Pachyrhizus ahipa: reassessment of ancient crop as alternative starch source

La ahipa (Pachyrhizus ahipa) es una planta Leguminosa cultivada antiguamente en la región andina, caracterizada por su resistencia al ataque de diversas plagas. Su raíz tuberosa acumula almidón como compuesto de reserva. El objetivo de este trabajo fue evaluar el comportamiento del cultivo de ahipa en la provincia de Misiones, caracterizar la composición química de las raíces obtenidas, analizar su conservación, implementar un proceso para obtener su almidón y evaluar las propiedades funcionales del mismo. P. ahipa se adaptó satisfactoriamente a las condiciones agroecológicas de Misiones, permitiendo obtener rendimientos máximos de 20.839 kg ha-1. Una vez en el CIDCA, las raíces se acondicionaron para su almacenamiento a 4, 10 ó 25ºC. Inicialmente, se cuantificó humedad, cenizas totales, materia grasa, fibra cruda, proteínas totales, compuestos libres de nitrógeno, concentración de sólidos solubles (ºBrix) y producción de CO2. Asimismo, durante el almacenamiento se determinó el color en el corte transversal de las raíces (usando un colorímetro Minolta CR400) y la textura (análisis del perfil de textura, TPA). Los resultados obtenidos permiten señalar que el tenor de proteínas (6,5%) resultaría medio, dado el elevado contenido de humedad de las muestras (82%). Sin embargo dicho contenido resultó superior al de otras raíces, como batata y mandioca. La conservación a bajas temperaturas produjo considerable daño por frío y ocasionó proliferación de microorganismos, en tanto que el almacenamiento a 25ºC no indujo cambios significativos en el color o la textura de las raíces de ahipa. El proceso de extracción de almidón comenzó con el lavado, pelado y procesado de las raíces. La pasta rallada se colocó en agua y se almacenó a 4°C durante 24h. La mezcla se filtró y se obtuvo el almidón en suspensión acuosa que se decantó a 4°C. El material insoluble sedimentado se secó a 40°C y se sometió a molienda. El rendimiento de la extracción de almidón de raíces de ahipa fue de 56,54 g/100 g de materia seca. Con el fin de proponer usos alimentarios para este producto, se evaluó la gelatinización y la retrogradación en condiciones de refrigeración de sus pastas mediante DSC, TPA y estudio del grado de sinéresis. Se halló que el almidón de ahipa gelatinizó a 67,18°C y sus pastas no retrogradaron en los tiempos ensayados, ya que la dureza de los geles no varió significativamente y el grado de sinéresis resultó muy bajo. Las propiedades funcionales evaluadas indican que el almidón de ahipa sería un espesante adecuado para la formulación de alimentos refrigerados.Ahipa (Pachyrhizus ahipa) is a leguminous plant cultivated formerly in the Andean region, characterized by its resistance to the attack of diverse pests. Ahipa tuberous root accumulates starch as reserve compound. The objective of this work was to evaluate ahipa crop management in Misiones (Argentina), to characterize the chemical composition of the obtained roots, to analyze its conservation, to implement a process to obtain ahipa starch and to evaluate its functional properties. P. ahipa successfully adapted to the agroecological conditions of Misiones, allowing maximum yield of 20,839 kg ha-1. Once in the CIDCA, roots were conditioned for storage at 4, 10 or 25 º C. Initially, moisture content, total ash, fat, crude fiber, total protein, nitrogen-free compounds, total soluble solids (º Brix) and CO2 production were quantified. During storage, color changes in the cut section of the roots (measured using a Minolta colorimeter CR400) and texture (texture profile analysis, TPA) were evaluated. Results indicate that the protein content (6.5%) would be intermediate, since samples showed relatively high moisture content (82%). However, protein levels were higher than that of other roots, like sweet potatoe and cassava. Conservation at low temperatures resulted in considerable injury and caused proliferation of microorganisms, while storage at 25 ° C did not cause significant changes in color or texture of the roots. The process of starch extraction began with the washing, peeling and processing of the ahipa roots. The paste of the grated ahipa was placed in water and stored at 4°C during 24hs. The mixture was filtered and the starch presented in the aqueous suspension was poured off at 4°C. The settled insoluble material was dried at 40°C and it was triturating. The yield of the extracted starch of the ahipa roots was 56.54 g/100 g of dry matter. In order to suggest food uses for this product, the starch pastes gelatinization and retrogradation under refrigeration conditions were evaluated by DSC, TPA and syneresis degree. Ahipa starch gelatinized at 67.18°C and its pastes did not retrograded during the assayed times, since the gels hardness did not significantly vary and the syneresis degree was too low. The evaluated starch functional properties indicate that it is an adequate thickener for refrigerated foods.Centro de Investigación y Desarrollo en Criotecnología de Alimento

