Horticultura y salud en Cojumatlán, Michoacán. Una aproximación a través de los biomarcadores y el contexto social / Horticultura e saúde em Cojumatlán, Michoacán. Uma abordagem através de biomarcadores e do contexto social

El progresivo uso de plaguicidas ha traído una serie de manifestaciones ambientales y efectos nocivos a la salud. Diversos estudios señalan que el empleo de biomarcadores  permite tener un estimado real del impacto de los plaguicidas en la salud humana, especialmente en aquellos asociados a la exposición crónica a bajos niveles en comunidades agrícolas; los biomarcadores permiten identificar mutaciones génicas, aberraciones cromosómicas  (AC) y daño al DNA. Con la oportuna detección del daño genético es posible tomar las medidas necesarias para disminuir o suprimir la exposición al agente cuando aún éste sea reversible, y de ese modo prevenir y disminuir el riesgo de desarrollar alteraciones patológicas, como el cáncer.En México a pesar de ser un país con gran actividad agrícola, los estudios al respecto han sido relativamente pocos. Sobre datos de Cojumatlán de Régules, Michoacán, México a donde se llevaron a cabo los estudios cuyos resultados se presentan, éste es un municipio que se ha dedicado de forma importante por más de tres décadas a la producción de hortalizas y han llevado a cabo un uso indiscriminado de plaguicidas como lo señalan los trabajadores agrícolas. A través del análisis de biomarcadores genotóxicos en un total de 67 individuos entre hombres y mujeres expuestos de forma directa e indirecta a plaguicidas del municipio y un grupo testigo de la región (Municipio de Sahuayo), conformado de 50 individuos no expuestos a plaguicidas y dedicado a labores comerciales y de servicio, se observó que no hay diferencia entre población expuesta directa e indirectamente en Cojumatlán, sin embargo, al compararse con el grupo testigo sí existió diferencia en cuanto a la frecuencia de micronúcleos y otras alteraciones cromosómicas derivadas de daño al DNA. Esto podría guardar relación con una deficiente información sobre efectos a la salud y sobre las medidas de seguridad y manejo de estas sustancias en los campos de cultivo y a nivel doméstico que quedó evidencia a través del trabajo etnográfico

Procjena genotoksičnosti insekticida Lannate-90® i njegovih biljnih i životinjskih metabolita u kulturi ljudskih limfocita

This study evaluated direct and metabolic genotoxic effects caused by Lannate-90®, a methomyl-based formulation (90 % active ingredient), in human lymphocyte cultures using sister chromatid exchange assay (SCE). Two processes were used for the plant promutagens evaluation: in vivo activation, applying the insecticide systemically in plants for 4 h and subsequently adding plant metabolites containing extracts to lymphocyte cultures; and in vitro activation, where the insecticide was incubated with Vicia faba S10 mix plus human lymphocyte culture. Direct treatment with the insecticide significantly increased SCE frequency in human lymphocytes (250-750 mg L-1), with cellular death observed at 1000 mg L-1 concentration. Using the extracts of Vicia faba treated with Lannate-90® to treat human lymphocytes, a dose-response relationship was observed. In lymphocyte cultures treated directly with the insecticide for 2 h, a negative response was obtained. When S10 mix was added, SCE frequency did not change significantly. Meanwhile, a mixture of S9 mammalian metabolic mix and Lannate-90® increased the SCE frequency, with an observed concentration-dependent response. Although Lannate-90® induced cellular death at the highest concentrations, it did not cause a delay in cell proliferation in any of the treatments, confirming its genotoxic action. This study is one of the first to evaluate and compare the direct effect of Lannate-90® in two bioassays, animal and vegetal, and the effect of plant and animal metabolism on its genotoxic potential.Korištenjem testa izmjena sestrinskih kromatida (eng. Sister Chromatide Exchange Assay – SCE) u kulturama ljudskih limfocita ispitivani su izravni i metabolički genotoksični učinci insekticida Lannate-90®, formulacije koja se temelji na metomilu (90 % aktivni sastojak). Za procjenu biljnih promutagena provedena su dva postupka: in vivo aktivacija, kod koje se insekticid četiri sata sustavno primjenjivao na biljci, a potom su kulturama limfocita dodani biljni metaboliti s ekstraktom, i aktivacija in vitro, kod koje je insekticid inkubiran mješavinom S10 biljke Vicia faba i kulturom ljudskih limfocita. Izravno tretiranje insekticidom značajno je povećalo učestalost SCE-a u ljudskim limfocitima (250-750 mg L-1), a stanična smrt uočena je pri koncentraciji od 1000 mg L-1. Nakon tretiranja ljudskih limfocita ekstraktima biljke Vicia faba koji su tretirani insekticidom Lannate-90®, primijećen je odnos između doze i učinka. Kod kultura limfocita koje su dva sata bile izravno tretirane insekticidom primijećen je negativan odgovor. Kada je dodana S10 mješavina za metaboličku aktivaciju, učestalost SCE-a nije se značajnije promijenila. Naspram tomu, metabolička mješavina S9 za kultivirane stanice sisavaca i Lannate-90® povećali su učestalost SCE-a, uz zamijećen koncentracijski ovisan odgovor. Premda je Lannate-90® inducirao staničnu smrt pri najvišim koncentracijama, nije uzrokovao zastoj stanične proliferacije ni u jednom postupku, čime se potvrđuje njegovo genotoksično djelovanje. Ovo je ispitivanje među prvima kojim se procjenjivao i uspoređivao izravan učinak insekticida Lannate-90® u dvama biološkim testovima, životinjskom i biljnom, te učinak biljnog i životinjskog metabolizma na njegov genotoksični potencijal

