Intervención nutricional en niños y adolescentes con fibrosis quística. Relación con la función pulmonar

[email protected]; [email protected];Objetivo: Evaluar los efectos de la intervención nutricional precoz y continuada en pacientes pediátricos con fibrosis quística (FQ) y su posible implicación en la función pulmonar. Pacientes y métodos: Se incluyen el seguimiento de 19 pacientes con FQ (11 niñas, 8 niños) de 17 meses a 18 años de edad y promedio de 10 años de enfermedad. El genotipo de 16 pacientes es delta F 508 (10 homo, 6 heterocigotos). Cada 2-3 meses se les ha realizado: valoración clínica, dietética y antropométrica clasificando el estado de nutrición (EN) según Z pesto/talla, % peso para la talla, índice de masa corporal y Z talla/edad. Coincidentemente se obtuvo cultivo de secreciones respiratorias y espirometría; y anualmente determinaciones bioquímicas, hematológicas y de heces. La intervención nutricional incluyó: recomendaciones dietéticas, nutrición enteral (NE) oral o invasiva y tratamiento farmacológico con ezimas pancreáticos, vitaminas liposolubles, minerales y oligoelementos. Resultados y comentarios: La mayoría experimentaron mejoría antropométrica resultando significativa para el peso, relaciónpeso/talla y pliegue tricipital (p < 0,05). La puntuación Z se ha mantenido estable. Dieciséis pacientes (84%) han desarrollado insuficiencia pancreática exocrina y 3 (16%) intolerancia a la glucosa. Catorce (73%) se han colonizado por Pseudomonas aeuroginosa. Los valores promedio de la última espirometría fueron: FVC (%) 85,4 ± 18,6 y FEV1 (%) 85,9 ± 24,1 encontrándose unc orrelación positiva significativa entre el % del peso para la talla y FVC (coef 0,552, p = 0,022) y con FEV1 (coef. 0,625; p = 0,007). El 79% han requerido algún tipo de apoyo nutritional: 3 casos (16%) NE invasiva y el resto tratamiento con NE oral. Conclusiones: Sin soporte nutricional muchos pacientes con FQ no parecen cubrir su requerimientos. La monitorización del EN permite la actuación precoz y efectiva. Se demuestra una correlación estrecha entre el estado de nutrición y la función pulmonar.Objective: To assess the effects of early and continuous nutritional intervention in pediatric patients with cystic fibrosis (CF) and its possible implication in pulmonary function. Patients and methods: Included is the follow-up of 19 patients with CF (11 female and 8 male children), from 17 months to 18 years of age, and a mean disease duration of 10 years. Genotype from 16 patients is delta F 508 (10 homozygotic, 6 heterozygotic). The following items have been performed every 2-3 months: clinical, dietary and anthropometrical assessment, classifying nutritional status (NS) by Z scores of weight/height, % of weight to height, body mass index, and Z scores of height/age. Concurrently, respiratory secretions culture and spirometry were obtained; and annually, biochemistry, hematologic and feces determinations. Nutritional intervention included: dietary recommendations, oral or invasive enteral nutrition (EN) and pharmacologic treatment with pancreatic enzymes, fat-soluble vitamins, minerals and oligoelements. Results and commentaries: Most of them experienced anthropometrical improvement being significant for weight, the relationship of weight/height and the tricipital fold (p < 0.05). The Z score for height has remained steady. Sixteen patients (84%) have developed exocrine pancreatic failure, and 3 (16%) glucose intolerance. Fourteen (73%) have been colonized by Pseudomonas aeruginosa. Last mean spirometry values were: FVC (%) 85.4 ± 18.6 and FEV1 (%) 85.9 ± 24.1, with a significant correlation between % of weight to height and FVC (coefficient 0.552, p = 0.022) and FEV1 (coefficient 0.625, p = 0.007). Seventy nine percent have required some sort of nutritional support: 3 cases (16%) invasive EN, and the remaining oral EN. Conclusions: Without nutritional support, many patients with CF do not seem to meet their demands. EN monitoring allows for and early and effective intervention. A close correlation has been demonstrated between nutritional status and pulmonary function