A pragmatic clinical effectiveness trial of a novel alternative to punishment for school-based substance use infractions: study protocol for the iDECIDE curriculum

BackgroundAdolescents who use alcohol and other drugs on school campuses are at heightened risk for adverse consequences to their health and wellbeing. Schools have historically turned to punitive approaches as a first-line response to substance use. However, punishment is an ineffective deterrent for substance use and may cause harm and increase inequities. iDECIDE (Drug Education Curriculum: Intervention, Diversion, and Empowerment) was developed as a scalable and youth-centered drug education and diversion program that can be used as a skills-based alternative to punishment. We aim to evaluate the effectiveness of the iDECIDE curriculum as an alternative to punishment (ATP) for school-based substance use infractions in the context of a large pragmatic clinical effectiveness study.MethodsWe will conduct a Type 1, hybrid effectiveness-implementation trial. Using a stepped wedge design with approximately 90 middle and high schools in Massachusetts, we will randomly allocate the timing of implementation of the iDECIDE curriculum compared to standard disciplinary response over approximately 36 months. We will test the overarching hypothesis that student-level outcomes (knowledge of drug effects and attitudes about substance use; frequency of substance use; school connectedness) improve over time as schools transition from a standard disciplinary response to having access to iDECIDE. The secondary aims of this trial are to (1) explore whether change in student-level outcomes vary according to baseline substance use, number of peers who use alcohol or other drugs, age, gender, and school urbanicity, and (2) determine the acceptability and feasibility of the iDECIDE curriculum through qualitative stakeholder interviews.DiscussionSubstance use continues to be a major and rapidly evolving problem in schools. The importance of moving away from punishment to more restorative approaches is widely accepted; however, scalable alternatives have not yet been identified. This will be the first study to our knowledge to systematically evaluate an ATP for students who violate the school substance use policy and is well poised to have important implications for policy making

A Retrospective Review of Supratherapeutic Modafinil Exposures

Modafinil is a non-amphetamine wakefulness-promoting agent used for the treatment of various sleep disorders characterized by excessive daytime sleepiness. There is little information in the medical literature with respect to supratherapeutic doses of this medication. We performed a retrospective review of the California Poison Control System database for all cases of single-substance ingestion of modafinil with follow-up to a known outcome for the time period 1998–2008. Data collected included age, gender, dose ingested, clinical effects, and medical outcome. There were a total of 87 patients, 53 (61%) of which were female. Patient ages ranged from 1.25 to 72 years with a mean of 30 years; 17 (20%) patients were aged 6 years or less. Thirty-three (38%) were intentional overdoses. Most commonly reported effects were tachycardia (n = 23), agitation (n = 14), anxiety (n = 11), headache (n = 8), hypertension (n = 6), dystonia/tremor (n = 6), and dizziness (n = 5). Forty-nine patients (56%) were managed at home, and 38 (44%) were managed in a healthcare setting. Therapies administered included activated charcoal (n = 8), benzodiazepines (n = 7), antihistamines (n = 2), intravenous fluids (n = 2), haloperidol (n = 2), and beta-blockers (n = 1). Effects were classified as none (n = 22), minor (n = 54), and moderate (n = 11). No major effects and no deaths occurred. Effects of modafinil overdose appear to be mild in most cases, with tachycardia and CNS symptoms predominating. Clinically significant effects requiring treatment occurred in a small number of patients

Weight Variation over Time and Its Association with Tuberculosis Treatment Outcome: A Longitudinal Analysis

