions were influenced by planting seasons. Plant densities affected the production of Fresh Matter, Dry Matter and Plant Height, as well as the interaction season by corn INIAP hybrids. While INIAP corn hybrids showed statistical differences in the production of Fresh, Dry Matter, Plant Height and Crude Protein. The eight INIAP hybrids productions were: Fresh Matter (58.86 ton/ha ±5.19); Dry Matter (21.45 ton/ha ±4.71); Plant Height (2.46 m ±0.16) and Crude Protein (10.6±1.12). Conclusions. The performance showed by hybrids INIAP CML-172, INIAP 6021 and INIAP 551 were very acceptable forage material and could be used for silage purposes.

Objetivo. Evaluar el efecto de la interacción época y densidad de siembra en ocho híbridos de maíz para producción de forraje sobre la obtención de materia fresca MF, seca MS, altura de planta AP y proteína cruda PC. Materiales y métodos. Se empleó un diseño de parcela dos veces dividida con tres repeticiones. Se evaluó el efecto de dos épocas de siembra (28 de enero y el 8 de abril) que se dispusieron en la parcelas grandes, dos densidades de siembra (65.500 y 125.000 plantas/ha) que se ubicaron en las subparcelas y ocho híbridos de maíz INIAP dispuestas en las sub-subparcelas. Las variables evaluadas fueron producción de MF, MS, AP y PC. Resultados. La época de siembra tuvo su influencia sobre la producción de MF y contenido de PC. La densidad de cultivo y época de siembra afectó la producción de MF, MS y AP por híbridos de maíz. Mientras que los híbridos INIAP de maíz mostraron diferencias estadísticas (p<0.001) en la producción de MF, MS, AP y PC. La producción de los ocho híbridos INIAP fue de MF (58.86 Ton/ha ±5.19); MS (21.45 Ton/ha ±4.71); AP (2.46 m±0.16) y PC (10.6±1.12). Conclusiones. Los rendimientos mostrados por los híbridos INIAP CML 172, INIAP 6021 e INIAP 551 son materiales aceptables con relación a las variables evaluadas y pueden ser empleados especialmente para ensilaje.

Treatment considerations in hutchinson-gilford progeria syndrome: a case report.

Hutchinson-Guilford progeria syndrome is an extremely rare condition classified as one of the premature ageing syndromes. This case presents a 16-year-old Israeli female patient, suffering from a variant of Hutchinson-Guilford progeria with a history of treatment with oral biphosphnates. The patient presented with typical cranial and facial features of the syndrome including delayed teeth eruption and root development probably due to insufficient jaw growth and severs retrognatic position of the maxilla and mandible. Orthodontic treatment considerations are described along with those required in light of the previous treatment by oral biphosphonates.All primary teeth were extracted in three appointments while creating as minimal trauma as possible to the surrounding tissue and alveolar bone. For now, the patient refuses to begin the orthodontic treatment course. There are no limitations to conduct any dental procedures in progeria patients, however, extreme caution must be exercised during oral surgery due to the inelasticity of tissues and dermal atrophy. Orthodontic procedure commencement should be early enough to manage the delayed development and eruption of teeth. Patients taking oral biphosphonates should be advised of this potential complication. If orthodontic treatment is considered appropriate, plans should be assessed and modified to include compromises.

Periodontal cytokines profile under orthodontic force and extracorporeal shock wave stimuli in a rat model.

BACKGROUND AND OBJECTIVE: Extracorporeal shock wave therapy has been used in various clinical conditions as a result of its ability to stimulate healing processes in acute and chronic inflammatory states. Orthodontic force application triggers an inflammatory reaction in the periodontal tissue surrounding the involved teeth, resulting in tooth movement. Preliminary work revealed that extracorporeal shock wave therapy increased the expression of the inflammatory cytokines involved. Our aim was to investigate the expression of inflammatory cytokines in the periodontal tissues following orthodontic force induction, with and without shock wave therapy, in experimental rats. MATERIAL AND METHODS: An orthodontic appliance was fabricated and applied between the molars and the incisors of adult Wistar rats. In conjunction with orthodontic force commencement, the rats were treated with a single episode of 1000 shock waves. Every day, during the 3 d of the study, rats were killed and the immunolocalization of RANKL, interleukin (IL)-1ß, IL-6 and tumor necrosis factor-alpha was evaluated. RESULTS: The percentage of the area staining positively for all inflammatory cytokines during the first 2 d decreased statistically significantly more in the shock wave-treated group compared with the nontreated control group. On the first day, the percentage of the area staining positively for IL-1ß and RANKL on the compression side peaked in both groups, with a sequential rise in the number of TRAP-positive cells. CONCLUSION: The induction of shock wave therapy during orthodontic tooth movement influences the expression of different inflammatory cytokines in the tissue and might alter the expected periodontal remodeling rate.

