Nutrición de precisión en los tiempos de la medicina del estilo de vida: Precision nutrition in the life style medicine times

The etymological origin of the term Diet, derives from the Greek δίαιτα, understood as "lifestyle"; currently the Science shows that prevention and protection of well-being begin in the diet and continue in our Lifestyle. Diet is a key factor for the health status of the individual since the interaction between diet, environmental factors and genes, determines the well-being of people. The negative impacts on health, caused by an inadequate diet, are increasing every day. The obesity, the main consequence of this nutritional alteration, is one of the main causes of morbidity and mortality in most countries for the diseases associated with it, NTCDs (Non Transmissible Chronic Disease): dyslipidemias, cardiovascular diseases, diabetes mellitus type 2, fatty liver not alcoholic and even Cancer.El origen etimológico del término Dieta, deriva del griego δίαιτα, entendido como “estilo de vida”; actualmente la ciencia demuestra que la prevención y la tutela del bienestar empiezan en la alimentación y continúan en nuestroestilo de vida. La dieta es un factor clave para el estado de salud del individuo ya que la interacción entre dieta, factores ambientales y genes determina el bienestar de las personas. Los impactos negativos en la salud, originados por una inadecuada alimentación, son cada día mayores. Laobesidad, principal consecuencia de esta alteración nutricional, es una de las principales causas de morbilidady mortalidad en la mayoría de los países para las enfermedades asociadas con ella, las NTCDs ( Non TransmissibleChronic Disease) : dislipidemias, enfermedades cardiovasculares, diabetes mellitus de tipo 2, hígado graso noalcohólico e inclusive Cáncer

Building sustainable capacity for health research in africa through cloud computing applications

Access to information and continuous education represent critical factors for physicians and researchers over the world. For African professionals, this situation is even more problematic due to the frequently difficult access to technological infrastructures and basic information. Both education and information technologies (e.g., including hardware, software or networking) are expensive and unaffordable for many African professionals. Thus, the use of e-learning and an open approach to information exchange and software use have been already proposed to improve medical informatics issues in Africa. In this context, the AFRICA BUILD project, supported by the European Commission, aims to develop a virtual platform to provide access to a wide range of biomedical informatics and learning resources to professionals and researchers in Africa. A consortium of four African and four European partners work together in this initiative. In this framework, we have developed a prototype of a cloud-computing infrastructure to demonstrate, as a proof of concept, the feasibility of this approach. We have conducted the experiment in two different locations in Africa: Burundi and Egypt. As shown in this paper, technologies such as cloud computing and the use of open source medical software for a large range of case present significant challenges and opportunities for developing countries, such as many in Africa

Medicina de precisión: el futuro de la medicina: Precision medicine: the future of medicine

The sequencing of the human genome back in 2001 generated the greatest health knowledgerevolution of the 21st century, thanks to this event today we can clearly know how biologicalsystems work. On the other hand, the implementation of diagnostic platforms increasinglysophisticated and sensitive that added to the development of the pharmaceutical industry, in thelast 18 years, have generated a paradigm shift called: Precision Medicine, a situation that makes itincreasingly distant to think in a medicine such as the one practiced today, based on trial anderror, where the objective is a diagnosis and treatment directed against the symptomatology.In that order of ideas, imagine that at this moment a medical colleague, is treating one of hispatients and to diagnose it has requested a series of support tools such as images or clinicalanalysis, complying with a Clinical Practice Guide that joins his experience will take you (ifnecessary) to design and prescribe a symptomatic and modifying treatment, seeking that thedrugs interact with a specific objective in the biological network underlying the disease, directly orindirectly impacting the progression of the disease and the person; up there all right, to this wecall "conventional therapy", a practice accepted and validated by our health system.   DOI: 10.25176/RFMH.v18.n2.1279La secuenciación del genoma humano allá por el año 2001 generó la más grande revolución de conocimiento en salud del siglo XXI, gracias a este acontecimiento hoy podemos saber con claridad como funcionan los sistemas biológicos. Por otro lado, la implementación  de plataformas diagnósticas cada vez más sofisticadas y sensibles que adicionadas al desarrollo de la industria farmacéutica, en los últimos 18 años, han generado un cambio de paradigma llamado: Medicina de Precisión, situación que hace cada vez más lejano pensar en una medicina como la que se practica actualmente, basada en el ensayo-error, donde el objetivo es un diagnóstico y tratamiento dirigido contra la sintomatología. En ese orden de ideas, imaginemos que en este momento algún colega médico, está tratando a uno de sus pacientes y para diagnosticarlo ha solicitado una serie de herramientas de apoyo como imágenes o análisis clínicos, cumpliendo con una Guía de Práctica Clínica que aunada a su experiencia lo llevará (si es necesario) a diseñar y prescribirle un tratamiento sintomático y modificador, buscando que los fármacos interactúen con un objetivo específico en la red biológica subyacente a la enfermedad, impactando directa o indirectamente en la progresión de ésta y en la persona; hasta allí todo bien, a esto nosotros denominamos “terapia convencional”, una práctica aceptada y validada por nuestro sistema de salud.   DOI: 10.25176/RFMH.v18.n2.1279 &nbsp