OBJECTIVE: Weight variation during therapy has been described as a useful marker to predict TB treatment outcome. No previous study has used longitudinal analysis to corroborate this finding. The goal of this study was to evaluate change and trends of patients' bodyweight over time depending on TB treatment outcome. METHODS AND FINDINGS: A retrospective cohort study with all TB cases diagnosed from 2000 to 2006 was carried out. Information from 5 public tuberculosis treatment facilities at Pampas de San Juan de Miraflores, Lima, Peru was analyzed. Poor outcome was defined as failure or death during TB therapy, and compared to good outcome defined as cured. Longitudinal analysis with a pre-specified marginal model was fitted using Generalized Estimating Equations to compare weight trends for patients with good and poor outcome adjusting for potential confounders. A total of 460 patients (55.4% males, mean age: 31.6 years) were included in the analysis: 42 (9.1%) had a poor outcome (17 failed and 25 died). Weight at baseline was not different comparing outcome groups (p = 0.17). After adjusting for age, gender, type of TB, scheme of treatment, HIV status and sputum variation during follow-up, after the first month of treatment, patients with good outcome gained, on average, almost 1 kg compared to their baseline weight (p<0.001), whereas those with poor outcome lost 1 kg (p = 0.003). Similarly, after 4 months, a patient with good outcome increased 3 kg on average (p<0.001), while those with poor outcome only gained 0.2 kg (p = 0.02). CONCLUSIONS: Weight variation during tuberculosis therapy follow-up can predict treatment outcome. Patients losing weight during TB treatment, especially in the first month, should be more closely followed as they are at risk of failure or death

Metabotropic glutamate receptor 5 as a potential target for smoking cessation

Rationale Most habitual smokers find it difficult to quit smoking because they are dependent upon the nicotine present in tobacco smoke. Tobacco dependence is commonly treated pharmacologically using nicotine replacement therapy or drugs, such as varenicline, that target the nicotinic receptor. Relapse rates, however, remain high and there remains a need to develop novel non-nicotinic pharmacotherapies for the dependence that are more effective than existing treatments. Objective The purpose of this paper is to review the evidence from preclinical and clinical studies that drugs that antagonise the metabotropic glutamate receptor 5 (mGluR5) in the brain are likely to be efficacious as treatments for tobacco dependence. Results Imaging studies reveal that chronic exposure to tobacco smoke reduces the density of mGluR5s in human brain. Preclinical results demonstrate that negative allosteric modulators (NAMs) at mGluR5 attenuate both nicotine self-administration and the reinstatement of responding evoked by exposure to conditioned cues paired with nicotine delivery. They also attenuate the effects of nicotine on brain dopamine pathways implicated in addiction. Conclusions Although mGluR5 NAMs attenuate most of the key facets of nicotine dependence they potentiate the symptoms of nicotine withdrawal. This may limit their value as smoking cessation aids. The NAMs that have been employed most widely in preclinical studies of nicotine dependence have too many \u201coff target\u201d effects to be used clinically. However newer mGluR5 NAMs have been developed for clinical use in other indications. Future studies will determine if these agents can also be used effectively and safely to treat tobacco dependence

Cytokines and T-Lymphocute count in patients in the acute and chronic phases of Bartonella bacilliformis infection in an endemic area in peru: a pilot study

Human Bartonellosis has an acute phase characterized by fever and hemolytic anemia, and a chronic phase with bacillary angiomatosis-like lesions. This cross-sectional pilot study evaluated the immunology patterns using pre- and post-treatment samples in patients with Human Bartonellosis. Patients between five and 60 years of age, from endemic areas in Peru, in the acute or chronic phases were included. In patients in the acute phase of Bartonellosis a state of immune peripheral tolerance should be established for persistence of the infection. Our findings were that elevation of the anti-inflammatory cytokine IL-10 and numeric abnormalities of CD4+ and CD8+ T-Lymphocyte counts correlated significantly with an unfavorable immune state. During the chronic phase, the elevated levels of IFN-γ and IL-4 observed in our series correlated with previous findings of endothelial invasion of B. henselae in animal models