Procjena genotoksičnosti insekticida Lannate-90® i njegovih biljnih i životinjskih metabolita u kulturi ljudskih limfocita

This study evaluated direct and metabolic genotoxic effects caused by Lannate-90®, a methomyl-based formulation (90 % active ingredient), in human lymphocyte cultures using sister chromatid exchange assay (SCE). Two processes were used for the plant promutagens evaluation: in vivo activation, applying the insecticide systemically in plants for 4 h and subsequently adding plant metabolites containing extracts to lymphocyte cultures; and in vitro activation, where the insecticide was incubated with Vicia faba S10 mix plus human lymphocyte culture. Direct treatment with the insecticide significantly increased SCE frequency in human lymphocytes (250-750 mg L-1), with cellular death observed at 1000 mg L-1 concentration. Using the extracts of Vicia faba treated with Lannate-90® to treat human lymphocytes, a dose-response relationship was observed. In lymphocyte cultures treated directly with the insecticide for 2 h, a negative response was obtained. When S10 mix was added, SCE frequency did not change significantly. Meanwhile, a mixture of S9 mammalian metabolic mix and Lannate-90® increased the SCE frequency, with an observed concentration-dependent response. Although Lannate-90® induced cellular death at the highest concentrations, it did not cause a delay in cell proliferation in any of the treatments, confirming its genotoxic action. This study is one of the first to evaluate and compare the direct effect of Lannate-90® in two bioassays, animal and vegetal, and the effect of plant and animal metabolism on its genotoxic potential.Korištenjem testa izmjena sestrinskih kromatida (eng. Sister Chromatide Exchange Assay – SCE) u kulturama ljudskih limfocita ispitivani su izravni i metabolički genotoksični učinci insekticida Lannate-90®, formulacije koja se temelji na metomilu (90 % aktivni sastojak). Za procjenu biljnih promutagena provedena su dva postupka: in vivo aktivacija, kod koje se insekticid četiri sata sustavno primjenjivao na biljci, a potom su kulturama limfocita dodani biljni metaboliti s ekstraktom, i aktivacija in vitro, kod koje je insekticid inkubiran mješavinom S10 biljke Vicia faba i kulturom ljudskih limfocita. Izravno tretiranje insekticidom značajno je povećalo učestalost SCE-a u ljudskim limfocitima (250-750 mg L-1), a stanična smrt uočena je pri koncentraciji od 1000 mg L-1. Nakon tretiranja ljudskih limfocita ekstraktima biljke Vicia faba koji su tretirani insekticidom Lannate-90®, primijećen je odnos između doze i učinka. Kod kultura limfocita koje su dva sata bile izravno tretirane insekticidom primijećen je negativan odgovor. Kada je dodana S10 mješavina za metaboličku aktivaciju, učestalost SCE-a nije se značajnije promijenila. Naspram tomu, metabolička mješavina S9 za kultivirane stanice sisavaca i Lannate-90® povećali su učestalost SCE-a, uz zamijećen koncentracijski ovisan odgovor. Premda je Lannate-90® inducirao staničnu smrt pri najvišim koncentracijama, nije uzrokovao zastoj stanične proliferacije ni u jednom postupku, čime se potvrđuje njegovo genotoksično djelovanje. Ovo je ispitivanje među prvima kojim se procjenjivao i uspoređivao izravan učinak insekticida Lannate-90® u dvama biološkim testovima, životinjskom i biljnom, te učinak biljnog i životinjskog metabolizma na njegov genotoksični potencijal