Caracterización clínico-patológica, genotipificación viral y heterogeneidad genética como determinantes de riesgo en COVID-19: Diseño del estudio y hallazgos iniciales: Clinical-pathological characterization, viral genotipification and genetic heterogeneity as risk determinants in COVID-19: Study design and initial findings

Introduction: The objective of the study is to describe the clinical, pathological, virological and genetic characteristics ofthe immune response of patients diagnosed with SARS-CoV-2 infection and its relationship with the unfavorable courseof the disease. Methods: Descriptive, relational, longitudinal and retrospective study based on the review of medicalrecords, taking post-mortem tru-cut biopsies of the lung and liver, taking blood samples and naso-oropharyngeal swabor endotracheal tube aspirate. In the first phase, the biopsies will be processed and studied with conventional andimmunohistochemical histology in the Pathological Anatomy service of the Carlos Seguín Escobedo National Hospitalin Arequipa, Peru. Results: Advanced mean age, male sex, and the presence of comorbidities were predominant indeceased patients. Lung biopsies showed predominantly the exudative and partially proliferative phases of diffuseand focal alveolar damage, associated primarily with intraalveolar macrophage hyperplasia with accumulation withinthe alveolar space-resembling desquamative pneumonia, as well as atypical binucleated intraalveolar pneumocytes,with eosinophilic nucleoli (similar to virocytes) in some cases. In the vast majority of cases, intravascular fibrin depositsassociated with the accumulation of inflammatory cells composed of neutrophils and monocytes, representingmicrothrombosis, were observed. Liver biopsies showed predominantly macrovesicular steatosis and in twocases microvesicular steatosis was observed. Additionally, varying degrees of necrosis and mild portal and lobularinflammation were observed. Conclusion: The clinical and pathological findings in this first report are consistent withprevious publications and confirm the pattern of diffuse alveolar damage associated with aggregates of intraalveolarmacrophages and microthrombosis; confirms in addition, macro and microvesicular hepatocytic steatosis, togetherwith variable degrees of necrosis.Introducción: El objetivo del estudio es describir las características clínicas, patológicas, virológicas y genéticas de larespuesta inmune de los pacientes diagnosticados con infección por SARS-CoV-2 y su relación con el curso desfavorablede la enfermedad. Métodos: Estudio descriptivo, relacional, longitudinal y retrospectivo basado en la revisión dehistorias clínicas, toma de biopsias tru-cut post-mortem de pulmón e hígado, toma de muestras de sangre e hisopadonaso-orofaríngeo o de aspirado del tubo endotraqueal. En la primera fase las biopsias serán procesadas y estudiadascon histología convencional e inmunohistoquímica en el servicio de Anatomía Patológica del hospital NacionalCarlos Seguín Escobedo de Arequipa, Perú. Resultados: La edad media avanzada, el sexo masculino y la presencia decomorbilidades fue predominante en los pacientes fallecidos. Las biopsias pulmonares mostraron predominantementelas fases exudativa y parcialmente proliferativa del daño alveolar difuso y focal, asociada principalmente a unahiperplasia de macrófagos intraalveolares con acumulación dentro del espacio alveolar, semejando una neumoníadescamativa, así como neumocitos intraalveolares binucleados y atípicos, con nucléolos eosinofílicos (semejante avirocitos) en algunos casos. En la gran mayoría de casos se observaron depósitos de fibrina intravascular asociadaal acúmulo de células inflamatorias compuestas por neutrófilos y monocitos, representando microtrombosis. Lasbiopsias de hígado mostraron esteatosis predominantemente macrovesicular y en dos casos se observó esteatosismicrovesicular. Adicionalmente, se observaron diversos grados de necrosis e inflamación portal y lobular. Conclusión:Los hallazgos clínicos y patológicos en este primer reporte son consistentes con publicaciones previas y confirmanel patrón de daño alveolar difuso asociado a agregados de macrofagos intraalveolares y microtrombosis; ademasesteatosis macro y microvesicular hepatocitica, junto a grados variables de necrosis

Recent advances in the structural and molecular biology of type IV secretion systems