Análisis de componentes de los modelos de madurez

Existen distintos modelos de calidad de software los cuales permiten que las industrias puedan contar con diferentes alternativas para la mejora continua de sus procesos de calidad. Tomando en cuenta que los modelos tienen el mismo objetivo, este artículo identifica los componentes genéricos de los modelos de madurez analizando para ello los componentes (elementos por ejemplo como: áreas de procesos, categorías, prácticas sugeridas, etc.) de seis modelos de madurez representativos que son CMMI (Modelo de Madurez de Capacidades), Moprosoft, BOOTSTRAP, y los estándares ISO/IEC 90003, ISO/IEC 29110, ISO/IEC 15504. Estos componentes nos llevan a definir la estructura de un modelo genérico propuesto. Luego se ejemplifica la inserción de los componentes específicos de cada modelo dentro del modelo genérico. Este modelo genérico permite comparar y analizar los componentes específicos de cualquier modelo de madurez y será principalmente de utilidad para sistematizar la implementación de los modelos de madurez dentro de un proceso de mejora

SARS-CoV-2 RNA and antibody detection in breast milk from a prospective multicentre study in Spain

This study has been supported by a research grant from Fundacion La Marato-TV3 (MilkCORONA, ref 202106).Objectives To develop and validate a specific protocol for SARS-CoV- 2 detection in breast milk matrix and to determine the impact of maternal SARS-CoV- 2 infection on the presence, concentration and persistence of specific SARS-CoV- 2 antibodies. Design and patients This is a prospective, multicentre longitudinal study (April–December 2020) in 60 mothers with SARS-CoV- 2 infection and/or who have recovered from COVID-19. A control group of 13 women before the pandemic were also included. Setting Seven health centres from different provinces in Spain. Main outcome measures Presence of SARS-CoV- 2 RNA in breast milk, targeting the N1 region of the nucleocapsid gene and the envelope (E) gene; presence and levels of SARS-CoV- 2-specific immunoglobulins (Igs)—IgA, IgG and IgM—in breast milk samples from patients with COVID-19. Results All breast milk samples showed negative results for presence of SARS-CoV- 2 RNA. We observed high intraindividual and interindividual variability in the antibody response to the receptor-binding domain of the SARS-CoV- 2 spike protein for each of the three isotypes IgA, IgM and IgG. Main Protease (MPro) domain antibodies were also detected in milk. 82.9% (58 of 70) of milk samples were positive for at least one of the three antibody isotypes, with 52.9% of these positive for all three Igs. Positivity rate for IgA was relatively stable over time (65.2%–87.5%), whereas it raised continuously for IgG (from 47.8% for the first 10 days to 87.5% from day 41 up to day 206 post-PCR confirmation). Conclusions Our study confirms the safety of breast feeding and highlights the relevance of virus-specific SARS-CoV- 2 antibody transfer. This study provides crucial data to support official breastfeeding recommendations based on scientific evidence.Fundacion La Marato-TV3 20210

SARS-CoV-2 RNA and antibody detection in human milk from a prospective multicenter study in Spain

Objectives To develop and validate a specific protocol for SARS-CoV-2 detection in breast milk matrix and to determine the impact of maternal SARS-CoV-2 infection on the presence, concentration and persistence of specific SARS-CoV-2 antibodies. Design and patients This is a prospective, multicentre longitudinal study (April-December 2020) in 60 mothers with SARS-CoV-2 infection and/or who have recovered from COVID-19. A control group of 13 women before the pandemic were also included. Setting Seven health centres from different provinces in Spain. Main outcome measures Presence of SARS-CoV-2 RNA in breast milk, targeting the N1 region of the nucleocapsid gene and the envelope (E) gene; presence and levels of SARS-CoV-2-specific immunoglobulins (Igs)¿IgA, IgG and IgM¿in breast milk samples from patients with COVID-19. Results All breast milk samples showed negative results for presence of SARS-CoV-2 RNA. We observed high intraindividual and interindividual variability in the antibody response to the receptor-binding domain of the SARS-CoV-2 spike protein for each of the three isotypes IgA, IgM and IgG. Main Protease (MPro) domain antibodies were also detected in milk. 82.9% (58 of 70) of milk samples were positive for at least one of the three antibody isotypes, with 52.9% of these positive for all three Igs. Positivity rate for IgA was relatively stable over time (65.2%-87.5%), whereas it raised continuously for IgG (from 47.8% for the first 10 days to 87.5% from day 41 up to day 206 post-PCR confirmation). Conclusions Our study confirms the safety of breast feeding and highlights the relevance of virus-specific SARS-CoV-2 antibody transfer. This study provides crucial data to support official breastfeeding recommendations based on scientific evidence

Ibogaine Administration Modifies GDNF and BDNF Expression in Brain Regions Involved in Mesocorticolimbic and Nigral Dopaminergic Circuits

