Maca: del alimento perdido de los incas al milagros de los andes. estudio de seguridad alimentaria y nutricional

El estudio ha sido diseñado para determinar el estado de salud en una población en los Andes centrales del Perú (Carhuamayo, 4100 m) que tradicionalmente consume maca comparado con aquella del mismo lugar que no consume maca. El estudio consiste en aplicar una encuesta sobre consumo de maca, aspectos sociodemográficos, de salud, y de fracturas en varones y mujeres de 35- 75 años de edad. A una submuestra se ha evaluado el perfil hepático, renal, y de hemoglobina. El 80% de los pobladores de Carhuamayo consumen maca. El 85% de esta población lo usa por motivos nutricionales. Se consume desde la niñez y principalmente cuando el hipocótilo es deshidratado naturalmente. El consumo es principalmente en forma de jugo y la variedade de consumo es una mezcla de colores. El consumo de maca se asocia a mejores puntajes de estado de salud, menores tasas de fracturas y menores puntajes de signos y síntomas de mal de montaña crónico. Se asocia igualmente al consumo de maca un menor Indice de Masa Corporal, y menor presión arterial sistólica. La función hepática, renal, el perfil lipídico y la glicemia se mantienen en lo normal. En conclusión, el consumo de maca como alimento es seguro

Estudio de tolerancia local de un candidato vacunal proteoliposómico contra Leptospira SPP en el biomodelo Mesocricetus Auratus (Study of local tolerance of a proteoliposome vaccine candidate against Leptospira SPP in Mesocricetus Auratus as biomodel)

La leptospirosis es una de las zoonosis bacterianas más difundidas en el mundo. En la actualidad existen registradas varias vacunas de células enteras contra Leptospira. Estos productos biofarmacéuticos cuentan entre sus desventajas las reacciones de hipersensibilidad a los componentes de las formulaciones y la alta frecuencia de toxicidad en el sitio de inoculación. En el presente trabajo fue evaluada la tolerancia local en el punto de inoculación generada por una nueva formulación vacunal proteoliposómica contra Leptospira spp. en el biomodelo el Mesocricetus auratus. Para ello los animales (ambos sexos) fueron inoculados dos veces por vía intramuscular, con 21 días entre la primera y la segunda inoculación. Seguidamente se realizaron eutanasias seriadas a los 3 días y luego semanalmente hasta 49 días de la primera inoculación. Los resultados demostraron la ausencia de muertes y de diferencias estadísticas en las variables: peso corporal, consumo de agua y alimentos entre animales inmunizados y controles negativos. Tampoco se detectaron lesiones macroscópicas en órganos y tejidos de importancia toxicológica en los animales inmunizados con el candidato vacunal. Las lesiones locales encontradas obedecen a la respuesta inmunológica generada por esta nueva formulación vacunal. La relevancia inmunológica del biomodelo se comprobó mediante la determinación de anticuerpos IgG en el grupo de animales vacunados. En función de los resultados obtenidos se concluye que el candidato vacunal evaluado no fue potencialmente tóxico al sitio de inoculación al ser administrado por vía intramuscular en el biomodelo Mesocricetus auratus. AbstractLeptospirosis is the bacterial zoonosis more overspread in the world. As a control measure some whole cell vaccines has been developed and registered. These biopharmaceutical products have as principal disadvantages the absence of cross-protection against serovars not included on formulations and reactogenicity at inoculation site. In this paper it is discussed the local toxicity at inoculation site elicited by a proteoliposome vaccine candidate obtained form outer membrane cell wall of Leptospira spp using the Mesocricetus auratus as biomodel. The experimental animals (both sexes) were inoculated with two doses of vaccine candidate (21 days between them) via intramuscular. The results obtained did not show statistical differences among immunized and animal controls for the variables: corporal weight, water and food intake. Neither macroscopic lesions of toxicological importance were observed. The histopathological findings describes are part of immunological response consequence against vaccine candidate. Besides the immunological relevance of the biomodel was check by means of IgG quantification. Agreement with these results, it can conclude that a single dose of the vaccine candidate immunized via intramuscular in Mesocricetus auratus did not show toxic potential at inoculation site