The microRNAs as potential biomarkers for predicting the onset of aflatoxin exposure in human beings: a review

The identification of aflatoxins as human carcinogens has stimulated extensive research efforts, which continue to the present, to assess potential health hazards resulting from contamination of the human food supply and to minimize exposure. The use of biomarkers that are mechanistically supported by toxicological studies will be important tools for identifying stages in the progression of development of the health effects of environmental agents. miRNAs are small non-coding mRNAs that regulate post-transcriptional gene expression. Also, they are molecular markers of cellular responses to various chemical agents. Growing evidence has demonstrated that environmental chemicals can induce changes in miRNA expression. miRNAs are good biomarkers because they are well defined, chemically uniform, restricted to a manageable number of species, and stable in cells and in the circulation. miRNAs have been used as serological markers of HCC and other tumors. The expression patterns of different miRNAs can distinguish among HCC-hepatitis viruses related, HCC cirrhosis-derivate, and HCC unrelated to either of them. The main objective of this review is to find unreported miRNAs in HCC related to other causes, so that they can be used as specific molecular biomarkers in populations exposed to aflatoxins and as early markers of exposure, damage/presence of HCC. Until today specific miRNAs as markers for aflatoxins-exposure and their reliability are currently lacking. Based on their elucidated mechanisms of action, potential miRNAs that could serve as possible markers of HCC by exposure to aflatoxins are miR-27a, miR-27b, miR-122, miR-148, miR-155, miR-192, miR-214, miR-221, miR-429, and miR-500. Future validation for all of these miRNAs will be needed to assess their prognostic significance and confirm their relationship with the induction of HCC due to aflatoxin exposure

Oksidacijski stres, aktivnost kolinesteraza i primarna oštećenja u jetri, krvi i plazmi Wistar štakora nakon 28-dnevnog izlaganja glifosatu