Bacteria use type IV secretion (T4S) systems to deliver DNA and protein substrates to a diverse range of prokaryotic and eukaryotic target cells. T4S systems have great impact on human health, as they are a major source of antibiotic resistance spread among bacteria and are central to infection processes of many pathogens. Therefore, deciphering the structure and underlying translocation mechanism of T4S systems is crucial to facilitate development of new drugs. The last five years have witnessed considerable progress in unraveling the structure of T4S system subassemblies, notably that of the T4S system core complex, a large 1 MegaDalton (MDa) structure embedded in the double membrane of Gram-negative bacteria and made of 3 of the 12 T4S system components. However, the recent determination of the structure of ∼3 MDa assembly of 8 of these components has revolutionized our views of T4S system architecture and opened up new avenues of research, which are discussed in this review

Development of Mouse Hepatocyte Lines Permissive for Hepatitis C Virus (HCV)

The lack of a suitable small animal model for the analysis of hepatitis C virus (HCV) infection has hampered elucidation of the HCV life cycle and the development of both protective and therapeutic strategies against HCV infection. Human and mouse harbor a comparable system for antiviral type I interferon (IFN) induction and amplification, which regulates viral infection and replication. Using hepatocytes from knockout (ko) mice, we determined the critical step of the IFN-inducing/amplification pathways regulating HCV replication in mouse. The results infer that interferon-beta promoter stimulator (IPS-1) or interferon A receptor (IFNAR) were a crucial barrier to HCV replication in mouse hepatocytes. Although both IFNARko and IPS-1ko hepatocytes showed a reduced induction of type I interferons in response to viral infection, only IPS-1-/- cells circumvented cell death from HCV cytopathic effect and significantly improved J6JFH1 replication, suggesting IPS-1 to be a key player regulating HCV replication in mouse hepatocytes. We then established mouse hepatocyte lines lacking IPS-1 or IFNAR through immortalization with SV40T antigen. Expression of human (h)CD81 on these hepatocyte lines rendered both lines HCVcc-permissive. We also found that the chimeric J6JFH1 construct, having the structure region from J6 isolate enhanced HCV replication in mouse hepatocytes rather than the full length original JFH1 construct, a new finding that suggests the possible role of the HCV structural region in HCV replication. This is the first report on the entry and replication of HCV infectious particles in mouse hepatocytes. These mouse hepatocyte lines will facilitate establishing a mouse HCV infection model with multifarious applications

Accessing and managing open medical resources in Africa over the Internet

Recent commentaries have proposed the advantages of using open exchange of data and informatics resources for improving health-related policies and patient care in Africa. Yet, in many African regions, both private medical and public health information systems are still unaffordable. Open exchange over the social Web 2.0 could encourage more altruistic support of medical initiatives. We have carried out some experiments to demonstrate the feasibility of using this approach to disseminate open data and informatics resources in Africa. After the experiments we developed the AFRICA BUILD Portal, the first Social Network for African biomedical researchers. Through the AFRICA BUILD Portal users can access in a transparent way to several resources. Currently, over 600 researchers are using distributed and open resources through this platform committed to low connections

Advances in prevention and therapy of neonatal dairy calf diarrhoea : a systematical review with emphasis on colostrum management and fluid therapy

Neonatal calf diarrhoea remains the most common cause of morbidity and mortality in preweaned dairy calves worldwide. This complex disease can be triggered by both infectious and non-infectious causes. The four most important enteropathogens leading to neonatal dairy calf diarrhoea are Escherichia coli, rota-and coronavirus, and Cryptosporidium parvum. Besides treating diarrhoeic neonatal dairy calves, the veterinarian is the most obvious person to advise the dairy farmer on prevention and treatment of this disease. This review deals with prevention and treatment of neonatal dairy calf diarrhoea focusing on the importance of a good colostrum management and a correct fluid therapy

Evaluación del perfil transcriptómico inmunológico y variantes genéticas del SARS-COV-2 como predictores de severidad de la enfermedad COVID-19