Susceptibilidad dE Lutzomyia verrucarrum a piretroides en zonas endémicas de Enfermedad de Carrión de Ancash

La enfermedad de Carrión es una infección metaxénica endémica del Perú, el control vectorial de la Lutzomyia verrucarum con insecticidas es una de las formas más usadas para reducir su morbilidad. Se determinó la susceptibilidad de este vector a los piretroides más usados (cyflutrina, alfacipermetrina y deltametrina) en dos zonas endémicas altoandinas de Ancash (Llumpa: 3200 msnm y Maya: 2600 msnm), Perú en junio de 1999. Se expuso a 50 mosquitos por cada zona e insecticida usando la prueba de contacto para anophelinos modificada. Se encontró una mortalidad del 100% para cada piretroide ensayado. Si bien se demostró una susceptibilidad total de L. verrucarum es necesario implementar la vigilancia de la resistencia a insecticidas como se hace con otros vectores en el Perú

Susceptibilidad de Lutzomyia verrucarum a piretroides en zonas endémicas de enfermedad de Carrión de Ancash.

Carrion disease is an endemic vector-borne infection of Peru, the vector control of the Lutzomyia verrucarum with insecticides is one of the most commonly used to reduce morbidity. It was determined the susceptibility of this vector to the most pyrethroids widely used (cyfluthrin, alfacypermethrin and deltamethrin) in two endemic areas of highlands from Ancash (Llumpa: 3200 and Maya: 2600 meters above sea level), Peru in June 1999. Were exposed to 50 mosquitoes from each area and insecticide, using an anopheline contact test modified. We found a mortality rate of 100% for each pyrethroid tested. While total susceptibility of L. verrucarum showed, is necessary the implement of surveillance to insecticides resistance as is done with other vectors in Peru.La enfermedad de Carrión es una infección metaxénica endémica del Perú, el control vectorial de la Lutzomyia verrucarum con insecticidas es una de las formas más usadas para reducir su morbilidad. Se determinó la susceptibilidad de este vector a los piretroides más usados (cyflutrina, alfacipermetrina y deltametrina) en dos zonas endémicas altoandinas de Ancash (Llumpa: 3200 msnm y Maya: 2600 msnm), Perú en junio de 1999. Se expuso a 50 mosquitos por cada zona e insecticida usando la prueba de contacto para anophelinos modificada. Se encontró una mortalidad del 100% para cada piretroide ensayado. Si bien se demostró una susceptibilidad total de L. verrucarum es necesario implementar la vigilancia de la resistencia a insecticidas como se hace con otros vectores en el Perú

Bartonella bacilliformis: a systematic review of the literature to guide the research agenda for elimination.

BACKGROUND: Carrion's disease affects small Andean communities in Peru, Colombia and Ecuador and is characterized by two distinct disease manifestations: an abrupt acute bacteraemic illness (Oroya fever) and an indolent cutaneous eruptive condition (verruga Peruana). Case fatality rates of untreated acute disease can exceed 80% during outbreaks. Despite being an ancient disease that has affected populations since pre-Inca times, research in this area has been limited and diagnostic and treatment guidelines are based on very low evidence reports. The apparently limited geographical distribution and ecology of Bartonella bacilliformis may present an opportunity for disease elimination if a clear understanding of the epidemiology and optimal case and outbreak management can be gained. METHODS: All available databases were searched for English and Spanish language articles on Carrion's disease. In addition, experts in the field were consulted for recent un-published work and conference papers. The highest level evidence studies in the fields of diagnostics, treatment, vector control and epidemiology were critically reviewed and allocated a level of evidence, using the Oxford Centre for Evidence-Based Medicine (CEBM) guidelines. RESULTS: A total of 44 studies were considered to be of sufficient quality to be included in the analysis. The majority of these were level 4 or 5 (low quality) evidence and based on small sample sizes. Few studies had been carried out in endemic areas. CONCLUSIONS: Current approaches to the diagnosis and management of Carrion's disease are based on small retrospective or observational studies and expert opinion. Few studies take a public health perspective or examine vector control and prevention. High quality studies performed in endemic areas are required to define optimal diagnostic and treatment strategies