Ibogaine is an atypical psychedelic alkaloid, which has been subject of research due to its reported ability to attenuate drug-seeking behavior. Recent work has suggested that ibogaine effects on alcohol self-administration in rats are related to the release of Glial cell Derived Neurotrophic Factor (GDNF) in the Ventral Tegmental Area (VTA), a mesencephalic region which hosts the soma of dopaminergic neurons. Although previous reports have shown ibogaine’s ability to induce GDNF expression in rat midbrain, there are no studies addressing its effect on the expression of GDNF and other neurotrophic factors (NFs) such as Brain Derived Neurotrophic Factor (BDNF) or Nerve Growth Factor (NGF) in distinct brain regions containing dopaminergic neurons. In this work, we examined the effect of ibogaine acute administration on the expression of these NFs in the VTA, Prefrontal Cortex (PFC), Nucleus Accumbens (NAcc) and the Substantia Nigra (SN). Rats were i.p. treated with ibogaine 20 mg/kg (I20), 40 mg/kg (I40) or vehicle, and NFs expression was analyzed after 3 and 24 h. At 24 h an increase of the expression of the NFs transcripts was observed in a site and dose dependent manner. Only for I40, GDNF was selectively upregulated in the VTA and SN. Both doses elicited a large increase in the expression of BDNF transcripts in the NAcc, SN and PFC, while in the VTA a significant effect was found only for I40. Finally, NGF mRNA was upregulated in all regions after I40, while I20 showed a selective upregulation in PFC and VTA. Regarding protein levels, an increase of GDNF was observed in the VTA only for I40 but no significant increase for BDNF was found in all the studied areas. Interestingly, an increase of proBDNF was detected in the NAcc for both doses. These results show for the first time a selective increase of GDNF specifically in the VTA for I40 but not for I20 after 24 h of administration, which agrees with the effective dose found in previous self-administration studies in rodents. Further research is needed to understand the contribution of these changes to ibogaine’s ability to attenuate drug-seeking behavior

Decisions about the diagnostic and treatment criteria of dental caries among a group of dental students, faculty staff and dentists within the city of Medellin, Colombia

Objective: To analyze the criteria for diagnosis and treatment decision-making in relation to dental caries in different participants (teachers of dentistry, dental students at dental schools, and dentists practicing at public oral health services) in the city of Medellin (Colombia). Material and Methods: A cross-sectional study was applied in the period September 2015-december 2016 by means of an international validated questionnaire in 340 participants (dental teachers: 69, dental students: 193, dentists: 78). The survey addressed several topics related to detection and restorative threshold, preferences of preparation type, restorative materials used and opinions about diagnosis and treatment for dental caries. A descriptive analysis was carried out and Chi square tests were applied to observe statistically significant differences between the study variables. Results: 340 participants were surveyed among teachers who teach cariology, health care dentists, and undergraduate final-year students. Most participants were women (70%). The age mean was higher for DDSs (46 ± 9 years). On average, practicing dentists and dental teachers had a work experience of 21 ± 9 years. In case of treatment decisions, the majority of the surveyed would use immediate operative restorative treatment for advanced carious lesions (inner one-third of the dentin for approximal and grade 5 for occlusal). In addition, respondents reported different cavities diagnosis for clinical occlusal cases and some significant statistically differences were found for restorative treatment decisions and type of materials according to the type of participant. Conclusion: Criteria for diagnosis and treatment of dental caries differed among the student, dentist and dental teachers with variety in diagnosis and treatment concepts. However, a conservative tendency for restorative treatment decisions was observed. Strategies for incorporating non-restorative and minimal measures in professional practice should be considered in curricula of universities

Conflictos socioambientales y alternativas de la sociedad civil

Los conflictos socioambientales se multiplican en todo el mundo. Giran en torno a la contaminación industrial, las actividades mineras, el cambio de uso de suelo, la deforestación, la construcción de presas, la introducción de semillas genéticamente modificadas, el mal manejo de desechos sólidos y la privatización de tierra, agua y biodiversidad, entre otros. ¿Cuáles son las causas subyacentes a estos conflictos? ¿Quiénes son los protagonistas? ¿Cuáles son sus demandas, propuestas y estrategias? ¿En qué medida han contribuido a proteger o sanear el medio ambiente? ¿Hay conflictos locales que se convierten en glocales con la intervención de la sociedad civil? Estas interrogantes se abordan en este libro, que recoge inventarios de conflictos ambientales en México, en especial en Jalisco.ITESO, A.C

Association Between Insulin‐Like Growth Factor‐1 and Social Cognition in Huntington's Disease