Duodenal strongyloidiasis and hyperinfection syndrome: Case report and literature review

Strongyloides stercoralis is an intestinal nematode that commonly causes chronic and asymptomatic infection, but in some situations, especially in cases of immunosuppression, infection by this parasite can manifest with extreme severity and high mortality. Hyperinfection syndrome and disseminated strongyloidiasis are two serious, life-threatening presentations associated with immunosuppression. We report the case of a 69 year-old male with diffuse abdominal pain, intermittent diarrhea, and fever. Stool analysis for parasitic infection was negative. Upper gastrointestinal endoscopy with duodenal biopsy revealed ulcerative duodenitis due to strongyloidiasis, showing the presence of several larvae in lymph and intraglandular ducts. Definitive diagnosis was established as S. stercoralis hyperinfection syndrome

Epigenetic mechanisms and posttranslational Modifications in systemic lupus erythematosus

The complex physiology of eukaryotic cells is regulated through numerous mechanisms, including epigenetic changes and posttranslational modifications. The wide-ranging diversity of these mechanisms constitutes a way of dynamic regulation of the functionality of proteins, their activity, and their subcellular localization as well as modulation of the di erential expression of genes in response to external and internal stimuli that allow an organism to respond or adapt to accordingly. However, alterations in these mechanisms have been evidenced in several autoimmune diseases, including systemic lupus erythematosus (SLE). The present review aims to provide an approach to the current knowledge of the implications of these mechanisms in SLE pathophysiology

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p&lt;0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (&lt;1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (&lt;1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Advancements in dementia research, diagnostics and care in Latin America : highlights from the 2023 Alzheimer's association international conference satellite symposium in Mexico City

While Latin America (LatAm) is facing an increasing burden of dementia due to the rapid aging of the population, it remains underrepresented in dementia research, diagnostics and care. In 2023, the Alzheimer’s Association hosted its eighth Satellite Symposium in Mexico, highlighting emerging dementia research, priorities, and challenges within LatAm. A wide range of topics were covered, including epidemiology, social determinants, dementia national plans, risk reduction, genetics, biomarkers, biobanks, and advancements in treatments. Large initiatives in the region including intra-country support showcased their efforts in fostering national and international collaborations; genetic studies unveiled the unique genetic admixture in LatAm; emerging clinical trials discussed ongoing culturally specific interventions; and the urgent need to harmonize practices and studies, improve diagnosis and care and implement affordable biomarkers in the region was highlighted

Photoprotection against the UVB-induced oxidative stress and epidermal damage in mice using leaves of three different varieties of Lepidium meyenii (maca)

Background Skin exposure to ultraviolet (UV) B radiation leads to epidermal damage and generation of reactive oxygen species. The photoprotective effect of extracts of three varieties of leaves (red, yellow, and black) from maca (Lepidium meyenii), a plant from the Peruvian highlands, was assessed in mouse skin exposed to UVB radiation. Materials and methods The hydroalcoholic extracts of three varieties of maca leaves were applied topically to the dorsal skin of young-adult male mice prior to exposition to UVB radiation. Results The three varieties had UVA/UVB absorptive properties and presented antioxidant activity, being highest with red maca, followed by black and yellow maca. The three varieties of maca leaves prevented the development of sunburn cells, epidermal hyperplasia, leukocytic infiltration, and other alterations produced by UVB radiation. Mice treated with black maca showed the highest superoxide dismutase levels, and mice treated with black and yellow maca showed higher catalase levels in skin, whereas red maca protected the skin and liver against significant increases in the lipid peroxidation activity observed in the unprotected animals. Conclusion The presence of significant antioxidant activity and the inhibition of lipid peroxidation suggest that the observed protection could be partly attributable to this mechanism. © 2011 The International Society of Dermatology.Fil: Gonzales Castañeda, Cynthia. Universidad Peruana Cayetano Herediam Lima; PerúFil: Rivera, Valery. Universidad Peruana Cayetano Herediam Lima; PerúFil: Chirinos, Ana Lucía. Universidad Peruana Cayetano Herediam Lima; PerúFil: Evelson, Pablo Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Gonzales, Gustavo Francisco. Universidad Peruana Cayetano Herediam Lima; Per