Efecto incretina sobre el metabolismo de LRT intestinal / Incretin effect on lrt metabolism

INTRODUCCIÓN Las enfermedades cardiovasculares son la principal causa de muerte en los pacientes diabéticos tipo 2, y los trastornos lipídicos cumplen un rol determinante en la enfermedad arteriosclerótica. El aumento de las lipoproteínas ricas en triglicéridos (LRT) de origen intestinal se ha asociado a mayor enfermedad coronaria. El incremento de LRT intestinales en los diabéticos tipo 2 está frecuentemente asociado a una disminución de una serie de hormonas provenientes del intestino, denominadas incretinas. Las dos incretinas principales son el polipéptido inhibidor gástrico (GIP) y el péptido similar al glucagón de tipo 1 (GLP-1). Ambos son secretados en respuesta al consumo oral de alimentos, y su acción principal es estimular la secreción de insulina. Una vez liberados a la sangre, son degradados por la enzima dipeptidil peptidasa-IV (DPP-IV). OBJETIVOS Evaluar el efecto incretina por intermedio de un inhibidor de I-DPP-VI como la linagliptina sobre el metabolismo de LRT intestinales, utilizando un test de carga oral en lípidos. MÉTODOS Los pacientes diabéticos tipo 2 fueron evaluados en tres tiempos antes del tratamiento (T0), a las 4 semanas (T1) y a las 12 semanas (T2) de tratamiento con I-DPP-VI (N=10, efecto incretina) frente a tratamiento estándar (N=10, sin efecto incretina) en condiciones posprandiales. Se evaluaron los niveles de triglicéridos (TG), glucosa, insulina y HbA1c. RESULTADOS Se redujeron los niveles de TG posprandiales en un 67% a las 4 semanas (p=0,02) y en un 40% a las 12 semanas (p=0,04), con una disminución de la Hba1c de 1% en el grupo incretina (p=0,01) y de 0,9% en el grupo estándar (p=0,01). DISCUSIÓN a linagliptina reduce la lipemia posprandial, aumentando el efecto incretina. Estos resutados podrían explicar la reducción de mortalidad cardiovascular en pacientes DT2 tratados con I-DPPIV.

The reverse quad helix expander: easy access for bone graft manipulation in the cleft maxilla.

Cleft-affected patients are characterized by a normal/almost normal posterior maxillary width and a severe anterior constriction of the maxilla in the mixed dentition period. The purposes of this paper were to present: two cases of unilateral cleft-affected patients treated with a reverse quad-helix appliance; and a new method for differential expansion of the premaxillary area of the palatal cleft using a reverse quad-helix expander, thus enabling improved access for the surgeons during secondary bone graft procedures. /// Orthodontic and Craniofacial Department, School of Graduate Dentistry, Rambam Health Care Campus and Bruce Rappaport Faculty of Medicine­Technion, Israel Institute of Technology, Haifa, Israel. aizenbud@ortho.co.il

A Verification Method for MASOES.

MASOES is a 3agent architecture for designing and modeling self-organizing and emergent systems. This architecture describes the elements, relationships, and mechanisms, both at the individual and the collective levels, that favor the analysis of the self-organizing and emergent phenomenon without mathematically modeling the system. In this paper, a method is proposed for verifying MASOES from the point of view of design in order to study the self-organizing and emergent behaviors of the modeled systems. The verification criteria are set according to what is proposed in MASOES for modeling self-organizing and emerging systems and the principles of the wisdom of crowd paradigm and the fuzzy cognitive map (FCM) theory. The verification method for MASOES has been implemented in a tool called FCM Designer and has been tested to model a community of free software developers that works under the bazaar style as well as a Wikipedia community in order to study their behavior and determine their self-organizing and emergent capacities.