Insulin-like growth factor 1 (IGF-1) seems to be involved in the neural circuits associated with social cognition and brain structure.Study funded by Gerencia Regional de Salud de Castilla y Leon (Sacyl GRS 1768/A/18)

A clinically compatible drug-screening platform based on organotypic cultures identifies vulnerabilities to prevent and treat brain metastasis

We report a medium-throughput drug-screening platform (METPlatform) based on organotypic cultures that allows to evaluate inhibitors against metastases growing in situ. By applying this approach to the unmet clinical need of brain metastasis, we identified several vulnerabilities. Among them, a blood-brain barrier permeable HSP90 inhibitor showed high potency against mouse and human brain metastases at clinically relevant stages of the disease, including a novel model of local relapse after neurosurgery. Furthermore, in situ proteomic analysis applied to metastases treated with the chaperone inhibitor uncovered a novel molecular program in brain metastasis, which includes biomarkers of poor prognosis and actionable mechanisms of resistance. Our work validates METPlatform as a potent resource for metastasis research integrating drug-screening and unbiased omic approaches that is compatible with human samples. Thus, this clinically relevant strategy is aimed to personalize the management of metastatic disease in the brain and elsewhere.Acknowledgments: This work was supported by MINECO (SAF2017-89643-R, SAF2014-57243-R, SAF2015-62547-ERC) (M.V.), Fundacion FERO (IX FERO Grant for Research in Oncology) (M.V.), Fundacio La Marato de TV3 (141) (M.V.), Melanoma Research Alliance (Bristol-Myers Squibb-Melanoma Research Alliance Young Investigator Award 2017 (https://doi.org/10.48050/pc.gr.75716)) (M.V.), Beug Foundation (Prize for Metastasis Research 2017) (M.V.), Fundacion Ramon Areces (CIVP19S8163) (M.V.) and CIVP20S10662 (E.O.P.), Worldwide Cancer Research (19-0177) (M.V.), H2020-FETOPEN (828972) (M.V.), Cancer Research Institute (Clinic and Laboratory Integration Program CRI Award 2018 (54545)) (M.V.), AECC (Coordinated Translational Groups 2017 (GCTRA16015SEOA) (M.V.), LAB AECC 2019 (LABAE19002-VALI) (M.V.), ERC CoG (864759) (M.V.), Sophien-Stiftung zur Förderung der klinischen Krebsforschung (T.W.), Promedica Stiftung (T.W.), Stiftung f€ur angewandte Krebsforschung (T.W.), Forschungskredit of the University of Zurich (FK-18-054) (T.W.), Betty and David Koetser Foundation for Brain Research (T.W.), Foundation for Applied Cancer Research in Zurich (T.W., M.W.), Comunidad de Madrid (S2017/BMD-3867 RENIM-CM and Y2018/NMT-4949 NanoLiver-CM) and European structural and investment funds (M.D.), ISCIII (PT20/00044) co-funded by FEDER “A way of making Europe” (M.D.), Ministero dell’Istruzione, dell’Universita e della Ricerca-MIUR, “Dipartimenti di Eccellenza 2018-2022”, (D15D18000410001) (L.B. and P.C.), Science Foundation Ireland Frontiers for the Future Award (19/FFP/6443) (L.Y.), Science Foundation Ireland Strategic Partnership Programme, Precision Oncology Ireland (18/SPP/3522) (L.Y.), Breast Cancer Now Fellowship Award/ with the generous support of Walk the Walk (2019AugSF1310) (D.V.), La Caixa-Severo Ochoa International PhD Program Fellowship (LCF/BQ/SO16/52270014) (L.Z.), La Caixa International PhD Program Fellowship-Marie Sklodowska-Curie (LCF/BQ/DI17/11620028) (P.G-G), MINECO-Severo Ochoa PhD Fellowship (BES-2017-081995) (L.A-E.), AECC Postdoctoral Fellowship (POSTD19016PRIE) (N.P.), Boehringer Ingelheim Fonds MD fellowship (L.M.). The contribution of the Experimental Therapeutics Programme was supported by core funding from the Spanish National Cancer Research Center (CNIO). CNIO is supported by the ISCIII, the Ministerio de Ciencia e Innovacion, and is a Severo Ochoa Center of Excellence (SEV-2015-0510). The CNIC is supported by the ISCIII, the Ministerio de Ciencia e Innovacion and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (SEV-2015-0505). M.V. was named Ramon y Cajal Investigator (RYC-2013-13365) and is member of EMBO YIP (4053)