Resumen del Proyecto: Introduccion: La variabilidad genetica del SARS-CoV-2 ha sido reportada por varios autores. La respuesta del huesped frente al virus es clave para determinar su evolucion. El objetivo es identificar genes o vías de señalización de respuesta antiviral o pro inflamatoria en el huésped asociadas a variantes genéticas de SARSCoV-2 que permitan predecir la progresión de COVID-19 moderado a Severo. Métodos: Estudio observacional, exploratorio de identificacion pronóstica, en pacientes hospitalizados con COVID-19 comparando aquellos con evolucion favorable con los afectados severamente. Del hisopado nasal se extraera RNA viral, Según procedimiento se extraerá RNA y se convertirá a DNA. De muestras sanguíneas de los días 1, 5 y 10 de hospitalización se extraerá RNA/DNA. Las muestras serán centrifugadas para la obtención de plasma y preservadas a -80 0C. Se procederá a preparar manualmente las librerías genéticas a partir del cDNA de sangre y del virus. El análisis de la data primaria se realizará con el software Torrent Suite. Se determinará los genes diferencialmente expresados y el análisis de enriquecimiento de genes entre pacientes. Adicionalmente se realizará una RTPCR para evaluar polimorfismos de genes específicos: ACE2, VEGFA. Se correlacionará el perfil inmunológico del huésped con las variantes genéticas de SARS-CoV-2. Se utilizará un modelo estadístico predictivo para establecer un perfil inflamatorio/viral que determine la progresión a COVID-19 severo. Resultados Esperados: Validacion de resultados previos que demuestran la presencia de un incremento en la expresión de citoquinas proinflamatorias como IL6 y TNF. Se espera encontrar una respuesta antiviral disminuida en aquellos pacientes que presentan una evolución desfavorable. Ademas se evaluaran otros genes de la inmunidad innata y adaptativa que puedan estar asociados a la progresión a un cuadro de COVID-19 severo, así como evaluar genes de predisposición genética para enfermedad grave, que serán complementados con la evaluación de los polimorfismos ACE-2 y VEGFA. El estudio permitirá identificar la cepa prevalente en pacientes con COVID-19 moderado en Perú y variantes asociadas a una evolución desfavorable o a un perfil inmunológico especifico, además de evaluar predisposición genética basal. Finalmente, este estudio puede potencialmente permitirnos identificar pacientes con un perfil inmunológico que respondan mejor a una terapia específica.Trabajo academic

Intestinal Protists in Captive Non-human Primates and Their Handlers in Six European Zoological Gardens. Molecular Evidence of Zoonotic Transmission

We assessed the occurrence, genetic diversity, and zoonotic potential of four protozoan (Cryptosporidium spp., Entamoeba histolytica, Entamoeba dispar, Giardia duodenalis), one stramenopile (Blastocystis sp.), one microsporidia (Enterocytozoon bieneusi), and two ciliate (Balantioides coli, Troglodytella abrassarti) intestinal parasite or commensal protist species in captive non-human primates (NHP) and their zookeepers from six European zoological gardens in France (n = 1), Germany (n = 1), and Spain (n = 4). Faecal samples from NHP (n = 454) belonging to 63 species within 35 genera and humans (n = 70) were collected at two sampling periods in each participating institution between October 2018-August 2021. Detection and species identification was accomplished by PCR and Sanger sequencing of the ssu rRNA and/or ITS genes. Sub-genotyping analyses using specific markers were conducted on isolates positive for G. duodenalis (gdh, bg, tpi) and Cryptosporidium spp. (gp60). Overall, 41.0% (186/454) and 30.0% (21/70) of the faecal samples of NHP and human origin tested positive for at least one intestinal protist species, respectively. In NHP, Blastocystis sp. was the most prevalent protist species found (20.3%), followed by G. duodenalis (18.1%), E. dispar (7.9%), B. coli and T. abrassarti (1.5% each), and Cryptosporidium spp. and E. bieneusi (0.9% each). Occurrence rates varied largely among NHP host species, sampling periods, and zoological institutions. The predominant protist species found in humans was Blastocystis sp. (25.7%), followed by Cryptosporidium spp. (2.9%), E. dispar (1.4%), and G. duodenalis (1.4%). Sequencing of PCR-positive amplicons in human and/or NHP confirmed the presence of Cryptosporidium in six isolates (C. hominis: 66.7%, C. parvum: 33.3%), G. duodenalis in 18 isolates (assemblage A: 16.7%, assemblage B: 83.3%), Blastocystis in 110 isolates (ST1:38.2%, ST2:11.8%, ST3: 18.2%, ST4: 9.1%, ST5: 17.3%, ST8: 2.7%, ST13: 0.9%), and E. bieneusi in four isolates (CM18: 75.0%, Type IV: 25.0%). Zoonotic transmission events involving Blastocystis ST1-ST4 were identified in four zoological institutions. Zoonotic transmission of C. hominis was highly suspected, but not fully demonstrated, in one of them. Monitoring of intestinal protist species might be useful for assessing health status of captive NHP and their zookeepers, and to identify transmission pathways of faecal-orally transmitted pathogens.This study was funded by the Health Institute Carlos III (ISCIII), Spanish Ministry of Economy and Competitiveness under project PI16CIII/00024. DG-B was recipient of a Sara Borrell Postdoctoral Fellowship (CD19CIII/00011) funded by the Spanish Ministry of Science, Innovation and Universities. AD was recipient of a PFIS contract (FI20CIII/00002) funded by the Spanish Ministry of Science and Innovation and Universities.S