In this 28 day-study, we evaluated the effects of herbicide glyphosate administered by gavage to Wistar rats at daily doses equivalent to 0.1 of the acceptable operator exposure level (AOEL), 0.5 of the consumer acceptable daily intake (ADI), 1.75 (corresponding to the chronic population-adjusted dose, cPAD), and 10 mg kg-1 body weight (bw) (corresponding to 100 times the AOEL). At the end of each treatment, the body and liver weights were measured and compared with their baseline values. DNA damage in leukocytes and liver tissue was estimated with the alkaline comet assay. Oxidative stress was evaluated using a battery of endpoints to establish lipid peroxidation via thiobarbituric reactive substances (TBARS) level, level of reactive oxygen species (ROS), glutathione (GSH) level, and the activity of glutathione peroxidase (GSH-Px). Total cholinesterase activity and the activities of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) were also measured. The exposed animals gained less weight than control. Treatment resulted in significantly higher primary DNA damage in the liver cells and leukocytes. Glyphosate exposure significantly lowered TBARS in the liver of the AOEL, ADI, and cPAD groups, and in plasma in the AOEL and cPAD group. AChE was inhibited with all treatments, but the AOEL and ADI groups significantly differed from control. Total ChE and plasma/liver ROS/GSH levels did not significantly differ from control, except for the 35 % decrease in ChE in the AOEL and ADI groups and a significant drop in liver GSH in the cPAD and 100xAOEL groups. AOEL and ADI blood GSH-Px activity dropped significantly, but in the liver it significantly increased in the ADI, cPAD, and 100xAOEL groups vs. control. All these findings show that even exposure to low glyphosate levels can have serious adverse effects and points to a need to change the approach to risk assessment of low-level chronic/sub-chronic glyphosate exposure, where oxidative stress is not necessarily related to the genetic damage and AChE inhibition.U okviru 28-dnevnog pokusa istražili smo učinke herbicida glifosata na modelu odraslih mužjaka Wistar štakora koji su oralno dobivali testirani spoj u subletalnim dnevnim dozama: 0,1 od prihvatljive razine izloženosti operatera (0,1xAOEL), 0,5 od prihvatljivog dnevnog unosa za potrošače (0,5xADI), 1,75 (odgovara kroničnoj populacijskoj prilagođenoj dozi, cPAD) i 10 mg kg-1 tjelesne težine na dan (odgovara 100xAOEL). Tijekom pokusa praćeni su sistemski toksični učinci. Nakon završetka svih tretmana svakoj je pokusnoj životinji izmjerena tjelesna težina i težina jetre te su uspoređene s polazišnim vrijednostima. Alkalnim komet-testom izmjerena je razina primarnih oštećenja DNA u leukocitima i jetrenim stanicama. Primjenom metoda za procjenu oksidacijskog stresa izmjerene su razine lipidne peroksidacije (TBARs), reaktivnih kisikovih vrsta (ROS) i glutationa (GSH) te aktivnost enzima glutation peroksidaze (GSH-Px). Izmjerene su i aktivnosti ukupnih kolinesteraza (ChE), acetilkolinesteraze (AChE) i butirilkolinesteraze (BChE). Izloženi štakori imali su manje priraste težine od kontrolnih. Izloženost glifosatu uzrokovala je značajne poraste razine primarnih oštećenja DNA u jetrenim stanicama te malo manje u leukocitima. U svim izloženim skupinama izmjerene su niže vrijednosti TBARs u odnosu na kontrolu, sa značajno nižim vrijednostima u AOEL, ADI i cPAD skupinama u uzorcima jetre te u AOEL i cPAD skupinama u uzorcima plazme. Aktivnost AChE bila je smanjena u svim tretmanima, s najnižom stopom nakon izlaganja dozi ADI. Aktivnost BChE blago je smanjena nakon izlaganja ADI, a povećana nakon izlaganja dozama cPAD i 100xAOEL. Ukupna aktivnost ChE te razine ROS/GSH u plazmi / jetri nisu se značajno razlikovale od kontrole, osim značajnog smanjenja jetrenog GSH nakon izlaganja dozama cPAD i 100xAOEL te 35-postotnog smanjenja aktivnosti ChE nakon izlaganja dozama AOEL i ADI. Aktivnost GSH-Px u krvi značajno je smanjena u AOEL i ADI tretmanu, a aktivnost GSH-Px u uzorcima jetre značajno je povećana u skupinama ADI, cPAD i 100xAOEL prema kontroli. Dobiveni rezultati pokazuju da čak i izloženost vrlo niskim dozama glifosata može izazvati mjerljive toksične učinke te upućuje na potrebu za promjenom pristupa procjeni rizika zbog kronične/subkronične izloženosti niskim dozama glifosata gdje oksidacijski stres ne mora nužno korelirati s razinom oštećenja DNA i inhibicijom acetilkolinesteraz

Emprende Educación (EMED)

El proyecto se centra en el desarrollo de la Competencia Transversal del Grado de Educación Social (CT5): Valorar la importancia del liderazgo, el espíritu emprendedor, la creatividad y la innovación en el desempeño profesional. Se enmarca, por tanto, en la línea ocho de la convocatoria de Innova – Docencia: Fomento de la Inserción laboral y el emprendimiento entre los estudiantes. El proyecto se vertebra a partir de dos objetivos: 1) Transversalizar en la docencia del Grado de Educación Social un enfoque centrado en el desarrollo de la Competencia Emprendedora para poder vincular los diversos contenidos de las asignaturas con el desarrollo futuro de proyectos de Emprendimiento Social. 2) Despertar en los alumnos la iniciativa emprendedora como una oportunidad laboral real en el ámbito de la Educación Social para la mejora de su empleabilidad. Pretende fortalecer las metodologías participativas y colaborativas en el diseño, la aplicación y el desarrollo de la competencia emprendedora ligada al contenido de las diversas asignaturas del Grado Educación Social

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group